The TRAVELER'S JOURNAL: June fourteenth, asking, is there a doctor on the plane?

Statistics show eight commercial airline passengers out of every million suffer a medical calamity. While that number's tiny, many more in-flight incidents require medical attention. American Airlines handles an average of four en-route health emergencies each week. But how prepared are carriers to dispense health services at 35,000 feet?

The good news is, most big commercial aircraft are required to carry two medical kits. There's the first aid kit, with medicine cabinet items like ammonia, swabs, bandages and splints. There's also a medicine bag, which contains a stethoscope and blood pressure cuff, along with drugs to counter insulin shock, allergic reactions and cardiac pain. Some carriers also stock painkillers, antihistamines and anti-diarrheals. American Airlines planes pack automatic defibrillators, which may soon be mandatory on all U.S. carriers.

Unfortunately, cabin staff can only provide the basic first aid. Only qualified volunteers, doctors, nurses or paramedics who can and care to show proof, are permitted to open the medical bag. Carriers do staff doctors on the ground to radio up assistance, but the absence of an onboard volunteer often dictates an emergency landing. And the odds of that are worsening. This year 39 percent of in-flight medical crises had no expert volunteer, versus 28 percent five years ago.

Finally, sicker people are traveling, whom a doctor might have told to stay home. The bottom line: have reasonable expectations when you go to the airport, both about your own health and the medical care you can expect onboard.

There's a longer look at the problem in this issue of National Geographic Traveler, a supporter of our program.

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