01/15/2012 09:23 am ET Updated Mar 16, 2012

Why Can't Airlines Get It Right?

Because passengers expect too much.

I'm not denying that there are bad flight attendants out there. God knows I've seen them. Hell, on a really bad flight, I've probably been one. But lately, when it comes to high-profile airline "horror stories" the problem is usually the passenger.

Last week, the Wall Street Journal embraced the story of one such passenger. En route from Rome to New York, Marisa Acocella Marchetto became nauseous, pale and began experiencing a searing pain under her rib cage, so she asked a flight attendant if they had anything for an upset stomach. Of course, a 767 isn't a CVS and isn't licensed to dispense medication other than aspirin (some airlines won't go that far), so they didn't. Marchetto got upset about this, even though she now admits that she had a spicy dinner and forgot to bring a Tums. So she curled up into the fetal position and then asked the flight attendant to page for medical assistance.

If a doctor had responded, the flight attendant could have checked his or her credentials and then allowed the physician to assess Marchetto's condition and begin proper treatment. When no one answered the page, Marchetto asked the flight attendant to call her doctor on the ground.

Even if he could have been reached in this emergency, a crewmember can't begin using directed medical intervention -- there are extensive medical kits onboard for emergencies with pills, injections, defibrillators, etc. -- based on the instructions of an anonymous voice whose credentials can't be checked. Obviously.

Instead, the flight attendant called MedLink, a global response program and level-one trauma center in Phoenix that has been vetted by the FAA. Because the symptoms were consistent with a heart attack, the doctors there decided that a precautionary emergency landing was the safest course of action, presumably aware that the flight would soon be crossing the North Atlantic.

Suddenly, Marchetto decided all she needed was an antacid. So why did she want a doctor paged or her own doctor called? What could either have done to get her an antacid?

Well, at the mention of an antacid, a nearby passenger offered up a Nexium, a pill for heartburn sold by prescription only. News flash: Flight attendants can't write prescriptions or dispense prescription drugs.

Regardless, Marchetto was then under the care of the doctors at MedLink, who preferred to get her on the ground for treatment, what with her fetal position and pale color and growing anxiety and the fact that she has asked for a doctor and commandeered the flight attendant for all this time. Clearly there was a good chance that they were dealing with more than an upset stomach.

Perhaps fearing the rage of other passengers or being asked to pay the tens of thousands of dollars it would cost to divert, Marchetto then insisted it was nothing but heartburn and she didn't, in fact, need a doctor. But as flight attendant Bobbie Laurie points out on his blog Up, Up and a Gay, once MedLink is called, a crewmember can't legally or morally override that doctor's decision and administer an antacid, or any other protocol, instead.

I'm no medical expert, but I'm pretty sure that the friendly nurse passenger who turned up to proclaim that it wasn't a heart attack (based not on extensive testing but on observable heart-rate) couldn't have trumped a physician's orders either. Nor would it have been legal for her to administer the prescription Nexium without, um, a prescription.

So, they diverted to Shannon, one of the last possible landing fields before heading out over the Atlantic Ocean. Fortunately, Marchetto began feeling all better. Still, to be safe, she was taken to the hospital for observation. Lo and behold, after all that drama, she had some heartburn and was given an antacid.

And now the Wall Street Journal is proclaiming the crewmember who spent an entire flight administering to this woman's needs "The Flight Attendant from Hell." She is even compared to Kathy Bates's psychotic, kidnapping character in the thriller Misery.

As someone who has asked my pilots for an emergency medical landing -- which leads to untold costs for the airline, mountains of paperwork and hundreds of pissed off passengers -- please believe me that diverting is the next-to-last thing any crew wants. The last thing they want? To kill someone because it was easier to keep going.

Besides, what if this flight attendant had listened to Marchetto's changing tune and somehow convinced the pilots to press on over the ocean to New York? Ask RyanAir who is under fire for not diverting when a passenger, who declined that option, was later found to be suffering a heart attack.

When you work for an airline, it seems you just can't win.