Chapter 7:  Psychiatric Illness in Pilots


A flight attendant visiting the cockpit for a mid-air visit and a breath of fresh air, or to obtain permission to bring up passengers, or to inquire, “How much longer?” will immediately pick up on the flight deck atmosphere. If the captain is a well-balanced, happy-go-lucky type, heads will turn to see who has entered, and the reception will be cordial. If, however, “the boys” are not enjoying each other’s company, their bodies will remain motionless, and eyes will stay fixed on the nothingness ahead in space. The response to any request will be a bovine grunt quickly translated by the flight attendant as, “Don’t bother us.” The all-pervasive tension will inspire a fast retreat to inform the rest of the cabin crew, “Don’t bother to go up. The captain is an ass.” In his exalted position, he sets the tone, and his psychological characteristics rule the cockpit.

Usually, aviators get along with each other just fine. After all, they are mostly boys playing with their favorite toy, an aircraft. And when the plane is humming away on auto pilot, the flight deck becomes a locker room, a place where tall tales and gossip help maintain alertness during the hours of sheer boredom that are only rarely interrupted by some unforeseen incident that jolts the nervous system and sends the adrenaline soaring. How are pilots, individuals capable of changing within split seconds from a vegetative state to high alert, chosen by the airlines? And how are their psychological characteristics, tendencies, and aptitude for the job measured before and during their employment with a commercial carrier or the military?

When selecting airline pilots, commercial carriers search, more or less, for air “bus drivers,” while the military establishment looks for highly gifted and brilliant “race car drivers.”1 Psychologists, who design tests for the selection of pilots, want potential aviators in both categories to be stable introverts. This will ensure that rookie pilots will sweat over manuals, rather than spend time in local watering holes, and that they’ll pass training with flying colors. Fledgling pilots are then expected to emerge from their cocoons of studiousness and become stable, extroverted butterflies. In other words, the ideal pilot is the strong, silent type who is capable of occasional flashes of congeniality and intelligence. After all, pilots are known to fly “by the seats of the pants” and not by intellect.

Aptitude and motivation are perceived as much more important than IQ for a successful aviator career. Because intelligence, however, to some extent seems to positively influence adaptation to novel situations and the ability to cope with the deleterious effects of stress, some brain activity is an asset.2 The fact that commercial aviation pilots rarely pursue intellectual activities beyond the field of aviation is inconsequential, when we consider that their job description demands that they are not only capable of coping adequately with the responsibility for a multi-million dollar machine and innumerable lives, but that they maintain their equilibrium under adverse conditions.


Pilots’ Health

Because of the high stress inherent in aviators’ professional lives—stress which in uniformed personnel is second only to that of police officers—and because of physical problems created by altitude, speed, and motion, the standards for the physical health of pilots have been set by the International Civil Aviation Organization (ICAO). Practically every country in the world abides by those standards. In addition, pilots must meet physical health standards promulgated by government agencies responsible for issuing licenses to cockpit personnel.3 Pilot’s mental health, however, is not governed by anyone other than an individual carrier’s medical department.

It was estimated in the mid-70s that, of the more than 600 fatal aircraft accidents each year occurring in the U.S., 80 to 90% were caused by biomedical factors, including the use of drugs and alcohol which pilots may have taken to cope with stress, anxiety, or frustration on-board aircraft.4 One could assume that these facts would have encouraged carriers to investigate pilots’ long-term physical and psychological reactions to their work environment, but the lack of empirical data suggests otherwise.

In 1973, the latest data publicly available, only five airlines in the U.S. had full-time, in- house, medical departments staffed by personnel presumably familiar with aspects of aviation medicine. And each of these facilities, which were instrumental in the selection and supervision of flying personnel, had varying standards and rules for hiring pilots and for determining their inability to control aircraft during their piloting careers. Furthermore, whereas a pilot’s pre-employment physical examination might have been thorough, his or her psychiatric evaluation appears to be limited to short interviews, or superficial summaries of the results of a series of psychological tests, or entirely omitted.5

The renowned American psychologist Joy P. Guilford insists that, to make valid statements concerning an individual’s present and short-term health status, at least as much time should be spent on examining the psyche as is spent on evaluating the physical body. Airlines’ medical departments seem to differ with this view. Whereas pilots’ mandatory, and often trimestral physiological examination during their careers may be thorough, their mental health status is generally ignored under the pretense that the classification “suitable and fit for flying” had to have been established prior to flight training.6 Consequently, we can infer that in the view of these medical departments, a pilot’s psyche is reduced to a self-regulated, low-maintenance computer inessential to the individual’s overall well-being.

Whereas anxiety disorders, cardiovascular diseases, and sudden heart attacks in previously healthy and well-functioning earthbound individuals are often stress-related regardless of their profession, such ailments in professional aircrew are believed to be directly linked to the job. Incapacitating or distracting physiological phenomena may have psychological origins and be the underlying cause for many obscure crashes.7 Therefore, many aircrew health problems, projected by industry and governments to be of purely operational or physiological origin are, in fact, related to flying.8

In the mid-60s, after United Airlines’ Medical Department in Denver established a daily relationship with their flight training and flight operations department, they discovered within a five year span that ten of their pilots suffered psychiatric disorders, three had cerebral-cortical atrophy, two had brain tumors, and ten had hypoglycemia. Fourteen out of twenty of those aviators were thought to have operational or proficiency difficulties, because, initially, no medical issues were suspected. All of them constituted potentially serious accident hazards, and seven were in the process of being terminated as incompetent pilots.9

Again, one might reasonably assume that these results would have alerted carriers to take an interest in aircrews’ psychological and physical health. But the airlines have more than enough reasons not to, because it saves them millions annually to ignore the fact that cruising the skies for a living can have severe physical and psychological repercussions. However, when a carrier’s medical staff finds it impossible to ignore an individual’s psychological deficiencies, the medical staff is empowered to ground the aircrew member. For pilots, that means loss of license and, if grounded permanently, loss of livelihood.

How often do pilots get grounded because of psychiatric illnesses? A 1980 study in the U.K. revealed that 21.4% pilots lost their license because of psychiatric disorders, including alcoholism, and 39.8% because of cardiovascular diseases. According to British aircrew license insurance files, psychiatric disorders rank second only to cardiovascular disease as a reason for permanent grounding.10 Though no exact figures were given from the insurance files, Dr. Kornelis Vaandranger, KLM’s Chief Medical Officer in 1972, asserts that pilots known to have cardiovascular abnormalities such as hypertension or episodes of substernal discomfort, for which medication is being administered, are often permitted to continue their career. 11 The incidence of psychiatric illness in female aviators is unknown, except for a six year period (1976–82), following the U.S. Air Force’ initiation of female pilot training, during which seventeen women were referred to psychiatric evaluation out of a total of 2701. Of those seventeen, 53% returned to flying duty, compared to 64% of their male counterparts.12

In 1975, forced to consider that psychiatric disorders produce impaired performance in such vital components of flying as concentration, judgment, and attention, the industry had to heed appeals to monitor aviators’ psychological well-being. European aviation medicine health professionals had discovered that the number of pilots they examined demonstrating symptoms of flying fear and of being psychologically conspicuous had more than doubled within a five year period. Therefore, the aviation medicine specialists alerted the airlines and encouraged them to monitor aviator’s psychological well-being.13 But most airlines (if any) paid no heed because it is infinitely cheaper for them to haul disintegrating flyers into the office when at the cracking point and push them for early retirement, or depending on their seniority, fire them. If a pilot’s psychological disequilibrium causes a crash, who cares? It’ll just be broadcast as yet another “human error” accident.14

Such a calamity was narrowly avoided on January 17, 1995, shortly after the earth ceased to shake in and around Kobe, Japan, which had begun at 5:46 A.M. local time, killing 5000 people. Severe tremors were felt in Osaka, jolting a laying-over NorAm crew into an abrupt awakening—or interrupting the nail painting, soak in the bathtub, umpteenth trip to the bathroom, crossword puzzle, TV viewing, reading, knitting, needle pointing, studying, eating, or whatever else crew members do when coping with drastic time changes After the initial shocks subsided, the earthquake-seasoned Mexican purser and some Japanese flight attendants ascertained that their shaken crew members were physically intact, and then ventured to help wherever they could during the more than twelve hours remaining before flight departure at 1900 hours. The others huddled together, scared out of their wits, as threats of further major quakes loomed too alarmingly for comfort and relaxation. Aftershocks persistently throbbed throughout the region during the day, and exhausted the crew members’ inner resources. When midday approached, the captain requested that flight operations send out relief pilots. They refused. No eyes closed before departure time.

Crossing the Pacific, prohibited from snoozing on duty, the aircraft’s approach and landing in Vancouver the following morning at approximately 10 A.M. was uneventful. Cabin crew proceeded to the solace of their homes to recuperate from the earth shattering experience. The pilots, meanwhile, laid over at a downtown hotel, then worked to their Toronto base the following morning, where they eventually drove to their respective residences by mid-afternoon.

The captain briefly shared his earthquake adventure with his wife, showered, dove into civvies, and they both went to their son’s birthday party. Minutes after their arrival, he collapsed with a massive heart attack. He was three months short of mandatory retirement at age sixty. If he had suffered the heart attack during the approach into either Vancouver or Toronto and a crash resulted, would the blame have been laid squarely upon his unblemished shoulders by calling it “human error?”15 And had the heart attack occurred at the steering wheel while on his way home from the airport, to what would it have been ascribed if he had accidentally killed a few people?

The captain survived, but would never be able to control an aircraft again. Even if he had been fifty years of age, his health was ruined forever simply because the carrier failed to acknowledge the severe psychological trauma of the earthquake on his psyche. One shudders when thinking about the compounded psychological affects on these pilots and flight attendants had they faced an aircraft emergency during the approach into Vancouver that same day.

Psychiatric disturbances such as depression and anxiety in private pilots are commonly attributed to business and personal stressors. In professional aircrew, however, they are believed to be mainly caused by flying, where the inherent stresses involved virtually ascertain that a significant number of pilots continue to control aircraft while suffering psychiatric instability to a greater or lesser degree.16 Mental health professionals assert, however, that it is difficult to define the boundaries between psychiatric ailments and normality in aircrew, because the profession tends to attract eccentrics.17

Doubtlessly, all humans cross the border between “normality” and eccentricity occasionally but, perhaps, aircrew does so more frequently than earthbound folks. After all, much of our lives is spent flying and figuratively speaking we live in “the twilight zone,” a state induced by the nature of our job and rapid time zone changes. Skinny dipping off Honolulu’s Ala Moana Beach at 3:00 A.M. on star-studded nights became one of our trends for a while, driving police to distraction. We’ve also been known to launch happy hours at swimming pools around the world, while other hotel guests were having breakfast. What both mental health professionals and the general public view as unconventional, eccentric, or downright lunatic behavior when observing or hearing about some of our jet-lagged antics, we simply call enjoying ourselves.

One such escapade found us drinking wine out of brown paper bags in front of a very reputable London hotel around 9:00 A.M. one sunny summer morning. Our unconventional activity so aroused the curiosity of two New York journalists that they approached us, bedazzlement on their faces. After sending the journalists to Marks and Sparks to augment our quaint outing with appropriate beverages, the ten of us promptly took them along to our Hyde Park picnic.

At 4:00 P.M., booze all gone and feeling no pain, the five of us that remained, including the First Officer, stood at the curb at Oxford Circle. While hailing a cab, the cotton scarf which I wore as a bodice slipped to my waist. A taxi came to a screeching halt seconds later, a wildly protesting passenger tumbled out, we happily climbed in, told the driver where to go, and entertained him with exotically truthful tales throughout the journey. Generously tipped upon arrival at the hotel, we also rewarded him with our classy picnic utensils. The First Officer, wanting to sober up before happy hour, fell asleep in the tub while running his cold bath, flooding seven floors beneath. The hotel, used to aircrew antics, bore the event with fortitude.

To eliminate any risk of boredom while spending time away from home in the line of duty, aircrews carry along gym gear and, if a layover is long enough, they undertake excursions by plane, bus, train, or boat on the spur of the moment. If the mundaneness of earthly life drags down the spirit during a longer stretch at home, the possibility of curing the malady by hopping on a plane is always there. And if in doubt as to where to go for a change of scenery, there’s always the “Paris quickie” for a champagne and Crepe Suzette luncheon for those based on the East Coast, or popping over to Hawaii for the West Coasters. And—according to our yard stick—these activities are all so perfectly normal.

Extremely free spirits, unbound by distances and locations, we are exotic, colorful and unusual, perceiving the entire globe, not our place of birth or domicile, as a playground created for our pleasure. We’re at home wherever the wind blows us—willing and able to entertain ourselves anywhere, any time, and with an unbounded curiosity about our surroundings and it’s inhabitants. Wherever we go, be it for a few hours or days, we live life the way it is meant to be—with fun, enjoyment, and with kindness to our fellow humans. Adding rays of sunshine and rainbow colors to the world, we have given many a soul good reason to burst out laughing about our “overt and unusual behavior” when off duty—and sometimes even when on duty. Naturally, our psyche gives the mental health profession cause to wonder. We do not fit in their molds, nor into anyone else’s. If that earns us the reputation for eccentricity, so be it. Within our souls we know that we are the epitome of normality. This perception we doubtlessly share with the Wright brothers of Kitty Hawk, Charles Lindbergh, and Amelia Earhart.

Because aircrew are aware of the perception of “oddity” they inspire in the earthbound population, 442 British commercial airline pilots participating in the most recent study on stress in aviators (published in 1986) most likely did what they are accused of when asked about their mental health and smoking and drinking habits—downrated and modified their answers.18 However, despite the boys’ efforts, the researchers still judged 28% of them as mentally handicapped, a percentage greater than that expected in a male industrial population. After the researchers developed a cut-off point by dividing pilots considered “normal,” but at the upper end of the average distribution, from those that were clinically “ill,” just over 12% of pilots showed mental health scores above that point. And 2.2% had scores higher than those expected in psychiatric outpatients. Of course, those participating in the survey had all passed their mandatory airline check ups in recent months with flying colors.

Puzzled almost beyond belief, and looking for explanations, the researchers discovered that pilots with difficulties relaxing and winding down, and those avoiding stress level reduction by socializing with colleagues and friends, generally reported higher ill-health scores than those demonstrating proficiency with our forte—to mix and mingle. Socializing with our own is one of the most cherished and perfected activities of the flyers’ trade, and many of our innermost secrets are shared with peers on such occasions. Often we know each other’s life stories more intimately than do our closest and dearest family members. Unless in severe physical discomfort, nothing will stop us from seeking each other’s company during layovers, and anyone crying the blues—despairing loneliness—does so of their own volition. A perpetually anti-social crew member is viewed as a very sick puppy.

One of our captains exhibited such a personality, causing everyone flying with him to moan and groan. His reputation as a pilot was excellent, but he ran his domain with an iron fist—no locker room talk or laughter on his flight deck. Cabin crew shunned the cockpit, passenger visits were prohibited, and long haul journeys turned into an eternity for co-pilots, while the commander cherished his solitude in a crowd of three. He was never seen in England’s pubs or Germany’s Weinstuben, routes he preferred to fly, and no one missed him. His unflattering reputation was further enhanced when it simmered through the grapevine that the barking of his neighbor’s German shepherd had driven him into such a frenzy that he shot and killed the beast. Henceforth, he became known as “Mad-dog McCarthy.”

Thus, he startled me, as I dined in splendid solitude, when he stopped at my well-hidden table in the farthest corner of our hotel’s Weinstube, where I was studying for a mid- term exam. He was eager to engage me in conversation. Because it was almost midnight—but far too early to retire—I, out of politeness and expecting no for an answer, invited him to join me. He sat down.

At closing time, and a few beers later, we shifted to the lobby to watch people meander to and fro as we talked some more. I became the commander’s father confessor throughout the evening. Our presence there was not unusual, for more than 250 crew members from around the world laid over at this hotel, providing around the clock entertainment in the reception area. By the time we bid each other good night in the lobby at 3:00 A.M., my perception of the skipper considerably changed, none of our crew had rolled in. The nearby disco closed at 5:00 A.M., almost within the mandatory twelve hour “bottle-to- throttle” rule. Our departure time was set at 16:00 hours.

From that evening onward, I made it a point to visit the flight deck whenever McCarthy was in command, and he always made me feel welcome. However, he continued to cherish his solitude on layovers, and we had no further private conversations. But one September McCarthy flew us into Frankfurt and we, on our way to the hotel, discovered that the Wine Festival, the carousels, the beer tents, the um-pah-pa, awaited our enjoyment. The layover’s shortness did not deter anyone from diving into civvies and participating in the festivities for as long as our feet could carry us—except for McCarthy that is. Since time doesn’t count when having fun, some of us rolled in very, very late.

A few hours later, one of the revelers climbed on the crew bus taking us to the airport looking like death warmed over. Once aboard the aircraft, we forced her to eat a dry bun, which only made her sicker. The tea we imposed upon her as a health remedy sent her to the washroom with lightning speed. A heart-wrenching and sorrowful sight to behold during takeoff, she required but one resolution to ease her misery. Into the cockpit I went, and with unheard of formality, inquired, “Captain, one of our flight attendants is really ill. Would you mind if she came up to get some oxygen? She’s useless to us.”

Turning around inquisitively, and looking at me with sparkling eyes, he asked, “This wouldn’t have anything to do with the Wein Festival, would it, Tanya?”

“No, not to my knowledge, sir,” I replied, a smirky little grin on my face, knowing full well he knew the truth, but preferred not to hear it because of rules and regulations.

“Send her up, then,” he responded, turning back to his instruments.

Marianne, too incapacitated to protest about spending time in Mad-dog McCarthy’s company, fell asleep in the cockpit while imbibing copious amounts of bottled oxygen. She alighted in the back five hours later, as fresh and energetic as a healthy newborn. Meanwhile, the rest of us were fading fast.

“How did you do it?” she asked me.

“Oh, no big deal. He’s been there too, I guess,” I responded nonchalantly, but overjoyed within my soul. McCarthy had a heart, as I had expected all along. And whereas McCarthy’s earthly stressors did not affect his piloting skills, it appears to have been a different story for a Japanese Boeing 747 captain who, in the mid-80s, told his co-pilots of his dismal marriage minutes before the aircraft hit Mount Fujiyama.

In order to detect any form of psychiatric disturbance, some aviation medical professionals suggest openly questioning pilots during their mandatory check ups about whether they suffer from anxiety, irritability, depression, headache, impaired concentration, or insomnia, and if they abuse alcohol.19 This suggestion is ludicrous, because the chances of receiving honest answers from the boys to such a line of questioning are infinitesimal. It’s just too unbecoming for the strong, silent, macho ones to confess fragile mental health. Drinking is a different matter, and must always be admitted to, because it is well-known that liquor, the only drug officially sanctioned by commercial airlines, is as much part of aircrew existence as is milk to babies. It helps many of us to simmer down after performing our duties—for most often—extremely long hours.

Furthermore, research also suggests that, if company physicians suspect that a pilot is psychologically unstable, observations made about his behavior—as well as observations relayed by family, colleagues, and the employer—should be carefully analyzed.20 That suggestion is not only a trifle naive, but also rather difficult to carry out. The wife or significant other, already knowing she has an oddball on her hands, will hesitate to jeopardize her harmonious relationship and monetarily lucrative lifestyle by reporting his occasionally bizarre demeanor to the airline. His colleagues will decline to pass judgment on possibly overt behavior, or repeat drunkenness, knowing full well they themselves might go over the brink if the proverbial substance hits the fan once too often. And the employer doesn’t have a clue, because he is seldom present when exotic and eccentric behavior (as measured by earthly norms) takes place. Unless there’s a check-pilot around. (Check-pilots are pilots, in management positions, who conduct occasional line checks, meaning they check out a pilot while he or she is actively flying an aircraft rather than a simulator.) And if that’s the case, the entire crew is forewarned and behaves accordingly.

The only way carriers could detect something amiss with a pilot is through an increase in his or her book offs, but book offs can be due to a trillion reasons other than psychological fragility. That leaves check-performances in the simulator to detect a potential mental health issue. In the simulator testing, pilots are subjected to a wide range of potential mid-air crises, and it is widely believed that mental ill-health and intellectual deterioration are interconnected. There is a flaw in this reasoning as well, for simulator- check dates are known to pilots for months in advance, and therefore allow the pilot advance physical and mental preparations—such as laying off the booze a couple of weeks before the tests.

Perhaps the airlines should supervise pilots’ psychological states according to their age, since seniority apparently enhances aviators’ chances of developing psychiatric disturbances. Whereas in younger ones, ill mental health is purportedly caused by unspecified factors unrelated to aviation—only lack of money springs to my mind—the most common precipitating factor in middle-aged pilots is said to be domestic stress arising out of the way of life and frequent absences from home in the company of young females.21 This sounds utterly absurd, because by then a pilot’s lifestyle ought to be familiar to his wife (if he’s still married to his first spouse), and his colleagues have changed little since the beginning of his commercial piloting career. If it’s his second wife, she’s probably a flight attendant, and is thus unfazed by his way of life.

A transition to a new type of aircraft is reported to be another factor teasing that age groups’ psychiatric equilibrium, because, apparently, change challenges pilots’ rigid thinking. 22 If aircrew were, they would perpetually be in colossal turmoil. The “new- type-of-aircraft” theory, however, has more validity than one might wish to acknowledge, especially when “need-to-know” training methods forces the boys to command aircraft without knowing intrinsically how the machines work. Surely that method is a far greater threat to pilots’ psychiatric stability than marital squabbles.

Real or imaginary signs and symptoms of declining performance associated with the natural aging process are also assumed to distress middle-aged aviators’ psyche.23 One could discuss at length what types of performance the no longer golden-locked and rarely trim middle-aged pilot is worried about. But the experts fear that, if he perceives his assets and abilities as fading, then anxiety, depression, and boredom could set in. That, in turn—given the amount of social drinking and easy access to alcohol inherent in the life style—could lead to alcoholism.24 That appears to be pure hogwash.

Pilots are only bored on layovers when they want to be. Alcohol is available everywhere and is an aircrew staple. Drinking is age independent. And alcohol abuse over a series of years can, but not necessarily does, evolve into alcoholism. And, except for the few Alcoholics Anonymous members in our midst, we are very much in control over our liquor intake, have no intention of losing home and heart because of it, and are disinclined to hide our affinity for it as so many earthlings do. Vulnerability to psychiatric disturbances in middle-aged pilots, therefore, has nothing to do with mid-life crisis, but is related to accumulated mid-air stress, augmented by constant threat of potential malfunctioning of super-sophisticated aircraft.

This view seems to be substantiated by the fact that a major reason for psychiatric ailments in pilots of all ages is anxiety caused by a phobic fear of flying which may, insidiously, develop in response to stress and conflict or, more dramatically, in response to a single overwhelming stressor25 such as a near miss, or a potentially disastrous mistake in the flight deck. Aviation medicine experts suggest that, if the recollections of fear following the event are repressed, it can lead to the development of phobic symptoms.26 That most often happens, however, when no peers are available to discuss the incident immediately after it occurred.

Therefore it is the case that pilots worldwide—much more frequently exposed to undesirable events than one wants to know—maintain their equilibrium by sharing mid- air exploits over pitchers of beer during the customary sessions at brewery holes around the globe. It enables them to shake off any creeping phobia and to maintain the sense of invulnerability without which flying becomes an intolerable burden. Mental health professionals and airlines medical officers, unless they themselves are or were commercial pilots, lack the intimate experience of joyfully living with the ever present possibility of mishap and disaster. Hearing or reading about it doesn’t cut it. Only walking in a professional flyer’s moccasins imparts true understanding and the ability to assist when psyches reach the breaking point.


Coping With Stress

How flight crew cope with the insidious stress of flying is said to greatly depend on their home lives, their significant others, and their resting capabilities while in residence and abroad. Of 272 British commercial airline pilots surveyed in the mid-80s—which is the only study available to us—the majority judged their stress and arousal levels to be significantly higher when away from home.27 That does not seem at all surprising when we consider that commercial aircrew on domestic runs work up to six days in a row for up to fourteen hours daily, interrupted only by luxurious ten to twelve hours layovers that are insufficient to allow for abreaction—the chance to gear down and relax even though the brain continues to react to the adrenaline search. It is understandable that the accumulated stress, and consequent adrenaline flow combined with fatigue, prohibits appropriate resting upon collapsing at a hotel. On long hauls, however, the lack of recuperation might be influenced by other factors. If the port of call is exotic, fatigue and jet-lag may be ignored in lieu of explorative activities which, occasionally, deplete the energy resources to a bare minimum. It is for those reasons that rest away from home is perceived as inferior to that in the home, the oasis of tranquillity and quiet, a place to reload the batteries and let the world go by without participating in its movement.

But frequently the aviator’s nomadic existence is perceived as disruptive to residential harmony, because aircrews’ desynchronization with time and their physical and psychological fatigue generates a need for relaxation. This can become hampered if the wife and/or kids impose demands. In fact, aviators’ psyches are said to be burdened and troubled by a number of domestic issues: complying with household timetables; getting out of synchronization with normal home routines; sleep disturbances caused by noisy children; awareness of placing restrictions on other family members while relaxing; getting up too early or retiring too late; and being attracted by social activities that tempt him to cut rest to a minimum for fear of a broken social life.28

Those who maintain the home hearths may have failed to notice that for aircrew sleeping in leaps and bounds, at home and on layovers, is the norm. “Normal domestic routines” are an unknown concept for them, and earthly social activities hold little attraction. But there might be a valid reason for this, because those pilots surveyed limply conceded that they accepted traveling the world as part of the job, but failed, neglected, or chickened out in mentioning that cruising the globe in the line of duty—liberated from earthlings’ humdrum existence—is what they love and cherish just as much as flying itself. It is, however, not impossible that their significant others looked on while aviators completed the survey, thereby forcing pilots to misrepresent their actual sentiments. The desire for unlimited movement across time and space, and a longing for freedom from socio- cultural and industrial norms and boundaries might well have subconsciously propelled us into pursuing a flying career to begin with. Nevertheless, the “Do not disturb” signs swinging from all door knobs should remind co-habitants to tread lightly when an aviator is in residence wanting to do but one thing—relax, vegetate, phase out. And so it goes until retirement.

However, as much as pilots enjoy leaving the home, they seem to be greatly distressed when doing so because of the worries about administrative hassles when they arrive at the Sheratons and Hiltons of the globe. When safely settled in there, the environment feels restrictive and artificial to them, and the normal hotel routines apparently also disrupt their sleep patterns, thus depriving them of their beauty rest and disallowing optimal post- and pre-flight recuperation. Simultaneously, they struggle to adjust to local time. While whiling away the hours in hotel rooms feeling sorry for themselves, perceiving time spent as dead and wasted, their discomfort increases because of separation anxiety from their loved ones, the impotence to act if anything goes wrong in the home, and the events missed while tragically imprisoned on foreign shores. While in ports of call, such stressors to pilots’ tormented psyche, combined with the after-effects of a long and exhaustive flight, encourages them to silently lament their ill-fortune while teetering on the brink of a psychological abyss29

If away from home more often than desired, a pilot’s stress level is said to further increase significantly. Understandably so. Anyone who is where he or she doesn’t want to be is an unhappy trooper. Book offs are designed to avoid such conflicts of interest. But that recourse will only be taken as a last resource, and most likely only if a loved one is in mortal danger, or if the aviator is physically and/or psychologically too fatigued—because of excessively demanding, computer-designed, flight schedules that ignore punishment thresholds for body and psyche—to command aircraft or to cope with the flying public.

When viewed from a psychological perspective, a dismal picture emerges when combining all of the calamities aviators purportedly face when attempting to rest away from home and at home: 20% of them were judged to be at the edge of psychiatric ailment. But, because appropriate normative data for the analyses of flight crew moods’ were, and still are, unavailable, the findings have no statistical significance.30

Be that as it may, aircrew are largely less judgmental, more tolerant, more filled with bonhomie, more understanding, and psychologically better adjusted than many earthbound folk who often drown themselves in mind-altering chemicals or drugs to escape their true personality traits. With aircrew, on the contrary, what you see is what we are. So take your next flight without hesitation. Whoever is in control, is probably just as sane if not more so, than the majority of people on the face of the earth.


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Chapter Seven Notes


1 H.P. Goerres. “Medical Flying Fitness—a Routine Affair—But Who Examines and Assesses Psychic Health?” In: Aviation, Space, and Environmental Medicine. July 1975. See also, R.E. King and C.F. Flynn. “Defining and Measuring the ‘Right Stuff’: Neuropsychiatrically- Enhanced Flight Screening (N-EFS).” In: Aviation, Space, and Environmental Medicine. October 1975.

2 A.W. Black. “Psychiatric Illness in Military Aircrew.” In: Aviation, Space, and Environmental Medicine. July 1983.

3 K. Vaandrager. “Task of a Medical Department in Civil Aviation.” In: Aerospace Medicine. April 1972.

4 R.E. Yanowitch, III. “Medical and Psychiatric Aspects of Accident Investigation.” In: Aviation, Space, and Environmental Medicine. October 1975.

5 C.R. Harper. “Civil Aviation in the Coming Decade.” In: Aerospace Medicine. January 1973. P.A. Santy, et al. “Psychiatric Diagnoses in a Group of Astronaut Applicants.” In: Aviation,

Space, and Environmental Medicine. October 1991.

6 H.P. Goerres. “Medical Flying Fitness—A Routine Affair—But Who Examines and Assesses

Psychic Health.” In: Aviation, Space, and Environmental Medicine. July 1975.

7 V.B. Maxwell, and H.C. Davies, editors. “Psychiatric Disorders as They Relate To Aviation. Introduction to the Second Scientific Session of the Association of Aviation Medical Examiners, Cambridge, England.” In: Aviation, Space, and Environmental Medicine. July 1983. See also, S.P. Baker. “Putting ‘Human Error’ Into Perspective.” In: Aviation, Space, and Environmental Medicine. June 1995. L R Simson, Jr. “Investigation of Fatal Aircraft Accidents: Physiological Incidents.” In: Aerospace Medicine. September 1971.

8 R.J. Ursano, and W.G. Jackson. “The Flight Surgeon and Psychiatry: Interest and Skills.” In: Aviation, Space, and Environmental Medicine. February 1986. H.P. Goerres. “Medical Flying Fitness—a Routine Affair—But Who Examines and Assesses Psychic Health.” In: Aviation, Space, and Environmental Medicine. July 1975. R.J. Ursano, and D.R. Jones. “The Individual vs. The Organization’s Doctor: Value Conflict in Psychiatric Aeromedical Evaluation.” In: Aviation, Space, and Environmental Medicine. November 1981.

9 C.R. Harper. “Civil Aviation in the Coming Decade.” In: Aerospace Medicine. January 1973.

10 V.B. Maxwell, and H.C. Davies, editors. “Psychiatric Disorders As They Relate To Aviation: Introduction to the Second Scientific Session of the Association of Aviation Medical Examiners.” In: Aviation, Space, and Environmental Medicine. July 1983.

11 K. Vaandrager. “Task of a Medical Department in Civil Aviation.” In: Aerospace Medicine. April 1972.

12 D.R. Jones. “Psychiatric Assessment of Female Fliers at the U.S. Air Force School of Aerospace Medicine(USAFSAM).” In: Aviation, Space, and Environmental Medicine, October 1983.

13 H.P. Goerres. “Medical Flying Fitness—a Routine Affair—but Who Examines and Assesses Psychic Health.” In: Aviation, Space, and Environmental Medicine. July 1975.

14 S.P. Baker. “Putting ‘Human Error’ Into Perspective.” In: Aviation, Space, and Environmental Medicine. June 1995.

15 Ibid. See also, F.M. Townsend, and V.A. Stembridge. “Modern Concepts in Investigation of Aircraft Fatalities.” In: Journal of Forensic Science, 3:381–400, 1958. And, R.C. Leighton- White. “Airline Pilot Incapacitation in Flight.” In: Aerospace Medicine. June 1972.

16 R. Smith. “Psychiatric Disorders As They Relate to Aviation.” In: Aviation, Space, and Environmental Medicine. July 1983.

K. Vaandrager. “Task of a Medical Department in Civil Aviation.” In: Aerospace Medicine. April 1972.

17 G. Bennett. “Psychiatric Disorders in Civilian Pilots.” In: Aviation, Space, and Environmental Medicine. July 1983.

18 C.L. Cooper, and S.J. Sloan. Pilots Under Stress. Routledge & Kegan Paul: London and New York, 1986.

19 P.J. O’Connor. “Pointers to Diagnosis of Psychiatric Illness in Aircrew.” In: Aviation, Space, and Environmental Medicine. July 1983.

20 Ibid.

21 “Commercial Pilot Survey Levels III to IV Air Carrier Operations.” Transportation Safety

Board of Canada, 1991. G. Bennett. “Psychiatric Disorders in Civilian Pilots.” In: Aviation, Space, and Environmental Medicine. July, 1983.

22 Ibid.

23 Ibid.

24 G. Bennett. “Psychiatric Disorders in Civilian Pilots.” In: Aviation, Space, and Environmental Medicine. July, 1983.

25 A.W. Black. “Psyciatric Illness in Military Aircrew.” In: Aviation, Space, and Environmental Medicine. July, 1983. And, G.W. McCarthy and K.D. Craig. “Flying Therapy for Flying Phobia.” In: Aviation, Space, and Environmental Medicine. December, 1985.

26 M.A. Becker. “Mental Health Intervention in Aeromedical Evacuation.” In: Aerospace Medicine. March 1972.

27 C.L. Cooper, and S.J. Sloan. “Coping with Pilot Stress: Resting at Home Compared with Resting Away from Home.” In: Aviation, Space, and Environmental Medicine. December 1987.

28 Ibid.

29 Ibid.

30 Ibid.


Broken Wings: A Flight Attendant’s Journey

Copyright ©1997 Nattanya H. Andersen

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