On making it difficult for everyone else

I've entertained a theory that if a pilot can assemble his glider solo, push
it to the end of the runway and strap in, then he has, in effect,
self-administered a stress test sufficiently rigorous to indicate he is fit
to fly that day.

Bill Daniels


"danlj" wrote in message
oups.com...
On May 7, 11:59 pm, fred wrote:
At my operation, I have
a FAA rule that I preach...and apply to myself. Fred's air regulation
#1.01 "If for ANY reason you don't feel like flying, then don't take
off.
... how do regulations stop a pilot from running
out of fuel? I love the discussion.

I write as a power and glider pilot who's been an FAA-designated
aviation medical examiner for 20+ years...

This thread is interesting for several reasons, one of which is that
it exposes on one hand the folks that are thoughtful and base their
opinion on the best evidence they can find; and on the other had the
folks whose own opinion is the strongest evidence, but only to
themselves, that they are right.

Medical screening of pilots was put in place due to the experience in
WWI that something like 80% of the accidents were judged to be due to
the physical inability of the pilot. The consequence is that we saw a
change from no screening at all to unnecessarily strict screening,
from which we have been unsuccessful in fully extricating ourselves.

The chief usefulness of medical screening, it seems to me, is that it
focuses the attention of the prospective pilot on his or her own
physical condition and abilities, resulting in self-selection that is
far more judicious and effective than the formal screening required by
law.

Yet there is an important role for formal screening -- to hinder
pilots whose ambition to control an aircraft overwhelms good judgment
-- and there are not a few of these, and as an enthusiastic pilot I
fully understand. For example, a 28 year old airline pilot, whose
life dream is being fulfilled, collapses in the ready room of his air
carrier with an epileptic fit. The psychological blow and threat to
him personally is incalculable. We physicians, sympathetic to him,
expend every effort to prove whether or not this was truly epilepsy or
simply twitching from a faint due to illness. But in the end, the
existence of the formal process forces both him and us to the larger
sympathy we owe to the safety of others. In this case, he did have
epilepsy due to an old closed head injury in sport; he will never fly
again; he would not have been able to make this decision by himself.
The bureaucracy necessarily needed to put him into the paperwork
corral.

We medical professionals are often put in the uncomfortable position
of trying to predict the future. Being required to do the impossible
is a severe stress for any of us, and we decompensate as individuals
and institutions in interesting ways when such is required.

In this regard, the FAA aeromedical certification is viewed, by the
FAA, as a statement that the pilot is *unlikely* to suffer sudden in-
flight incapacitation for the duration of the certificate. We have
reduced the impossible to a risk assessment. This assessment is
always "wrong" in a sense, but the best we can do is to perform a
thoughtful judgment based on the information at hand, about natural
course of disease and about the pilot's current health status.

We eventually die. Prior to death, we begin losing physical
capability. For some of us, this is more or less gradual, and we have
the opportunity to exercise good judgment and adapt to it. Or we have
good judgment forced upon us by brave friends or an inexorable
bureaucracy. For a few, death is sudden and calamitous, and
occasionally this occurs while driving a vehicle or piloting an
aircraft. In this regard I like to tell patients for whom I'm doing a
cardiac stress test, "This test is pretty good at telling who's of the
verge of needing bypass surgery, but it doesn't predict sudden death.
You could pass this test with flying colors and drop dead on the way
home -- but you might be stuck by a speeding semi, too."

This is humorous, but makes the point about our inability to see the
future. Hence, "self-certification."

And hence our need to hold ourselves up to the light before each
flight (and during it) and ask if it's *really* a good idea to go (or
continue); and we must be brave and, gently or assertively, speak to
our colleagues who seem to be risking themselves or others. It's
hard, it's risky, and it's socially frightening. But we must do it.

Dan Johnson