“You gave us all quite a scare last night.” I gradually became aware that I was in a hospital and Martha was explaining to me that I had had a lapse of consciousness. You will appreciate that the very first thing that came into my mind was concern for my aviation medical certificate.
The hospital had done extensive tests to discover that I indeed did have a brain and there wasn’t much wrong with it. I was assured I had no long-term health issues. On the other hand, it soon became clear that concern for my aviation medical certificate was certainly warranted. And as with nearly every pilot, my aviation medical and flying are a very big deal to me.
I am particularly fortunate. If I were to I lose my medical, I could still fly with Martha. It just means that for our long-distance flying we would need to trade our old Falcon 10 for a lower-performance airplane that doesn’t require two pilots. But still, that would be a great loss to us. For the last 30 years we have been flying as a two-pilot crew in airplanes for which two pilots are required. On every leg we trade seats, and captain and copilot responsibilities. We get profound satisfaction from practicing the art of crew coordination.
What was now putting our precious flying as a crew in jeopardy was the fact that while getting out of bed in the middle of the night to go to the bathroom, I had passed out. The FAA understandably takes a very dim view of any loss of consciousness.
It was off to Rochester, Minnesota, and the Mayo Clinic. The neurologists at Mayo diagnosed my event as a seizure. Next we were directed to the Mayo Clinic in Scottsdale, Arizona, where there is a world-class specialist in seizures. After multiple tests, his conclusion was that my singular seizure was provoked by a number of circumstances, including excessive coffee consumption, medications I was taking and a prostate infection. He determined I was no more likely to have another seizure than the general public.
With that good news, I submitted myself for my aviation medical exam. Because of my report of the seizure, my medical examiner couldn’t issue my medical certificate directly. He instead was required to defer to the Medical Certification Division at Oklahoma City. Not long afterward he learned, much to my surprise, that the FAA in Oklahoma City was going to deny my medical. As many pilots had before me, I had begun my long odyssey through the FAA’s medical certification maze.
I could no longer act as a required crewmember. Martha had to recruit and train other copilots. I was riding in the back and practicing a very difficult new skill — keeping my mouth shut and not giving unsolicited advice to the flight crew.
I then went to another neurologist who specializes in aviation neurological cases. After examining me, this neurologist likewise stated that I do not pose a risk to aviation safety and that he would “recommend medical certification at this time.” He also suggested in his report that I would be willing to accept a “with or as a copilot” restriction.
Next I made a written request to the Medical Certification Division. I asked that with this more recent supporting neurological evaluation, if they were still unable to issue my certificate, they send my case for review by the Federal Air Surgeon. After four and a half months I received a letter from the Federal Air Surgeon saying that I was “ineligible for medical certification … ” To make matters worse, the letter from the Federal Air Surgeon threw additional obstacles in my path to recertification. There were new reporting requirements dealing with things it would be hard to imagine could have an impact on the safety of flight — such as a report on my urinary tract inflammation.
We decided we needed legal help. We selected Kathy Yodice, an attorney from Frederick, Maryland, who specializes in medical certification cases. Kathy has great experience and obvious expertise at this. She first filed a petition for review by the National Transportation Safety Board. Soon thereafter she requested an informal meeting with the FAA in Washington, D.C. There I made a heartfelt request that the FAA consider a risk mitigation strategy in which I be issued a medical certificate with a restriction that it be valid only with another qualified crewmember.
We thought we had made progress with the FAA because soon afterward they requested a new set of tests from me. Most applicants actually give up at this point. Multiple tests require multiple trips to medical facilities and considerable expenses, which many people can’t afford. But I was hopeful the tests would resolve my situation and I was more than willing to do them. A little over two and a half months later I was deeply disappointed to receive my second letter of denial from the Federal Air Surgeon. It was frustrating. I had two neurologists who had examined me, and both had said I was no more likely to have a problem than the general public, while FAA physicians who had never examined me were denying my medical.
At that time I sent a letter to the FAA Associate Administrator for Safety asking that the four core values developed by the Flight Standards division of the FAA be employed by the medical certification folks:
- Create a just culture.
- When reaching a hurdle, try to find ways to get to "yes."
- Conduct risk-based decision making.
- Treat people as individuals.
In a system based on self-reporting and voluntary compliance, these core values are critically important because they support the element of trust. When you are making yourself vulnerable with your flying future, you are placing tremendous power over yourself into the FAA’s hands. For this system to work, pilots need to feel that the FAA respects you, has your interest at heart, is predictable and plays by fair rules.
Less than a month after I sent the email to the Associate Administrator, I received my medical certificate.
Of course, I am thrilled. But my fondest hope is that this represents an embracing of those core values. And that my case represents an example of using innovation to find ways to get to “yes.” This was new territory for the FAA. I am told a restriction requiring a second pilot for a third-class medical or for a neurological issue has never been done before.
The FAA is working hard to improve the percentage of pilots who get their certificates directly from the Aviation Medical Examiner (AME). They hope it will get even better as they continue to implement an expanded list of what the AME can issue through what they call the “Conditions AMEs Can Issue” (CACI) program. The FAA medical folks are measuring their success by the improving number of pilots they are able to return to the skies with a medical certificate.
I am certainly thrilled to be one of their success stories!
