Getting to Yes
“We are all just one medical event away from flying as sport pilots.”
A pilot friend made that statement at a conference several years ago and, like most everyone else in the audience, I nodded sagely (or was it smugly?) while I thought sympathetically of those who could “only” fly with the driver’s license medical.
Little did I know that life was about to give me a visceral appreciation for that statement – and even greater appreciation for the many medical certification options available to today’s pilots. Ironically, it was just after that week that a subtly accumulating collection of odd symptoms finally drove me to the doctor, and eventually to a diagnosis of multiple sclerosis (MS).
My aviation friends all understood that my most immediate concern was not so much about the potentially dire consequences of the disease itself. Its implications for my FAA medical certification were the real source of the early tears and terror. Lucky for me, several pilot pals (one of whom preceded me into the “MS Pilot Club”) knew that MS didn’t have to spell the end of my PIC flying days. In addition to handing me hankies, they provided solid information and support as I began to navigate this strange new world of health and aeromedical management.
After eight years of working at FAA headquarters, I’ve heard most of the jokes and snide comments about this agency. Having also attended several years’ worth of the Administrator’s meetings with air show audiences, I’ve also heard lots of the frustration that pilots experience when medical issues result in delays or (occasionally) denial of the vital medical certification. I get it – even though I worked for the FAA, I knew nothing about the people or processes involved in special issuance, and I was terrified of being ground into the gears of the medical bureaucracy. What I quickly learned, though, is that the people who count – that would be Federal Air Surgeon Dr. Fred Tilton and his team, many of whom are pilots themselves – get it, too.
A particularly tough job belongs to the head of the Aerospace Medical Certification Division (AMCD), headed until recently by Dr. Warren Silberman (since retired) and now by Dr. Courtney Scott. Working for the FAA has given me the privilege of coming to know them not as names on a web page but as people, and I can assure you that they are people who care. Like everyone, the folks at AMCD are bound by the regulations. Their work and their decisions have profound implications not just for pilots, but for the public…and that is by no means an abstraction. You might not realize the extent to which aeromedical decisions are reviewed and second-guessed even in “routine” accidents. That level of scrutiny by the National Transportation Safety Board (NTSB), the press, the public, and sometimes even Congress, goes off the charts when an accident involves a public figure (think Ted Stevens or Cory Lidle).
In that context, it is even more impressive and heartening to know that, contrary to the jokes and fears and snide comments, the FAA’s medical mindset is not a knee-jerk “no.” Rather, Tilton, Scott, and the dedicated folks who work for them are all about getting to “yes.” Just as in the Roger Fisher and William Ury book on Getting to Yes, which offers a toolbox for negotiating mutually acceptable outcomes, the FAA’s medical professionals have developed a wide range of options for medical certification of many conditions that would have once grounded pilots for good. Even more encouraging is the fact that aeromedical research continues to broaden both the list of certifiable conditions and options for demonstrating compliance with medical certification standards. Yes, there are still occasions and conditions that require the FAA to say “no.” But it is increasingly uncommon to find cases that are permanently impossible to certify. In all other cases, the FAA medical team is more than willing to work with airmen and AMEs to find a path to certification.
Thank you, colleagues, for all you do to help keep so many of us flying. (FAA Safety Briefing – JanFeb 2013)