A few years ago, there was a widely publicized health incident that bewildered a multi-disciplinary team of medical specialists for many weeks. Let’s see if your critical thinking skills are on a par with—or superior to—those of most physicians. This case presents information that was publicly available at the time of the incident, as reported by various newspapers.
The incident started with flight attendants for a particular airline who complained of a painful and troubling rash. The symptoms took the form of ‘red sweat’, appearing as small fluid-like red spots that felt like a ‘razor burn’, often with attending itching. The spots appeared on the face, hands, neck, and occasionally the upper chest. Both male and female flight attendants were affected. Passengers, pilots, and ground crew were never affected. The problem presented only on flights from New York to Miami and Fort Lauderdale, no other inland domestic flights. Flight attendants on Airbus A-300s, Boeing 727s, and Lockheed L-1011 aircraft were all affected. In all instances, the symptoms only lasted a few hours—by the time afflicted personnel consulted a physician they were assessed as ‘healthy as a horse.’
Many doctors and specialists were brought in and consulted to determine the cause of this problem, including dermatologists from Columbia-Presbyterian Medical Center, aerospace doctors from NASA, together with the airline’s own doctors. Here are just some of the many causes that were investigated and subsequently abandoned:
- cabin air too dry
- chemicals used to clean food ovens
- altitude changes
- genetic susceptibility
- chrome hydrosis (colored perspiration)
- ‘mass hysteria’
The problem went on for many weeks with none of the medical specialists able to pinpoint the cause or arrest the symptoms. Eventually, the flight attendants’ union escalated the issue and many attendants refused to fly the affected routes and aircraft.
This problem, like most other medical conditions, can be quickly and simply diagnosed with a careful and rigorous examination of the presenting facts. Let’s examine the relevant data. The first noteworthy and closely-related set of facts are that only flight attendants are affected—never pilots and passengers who share the same flights, nor ground crew who have common exposure to certain equipment. Also, the problem is limited to only one airline; flight attendants with other airlines are unaffected. The second relevant set of facts pertains to the nature of the symptoms themselves. The rash presents as a ‘red fluid’, with a ‘burning’ feeling and itching. No other unusual skin problems such as flaking, psoriasis, eczema, acne, rosacea, hives, etc. are ever observed.
Next, let’s look more closely at where the problem presents. The rash is experienced only on flights between New York and Miami or Fort Lauderdale—none of the many other flights operated by this airline on domestic inland routes. Also, the rash is limited to areas of exposed skin: mostly on the face, hands, neck, and occasionally upper chest. Finally, let’s assess the timing characteristics of the illness. It started fairly suddenly a few weeks prior, then fairly regularly when the affected flight attendants flew these routes with the indicated aircraft. Also, the symptoms only show up while performing their duties en route, and usually last only for a few hours.
The source of most problems can almost always be revealed by comparing the ‘affected’ vs. ‘unaffected’ data. Accordingly, let’s ask first, “What is different about flight attendants, that is not shared by pilots, passengers, and ground crew?” There are quite a few factors we can readily identify, any of which could be playing a role in this illness: food and beverage service, locations on the aircraft, demonstration of safety equipment, etc.
To narrow the list down further, let’s examine the differences between the affected vs. unaffected locations. What is different about the New York to Miami and Fort Lauderdale routes compared to all the domestic inland routes? One thing that stands out quickly is that it is operated for fairly long stretches over open ocean. Next, what is different about the face, hands, neck, and upper chest compared to any/all other locations on the body? These are areas of exposed skin (female flight attendants wear an open collar at the upper chest).
Lastly, let’s examine what is different about the timing of the problem vs. those times when the problem didn’t occur. Most notable is that the symptoms always manifest and flare up while the flight attendants perform their duties during the flight, never prior to or after the flight, and they only last for a few hours. What do the flight attendants do during the flight that neither the passengers nor pilots do—especially on flights operated over the ocean? One obvious answer is that they demonstrate the use of safety vests, as mandated by the FAA for these kinds of routes.
Can you brainstorm a possible link and mechanism for the production of this very specific type of symptom given these specific facts? In my frequent problem-solving workshops, I am always amazed how many non-medical people are able to clearly and accurately articulate the actual cause within a matter of minutes after examining this data. Usually the cause is stated something along the lines of: ‘Maybe there is some kind of red dye or chemical embedded in the life vests which is transferring to the skin of the flight attendants during the demonstration phase of the flight, which is subsequently felt as a chemical burning and viewed as ‘blood’ or ‘sweat’.
This of course is the actual cause, and it is one that most ordinary non-medical people can quickly narrow in on in a manner of minutes when they review all the facts in this kind of systematic manner. Most studies reveal that 80% or more of common and chronic illnesses are caused by similar types of external environmental triggers—triggers you don’t need a doctor to find and evaluate. In fact, most doctors are not trained nor have the time to ask you the relevant questions we’ve demonstrated are essential to ask and answer in order to discover the root cause of your health problem. Most of the time, doctors are pressured to examine you in less than ten minutes in order to manage their heavy daily patient schedule, and choose to treat your symptoms with drugs—or, if they are unsure of the cause, order more expensive and invasive tests.
This case (and many others I will continue to present in this blog) demonstrates that you don’t always have to rely upon traditional medical professionals to diagnose and treat your illness. Many, and perhaps most, illnesses can be easily diagnosed as to the underlying cause with information you uniquely have about your problem, and just as easily resolved in a non-invasive way by simply removing the triggering source from your environment. Always remember—you are the custodian of the most important healing tools, which is the unique knowledge you have about your body and the history of your illness.
By Reid Jenner