By Jeff Mullin
Just as aircraft mechanics at Vance Air Force Base work to keep the base’s training jets in top-notch condition, so the flight surgeons of the 71st Medical Group strive to keep the pilots in the best shape possible.
The flight surgeons’ duties involve everything from annual physicals and routine preventive measures to acute care.
The 71st Medical Group has three flight surgeons, one nurse in flight medicine and five technicians.
On a typical day, Vance’s flight surgeons see between 15 and 30 patients apiece.
Many of those are what are called return to flying status appointments. Many conditions, including common colds, can keep pilots from flying, and clearing up those acute problems and getting the pilots back in the air is a high priority.
“They have to be checked out again by a flight surgeon before they can go back to fly,” said Maj. Stacey Branch, chief of aerospace medicine at Vance.
It doesn’t take much to keep a pilot off flying status. Nasal congestion is enough to ground a pilot.
“Anything that would affect their ability to clear their ears while flying,” said Branch. “And stomach illnesses. If you’re not eating and you’re too sick to sleep well, we can’t let you fly.”
These are conditions that will only keep a pilot out of the air for a short time. Once the ailment clears up and they are cleared by the flight surgeon, pilots can return to flying status. But other conditions require more extensive treatment, such as elevated cholesterol levels beyond Air Force limits for fliers.
“We can treat you with a statin, determine that you don’t have any side effects from that particular medication, that your cholesterol levels are going to return to normal, and then we would submit kind of a history,” said Branch. “Then you’ll be approved to be returned to flying status.”
Some conditions, however, can result in permanent grounding. Those would involve anything that would render a pilot unable to safely perform flying duties. Such conditions can range from seizure causing disorders and anything causing vertigo to orthopedic conditions.
“That’s because the Air Force has determined that it’s not safe for you to fly in an aircraft,” said Branch.
Dealing with such conditions often is the toughest part of a flight surgeon’s job.
“The most difficult part of my job, and fortunately I’ve only had to do it once, was to diagnose an experienced flier with a debilitating illness that was going to permanently remove him from flying status,” said Branch. “That’s the worst part of the job.”
Students occasionally are disqualified from flying because of their medical conditions. Breaking the news to them often is not easy, either.
“The ones that are hard to deal with are the ones who have had their hearts set from the time they were just a little grasshopper to be a flier in the military, and they have never considered Plan B,” said Branch. “Then when you have to tell them they don’t meet the physical standards to fly in the Air Force, it’s like their entire world crumbles because they haven’t thought about what they would do if they didn’t fly.”
Since flight surgeons can determine whether or not a pilot can fly, a visit to the flight doc is not at the top of most pilots’ “fun things to do” list.
“Flight surgeons are also afraid to see other flight surgeons,” said Branch. “Because we, as rated fliers, run the same risk that the other fliers do, in terms of finding something that doesn’t meet medical standards for flying anymore. We try to convince them we’re not scary.”
Every student pilot is required to take an extensive flying class 1 physical before they enter the program. All Air Force pilots must take an annual flying class 2 physical, which is not quite as intense.
“We’re not trying to find anything wrong with them,” said Branch. “The idea is to make sure they are still healthy, so we do a head to toe physical exam on them. Every five years we’ll do a cholesterol check on them. We’ll do a more extensive exam if they have a particular complaint.”
“We all get annual physicals,” said Capt. Lisa Stolzer, flight nurse and element leader for primary care, “but the flier physicals are a bit more extensive than the regular active duty, because of the requirements for flying in a plane.”
All active duty pilots who have been transferred to a new base must pass muster with that base’s flight surgeons before being able to fly at that facility.
“They still have to get another clearance from the flight doc from each base,” said Stolzer.
“That mainly entails going back into their medical records,” said Branch.
Flight surgeons see many instances of motion sickness, said Branch, particularly when a new class takes to the flight line.
“Usually when we have a new class starting, we’ll have one a day or so,” she said. “But most of them eventually get over it. Usually they’re not too green (from nausea) when they get to us, meaning they’ve gotten over the acute sickness, but we still have to counsel them.”
Flight surgeons brief pilots on how to deal with airsickness, like increasing the oxygen levels in their masks to 100 percent.
“Most of what we do talk about is nutrition, adequate sleep, proper hydration,” said Branch. “With of some of them we do have to talk about anxiety, because once they’ve gotten airsick, some of them will start expecting to get airsick when they do the same maneuvers.”
