The opinions expressed are based on my own experiences and on “fly on the wall” observations. These experiences come from a background as both a medical doctor and as an airline pilot and have therefore provided a rather unique perspective.
Not only have I had to deliberate on a great many pilots’ fitness to fly, but I have also had the privilege to share a great deal of time with some of them, both on and outside of the flight deck.
“One’s good health is not infinite.”
One observation that has become very apparent to me is that being of sufficient medical health in order to be trusted with the controls of an aircraft, especially in the capacity of commercial operations, is a tremendous privilege. Pilots who are able to have all the regulatory boxes ticked off the bat are also very lucky! Most of all, one’s health is not infinite and it must be protected for as long as possible.
I often tell my pilots that being a pilot is not that different from being a professional athlete. Albeit a professional athlete with, hopefully, a really long career ahead of them! If your body develops a problem, your career may very well be in jeopardy. Genetics and occasional pure bad luck plays its part of course, but for the most part our daily lifestyle will arguably, play the greatest role in our longevity.
“Your health and senses are best in your early twenties”
The majority of pilots will start their careers at a young age. I feel that this sometimes makes it easy to miss how stringent the aviation medical standards really are. There is a world’s difference between doing an initial flight medical examination on a twenty year old versus doing one on a forty year old. Despite what the law may say about when you are fully grown up, you are in fact still very much in a state of development until you are into your early twenties. Your metabolism is at its peak and your senses will never be better. Your brain only finally reaches full development around the age of 25.
After this, as we know, the slippery slope of ageing takes its gradual toll on our vitality. Certain metrics will invariably demonstrate this throughout a pilot’s career. Blood pressure will slowly creep up, vision and hearing will change, muscle mass will decrease, metabolic markers will change and so on. This is not to be lamented. It is being part of the circle of life. What is important is to realise that we can greatly influence the rate of these changes by means of our lifestyle habits. The earlier we do this, the better.
Good lifestyle habits
So what are these habits? Firstly, you need to do at least some exercise. After all, doing no exercise is of no good for a professional athlete. Does that mean you need to hit the gym like the next guy to play in a superhero movie? Of course not.
I recommend finding a daily ‘cardio’ exercise routine that fits in with your interests, schedule and physical ability. This routine must, at a minimum, double your resting heart rate for thirty minutes a day. Walking to and from the airport car park doesn’t count! Aim to do your routine daily so that if you miss a few days you will still be doing your bit. Stress is a bad side-effect of our modern lifestyles and can be relieved with great effect by exercise.
Stress does not just exist within your head and mind. It is an actual physiological process that has a long-term detrimental effect on your body on a cellular level. It is important to be mindful of the fact that stress must be managed.
Another great burden on aviation medical fitness comes from the intake of nicotine when smoking tobacco and vaping products. Never mind the eventual risk of cancer, heart disease, stroke, emphysema or the multitude of other horrible diseases that smoking accelerates, or the indirect effect on productivity on the flight deck and the inevitable financial burden of addiction.
Part of the nervous system and muscles in your body have these essential bits called nicotinic acetylcholine receptors. Your body needs them to function correctly.
Nicotine attaches itself to these receptors. It messes with the body’s ability to work correctly. It raises blood pressure and stiffens arteries.
I personally don’t mind if people choose to smoke as I am the first to admit that we must remain free to make our own decisions as adults. In fact, the health care system probably gets a sizeable chunk of income from those that smoke! However, pilots that smoke give me great cause for concern, as I see this habit as a demonstration of ignorance at best, and at worst, a wilful disregard for their own health This certainly is a bit of a poor show for an athlete!
My first message to pilots, of more to come, is that being declared medically ‘fit to fly’ starts at home with a good level of general fitness and a healthy lifestyle.