Doctor Gives Up Lie-Flat Seat to Save American Airlines Flight—Gets Ignored and Exiled to Coach

Dr. Erin Nance, a New York-based orthopedic hand surgeon, and founder of a social media platform for women dealing with chronic health issues, flew American Airlines in business class to Europe. She stepped in and gave up her lie flat seat to save the flight from having to divert to Canada. And now the airline is pretending they don’t know who she is when she’s asking about a make-good on her ticket.

  • About an hour into the flight, she says, a flight attendant made an announcement asking for a doctor to assist with a medical emergency. She says she “always responds to these requests.”

  • A passenger had fainted but was awake and “feeling ok” and wanted to return to her seat. Then half an hour later there was a second medical emergency – the same woman – and she was not well.

  • The woman was stable and communicative, but couldn’t get up from a flat position on the floor in front of the lavatory.

  • The captain considers diverting to Nova Scotia. The doctor volunteers her business class seat (and her husband’s) so the passenger can lay down, and the flight doesn’t have to divert.

The doctor and her husband were on paid business class tickets, and were swapped out for two seats in the back of coach with no recline.

After the trip, she contacted American Airlines. While she would “100% do it again and volunteer [her] seat” in the situation, she was hoping to have a future business class experience. She was told to fill out a form on the website. After more than a month she’s heard nothing.

@littlemissdiagnosed @delta would never…still waiting for a response @American Airlines ♬ original sound – Dr. Erin Nance

The doctor did volunteer her seat! It’s the right thing to do, she thought. Maybe she shouldn’t be compensated for that?

But it also saved American Airlines from an incredibly costly diversion. She responded to the airline’s call for help. And she didn’t get the product she’d purchased. Should she get a refund, or miles equivalent to a future business class one-way saver award? Or… at least… the courtesy of a response from the airline?

I reached out to American Airlines and they opted not to comment.

(HT: James W)

About Gary Leff

Gary Leff is one of the foremost experts in the field of miles, points, and frequent business travel - a topic he has covered since 2002. Co-founder of frequent flyer community InsideFlyer.com, emcee of the Freddie Awards, and named one of the "World's Top Travel Experts" by Conde' Nast Traveler (2010-Present) Gary has been a guest on most major news media, profiled in several top print publications, and published broadly on the topic of consumer loyalty. More About Gary »

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Comments

  1. Such a missed opportunity by AA to make a big deal out of a “hero passenger” by doing something special and putting out a press release about it. The free PR would be a 100x return on whatever they gave her.

  2. Doug has it right. “Missed opportunity” is exactly what I was thinking. With just a little finesse and at laughably low cost compared to what big companies opt to spend elsewhere to meet the same aims, AA could make themselves look really good in this scenario and many others that get highlighted by viral stories like this. Why don’t they ? Is the theory that “then others will also expect handouts and freebies” ? Or “we don’t have to do anything for you, so we’re not gonna” ? These stories are just inexplicable to me. It would be wonderful if the motivating goal that animates airline responses to these situations were “let’s do what’s right for the customer even if it isn’t best for us” – but of course that is a pipe dream. Nonetheless, if I’m an AA shareholder (hahahahahahahahahahaha), I’m definitely wanting the airline to do what’s right for the customer WHEN IT”S ALSO A WIN FOR THE AIRLINE!

  3. Didn’t AA just move the remainder of their US-based customer service ops (the ones that dealt with non-typical issues) offshore? This sounds about right then.

  4. yet another post @Gary shares rambling about topics he knows nothing about.

    Do you even know what MedAire is? Who retains authority and who has final say during a medaire event?

    Gaurentee they just gave her some orange juice and a O2 bottle and called it a day.

    go work for AA, I’m sure you’d fit right in with the clueless morons there.

  5. DWT. Thank you, and rest assure we are taking this very serious. We will take care of this very well. You don’t have to worry. Rest assure. Yes, American is about to learn the hard way

  6. These doctors are nothing but virtue signaling. A few years back there was an older woman and her daughter traveling in coach. I was in 1A in first, on AA. The mother started having some kind medical issue in flight and after a nurse looked at the mother to save the flight from a possible diversion the flight attendants put the mother in 1B, which was empty (if there’s an empty seat in first it’s usually one of the aisle seats in row 1). We were about an hour out so the meal service was over. The older woman was distraught so I, and let me be very blunt about this NOT WANTING A DIVERSION, told the flight attendants I’d give up 1A and take her place in coach for the remainder of the flight. I did not expect in any way shape or form AA to compensate me or “acknowledge” me. I did it hoping the daughter next to her would keep the old woman stable until we landed.

  7. Why did the flight attendants ask for a doctor? I thought they were all trained in medical stuff and counterterrorism-strike-force stuff…which is why that can’t provide any other kind of service because they too busy “observing” the cabin….oh and “pay me for boarding or I won’t perform any other of my responsibilities either”

  8. @jns
    but then they raise their own salaries AND think they deserve more perks. AA employees first and passengers last.

  9. I believe that AA should be doing sommersaults for the surgeon who came to the passenger’s and AA’s aid, in flight.

    AA’s treatment of that surgeon (and her spouse) is just disgusting.

    It will be a cold day in hell that I offer medical assistance on an AA flight.

  10. I’d say both the ill person and the doctor couple were extremely lucky. Imagine the ill person got permanant damage because the plane didn’t diverted, she could’ve sued the doctor couple or airline. but miraculously sitting in a business class seat cured all illness. WOW.

  11. Disappointed in AA. They should have refunded and given two sets of system wide upgrades at a minimum In my opinion and another opinion if the one person on this post is so distraught with Garys post stop reading them. I found the story interesting.

  12. Sometimes I think Congress should force American Airlines to change their name.
    This is due to the nonstop PR and customer service disasters.
    Nowadays this legacy airline is unworthy of the name and brings shame to all Americans.

    People in other countries think AA is a state sponsored airline instead of a private company.
    An airline using the name “American Airlines” should strive to be the gold standard in service.
    Instead they seem to strive to be at the bottom of the barrel.

  13. I don’t even know where to start…

    YES, absolutely AA screwed up…yet again… If there is a choice between spending a few pennies and reaping big awards, or hoarding the pennies and shooting themselves in the foot, AA will hoard the pennies every time.

    /\/\/\/\/\

    George? You’re an idiot. If you cannot see the difference between assisting a passenger who was ill, and giving up your precious 1A seat solely because YOU are too important to be diverted, I feel sorry for you.

  14. “These doctors are nothing but virtue signaling…”

    No George, I don’t think so. She gave up her seat, she handled a medical emergency pro bono, and saved American a ton of money by ensuring that the plane didn’t have to divert. She also saved the other passengers the inconvenience of not arriving late due to a diversion, with all of the accompanying problems with making connections and so on. All American has to do is compensate her for the seat, or give her a business class seat on an upcoming flight. Just make her whole. Instead, they’re going radio silent. I mean, at least THANK HER for her assistance! But no, American can’t even do that!

    As an aside, I used to prefer flying American all the way through the eighties and nineties, but the level of their service dropped precipitously, even below United’s in the Dr. Dao days.

  15. Same thing happened to a physician friend of mine several years ago. He sat and cared for a sick psgr all the way back to Phl. Saved them form a return to Phx. No thank you from the crew or AA. after a lot of corresponded they finally gave him some award miles that he could use for a future trip.

  16. No unlike a couple of commenters I don’t think the world revolves around me. But clearly the 2 smart as% commenters think they’re the center of the universe. Just like these 2 doctors.

  17. I agree with George N Romey on virtue signaling. Especially trying to shame the airline not having given compensation. There’s no law saying you should give up your seat or ask for compensation if you did.

  18. Three things:
    1) @Steve and @Karl Rupp are spot on, for sure it would have been an easy layup for AA to highlight this and also make it right with the Surgeon, but they screwed it up big-time. Side comment: Crediting the Surgeon and her husband for the Business Class Seats would NOT be a freebie or handout, they PAID for them.
    2) @Steve is positively clueless for thinking that tele-medicine is even remotely comparable to being tended to by a Surgeon live. Extra credits for cluelessness by also insulting Gary Leff in the process.
    3) @George N Romey, cry me a river for your giving up what was probably a comped FC seat (row 1 always goes last), which regardless of comped or paid for is not remotely comparable to a Lie-Flat Business Class seat on a transcontinental flight.

  19. Years ago I was in first class on AA and the passenger sitting next to me was violently ill coughing up blood ,wheezing sneezing etc When he coughed up wads of phlegm too I was ready to move
    I asked flight attendant if I could be reseated and she said only in coach
    She also let me know I would have nothing to eat on the transcon once I leave first class
    But off I went to coach skipping dinner.Better than getting sick I thought
    Called AA and was told to stuff it despite my 9 million miles with the airline
    Sir you voluntarily gave up your seat (sigh)
    I suppose I need to be dragged off my seat to get a future upgrade (roll eyes)

  20. Dear Dr. Nance,

    You are a true hero. American Airlines seems to me to be a bit “slow” here. If anything like this might ever happen to you again, I would suggest that before offering your own seat, you might consider telling a stewardess that if only “a passenger in first class” could give up their recliner seat, the flight could be spared an unnecessary stop. Then, if nobody “volunteers” then “conditionally” offer your own seat, based on the “condition” that you get a refund for the “downgraded seat.”

    American Airlines should be called “Ugly American Airlines” for their apparently greedy behavior here.

    Thanks,

    Scott Perry

  21. They just can’t get rid of that ULCC DNA. We didn’t need another example of American’s managerial ineptitude but got one nonetheless. It’s well past time to kick out the board and install a capable one that will hire leaders rather than retain incompetent managers.

  22. Perhaps the doctor should have made it clear to the cabin crew and pilots what the situation was. The situation was that there was a reason to divert but that diversion could be safely (within reason) avoided if the sick passenger was lying flat in a business class seat. The cabin crew could choose which person to downgrade (maybe a non-rev?) or document that they were instructing the doctor to downgrade and receive compensation.

    Maybe if you pay for a seat, you should also make a screenshot of the economy class ticket price so that you have documentation of the differences in cost?

    I was recently on a Delta flight. During the flight, I was offered a Premium Select (premium economy) seat. I declined because I had an entire row of 4 seats that allowed me to lie down while Premium Select didn’t.

  23. I’ve responded to medical emergencies several times. I don’t think I’ve ever been compensated, but neither have I ever given anything up. But one time the captain gave me his good luck charm and for some reason that gesture has remained with me. It’s still in my bag.

  24. I agree with Doug, a missed opportunity for solid AA PR. Also, if DL or UA had a visible (to the masses) and popular CEO, they would have a great opportunity for PR and throwing shade on AA. Imagine DL (or UA) CEO saying “we celebrate the selfless humanitarianism of Dr. Nance and her husband and offer them free international J travel on DL for the next 12 months.” How many trips you think Nance would actually fly? Cheap, good PR.

  25. The doctor should send American bill. Flight attendant asked for a doctor and they got one. Emergency services are very expensive!

  26. No she should not EXPECT anything. It was a very nice gesture and it was 100% her choice. Once she expects something for it – it has stopped being a nice gesture and become transactional – you pay me for my gesture. It would be nice for AA to do something, but due – no.

  27. Haven’t we read enough about fake service dogs, emotional support animals, wheel chairs who don’t need ? I don’t buy giving business seat to someone miraculously heal someon who seriously needed medical attention. Ill passengers are the ones who should pay the business class seats for the doctor.

  28. What a shame that AA don’t even have the decency to instinctively do the right thing and thank the female doctor and her husband and make amends by providing a refund on their business class tickets and sparing the airline and the rest of the plane from the costly hassle of a diversion to Canada.

  29. Lufthansa used to have some kind of special enrollment bonus for doctors to preregister to help in case of in-flight medical emergencies. Maybe they still do.

  30. Physician here. EM/Critical Care. This was a magnanimous gesture, and yes the airline skills compensate her.

    But the flight should have been diverted. The passenger might have had any number of life threatening issues, and having dealt with that little medical kit at 30,000 feet vs a full emergency department, there’s not much you can do if the situation worsens. The pilot should have known better.

  31. So a woman in poor enough condition she couldn’t sit up on her own was left lying in a seat for 4-6 hours, possibly getting worse and not getting better? After signs of worsening to begin with? And a doctor thought this was a good idea?

    Doctor needs to lose their license.

  32. Again, American is a crypto currency thinly disguised as an airline.

    Unless it improves D0, the metric doesn’t matter.

  33. I think someone was just trying to make American great again. She obviously should have been home taking care of her child and man instead of taking away a doctor job from a more deserving white male (you know, the kind that run American Airlines).

  34. That’s terrible by AA. It probably would have cost them hundreds of thousands in fuel and other cost had the physician asked the pilot to divert the flight. It seems that physicians are the only porofessionals that are expected to volunteer their time and risk potential litigation for in flight emergencies. The FAA should provide a fee for this service. For similar service for a home emergency repair, i’m typically billed 1.5X or 2X the usual fee. As a physician, i performed a similar service on a Lufthansa flight and went back to sleep. 2 hours later, i was awaked by the flight attendant because “my patient” had another question for me!!! Dr. G

  35. My husband is a physician who has been called upon many times over our years of travel. American, US Airways, United, Delta, Northwest, BA, Lufthansa, Virgin Atlantic, Hawaiian, and probably some I’m not recalling. Almost all were long-haul, wide-body international aircraft. In several of these occasions, the captain was involved, MedLink (a ground medical service most airlines contract with for in-flight emergencies) was involved. In most cases the captain replied upon husband’s expertise to make the determination whether a diversion was necessary. Once the situation is in hand, the flight service manager works through the extensive incident report paperwork with husband, requiring ID, medical license, practice details, etc. The whole thing generally consumed hours of a flight and in some cases, he was monitoring the patient/passenger throughout.

    In all cases the crew were very grateful and appreciative, but really have nothing material to offer. Not that he’s looking for anything; he’s definitely not. On each flight, we were passengers in either First or Business class. (Fortunately, he never had to give up his own seat!) It always amazed me that not one time did an airline reach out in any way to thank a First or Business Class passenger for taking a sizable amount of time out of his flight to help one of their passengers with medical treatment and to keep the airplane from having to divert. Imagine the cost savings. And still, it’s not even worth a form letter of thanks.

  36. It really tells you what kind of a company you are dealing with. I have flown American Airlines many times and have a credit card of theirs BUT, I will not ever use either again. They should be ashamed.

  37. The pilot is a pilot, not a trained health professional. The pilot will get input from trained health professionals in a situation such as this. Some of those professionals could be on the airplane and some could be remote from the airplane. Those professionals made the call on whether the situation was serious enough to require a diversion.

  38. I once attended a patient on a trans Atlantic Lufthansa flight. The crew gave me a couple of decent bottles of wine on arrival and I got a personal letter of thanks from the airline.

  39. I’m constantly reminded these days about how true the old “No good deed goes unpunished” adage is. It just doesn’t make sense to do anything for anyone else anymore.

  40. As much as I despise American, they don’t owe her anything other than thanks for helping with a passenger suffering a medical issue – but she WILLINGLY gave up her seat to that passenger, and it’s not like they bumped her out of it for some lame reason. In this case, she is acting entitled because she thinks she is owed something. If she wanted to have the experience of the seat she GAVE UP, then maybe she shouldn’t have given it up along with her husbands seat. She screwed herself

  41. Why bother helping people anymore. It isn’t worth it. You’ll either be despised, shouted at, sued or worse. We are in an age of “every man for himself”.

  42. As an exec platinum, it’s bothering me that AA chose not to comment. Like, these things can be PR wins and they won’t lose too much money on giving the doc a SWU for a future flight. The doc easily saved them $50k and will probably not fly AA again. So instead of a win-win it’s a lose-lose.

  43. World Class service should dictate at the very minimum a personal letter from a Sr. Executive and the offer of a pair of courtesy upgrades. However, American for one has lost touch with their clients, it has been this way for at least the past 20 years. Only when clients stop using a vendor and the board of directors see a dramatic downward trend in the revenue will they ask why? By then it is usually too late!

  44. @Dave they probably do owe these doctors. How much would they have incurred in costs to divert the plane, in addition to whatever other additional costs that would have incurred for them?

  45. Many years ago when I was an Airport Duty Manager we attended all reported medical emergencies on site.
    In this case a man had a heart attack in a gate boarding area and when I arrived on scene a passenger who was a doctor had already begun CPR and utilized a defib unit that was part of the kit with the Airport nurse. This was back in the 80’s and IV was also started by nurse who was licensed (delegated) to administer certain life drugs without a Dr being present given her role, as most of the time there would be no Dr present.
    Between the Airport Nurse and the Dr the guy regained consciousness and was transported to Hospital.
    As the site was being cleaned up I approached the gate desk and asked if they could get the Dr and his wife a little more leg room on the flight. The Agent immediately asked me to bring the Dr over and with no hesitation bumped the 2 up to Business. This was Air Canada in Toronto and no “I need to get permission talk from the gate agent”
    Not so sure this could happen today, but it was time when flying was still fun and Air Carrier, and Airport staff cared about their passengers.
    A diversion would have cost thousands and inconvenienced a complete flight. Come on AA you can do better.

  46. Well, I’m a Plat Pro and I’m not surprised by this treatment. But most of the doctors I know say they never raise their hands when they hear a call for a doctor like in this situation, so I guess this shows why.

  47. I have a friend who is a French doctor. He told me he always volunteers to help sick passengers on flight, EXCEPT
    1) If the passenger is American, because he might get sued
    2) if the airline is any American one, because he might get sued,

  48. AA has again earned my award for worst airline of the many I’ve flown in travels to 66 countries. I have enough miles for a long international flight, but I’m not sure that flying free is worth the insufferable customer care in counter, gate, cabin, and after-trip operations.

    But this story tops the cake for deserved criticism.

  49. I will never fly American Airlines again. I Would gladly take a train, a boat, a bicycle or walk to avoid their version of customer service.

  50. I stopped raising my hand after I read a report in the medical journal, Lancet, where a leading UK surgeon asked BA if they would have paid his legal bills in case of a law suit. The answer was, No, you volunteered to help ! Also, there is the issue of Doctors being licensed only in their country and whose jurisdiction applies over international waters. Once, I provided medicine from my personal kit to a passenger with uncontrolled vomiting and diarrhea on a flight from Bangkok and watched him most of the night. Interestingly, the crew was very appreciative but the patient never said a word of Thanks !

  51. This passenger was gracious, empathetic, and thoughtful.

    AA should have thanked her with a hand signed card or letter from leadership.

    (She does not deserve any future flight credit, unless it was bartered or agreed to at the time of seat swap).

  52. I was once on a long-haul AA flight that diverted to a mid-sized airport that could not handle a widebody. We did so in spite of being relatively close to two major AA hubs, presumably in a misguided attempt to get the patient care faster. It took the local fire department nearly an hour to figure out how to access the aircraft in a manner that would allow for a stretcher to be brought on board. Had we instead continued on to our destination or diverted to the other hub, the suffering, extremely sick patient would have been extracted far faster. Based on this experience alone, I am totally unsurprised that AA fails to recognize heroic first responders who are under no obligation to assist. The airline truly does not “cAAre” about anything these days besides saving money in ridiculous ways, and touting their stupid credit cards.

  53. @PeeAm: “Once, I provided medicine from my personal kit to a passenger with uncontrolled vomiting and diarrhea on a flight from Bangkok and watched him most of the night. Interestingly, the crew was very appreciative but the patient never said a word of Thanks !”

    If the patient is in too much distress, having them be polite and say thank you at the time may not be what is on their mind. It is possible after the ordeal that they wanted to thank you but had no way to get in touch.

  54. This is the only failsafe channel to get American’s attention:

    https://secure.dot.gov/air-travel-complaint

    (or any other airline for that matter)

    I don’t even bother with contacting the carrier, complete waste of time.

    NOTE: The carrier is REQUIRED to provide a direct response to EVERY complaint filed — EVERY, SINGLE, ONE.

  55. Corporations aren’t people. Even if they send a thank you letter, they certainly don’t mean it. They’d rather you die than lose a few pennies in profit. It’s the nature of the construct. Expectations are nonsensical, especially regarding a corp. The kind doctor has earned a ton of good karma, and that beats a letter and a million future upgrades.

  56. I do think AA owed this doctor a gratitude with thanks. They provide a product, and having the doctor step up and prevent a diversion was huge. Take it out of marketing’s budget, but here they had a chance to keep a customer, they just lost her (likely) and me (absolutely!)

  57. Why not at least reply to the doctor & this inquiry? Common decency does not cost anything, but being azz holes can cost a lot in the long run!! #AmericanFlyerBeware

  58. The problem is obviously bad recordkeeping. If AA corporate had a record of this happening, I’m sure they would make things right. But they apparently don’t have a record, and have to base their decision on a semi-influential customer writing a customer service complaint.

    Not sure if it would be the pilot’s job or the flight attendant’s, but there should be some mechanism to document what occurred in these situations.

  59. Imagine what a great story this could have turned in to for the airline. Instead they chose to take a customer that was willing to pay for business class and stiff them for their willingness to help. Thank you Doctor for volunteering your time and expertise during a flight. Make it right American, quickly !

  60. No good deed goes unpunished! Our airlines are far from what they once were. There is no competition, no aircraft manufacturers but a few which are overwhelmed, no standards in hiring flight attendants.

  61. I’m not a fan of American Air (or Delta or United, etc), however….
    I’ve been called upon 4 different times to help with a medical emergency on board and have been happy to assist. I have never done it because I expect anything in return. It’s a sad world we live in that if do good deeds expecting rewards in return. Someone in the comments said: no good deed goes unpunished. What?! Nobody got punished. She volunteered, and the warm, fuzzy feeling should suffice. It’s called charity and being a good human. Not to mention she saved oodles of time and her own vacation time along with everyone on board. Maybe she should start a gofundme…cause any good karma out of her act has been neutralized.

  62. Thank you for this cautionary warning to *NEVER* purchase travel from American Airlines!!

    I prefer to support *HONEST* companies, even at a slightly higher cost. Until more people decide to do the same, these abuses of Power will only continue.

  63. I’ve been involved in a few of these instances and have a few thoughts.

    Nurses, EMT’s and other healthcare professionals respond, in addition, to physicians, so want to make sure we recognize there service. These situations are incredibly stressful with limited resources, requiring life or death decisions.

    Aside from never being financially remunerated ($$, vouchers, miles or upgrades), I’ve never had anyone check on me after the event. It’s shame that airlines, with all of there resources, can’t pick up the phone and personally thank another human being and make sure they are mentally well after these types of medical emergencies. It’s ashame AA chose not to comment, not even a we thank those that responded message…

  64. I was on an Alaska airlines flight to Hawaii a few years ago when they requested help for a medical emergency. I pressed the button as I am a fp physician. Turns out it was a kid a few rows behind me that was having an allergic reaction. Swelling of the face and lips after taking ibuprofen for the first time ever. A pediatric nurse was also nearby and my wife is a hospital pharmacist. So an ideal team to treat this. Well guess what after we got up to help they asked me what we should do and I said give benadryl the dose on the pediatric bottle to start with. The. i asked what other medications were available in the airplane kit. That’s when it got crazy the flight attendant who asked for my help told me to sit down in a very stern voice. I repeated myself and said I am a doctor I know the dosing for this. She says “Sir sit down and get back in your seat now!” I did because I was shocked. She says to me, “in this situation we call the medlink doctor for what to do.” I’m thinking then why the hell did you announce it overhead and then come get me from my seat. It took over 20 min for them on the satellite phone to finally give this child a dose of benadryl and the whole time I’m thinking she’s going to crash and then its really going to be my problem. You just know the doc on the ground would rather have me running the decisions since I’m actually there. I spent the rest of the flight checking in with the parents because I was still worried about the child. At the end the flight crew said that they needed to follow protocol or they could get in trouble so sorry about getting in your face. Well I decided after that I’m not pressing the button anymore. Call your medlink next time. If you are asking for help let me do it, if you are just having me wait till it goes to hell no thanks.

  65. She should at a minimum get 2 confirmed upgrades for her and her husband giving up their lie-flat business seats.

    Since AA is ignoring her, she should make the rounds on the national morning TV shows to share her story. I suspect then AA would reach out rather quickly to silence her, er, that is, make it right.

  66. This is unfortunately unsurprising. Was exec plat on AA, stopped flying them cold turkey about a year and a half ago. All the airlines are are bad, and have things go wrong, but things on AA always go far worse and they take zero responsibility.

  67. @Art, your story shows how shocking incompetent the people developing and enforcing the protocols are. If someone has a heart attack, are they going to wait for the medlink instructions before starting CPR and before trying the automatic defibrillator? Where will the golden minutes go?

  68. She couldn’t get up off the floor to get back into her coach seat, but miraculously she could get up off the floor to walk to the J cabin, and lay down in a lie flat J seat. Miracles do happen!

  69. Think of it this way: if AA did give you a compensatory flight, you’d have to fly AA again. So just look at this as a blessing in disguise.

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