Wheels Down

Abstract

I am looking at a stranger’s hand. It is older than mine, resting on her lap, expressionless and calm. It does not look nervous or sweaty at all. I am wondering if I should hold it. Will she notice? Will she mind? Will it help? A sense of mortality is in the air. Like one in five people, I hate flying. Not the packing, lines, searches, waiting, delays, carrying heavy suitcases, putting tiny bottles of shampoo in little plastic baggies. That stuff is part of the ritual that helps me relax. I hate flying. Takeoff, landing, turbulence, engine sounds, safety cards, counting rows to emergency exits, oxygen masks, and seat-cushion-flotation devices. Part of it is my own ignorance. I really do not understand how flying works. Thrust and lift, a little drag, sure. Plus, going really really fast. But all I understand is that tons of metal and people are suspended seven miles high. I look longingly at the sleeping woman’s unoccupied hand. I continue to analyze my phobia. So I don’t understand physics. What else? While I am thinking, the engine changes pitch and I feel the plane descend. I grab the armrest, cursing the pilot. Really? Powering down? And you didn’t think I would want to know ahead of time? So that is another thing feeding my anxiety. No sense of expectation or frame of reference. Would it really be so hard for them to say, “Hey, we’re about to throttle down. You will hear a different sound, but that’s normal.” I think some information updates might help. I’m on a roll now. I have read that 88% of all aviation accidents are on account of human error. Paying for my own mistakes is one thing. Someone else’s mistakes are a whole other matter. Someone who maybe works odd hours or does not have a ton of experience is making decisions that could impact me and this nice lady next to me. I have never met this pilot. I do not know about his training, job frustrations, whether this flight feels routine, or if he’s off his game today. I heard him joking with the flight attendant and I wonder if he’s taking this responsibility seriously. After some turbulence, the seatbelt light goes on, and someone announces that it will remain that way, since the air is a little “rough.” His voice is matter-of-fact and quite routine. I am terrified. A flight attendant offers me some ginger ale, which I do not want, but take anyway. It does not help. And then we land. I never held the stranger’s hand, and suffered through the ordeal on my own. Wheels down and I survive, and I thank the pilot with an inexpressible and wholehearted gratitude that he does not understand. And I think of my patients in my emergency department. Not my first-class, entitled, red-carpet patients, who are really customers, but my patients who are patients. And I comprehend in a visceral way what it is like for those people in that environment. They do not understand medicine, their symptoms, their diagnoses, or my jargon. Lift and thrust. Drag and speed. I do not do a good job letting them know what is happening now, or what will be happening next, and they wait with painful anticipation. Banking right. Throttle down. They do not know me or my training, and sometimes I probably do not even introduce myself. Odd hours. Questionable experience. This is your captain speaking. But they know I make mistakes, they have heard doctors kill patients, and they relinquish their control to me. Prepare for takeoff. I joke about sickness and death because it is routine to me, and I give them ginger ale as though it helps. It doesn’t. Meanwhile, my guess is that they are wondering the whole time if it’s alright if they hold my hand. If I would notice, or even mind. They think it might help. Often, when they leave, they thank me with an inexpressible and wholehearted gratitude that I do not understand. But I would like to do better before wheels down.