Pilotage

With a fresh second-class medical certificate in my pocket, I feel like I've just signed a lease for another year of life. The relief is exhilarating. Suddenly gone are the tensions, built up for weeks before the fateful exam. My blood pressure — in the drug store — is 30 points lower than it was an hour before in the examination room.

The annual (for me) ordeal is not a function of my age; it was ever thus. As a young, borderline hypochondriac, it just seemed to make good sense to be frightened of the flight physical; after all, my career was on the line each time. Now, well into my 50s, I have better reasons for being in touch with my mortality, but, of course, the fear remains.

There are some very good reasons for putting us pilots through this trial each six, 12, or 24 months, aren't there?

Let me try to tote them up on my cocktail napkin.

I guess the main reason would be public safety. An airline passenger surrenders his welfare to a crew and has the rightful expectation of mental and physical fitness in the cockpit. Fine, that explains the first-class medical certificate, but what about the second and third classes? Is there some reason why the air-taxi or sightseeing pilot is held to a lesser physical standard? Is a passenger among nine somehow less significant than one among 90?

If logic prevailed, one might argue the other way, that the single pilot of a Beech 18 full of skydivers needs more medical scrutiny than a 747 captain hauling parcels with a fully qualified first officer at his side. The loaded Beech is (on instruments, at least) physically and mentally more challenging, and the pilot usually has no backup.

I make no case here for requiring first-class physicals each six months for the Beech 18 driver. Rather, I would lighten up on the 747 jocks, letting a single class of medical certificate cover all flying for hire. And while I was at it, I'd look long and hard at doing away with the third class altogether (at least for VFR pilots), substituting the signed statement that is now made by a glider-rating seeker: "I have no known physical defect which makes me unable to pilot a glider or free balloon."

The above statement puts the responsibility for medical certification in the hands of the pilot. His airman certificate is made invalid whenever he develops a dangerous or impeding disorder, which, of course, is precisely the same as for the holder of a first-, second-, or third-class certificate in a like situation.

A check of FAA and National Transportation Safety Board records — to try to determine if the public is better served by one system or the other — is difficult, because records are not kept on gliders in the form of accidents per 100,000 hours flown as they are for piston-powered aircraft. For one thing, there are too few glider crashes to build a statistical model (12 fatals in 1988), but if one divides the number of deaths into the number of aircraft on the FAA registry in each case, the answers are about the same: .002 deaths per aircraft per year for piston- powered aircraft and for gliders.

Who is best qualified to judge one's health? Ordinarily, we see a doctor when we're feeling bad. He questions, touches, and tests and usually comes up with a diagnosis and a palliative, if not a cure. He's good at that, but like the rest of us, he doesn't have much of a track record in predicting the future. He can only use statistics taken from large groups, which mean nothing to individuals. Lots of folks with moderately elevated blood pressure or cholesterol levels, for instance, outlive their families and friends. Others, with perfect vital signs, pronounced fit at a checkup, fold up dead in the parking lot.

Medicine is not a science, but an art. The inexactness of health testing makes it seem that much more crude and cruel for the FAA to increasingly tie the hands of individual aviation medical examiners, in favor of decisions made by faceless M.D. bureaucrats in Oklahoma City.

A friend, a robustly healthy gent in his 70s, a commercial-rated pilot who flew 1,000 hours in World War II, still likes to fly an hour or so of solo aerobatics each week. He also plays regular, vigorous tennis. A few years ago, he elected to have a leaky heart valve replaced (he'd never had a heart attack). Cleared for full activity, including flying, by his cardiologists, he's nevertheless been forced by the FAA to undergo extensive, expensive, invasive, and dangerous testing each six months just to maintain a third-class medical. After five years of that and though he remains healthy, the Feds have now revoked his certificate. He'll soon take his commercial glider flight test, signing the statement of health with a clear conscience.

It's reasonable and prudent to hold professional pilots to a higher physical standard than the public at large, but how much higher? The percentage of accidents attributable to pilot impairment by booze and drugs is tiny; accidents caused by medical impairments are vanishingly few. Should we be tested more often or more thoroughly than a bus driver who — with sudden incapacitation — can take 50 lives in an eye blink? How often are lives lost when a pilot fails to discern red from green or misses a clearance that was whispered from a distance of 20 feet?

We professional pilots need to be tested to determine our continued fitness for work, and the more complex flying needs the most testing. Part of that must be done by a physician to assess our ability to handle the stresses of our jobs, imposed mainly these days by long hours and weather. But I would argue that private VFR flying is — for the most part — stressless, especially when compared to driving in freeway traffic where participants are so stressed that they cut off, flip off, and even bump off each other, and for which no medical is required.