To the Editor.— The SPECIAL COMMUNICATION on "Medical Aspects of Transportation Aboard Commercial Aircraft" (1982;247:1007) was of great interest to me. Not too long ago, I responded to an "if there is a doctor aboard..." request. An elderly woman had lost consciousness; according to her daughter, there was a history of heart disease, and chest pain had preceded the unconsciousness. She spontaneously regained consciousness; I examined her as well as I could under the circumstances (there were no instruments available, and I am a psychiatrist). I was reasonably sure that she was not having a myocardial infarction. Nevertheless, the trying part of this episode was when the copilot asked if I felt that we should make an emergency landing (!). My answer was "no," but I requested that an ambulance be available at our scheduled destination. However, I have often since thought about something that the article did not deal with: