A few months ago, my colleague Lale Arikoglu was flying through the night from New York to Istanbul when a group of flight attendants rushed down the aisle and stopped next to a woman two rows behind her. The passenger had been unresponsive when her seatmate tried to wake her so he could use the bathroom. The crew called for a doctor, and the pilot got on the PA system to let passengers know they would be making an emergency landing in Zurich.
“We all sat in silence, listening to the flight attendants yell at each other in Turkish as they tried to resuscitate the woman while we descended,” says Arikoglu. On arrival, the plane sat on the tarmac; you could see the flashing lights of the police and ambulance waiting outside, she says. The emergency officials boarded the plane and carried the woman down the aisle past bleary-eyed passengers. The Swiss police, struggling to find the woman’s bag—she was travelling alone—asked passengers to claim their own as the police used the process of elimination to recover it. The remaining passengers stayed on the plane; an hour went by, maybe two. Without further explanation, the pilot said they were clear to leave and the plane continued on its journey to Istanbul. “Even a year on, I think about that woman a lot,” says Arikoglu. “We never found out what happened. She was only around 30.”
It’s not surprising that in-flight deaths regularly grab the headlines—the experience can be traumatic, to say the least. But despite the media fascination with in-flight deaths, “death onboard a commercial aircraft is actually quite rare,” says Dr Claudia Zegans, associate medical director of Global Rescue, which focuses on medical emergencies while travelling. “Medical emergencies occur in approximately 1 in 600 flights, which represents 16 medical emergencies per one million passengers.” A New England Journal of Medicine study from 2013 found that just 0.3 percent of in-flight emergencies over a two-year period involved passenger death.
Yet the intensity of the experience, in such constrained quarters, magnifies the effect for passengers and staff involved, says Dr Paulo Alves, MedAire’s global medical director, who previously worked as the medical director of Brazil’s Varig Airlines. It may not be as rare as a baby born in the sky, but in a tight space where nerves are already high, experiencing a death can leave its mark—even a year on, as it did for Arikoglu. Airlines, for their part, plan as well as they can: Many carriers have traditionally carried stretchers on board, he says.
When airlines allow those not fit to fly
Alves says Arikoglu’s story was also atypical, and per his experience, most in-flight fatalities are not unexpected. When a terminally ill patient wishes to visit a country for the last time—usually to see family—airlines allow them onboard as a humanitarian gesture, even though the low oxygen environment of a pressurized cabin might cause distress. “If you don’t accommodate the passenger, they wouldn’t have their very last wish,” he says, “So airlines might enter into some accord with the family, agreeing in advance that the flight will not divert. Sometimes the person carries a formal DNR certificate, too.”