Was the JetBlue slide incident caused by head injury?

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Many explanations have been offered for JetBlue flight attendant Steven Slater’s meltdown and dramatic emergency slide exit on Monday—from “air rage” to suggestions of a relapse into alcoholism. But none of the media coverage has noted what could be the most obvious and chilling reason for his bizarre behavior: at the beginning of now notorious 46-min. Flight 1052 from Pittsburgh to New York City, Slater may have suffered a head injury.

The whole incident apparently started when he confronted a woman trying to place a large and presumably heavy bag into the overhead compartment before take-off. During the ensuing altercation, Slater was hit in the head at some point and was seen bleeding from a gash in his forehead.

That was the point at which everything changed. Slater conducted the safety drill with his shirt unbuttoned, showing his belly. Passengers said he seemed disconcerted, dropping or throwing the oxygen mask demonstrator to the floor, prompting anxious laughter, according to the New York Daily News. During the flight, he banged into passengers, suddenly quit providing drinks and snacks before serving everyone and otherwise behaved oddly. Previously known as cheery (at least according to one passenger who has flown with him before, quoted here), he was abrupt. One passenger told the Daily News, “He was very disturbed. He was almost hysterical.”

All of these behaviors—impulsivity, clumsiness, confusion, disorientation, irritability, “out of character” behavior—can be head injury symptoms. When the brain gets hit, the outer regions that prevent people from doing things, like telling off customers, quitting work and activating the emergency slide to make a dramatic exit, are often the first to be affected.

In addition, according to interviews with passengers and crew reported by ABC News, at some point before or during the flight, Slater—who is rumored to be a recovering alcoholic—started drinking. The same symptoms and behavioral disinhibition associated with head injury can also signal alcohol working on the brain. If Slater had been in recovery and began drinking after a long period of abstinence, lack of tolerance could exaggerate the effect of even one or two drinks.

So, while it’s fun to cheer for someone who did what most overworked and underappreciated people secretly yearn to do, a better takeaway from the incident might be that head injuries are too often ignored, denied or misunderstood. If a person starts exhibiting any type of odd behavior after being hit on the head, people around him or her should behave calmly and sympathetically and seek medical attention as soon as possible. Early treatment can be the difference between an injury that produces lasting symptoms and one that resolves quickly.

Also, in regard to alcohol dependence, remember that a relapse into drinking does not have to be a disaster. Most people with alcoholism will have at least one slip. But deciding that “all is lost so why not?” often prolongs relapses (it’s known as the abstinence violation effect), while recognizing the situations and emotions that prompt such incidents can be important to maintaining sobriety. (Hat tips to Tamara Holt and Alissa Quart for their suggestions for this post.)