Louisville Medicine Volume 64, Issue 3 | Page 19

of Canada and the Pacific to Tokyo-Haneda airport. I traced the route in the inflight magazine, wondering what would be served for dinner. After the perfunctory inflight instructions were completed, the blinking lights of Motown disappeared as the big jet lumbered flawlessly into a sky that was growing darker by the minute. Finally it was safe to “move about the cabin.” The cabin crew appeared fresh, friendly and eager to serve dinner. The aforementioned man now seemed very uneasy. I noticed him and the young lady sitting a few rows behind me. They navigated around the serving carts towards a sign marked lavatory. About 15 minutes later, he came out with his friend in tow, his arms folded across his chest, his sweaty face now looking ashen and pale. I was snacking on peanuts tumbling out of a crinkly plastic bag as I identified myself to the flight attendant and asked if there was anything I could do to help the man. He obviously seemed very ill. The flight attendant asked the couple and came back to inform me that he had declined my offer. The meal and wine soon followed. I proceeded to polish off the last pieces of fromage and fruit and made the best of the airline meal. They dimmed the cabin lights. I planned to go to bed. The young lady promptly punched the overhead reading light as the gentleman again walked to the lavatory with the young lady in tow. It could not been more than 15 minutes before the man came out and lay down in the aisle doubled over. The flight attendant now came over and asked me if I could help. I had my own doubts; I doubted if he would let me take care of him, or whether I was even qualified to do so. What if he were having