It is a whole different world sinking into the comfort of your business class seat, compared with trying to find “the workable” spot on that physically restrictive economy class seat.

In economy, you worry about modest things like seat pitch or how seatmate is infringing on your personal space or even worse, the passenger in front of you trying to recline their economy class seat into a first class flatbed, squeezing your little space even further.

The food is never right, service below par, inflight entertainment pathetic, the legroom punishing and the cabin temperature is never to your satisfaction; either too cold or too warm.

These may seem like very critical concerns during a flight, until you consider other things that you most likely take for granted.

For instance, you are probably seated in one of the populous commercial passenger jet, the Boeing 737-800, which is about 80 tonnes in weight and cruising at 940kph at an altitude of 37,000 feet above sea level.

I cannot begin to count how many things can go wrong with that mass in the air moving at that speed.

With even the best aircraft, competent pilots and very favourable flying conditions, there is always the thought of what could go wrong, despite air travel being touted as the safest mode of transport.

Ordinarily, the cockpit is the last place one would expect to be the cause of panic, yet pilot error is the biggest contributor to air accidents, outweighing other factors like weather, sabotage and mechanical failure.

Yet these unexpected incidents go beyond pilot errors. Pilots, like any other human beings, are bound to have medical emergencies. In 2016, on a TUI Fly flight from Hanover, Germany, to Palma Mallorca in Spain, one of the pilots fell ill and passed out during a toilet break due to dizziness and low blood pressure as the flight cruised above the Mediterranean Sea.

Consequently, one of the flight attendants took the co-pilot’s place in the cockpit and helped the other pilot land the aircraft by reading the checklists.

The aircraft, with 190 passengers on board, landed safely.

While the report concluded that the actions of the crew did not in any way compromise the flight’s security and the airline cited the actions of the stewardess as worthy of reward and recognition, some commentators downplayed the occurrence and termed it normal.

In any case, some argued, pilots by training are prepared to takeoff, fly and land solo.

But what if both pilots were affected and incapacitated? Would the outcome have been the same?

Probably not. Even if there was a passenger who could fly, they would have no way of accessing the cockpit which — following changes in regulations of international rules of flying after 9/11 — is locked from the inside for security reasons.

The cockpit door aside, and far from what the movies would have us believe, that fairytale moment when one of the passengers volunteers to “rescue” the aircraft because both pilots are incapacitated is not likely to happen on your flight.

What’s more, there is no recorded incident involving a commercial airliner where both pilots are incapacitated and a passenger has had to land the aircraft, so rest easy on that thought.

But, just like in the movies, chances are that there will be a doctor or some sort of medical practitioner on board.

By default, a single pilot is sufficiently trained to fly and safely land an aircraft in case the other is indisposed.

Of the different kinds of medical emergencies to occur on board, it is remarkable to note that the most common are dizziness and fainting, respiratory problems, nausea and vomiting and cardiovascular problems.

Not all medical emergencies that occur during a flight mean automatic flight diversion. In many cases, the cabin crew and a medical practitioner on board do contain the situation.

Crew members rely on their mandatory training to offer medical assistance. However, there will be air-to-ground communication between the cockpit and ground physicians.

It is important to note that beyond this emergency response, airlines do not serve as medical advisors to passengers, and there is no doctor-patient relationship between an airline and a passenger.

Word of advice though for medical practitioners who volunteer to assist with medical emergencies during flights, the captain of the flight is and remains always in charge of the flight.

Michael Otieno an aviation consultant and travel writer based in Nairobi. Twitter: @mosafariz; Email: [email protected]