Gray Skies and Golden Showers
The Twin Doctors Travel Bag takes a look at 2 reasons why some people may behave so badly on airplanes.

By Jamil Abdur-Rahman, M.D.
The Twin Doctors Travel Bag

Gerard Depardieu

When good airplane passengers go bad, the result can be gray skies and golden showers. What is it about the cozy confines of an airplane that makes some men just want to whip out their little carry on luggage and pee all over the place? Famous French thespian Gerard Depardieu is a bonafide high flying public pisser; although in all fairness to the portly public piddler, he actually urinated in the aisle of an Air France plane bound for Dublin BEFORE it had taken off from Paris. And then there is Jeff Rubin, the 27 year old JetBlue passenger from Gresham Oregon that the media dubbed “The Portland Pisser”. Jeff, while on a flight from Anchorage Alaska to Portland Oregon in 2015 stood up mid-flight, exposed his Hairy Houdini for the world to see and then urinated on the people and luggage in his immediate vicinity. So Jeff too is a certified and bonafide high flying purveyor of midair water sports.

Jeff Rubin – “The Portland Pisser”

But wait, there’s more! On a recent Air Méditerranée flight from Algiers to Paris, an already shirtless man stood up, unzipped his pants, exposed his beans and frank and proceeded to urinate all over the passenger seated next to him. Not surprisingly, after anointing this most unwilling congregant with his not-so-holy waste water, a brawl ensued. So what are we to make of all of these on-board displays of public urination?

Air Méditerranée passenger being restrained

Allow me to introduce you to the “2 A’s” responsible for many episodes of poor in-flight behavior; and no, I’m not talking about “aggressive assholes”. I’m talking about “altitude” and “alcohol”. The passenger cabins of most commercial airplanes are pressurized to an altitude of 8000 feet. This means that the air that passengers breath while on commercial airplanes is quite a bit thinner and contains quite a bit less available oxygen than does the air that they breath while on the ground. Most healthy people though can adjust to these temporary changes in air pressure and oxygen availability with little to no difficulty. But some people, possibly those who are already suffering from mental illness, or those that are predisposed to mental illness, they may struggle with their new in-cabin environments. In fact, it is thought that in some people, even small decreases in the amount of oxygen being delivered to their brains can profoundly alter how much of the mood and behavior regulating chemicals Serotonin and Dopamine their brain’s produce. With these alterations in Serotonin and Dopamine production, the behavior of some passengers may become erratic, highly unusual and even sometimes surprisingly aggressive. Consider for example the fact that Mental Health researchers have long known that people living in communities 2000 feet or more above sea level are 30% more likely to suffer from mental illness and/or to commit suicide than are people living in communities located at altitudes below 2000 feet above sea level. This observation is thought to result from the persistent effects of diminished oxygen availability on the production of the mood and behavior regulating chemicals in certain at higher altitudes.

Look out below!!!

Much like altitude can affect how much oxygen the brain receives, so too can the consumption of alcohol. Normally, the oxygen that we breath enters our blood stream through our lungs. Once in our blood stream, oxygen is bound to red blood cells which then carry it to vital organs like the brain. Alcohol however makes it more difficult for red blood cells to bind and then to subsequently carry oxygen. So after consuming alcohol fewer of an alcohol drinker’s red blood cells are able to carry oxygen. In addition, alcohol also causes red blood cells to clump and to stick together. This makes it more difficult for them to circulate throughout the body. So, even when some red blood cells are still able to carry oxygen after they’ve been exposed to alcohol, many of them will still never reach the brain. Instead they will just clump together and get stuck in blood vessels.  So basically, both alcohol and altitude can in effect decrease the amount of oxygen being delivered to the brain of an airplane passenger that chooses to imbibe. While most flyers may be able to cope with the effects of altitude and alcohol with very little difficulty, some flyers, for reasons still not totally clear, simply cannot. And when these people suffer the one-two punch better known as the “2 A’s” that are responsible for most episodes of poor in-flight behavior, the passengers sharing the cabin with them better get ready for a flight that features gray skies and golden showers.