A Sigh of Relief

There are words that strike fear deep into the heart of any pilot. No, I’m not talking about “in-flight fire,” or “mid-air collision,” “engine-failure,” or even, “I’m with the FAA.” Although all of those certainly qualify as sweat- and tremor-producing gems. No, the words I’m thinking of might seem far more benign to the average non-pilot Joe. They are…

FLIGHT PHYSICAL! (Cue cheesy thriller-movie music, dun-dun-dun-DAAAAA, woman screams in background.)

Pilots who fly for a living have to take periodic medical exams administered by an FAA-approved “flight surgeon” or Aviation Medical Examiner ("AME"). We pilots love our jargon! If we pass, we get a little white slip of paper (“medical certificate” or just "medical") that we must carry around with us to prove it, should we ever be asked (it happens). To us, it is a more important piece of paper than our mortgages, marriage or driver's licences. For without a "medical" even our pilot’s licenses aren’t worth the plastic they’re printed on. Without a "medical", we don’t have a job. (Pilot licenses never expire; to be valid they are contingent upon having a current "medical.") I may be single, homeless and walking to work, but dammit don't make me not-a-pilot anymore. At least not yet, okay?

Most helicopter pilots endure this exam on an annual basis; airline pilots go every six months, the unlucky chumps. And we all dread the thought of it. I’ll tell you why. Elevated blood sugar? You’re history. The FAA will not issue you a medical certificate if you have diabetes. It grounds more pilots than you’d imagine. We all have seen seemingly healthy guys who were here one day, gone the next. Gone for good, too. And there’s not much you can do to prevent it. It is our Sword of Damocles.

The Flight Physical is not an in-depth probe of your health, nor is it meant to be. It’s more of a “How’s it going?” type of thing. They check the usual problem areas like blood sugar, pressure, and vision, as well as documenting our height and weight. However, none of us like to be scrutinized, and even though it’s a superficial check, many of us worry that “something” will turn up - the thread will break, the sword will fall and our careers will be over in a flash.

While the “exam” is not comprehensive, some doctors treat it more seriously than others. Pilots often joke about fortuitiously finding a so-called “Santa Claus” whom we will visit faithfully until one of us dies. I kid you not. Some friends and I had this great doctor here in Pensacola who was well-known to be, um, “easy.” (I forget his name, as it was quite a few years ago.) But he was great. He did the exams in a very comfortable “office” in his house - his living room. You bent over, the nurse shined a flashlight in your mouth and the doctor looked in the other end. If he did not see light, you passed! If you could fog a mirror, you passed! If you walked into the doctor’s office under your own power, you passed! You get the idea. We liked him! Only problem, he was about 100 years old...

Then one morning my friend Greg called me up in (mock) tears. “Bob!” he sobbed. “Did you see the News Journal today? Doc Adams passed away! His obit’s in the paper. What are we gonna do?!” I pretended to break down too in commiseration and mutual trepidation. We had a good laugh about it, great comedy. But then, seriously, we had to find another flight surgeon – preferably one with small hands.

My new AME is a great guy to whom I’ve been going annually since the death of Dr. Santa Cl…err, I mean my former flight surgeon. This new guy doesn’t actually know me, but he’s got more than ten years of data on me now, so he can see where my “vitals” are headed. The Physicians Assistant does most of the work, leaving the doctor to come in and chat with me for fifteen minutes or so while he listens to my innards and presses and pokes various areas including the naughty bits (a press there, not a poke, thank you). He asks me how I'm feeling? I always answer, "Fine," without elaborating/incriminating.

Anyway, today was my Flight Physical day. And it was an anti-climax. I passed. I don’t know why I fret over these things. No diabetes. No hernia (oh yeah, like that’s a surprise, me never doing any actual physical work and all). Nothing glaringly wrong with the ticker. Blood pressure was fine. That wasn’t always the case.

Time was, when I was living in New York City and flying a helicopter based at JFK and taking my flight physicals at that airport, my sky-high blood pressure would set off alarms way down in Oklahoma City where the FAA’s main medical offices are. They would yell at me to quit smoking (even though I’ve never smoked) and start getting some exercise (which I was already doing). But there must be a sliding scale for acceptable blood pressure based on age, and evidently I’ve grown-into mine. At least, this year they didn’t yell at me. On the other hand, I’ve cut out coffee and Coke since I’ve been back in Florida. And I'm somehow nearly fifteen pounds lighter than last year.

I mentioned the need to find an AME with small hands. We have this thing called the dreaded, “Digital Rectal Exam.” Remember how I said we pilots love jargon? “Digital Rectal Exam” is our jargon for “Hideously Painful Torture.” Its purpose is to inspect the prostate gland to see if there is any sign of a very prevalent form of cancer in men. The doctor could take your word on its condition, but they always say, "Ahh, I better see for myself!” Trouble is, the prostate is on the inside of the body. And you know what that means. To inspect it, there’s only one way to get to it: The Bad Way. It is never pleasant. Neither is it mandatory, but at my age, it’s not a test that I can in good conscience neglect or weasel out of any more. (Luckily, my AME keeps an ample supply of bullets to bite on in his exam room. I went through three or four this time. I may have lost consciousness. I think I'd rather break my clavicle again.)

So I’ve got my new piece of paper that says I’m good-to-go for another year. No matter where you are in the world, if you were up and about around 9:15 CDT this morning, you probably heard a big contented sigh and wondered where it was coming from. I'll give you a clue: The corner of 9th and Underwood Avenues in Pensacola, Florida, USA.