This thread has been bugging me all weekend. The lady who asked the man if he might let her have his seat said that he "refused".

The more I think about this, the more I'm convinced the man was a selfish dork and there was nothing wrong with him.

If it had been me, and I'd been unwell and unable to give up my seat, I'm sure I'd have said something like, "I'm terribly sorry, but I just can't. I'm sorry." No need for details - just a simple expression of a greater need and I'm sure the lady would have understood. Even if he had been unwell, I think that failing to give any kind of explanation - however vague - is offensive and selfish. Illness is no excuse for bad manners.

As for the surrounding passengers who failed to 'rise' to the occasion, I'm pretty speechless (which is probably just as well).