Many of you know that I recently attended a healthcare professionals conference in San Diego,which was a real thrill. Due to busy schedules, however, I had to fly to the west coast and back in less than 72 hours. I don’t often fly and when I do, my flights are rarely so lengthy. My time in the air has allowed me to make some observations about the etiquette of air travel that others may find helpful, specifically if they are also non frequent fliers, like myself.


First, let me set the stage. My flights on Wednesday and Friday were not actually on air planes. They were on what is called air buses. As a general rule, I have avoided buses since the sixth grade as they seem to be a slightly less sophisticated mode of transportation. While you may call me a snob, I ask you when was the last time you saw paparazzi swarm an arriving Greyhound. Additionally, the air buses that I flew recalled a particular expression that my parents and grandparents used to use to describe crowded vehicles: “belly to belly”. Belly. To. Belly. I don’t know about you, but I can live through a brushed knee or an awkwardly shared armrest, but if my belly is touching your belly, we have a really serious problem. Serious as in I am looking for the exit door. Good -bye -cruel -world kind of problem.

A few things to contemplate when travelling a “belly to belly” air BUS:

  1. I can see you. Don’t pick your nose. Don’t scratch your balls. Don’t groom any form of facial hair in any fashion. They’re called eyes, people. We are jammed in here together and I can see you.

  2. For the gentlemen in particular: don’t bring, wear or associate yourself in any way with a neck pillow and expect to be ever seen as attractive or masculine again. By purchasing the pillow ahead of time and bringing it on board loudly communicates that you are delicate. And wanting a nappy-poo. The anticipation of your own potential discomfort doesn’t make you an Eagle Scout here, it just reminds us of a hemorrhoid donut - near your face.

  3. For the LOVE OF GOD, if you do have a neck pillow, you should not be allowed to sit in the exit row. We already know you are no one’s Harrison Ford.

  4. You have the right to lower your seat back. Into my row. For the entirety of the flight. You do. You should also expect to be clotheslined at baggage claim.

  5. Flight attendants: most men over 60 have an enlarged prostate. If they aren’t seated in the aisle, don’t serve them liquid. Please. They are pissing of the neck pillows with all their ups and downs.

  6. Upon purchasing an airplane ticket, one should have to complete some form of spatial relations test. I don’t know traveller’s think they are kidding trying to bring Wilt Chamberlain’s coffin protocol for the overhead bin, but I can tell you that if I get hit with it upon disembarkation, they too can expect a clothes line.

  7. Another caution:  if you are not in the window seat, do NOT act like an eight year old trying to find your house from 30, 000 feet. It isn’t much but it is my personal space. Get out of it.

  8. Finally, if I have to use the bathroom (God forbid), kindly swiftly stand up and step aside. Don’t make me wake you, neck pillow. Neither of us want that.

Please keep in mind these rules are for in flight only. I have a plethora of others for TSA check behavior and baggage claim etiquette.  But I think that’s enough for now.

Fly HOPE Air.

Thirteen years ago today was a day that took my breath away. In past blogs, I have mentioned by beautiful niece, Casey. Tomorrow, February 20th, she will turn 13. Every child’s birthday is a milestone and an opportunity to celebrate their growth and accomplishments. Casey’s birthdays are admittedly an extra special celebration for those of us that love her because we can reflect upon all that she has overcome.


What I am remembering tonight, however, is the feelings I had on this day thirteen years ago. Today was the day we found out that Casey was no longer thriving and she had to come out. Tomorrow.  This new date put Casey only two weeks premature, but the necessity of taking her out of the womb to “take her chances” in the outside world was a terrifying reality.  We already knew about Casey’s heart condition but none of us, doctors included, were really quite sure what else might be going on with her. There were plenty of horrific possibilities and minimal assurances that they wouldn’t occur.


As I think back on this day, thirteen years later, I think I can better articulate my feelings. And there is a reason why I want to do that. When we found out that Casey would be arriving in the next 24 hours, I felt like I was getting on an airplane, going on a trip. All of a sudden, I was boarding, filing in with other uncertain passengers. I had baggage that I wasn’t sure where to store. I didn’t know where to sit. The people around me seemed nice enough, yet I wanted NOTHING to do with them. Why were they on this flight with me? Once sitting, I was taken back about the seeming inadequacy of the lap belt. A flight attendant was talking about exits I couldn’t see and oxygen masks I wasn’t sure I could manage.


After waiting for what seemed like an eternity, we take off.  Why is it so shocking/ exhilarating when it happens when you’ve known it was coming? My stomach dropped. Ground is getting further and further away and I am having a hard time hearing. We are really off here in a confusing blend of thrill and terror.


As we level of to our “cruising altitude”, I have more thirst than I have ever known and yet the professionals on this flight offer me what seems like a thimble full of liquid.  How can they not see my profound needs?


And then there is turbulence. Holy Hell! I was beginning to acclimate to this plane, this flight, and we are dropping, we are bouncing, I am c.l.u.t.c.h.i.n.g. The turbulence is over pretty quickly, but the memory is lasting. Will it come back? Will it be worse?


It is the turbulence that leads every passenger of every flight EVER to ask (don’t lie, you do), what in the hell holds this plane up anyway? If you are an aeronautical engineer, please don’t ruin it. The gen pop among us question how we remain suspended in air. It seems unfathomable.


Getting back to thirteen years ago today, I remember anticipating the turbulence and wondering what would hold each of us up in the air? A precious baby was being born and the universe had already dealt her an unfortunate hand. How would we reach the destination of her growth and health? Where would we land? Every day I see patients and families that ask these questions.


Casey’s thirteenth birthday isn’t the only reason I am having these thoughts. This week, a young boy at our elementary school was diagnosed with a very scary and aggressive cancer. He is in first grade. I don’t know this family personally and I don’t share his story pretending in any way that it is my own. Being a part of a tight and loving community, however, there is some element of all us sharing in each other's joys and battles.


This precious little boy’s family just got on the plane. They didn’t even know they would be flying that day. Every day, families board planes they weren’t expected to fly. Without warning, they have been herded into what feels like a very small and nauseating place and they are taking off.  My guess is that as they watched the ground become more and more distant, they wondered why they had to leave that familiar place.


I can’t help but think about the turbulence that awaits them on their very very long trip. I pray the “professionals on board” will give them the needed fluid, food, oxygen, and probable barf bag.


But as they hang in the atmosphere, if I could share one thing with them that I learned thirteen years ago today, or thirty years ago when I had cancer, or last week when I met the most wonderful young woman with ALS, or so many other times,  is that I have learned what is keeping the plane in the air.




The plane will not, can not crash as long as HOPE keeps it suspended. The phrase, if you keep hope alive, it will keep you alive, is the absolute truth. What I cannot promise this sweet and scared family and what none of us can have promised, is where the plane might land. What I can assure them, and you, and me when I need it is the uncomfortable plane can’t crash while HOPE keeps it in the sky.


Tomorrow my family will get together to celebrate Casey’s thirteenth birthday and it will be extra sweet this year. As we blow out her candles and offer gratitude for her safe landing, we will also blow some HOPE into the sky. Those of us that have ridden a plane suspended and protected by HOPE, I think it is our responsibility to put in back into the air.

P.S. If you are so inclined to support the Pope family and their sweet son, Wyatt, please follow #wywystrong