Wright State University CORE Scholar

Browse all Civil Aviation Medical Association Civil Aviation Medical Association Records Newsletters (MS-526)

9-2004

Flight Physician - September, 2004

Civil Aviation Medical Association

Follow this and additional works at: https://corescholar.libraries.wright.edu/special_ms526_newsletter

Part of the Aviation Safety and Security Commons, and the Medicine and Health Sciences Commons

Repository Citation Civil Aviation Medical Association (2004). Flight Physician - September, 2004. .

This Newsletter is brought to you for free and open access by the Civil Aviation Medical Association Records (MS-526) at CORE Scholar. It has been accepted for inclusion in Browse all Civil Aviation Medical Association Newsletters by an authorized administrator of CORE Scholar. For more information, please contact library- [email protected]. A A publication of the Civil Aviation Medical Association K A

Vol. 7, No. 4 September 2004

PRESIDENT'S COLUMN ANNUAL SCIENTIFIC MEETING HIGHLIGHTS Having Withstood the Issues of Time on Exceptional Program Includes Family; Much to Controversial Issues, the Voice ofCAMA See and Do in Omaha Continues to Be Heard BY JIM HARRIS In This Issue HE CIVIL AVIATION Medical OUR CAMA PROGRAM committee has put Association, CAMA, an TAMISIEA AWARD PRESENTED T Ytogether an exceptional scientific meeting for TO DR. BERRY 2 institution with long, healthy Omaha. Some outstanding authorities will present roots, can brag of its history FROM THE EDITOR 3 topics about aviation medicine and flight safety. over the last 50 years of its CAMA scientific meetings are designed to OMAHA AGENDA ...... 4 growth. A small group of Dr. Almand include the family. Time is provided to enjoy WE REMEMBER . 7 CAMA physicians has continued meals together and see some of the sights of to grow and lead the way by Omaha. A LETTER FROM exhibiting leadership in civil aviation medicine. V Thursday, the family can enjoy lunch and Cap- UNCLE HOMER 8 Gerald S. Blackenstoe, M.D., the first president tain Ron Nielsen's presentation, "Chicken Soup NEW MEMBERS 13 of CAMA (1955), led the fight to establish the for the Soul, the Fearless Flight Kit." In the after- Office of Civil Aviation Medicine that would be noon, the group will tour the Strategic Air and IN FLIGHT MEDICAL headed by a "Civil Air Surgeon" with power to Space Museum, followed by dinner at the Offutt EMERGENCIES ... 14 exercise civil aviation medical judgment and au- AFB Officers Club. thority commensurate with that held by the chief TAKING THE FIRST v Friday following lunch, Darrell Draper will STEP .... 16 flight surgeons of the Air Force and Navy in re- present a history of the Louis and Clark Expedi- spect to military aviation. tion. That evening, there will be a dinner cruise HONORING DR. BUZZARD... 17 The Backenstoe letter prompted later comments aboard the River City Star. to Senator Bricker (a member of the Senate Com- OBITUARY OF MEMBER V Saturday, following lunch, John and Martha 'GONE WEST' 19 mittee on Interstate and Foreign Commerce, which King will speak on an aviation topic. Enjoy the was then holding hearings on Senate Bill S.2647 — Honor's Night Dinner and Awards Saturday ON THE HORIZON 20 a proposal to amend the Aviation Act) from the evening, with guest speaker Felix M. Maguire

Continued on page Continued on page 6 /Z/67/rPHYSICIAN September 2004

TAMISIEA AWARD PRESENTED TO DR. BERRY Force at Wilford Hall USAF School of Aerospace Medicine, Lackland The John A. Tamisiea Award was established and AFB, Texas, he took the primary sponsored by the Civil Aviation Medical Association course in aerospace medicine at the in memory of John A. Tamisiea, M.D. The award is USAF School of Aerospace Medi- given annually to an aviation medical examiner or cine, Brooks, AFB, Texas. He then other individual who has made an outstanding con- spent 4 years as a fighter squadron tribution to the art and science of aviation medicine in its application to the general aviation field. flight surgeon in Madrid, Spain, and England. While in Madrid, he was flight surgeon to both the 98th ICHAEL A. BERRY, M.D., fields of preventive and aerospace Strategic Wing and the 613th Tac- M.S., received the John A. medicine. He has an outstanding tical Fighter Squadron and Chief MTamisiea Award for his international reputation and has Physician for remote radar sites in significant contributions to aerospace received a number of awards of Spain. He was also a member of a medicine and civil aviation medicine. excellence. Because of his outstanding special accident investigation team, He is a well-known aviation medicine reputation and expertise, he is often and commander of a transportable consultant who has performed consulted by major U.S. airlines hospital during NATO exercises. medical evaluations of pilots, risk including Delta, Southwest, and After a year as a flight surgeon at factor identification, and has Continental Airlines. He is currently RAF Lakenheath, UK, in 1976, he provided lifestyle modification a partner and Vice-President of entered his residency in Aerospace recommendations and clinical care Preventive and Aerospace Medicine Medicine at Ohio State University in services for pilots for more than 20 Consultants, P.A., in Houston, Texas. Columbus, Ohio, and received his years. He has extensive experience Dr. Berry was born in 1946 in Master's Degree in Preventive Medi- and service in aviation medicine and San Francisco, Calif. He received cine in 1977. In 1978, the American is a recognized leader in the aerospace his M.D. degree from the Univer- Board of Preventive Medicine in medicine community. He has also sity of Texas Southwestern Medi- Aerospace Medicine certified him. provided a broad scope of services, cal School in 1971. After a general Following his residency, he became nationally and internationally, in the surgery internship in the U.S. Air Continued on page 13

PRESIDENT'S COLUMN from page i Secretary of Commerce, the chair- followers. The joint effort of those in a strong civil aviation medicine man of the Civil Aeronautics Board, past CAMA members continues to representation for both a strong po- the president of the Air Line Pilots show the positive effect today of litical and aviation professional in- Association, the general counsel of CAMA's organizational harmony. fluence. Membership continues to the Air Transport Association, and Unity in vision results in increased rise and CAMA's success in the the president of the Aircraft Owners CAMA strength. CAMA's recent suc- most recent "CAMA Sunday" Age and Pilots Association, all of whom cess continues to resound with the Sixty meeting at the AsMA meet- were opposed to the CAMA recom- accomplishments of prior directors ing in Anchorage is just another mendations. Having withstood the and presidents. CAMA's unified force feather in CAMA's "cap." issues of time on controversial issues is shown in excellent annual meet- Omaha, October 6-9, 2004, will such as this and others, such as the ings and international sessions. be the next CAMA spectacular Age Sixty Rule and Sport Pilots Li- CAMA's financial stability and na- AVMED session. The subject will be censing, CAMA's voice continues to tional interest in aviation medical "Aviation Medicine and Flight be heard. subjects is invigorating and inspiring Safety." All flight surgeons should put Your earlier leaders worked to- to all its members and corporate this meeting on the front burner. It gether as a voice to serve the aviation sponsors, as well as international au- should be a real winner, along with medicine world. As a unified effort thorities in aviation medicine. 22 CME-approved hours. by our founding leaders, CAMA has CAMA's close-knit web of avia- FP continued to inspire subsequent tion medicine leaders has resulted FZ./C7//7PHYSICIAN September 2004

LETTER FL/GH7PHYSICIAN FROM A Publication of the Civil Aviation Medical THE Association (CAMA) We will be privileged to tour the EDITOR Strategic Air and Space Museum and President visit the Offutt AFB for dinner. The James R. Almand, M.D. BY DAVID BRYMAN, D.O. meeting will conclude Saturday night President-Elect after our honors night. David Bryman, D.O. ALL IS ALMOST upon us, and as CAMA is also planning for the Secretary-Treasurer such, this Arizonan is looking next meeting at the Aerospace Medi- Gordon L. Ritter, D.O. Fforward to a little cooler cal Association in May in Kansas weather. Besides getting a break from City. The traditional CAMA Sunday Executive Vice-President James L. Harris, M.Ed. the heat, the change of season also meeting will prove to be one of the marks the time of CAMA's annual best ever. Our intended topic will BULLETIN Editor scientific meeting. explore evidence-based medicine as David Bryman, D.O. This years meeting will take place it relates to medical certification of Associate Editors in the great state of Nebraska. The airmen, or better yet, the title should Mark C. Eidson, M.D. Petra A. Illig, M.D. location is in Omaha on October 6- be "Show me the evidence!" Alex M. Wolbrink, M.D. 9th , and we expect a great turnout As always, we strive to improve the Ingrid Zimmer-Galler, M.D. this year. We would especially like programs CAMA has to offer and CAMA Photographer to extend a welcome to those mem- value the opinions of our member- M. Young Stokes III, M.D. bers who have not attended any ship. We have plenty of opportunity CAMA meetings before and would for our newer members to become The editors of Fligh1Phys\c\an welcome submission of ar- also enjoy having our fellow physi- more involved, and look forward to ticles, letters to the editor, cians from the Omaha area attend as their participation. neyys bits, interesting aero- well. It's always nice to meet new I would also like to see more ar- medical cases, and photos for physicians that share our interest in ticles submitted for publication in publication. Please mail text in typewritten form or on Civil Aviation Medicine. the Flight Physician, as well. We are floppy disk (Microsoft Word This year's agenda includes some actively seeking articles from medi- preferred) to: very interesting topics that will be cal students or residents who are in- presented by well-known experts in terested in aviation medicine. David Bryman, D.O. the field of Aviation Medicine. The 5917 E. Danbury Rd. We will be offering a student Scottsdale, AZ 85254 theme of the meeting is "Aviation scholarship award for the best article Phone: (602) 549-2291 Medicine and Flight Safety." Besides on a yearly basis. Please forward any Fax: (602) 788-7951 E-mail: [email protected] a solid scientific program, there will articles or comments to my E-mail be opportunity to see some of the address at: James L. Harris sights and enjoy the fellowship of [email protected]. CAMA Headquarters P.O. Box 23864 other aviation enthusiasts. See you in Omaha! Oklahoma City, OK 73123 (405)840-0199 Fax: (405)848-1053 /Z/G//7THYSICIAN September 2004

THE CIVIL AVIATION MEDICAL ASSOCIATION ANNUAL SCIENTIFIC MEETING AGENDA

October 6-9, 2004 Omaha Marriott 10220 Regency Circle Omaha, Nebraska 68114 Phone (402) 399-9000

THEME: Aviation Medicine and Flight Safety

WEDNESDAY, OCTOBER 6, 2004 4:30 p.m. - 8:30 p.m. Registration 2:15 p.m. Adjourn 2:00 p.m. - 6:00 p.m. Board of Trustees Meeting 2:30 p.m. Buses depart for Strategic Air and Space Fremont Room Museum THURSDAY, OCTOBER 7 5:30 p.m. Buses depart for dinner at Offutt AFB 6:45 a.m. - 7:45 a.m. Breakfast Buffet - Salon DE 7:00 a.m. - 7:45 a.m. Registration FRIDAY, OCTOBER 8 6:45 a.m. Breakfast Buffet — Salon DE General Session—Salon ABC 8:00 a.m. General Session — Salon ABC 7:45 a.m. Welcome: James R. Almand, M.D., Moderator: Katherine Helleur, M.D. CAMA President 8:00 a.m. AME-AssistedAuthority for Special Issuance 7:50 a.m. Invocation: DeWayne E. Caviness, M.D. Warren Silberman, D.O. 8:00 a.m. Administrative Announcements 8:50 a.m. Crew Resource Management, I Hate It — What James L. Harris, M.Ed. Is It? Ron Nielsen, Captain, AWA 8:10 a.m. Opening Remarks: James R. Almand, M.D. 9:30 a.m. Circadian Dysrrythmia. John Caldwell, M.D. 8:15 a.m. General Session Moderator: David Bryman, D.O. 10:15 a.m. Break 8:15 a.m. What Can an AME Do to Assure Aviation 10:30 a.m. SSPJIOther Medications Update, Status of Safety? Robin E. Dodge, M.D. Certification With Their Use Warren Silberman, D.O. 9:15 a.m. Ethical Considerations of the AME-Pilot Relationship. Clayton Cowl, M.D. 11:15 a.m. Accidents Related to Poor Crew Resource Management. Mark Burman, AWA P.O. 10:15 a.m. Break 12:30 a.m. Lunch — Salon DE 10:30 a.m. The Drug Problem in Aviation Louis and Clark Expedition Charles Chesanow, D.O. Darrell Draper 11:15 a.m. Aviation Accident Investigation 1:45 p.m. General Session Charles A. Dejohn, M.D. Moderator: Mark C. Eidson, M.D. 12:15 p.m. Lunch: Salon DE 1:45 p.m. Otorhinolaryngology - SpatialDisorientation. Chicken Soup for the Soul Presents the Fearless Anthony J. Yonkers, M.D. Flight Kit. Captain Ron Nielsen 2:30 p.m. Sleep Deficit and Aviation Accidents 1:30 p.m. General Session — Salon ABC John Hey, M.D. Moderator: Susan Northrup, M.D. 3:15 p.m. Visual Illusions in Flight 1:30 p.m. Medical Certification Issues in the Field of R. C. Thompson, M.D. Ophthalmology 4:00 p.m. How an AME Handled an Accident. Ingrid Zimmer-Galler, M.D. Mark C. Eidson, M.D.

Continued FZ/G//7PHYSICIAN September 2004

4:30 p.m. Adjourn 5:30 p.m. Buses leave for dinner cruise aboard the River City Star — 6:00 p.m. - 8:00 8:15 p.m. Buses return to Marriott Hotel

SATURDAY, OCTOBER 9 6:45 a.m. Breakfast Buffet 8:00 a.m. General Session - Salon ABC Moderator: R. L. Bendixen, M.D. 8:00 a.m. Medical Programs Fredrick E. Tilton, M.D. 8:45 a.m. Obesity and Aviation Medicine — Implications and Treatment Options. David Bryman, D.O. 9:30 a.m. Preparations for Special Issuance Consideration Earl F. Beard, M.D. 1015a.m. Break 10:30 a.m. Chemical Dependency Steven I. Altchuler, M.D. 11:15 a.m. Pulmonary Problems and Treatment PROGRAM OBJECTIVES Forrest M. Bird, M.D., Ph.D. * To understand and apply the changes in aviation 12:15 p.m. Lunch - Salon DE Speakers: John and Martha King medicine to the individual's private practice. 1:30 p.m. General Session * To assess specific clinical conditions/ disciplines Moderator: Gordon Ritter, D.O. with respect to aviation medicine. 1:30 p.m. Panel: Clinical and Administrative Support From FAA Regional Flight Surgeons: * To correctly utilize the Federal Aviation medical David P. Millett, M.D., Southern Reg. standards with the specific conditions discussed. Nestor B. Kowalsky, M.D., Great Lakes Reg. Joel A. Dickmann, D.O., Central Reg. * To comprehend the FAA medical program initia- Christopher S. Taylor, M.D., tives. N.W. Mountain Reg. * To understand and be able to work with the aero- 2:15 p.m. Respiratory Physiology Forrest M. Bird, M.D., Ph.D. medical certification system. 3:00 p.m. Personal Altitude * To comprehend the legal aspects of being an John D. Hastings, M.D. AME today. 3:40 p.m. Break 3:55 p.m. Cardiac Complications in the Airman Andrew H. Miller, M.D. 4:50 p.m. Panel: " Would You Fly With This Pilot?" Moderator: James R. Almand, M.D. Members: Hugh O'Neill, M.D., Canada W.T. Haggai, M.D., Nigeria David P. Millett, M.D., USA CONTINUING MEDICAL EDUICATION 6:00 p.m. Adjourn The American Academy of Family Practice 7:30 p.m. Dinner: has approved up to 22 Prescribed Credit hours Honor's Night -Salon CDE for this scientific meeting. Awards Speaker: Felix M. Maguire FI/G//7PHYSICIAN September 2004

OMAHA from page 1 headquartered at Fort Omaha as closing, Dundy allowed Standing Commander of the Department of Bear to address the court. The as he discusses the work he is pio- the Plane. Chief's words: "My hand is not the neering to open a VFR route from General Crook followed federal same color as yours, but, if you Alaska across Russia to Japan. orders to arrest Standing Bear when pierce it, I shall feel pain. If you There are many things to see and he and a band of his followers left pierce your hand, you will also feel do while in Omaha. One is the their reservation in Oklahoma to pain. The blood that will flow from General Crook House Museum. carry the bones of his son back to mine will be the same color as General George Crook was a their homeland, "by the swift run- yours. I am a man, the same God Civil War and Indian Wars cavalry ning water, the Niobrara," which made us both." hero who was considered by Gen- had been his son's dying request. Tibbies wrote that the Judge eral Sherman to be "the nation's fin- But at the same time, Crook ap- wept openly, as did many in the est Indian fighter." Yet, General pealed to newspaperman Thomas courtroom. The verdict came a Crook's sympathies lay with the Tibbies to publicize the plight of week later, with Dundy ruling in Indian, as evidenced by his testi- the Ponca and recruit two promi- favor of Standing Bear, represent- mony in court for Ponca Chief nent Omaha attorneys to represent ing the first time the Indian was Standing Bear in the landmark trial the Ponca. given rights as a human being, in of 1879 that was held in Omaha. Tibbies and the attorneys, along the eyes of the law. "Standing Bear vs. Crook" during with local pastors, convinced Judge Be sure to attend this outstanding the time that General Crook was Elmer Dundy to hear the case. In meeting—and bring the family. FP Scenic Highlights Omaha, Nebraska

Strategic Air & Space Museum Offutt AFB Hospital

Crook Gerald R. Ford House Birthplace and and Scenic Gardens Gardens

Freedom Park Naval Museum fZ/G7/7PHYSICIAN September 2004

A S WE PUT this issue of the for 9:03, 9:59, and 10:29 a.m. — the We remember how patriotism / % Flight Physician to bed, a times of the second plane crash and and national pride surfaced re- JL. Anation remembers the third of the collapse of each tower. soundingly three years ago. Jenni anniversary of the worst terrorist We remember the 184 people Carlson, a writer for the Daily attack ever on its soil. We observe killed at the United States Pentagon, Oklahoman, remembers how the the lives lost in senseless aggression where that day another hijacked events of 9-11 took precedence against unsuspecting people, intent plane was deliberately crashed. In over even cherished sporting events on living in peace and harmony tribute and remembrance, officials of the day. "The importance of with their neighbors but forced to offered a wreath and observed a mo- sports paled in the days and weeks retaliate against the forces of unre- ment of silence. that followed. Stadiums welcomed lenting malice. We remember the 40 valiant pas- mourners, not fans," she wrote. While military battles are be- sengers and crewmembers of a fourth Even after the games resumed, ing fought abroad to keep the evil hijacked aircraft, all killed when they "they were as much about patrio- from our nation's doorstep, we refused to allow the terrorists to de- tism as about competition." At the have our ceremonies to com- stroy another cherished American University of Oklahoma, the Soon- memorate the events of Septem- landmark like the White House or ers unfurled an American flag that ber 11, 2001, but we also enjoy the Capitol Building. In Pennsylva- covered the football field. Rival our usual Saturday football and nia, bells tolled across the state at the Oklahoma State University's Cow- soccer games, talk politics, wash minute Flight 93 went down. boys organized spectators to pat- cars, go on picnics, fire up the We remember as a nation. All of terns of red, white, and blue for back-yard grills, and go about us, as communities, observe Sept. their game with Texas A&M. our normal week-end activities. 11 in our own ways, with services We remember our soldiers, the Regardless of what passes for at firehouses, memorial dedica- true heroes of our struggle against normal on this day, we remember. tions, bell-ringing events, and flag terrorism. Those who fight on the We remember the 2,749 people ceremonies. front lines of freedom in Iraq and lost in the World Trade Center at- We remember that three years ago, other places that demand their tack. In a ceremony at Ground we feared our normal way of life was presence. A grateful nation remem- Zero, parents and grandparents of over and that we would never again bers and honors the men and the victims read the names of the enjoy the same freedom to come and women in the armed forces of the lost. The recitation took more than go as we pleased. Perhaps it is so. We United States of America. May two hours. A moment of silence must do things in the name of secu- God richly reward them, protect was observed at 8:46 a.m., the time rity never before imagined. It is a cost them, and give them victory American Airlines Flight 11 slam- that we must bear to achieve victory against those who would destroy med into the center's north tower. in the time of all-out war against a our peaceful way of life and take Similar moments were observed relentless, faceless, immoral foe. away our freedom. FP FZ/G7/7PHYSICIAN September 2004

J3. Letter from Uncle Corner that most obstetricians are very conservative, knowingly or not, in What advice about flying can a physician offer his niece? their recommendations to pregnant BY HOMER C. ELLIS, M.D. pilots. Most obstetricians limit ex- ercise, activity, or work rather 'De.ar Mary, quickly in the face of possible com- I was delighted to hear that you Cancer of the female tract would plications of pregnancy. are going to start flying lessons; I be handled much as it would in Of some importance to the pro- am sure that you will enjoy flying males. Has it been adequately fessional pilot is the matter of preg- and becoming an excellent pilot. treated? Are there residual signs of nancy or sick leave policies of em- Your question as to certification of the cancer? These are the sorts of ployers. This is best dealt with on females is a good one. questions the FAA would want an individual basis with the em- The briefest answer is that there answered. ployer. Finding a comfortable uni- is nothing unusual or different for Perhaps the most discussed issue form acceptable to the employer certification of women. The most is that of pregnancy. The FAA does when pregnancy becomes more ad- important items come in relation not say a great deal about pregnancy vanced can be a pesky problem. to conditions related to the repro- in The Guide for Aviation Medical I earnestly hope that his will an- ductive system — pregnancy, en- Examiners. The only gender- swer some of your questions and re- dometriosis, menstrual problems, specific statements in that guide lieve your anxiety over the certifi- including dysmenorrhea, and the found on page 55. cation of women. timing of the exam for the pregnant These statements are: Your devoted Uncle, applicant. Most conditions specific Use of oral or repository contra- Uncle Corner to females are dealt with in terms ceptives or hormonal replacement of their symptoms, i.e., a menstrual therapy are not disqualifying for Dr. Ellis is a pilot, an Aviation problem resulting in anemia would medical certification. If the appli- Medical Examiner, and he has had be considered on the basis of the cant is experiencing no adverse a 40-year career in obstetrics and gynecology. anemia, just like anemia in a male. symptoms or reactions to cyclic FP Dysmenorrhea (cramps) is a hormones and is otherwise quali- condition that is not disqualifying, fied, the Examiner may issue the but caution with medications is in desired certificate. order. Hormonal therapy, e.g., oral Pregnancy under normal cir- contraceptives, is acceptable as are cumstances is not disqualifying. It Just Checking many pain relievers — Aleve, Ana- is recommended that the applicant's Little Mikey, four years old, walked prox, aspirin, or acetaminophen. obstetrician be made aware of all down the beach, and as he did, he spied a matronly woman sitting under a Narcotics would not be a choice for activities so the obstetrician can beach unbrella on the sand. pilots. properly advise the applicant. The He walked up to her and asked, "Are you Endometriosis, while specific to Examiner may wish to counsel ap- Jewish?" females, would be handled in rela- plicants concerning piloting air- "Yes," she replied. "Do you know the Ten Command- tion to signs, symptoms, and what craft during the third trimester, e.g., ments?" medications are used. Its degree of the proper use of lap belt and shoul- She nodded her head, "Yes." discomfort or disability dictate der harness warrants discussion. "Do you pray often?" the boy asked next, Often, we see the admonition in and again she answered, "Yes." whether or not to fly. Again, choice "Do you keep Kosher?" the boy asked. of medications holds the interest of print that the pregnant pilot dis- "I do," said the lady. FAA. Are the medications accept- continues flying if the enlarging ab- With that he asked his final question, able? Narcotics and mood-altering domen hampers the throw of the "Will you hold my dollar while I go swimming;?" drugs are not acceptable. yoke. Mary, my experience has been CIVIL AVIATION MEDICAL ASSOCIATION Sustaining and Corporate Members

The financial resources of individual members alone cannot sustain the Association's pursuit of its broad goals and objectives. Its forty-six year history is documented by innumerable contributions toward aviation health and safety that have become a daily expectation by airline passengers worldwide. Support from private and commer- cial sources is essential for CAMA to provide one of its most important functions: that of education. The follow- ing support CAMA through corporate and sustaining memberships:

SUSTAINING MEMBERS

James R. Almand, Jr., M.D. Halfbrd R. Conwell, M.D. Robert A. Stein, M.D. R.L. Bendixen, M.D. Gary E. Crump, PA. Christian Steindl, M.D. Forrest M. Bird, M.D., Ph.D. Robin E. Dodge, M.D. M. Young Stokes III, M.D. Stephen V. A. Blizzard, M.D. Francis C. Hertzog, Jr., M.D. James L. Tucker, Jr., M.D. David Bryman, D.O. James N. Heins, M.D. Albert van der Waag, Jr., M.D. Per-Johan Cappelen, M.D. John D. Mudrock, M.D. Alex M. Wolbrink, M.D. John R. Capurro, M.D. Gordon L. Ritter, D.O. Ingrid Zimmer-Galler, M.D.

CORPORATE MEMBERS

Aventis Pharmaceuticals Medaire, Inc Rummel Eye Care, P.C. Kathleen Briggs 1301 E. McDowell Rd, #204 1022 Willow Creek Rd. 1676 Fieldview Lane Phoenix, AZ 85006-2665 Prescott, AZ 86301-1642 Bethlehem, PA 18015 Motara Instruments, Inc. Schering Corporation Banyan International Corp. 7866 North 86th Street Kenilworth, NJ 0733 P.O. Box 1779 Milwaukee, WI 53224 Abilene, TX 70604-1779 Stereo Optical Company Inc. Nonin Medical Inc. Thomas Judy, CEO Continental Airlines 2605 Fernbrook Lane North Chicago, IL 60641 9900 Richmond Ave. Plymouth, MN 55447-4755 773-772-2869 Houston, TX 77210-4807 Percussion Aire Corp. Titmus Optical Data Transformation Corp. Forrest M. Bird, M.D., Pres. 3311 Corporate Drive 108-D Greentree Road Sandpoint, ID 83864-0817 Petersburg, VA 23805-9288 Turnersville, NJ 08012 Harvey Watt & Co., Inc. HP Heartstream P.O. Box 20787 2401 4th Ave., Suite 500 Atlanta, GA 30320 Seattle, WA 98121-1436

Cffiankjyou for Supporting the Civil Aviation Medical Association. Includes:

Ampules Airway Equipment Benadryi 1m! 50mg/ml (2) Airway, Pediatric (1) Epinephrine 1ml 1:1,000 Irng/ml (2) Airway, Small Adult (1) Airway, Large Adult (1) Inhalant Albuterol Inhaler 17gr (1) Manual Resuscitation Ambu Bag (1) Needles & Syringes Oral Medications Mask, Pediatric (1) 3ec,22gaugexl"(2) Acetaminophen 325gr (4) Mask, Small Adult (1) 3cc, 25 gauge x 5/8" (2) Aspirin 325gr (4) Mask, Large Adult (I) 18 gauge xl 1/2" (1) Diphenhydramine 25mg (4) CPR Mask Adapter (1) 20 gauge xl 1/2" (1) Nitroglycerin l/150gr (25) 22 gauge xl 1/2" (1) Miscellaneous Equipment Prefilled Syringes Alcohol Sponges (2) Reference Materials Atropine Sulfate 5ml (2) Gloves (1 pr.) AHA Algorithm Book (1) Dextrose 50% 50ml (1) Scissors (1) EMK Contents Placard (2) Epinephrine 10ml 1:10,000 (2) Tape(l) Seals: Red, Yellow, Green (1 ea) Lidocaine 2% 5ml (2) Tourniquet (1) Monitoring Equipment I.V. Equipment Blood Pressure Cuff (1) I.V. Catheter 20 gauge x 1" (2) Stethoscope (I) I.V. Set w/Y-site and clave (1) Sodium Cllloride, 500ml bag (1)

BILLING INFORMATION: SHIPPING INFORMATION: (IF DIFFERENT FROM BILLING.}

Name;. Name:.

E-Mail Address:. E-Mail Address:

Company/Organization;, Company/Organization:

Street Address; Street Address:

P.O. Box Number: P.O. Box Number:.

City:, City:.

.ZIP/Postal Code. State/Province:. . Z»P/PostalCode:

Telephone Number;. , Fax Number:, Telephone Number:, .FaxNu-

Credit Card: D American Express D Discover D MasterCard G VISA Quantity: _

Credit Card Number: Exp, Date:, Requested Delivery Date:

« P.O. iox 1779 • "A TollF .1874 • Fax 325.6', For Airlines

Dimensions: 13.5" x10.75" x 6.25" Weight: Bibs. Dptec® BDDD's Vision Testers Dptec® 5DDD(P) Manual Control Dplec® 55DD(P) Remote Control

NEW unsurpassed Homogeneous Illumination

Target Illuminance complies with ANSI Standard Z80.21-1992 (R1998)

Distance/Near Lens Systems test at 32" for intermediate testing*

Instrument can be operated from either side

Contact us about our Trade-in program!

F.A.A. Test Package: Slide #1 Peripheral Test Slide Slide #2** Distance Letter Acuity Monocular/Binocular (20/200-20/20) Slide #3** Pseudoisochromatic Color Perception Slide #4** Near Letter Acuity Monocular/Binocular (20/200-20/20) Slide #5** Lateral Phoria (1 Diopter Increments) Slide #6** Vertical. Phoria (1/2 Diopter Increments) Slide #7 Stereo Depth Perception (400-20 Seconds of Arc) Slide #8 Fusion Slide #9 Distance Tumbling "E" Acuity Monocular/Binocular (20/200-20/20) Slide #10 Tumbling "E" Color Perception Slide #11 Muscle Balance (Combination Lateral & Vertical Phoria) Slide #12 Distance Allen Test (20/100-20/30)

* This is a requirement for all pilots over the age of 50 ** These tests are requreed for F.A.A, vision exam

Chicago, Illinois [email protected] 1.773.777.2869 or 1.800.344.9500 for US (outside IL) & Canada only

wrww.stereooptical.com STEREO OPTICAL Optec is a registered trademarks of Stereo Optical Company, Inc. FLIGHTPKYSICIAN 13 September 2004

NEW MEMBERS

Kenneth W. Bassert, D.O. Michael Austin Healey, D.O. Eric L. Kerstman, M.D. 17600 North 79th Avenue, #722 20250 North 19th Avenue 5257 N.W. 109th Lane Glendale, AZ 85308-8685 Phoenix, AZ 85021-1945 Coral Springs, FL 33076 Phone: 623-328-7893 Phone: 602-943-9150 Phone: 954-755-4135 Medical Student Medical Student Phys/Rehab Med Pilot AME

Andrew Bursaw, D.O. Anatoly Hernandez, D.O. Margarida Lima, M.D. 13616 North 43rd Street, #237 6234 West Behreno Drive, #2160 Aeroporte de Lisboa, Apt. 8926 Phoenix, AZ 85032-6339 Glendale, AZ 85308 Lisbon, Portugal 1804-00 Lisboa Phone: 602-332-8411 Phone: 623-628-5861 Aviation Medicine AME Medical Student Medical Student Thomas Nguyen, M.D. John Steven "Steve" Geraghty, M.D. 1251 Nilles Road, Suite 6 14000 East Arapahoe Road, Suite 290 Fairfield, OH 45242 Centennial, CO 80112-4038 Phone: 513-759-2243 Phone: 303-632-3640 Internal Medicine AME Family Practice AME

CAMA Welcomes Our New Members to the Growing Body of Aviation Medicine Advocates

DR. BERRY fromP age 2 Association, and a fellow of the (1979 and 1982); NASA Special the Chief of the Medicine Clinic at American College of Preventive Achievement Award (1980); and the NASA Johnson Space Center in Medicine. He was also past Vice- the First Shuttle Flight Achieve- Houston, Texas, where he was re- President and is a member of the ment Award (1981). He has several sponsible for the screening and selec- Board of Trustees of the Civil Avia- academic appointments, including tion of new astronauts, clinical and tion Medical Association, and a Adjunct Assistant Professor of preventive medicine for the astro- past Director and Selector of the Aerospace Medicine at the Univer- nauts and their dependents, and par- International Academy of Aviation sity of Texas School of Public ticipated in the medical certification and Space Medicine. He served as Health in Houston, Texas, and Vis- and training of astronauts for space a Board member and Trustee of the iting Lecturer in Space medicine at flight, as well as medical monitoring American Board of Preventive the USAF School of Aerospace during flight. In addition to partici- Medicine and as the Vice-Chair for Medicine at Brooks AFB, Texas. He pating in the extensive medical prepa- Aerospace Medicine for the Board has published numerous articles in rations for the first flight of the Space from 1990 through 1998. He has professional journals and chapters Shuttle, he served as a member of the also served as President of the So- in major textbooks, including a flight control team for the first two ciety of NASA Flight Surgeons. chapter on Civil Aviation Medicine flights of the shuttle Columbia. He is the recipient of numerous in the standard textbook, "Funda- On leaving NASA, he entered his national awards, including the Air mentals of Aerospace Medicine." current private practice of aero- Force's National Defense Service He is also a member of the Space space medicine. He has been a Se- Medal (1971); the Special Award Medicine Branch of the AsMA, the nior Aviation Medical Examiner for for outstanding contributions in American College of Flight Sur- the FAA since 1979. He is also an the approach and Landing Test Pro- geons, the Society of NASA Air Aviation Medical Examiner for gram (1978);AsMA's Julian E. Force Flight Surgeons, the Society Canada Ward Memorial Award (1979); the of NASA Flight Surgeons, and the Dr. Berry is a Past President and Physician's Recognition Award of Wilderness Medical Society. Fellow of the Aerospace Medical the American Medical Association FP FLIGHTPHYS1CIAN 14 September 2004

IN FLIGHT MEDICAL EMERGENCIES cardiac events. The average age of a "Is there a doctor on the plane?" distressed passenger is 62 years old. Longer flights, combined with our aging populations medical concerns Typical sequence of events during an can add up to costly delays and diversions due to medical emergencies onboard medical crisis BY DAVID BRYMAN, D.O., SENIOR AVIATION MEDICAL EXAMINER, FAA, • The ill passenger calls the flight TRANSPORT CANADA, JAA attendant. • The flight attendant notifies the captain of the medical problem. RECENTLY FLEW from Phoenix, What concerns might a physician • The emergency medical system is Arizona, to the United or medically trained passenger aboard activated. IKingdom on a non-stop flight a commercial flight have regarding • An emergency room physician is in just over ten hours. Last week, I rendering care to a fellow passenger, consulted through a system called read about a scheduled flight from or worse, a member of the flight crew? Medlink (not all carriers have a Los Angeles to Mumbai on Air First, let us look at the general Medlink or UPMC ground-to-air India. Newer aircraft are designed health of the pilots. Pilots are rou- communication system.) to fly further and faster than ever tinely examined by their aviation If a medical assessment is needed, before. They carry more passengers medical examiner: captains every six the flight attendant will ask for a and flight crew than thought months and first officers every 12 medically trained individual to iden- possible several years ago. For months. The FAA medical standards tify themselves to the crew. There is example, a Boeing 747-400 holds are designed to keep pilots healthy, a physician passenger onboard a com- up to 425 passengers, and an Airbus as well as to protect the public from mercial flight 40-90% of the time. A380 has 550 seats. pilots who are not medically fit to fly, The medical provider will consult Rising fuel costs and other chal- thus highly motivating them to live with the captain and the Medlink lenges are forcing the airlines to carry healthy lifestyles. physician, if available. Together, they as many paying passengers as possible Studies show that commercial pi- will advise the captain about the ne- at one time. Long-haul flights are be- lots have fewer cases of hypertension, cessity to divert to a closer airport for coming increasingly common and are cancer, diabetes, and heart disease medical help. necessary for the airline industry as a than the general population (Avia- Diversions are also decided by whole to ensure economic survival. tion, Space, and Environmental Medi- weather and pilot/airline familiarity But longer flights, combined with cine).T\&KfoK, medical emergencies with the divert airfields. It should be our aging populations' medical con- involving the pilots and crew are recognized that regardless of the cerns, can add up to costly delays and minimal. thoughts of the physicians onboard diversions due to medical emergen- The health of passengers, on the or on the ground, the captain deter- cies onboard. An unscheduled land- other hand, is generally unknown to mines when to divert and to where. ing on a flight from LA to India de- the flight crew. Rarely will the captain challenge a feats the purpose of producing these Factors that may be associated physician's recommendation to divert advanced, long-duration aircraft. with a passenger becoming ill dur- but determines the destination air- The topic of handling In-flight ing a flight include: advanced age, field. Similarly, the smaller, regional medical emergencies are becoming alcohol consumption, flight anxiety, aircraft may be more likely to divert/ more common as part of risk man- fear of terrorism, circadian rhythm land because they can get to the agement and financial concerns with disturbances, low humidity, reduced ground much faster and are less likely the airlines. There must be some con- cabin pressure with mild hypoxia, to have qualified medical personnel sideration to the unique flight envi- and infectious diseases. aboard. ronment that may make medical The most common medical com- The nature of the medical condi- emergencies in the airplane more se- plaints onboard are dizziness and tion may also be considered as a fac- vere. Also, one must be sure there fainting, followed by respiratory tor to determine which airport is are adequate medical equipment symptoms and chest pain. Most most appropriate. For example, the and personnel onboard to handle a commonly, medical emergencies re- medical crisis. sult from neurogenic syncope and Continued —> FZ/G//7PHYSICIAN 15 September 2004 closest airport for diversion may be a epinephrine, lidocaine, broncho- air travel and when one should wait small city in Ohio. But if the passen- dilators, nitro, dextrose 50%/50cc to fly. The following list is just some ger is having chest pain, Cincinnati and, of course, an instruction book. general medical guidelines for air may be the wiser choice, even though The enhanced emergency kits are travel. it is further because they have a car- to be used only by medical profes- Conditions with which one should diac team on stand-by prepared to do sionals. In fact, the flight crew will probably not travel by air include: a bypass. likely ask for identification and cre- There are approximately 300-350 dentials before allowing the kit to be • Severe valvular heart disease medical events onboard per month opened. The flight attendants are not • Uncontrolled hypertension and approximately 20-25 deaths per expected to administer medication or • Active psychosis year per airline. On average, a major start IV's. • Severe asthma US airline diverts 20-25 times per The aircraft also has an auto- • Pleural effusion month with approximately 90% of mated external defibrillator (AED) • Severe chronic obstructive pulmo- these domestic. onboard. This device has been nary disease The cost of a medical emergency proven over and over to save lives. Conditions that should be com- is related to the expense of a diver- In a one-year period, an AED was pletely resolved prior to flying: sion. I have been told it can range used to deliver at least one shock • Pneumomediastinum from $50,000 to $100,000 depend- in 17 separate events from 119 car- • Otitis media ing on whether the diversion is do- diac events. From these events, 4 • Sinusitis mestic or international. Factors in- passengers and 1 crewmember re- • Pneumothorax clude landing fees, fuel dumping, portedly survived. AEDs are so Those with recent abdominal sur- taxes, and hotel accommodations user-friendly that they are now de- gery should wait at least 2 weeks. for passengers and crews. Other fac- scribed in basic CPR classes. Patients who underwent lap- tors include schedule delays and Physicians and licensed providers aroscopy or colonoscopy should wait safety risks. who choose to respond to an onboard at least 2 days. In response to the cost and in- medical emergency are covered un- Retinal detachment patients creased incidence of in-flight medi- der the "good Samaritan" law from should wait 2-6 weeks. cal emergencies, the airlines have malpractice/damages, but that still Skilled, onboard medical atten- training programs for the flight crew means they need to provide a reason- tion is likely needed for patients to help them recognize and respond able standard of care. Additionally, who have uncontrolled diabetes, to medical emergencies. They are also they should not expect to be com- significant anemia, or rapidly pro- improving the onboard medical pensated by the airline for their work. gressive renal failure. equipment. Commercial aircraft usu- Doing so represents the appearance Future considerations ally carry medical equipment suitable of a "contract" between physician and for many different emergencies. The airline, opening up the "deep pocket" In the near future, aviation medi- medications and equipment in the for law suits. cine will likely include more recom- Enhanced Emergency Kits (EMKs) Although the equipment onboard mendations regarding air travel. As are found on carriers as small as the is improving, the number of emer- aircraft get larger, I wonder if one day 7,500 Ibs regional a/c, to the "big gencies attended to in flight is still there will be a need for a small guys." One can expect the minimum ever-present and increasing. What onboard emergency treatment area. supplies in the kit, not much more. response should the airlines and phy- Also, some consideration might be EMKs typically contain the fol- sicians trained in Aerospace and Avia- given to including medical certifica- lowing items: BP cuff, stethoscope, tion medicine do to improve and tion and standards tot passengers, as adult and pediatric airways, CPR decrease this problem? well as the flight crew. Imagine the masks, IV set, alcohol, tape, scissors, One thing the aviation medical logistics of diverting an aircraft that tourniquet, 500cc saline bag, gloves, physician might do is to educate the travels to the limits of the atmosphere needles, syringes, ASA, oral and general medical community on in the future. injectable antihistamine, atropine, what illness may be appropriate for FP FLIGHTPHYSICIAN 16 September 2004

TAKING THE FIRST pressure suit and that man could happened, I knew I might never get eject from aircraft at extreme alti- another chance because there were Riding a helium balloon to 20 tudes and survive. lots of people who didn't want this miles above the Upon Kittinger's return to base, test to happen. I took a calculated Earth, he stood a congratulatory telegram was wait- risk, that I might lose use of my up, turned ing from the Mercury Seven astro- right hand. It quickly swelled up, around to the nauts—including Alan Shepard and I did lose its use for the dura- door, took one and John Glenn. More than four tion of the flight. But the rest of final look out, decades later Kittinger's two world the pressure suit worked. When I and said a silent records—the highest parachute reached 102,800 feet, maximum prayer, "Lord, take care of me jump, and the only man to break altitude, I wasn't quite over the tar- now." Then he the sound barrier without a craft get. So I drifted for 11 minutes. The jumped over the and live—still stand. We decided to winds were out of the east. side... visit the retired colonel and Avia- FORBES: What's it look like from —Recalling a wild ride and tion Hall of Famer, now 75, at his so high up? world records that remain un- home in Altamonte Springs, KITTINGER: You can see about challenged after four decades Florida, to recall his historic jump. 400 miles in every direction. The BY JIM CLASH most fascinating thing is that it's FORBES GLOBAL: Take us back just black overhead—the transition to New Mexico and Aug. 16,1960. OE KITTINGER is not a household from normal blue to black is very aviation name like Neil Armstrong KITTINGER: We got up at 2 a.m. stark. You can't see stars because J to start filling the helium balloon. there's a lot of glare from the sun, or Chuck Yeager. But what he did for the U.S. space program is At sea level, it was 35 to 40 feet so your pupils are too small. I was comparable. On Aug. 16, I960, as wide and 200 feet high; at altitude, struck with the beauty of it. But I research for the then- fledgling U.S. due to the low air pressure, it ex- was also struck by how hostile it is: space program, Air Force Captain panded to 25 stories in width, and more than 100 degrees below zero, Joseph Kittinger rode a helium still was 20 stories high! At 4 a.m. I no air. If my protection suit failed, balloon to the edge of space, 102,800 began breathing pure oxygen for I would be dead in a few seconds. feet above the earth, a feat in itself. two hours. That's how long it takes Blood actually boils above 62,000 Then, wearing just a thin pressure to remove all the nitrogen from feet. I went through my 46-step suit and breathing supplemental your blood so you don't get the checklist, disconnected from the oxygen, he leaned over the cramped bends going so high so fast. Then balloon's power supply and lost all confines of his gondola and it was a lengthy dress procedure lay- communication with the ground. I jumped—into the 110-degree- ering warm clothing under my pres- was totally under power from the below- zero, near- vacuum of space. sure suit. They kept me in air- kit on my back. When everything Within seconds, his body accel- conditioning until it was time to was done, I stood up, turned erated to 714 mph in the thin air, launch because we were in the around to the door, took one final breaking the sound barrier. After desert and I wasn't supposed to look out and said a silent prayer: free- falling for more than four and sweat. If I did, my clothes would "Lord, take care of me now." Then a half minutes, slowed finally by freeze on the way up. I just jumped over the side. friction from the heavier air below, FORBES: How was your ascent? FORBES: What were you thinking he felt his parachute open at 14,000 KITTINGER: It took an hour and as you took that step? feet, and he coasted gently down to a half to get to altitude. It was cold. KITTINGER: It's the beginning of the New Mexico desert floor. At 40,000 feet, the glove on my a test. I had gone through simula- Kittinger's feat showed scientists right hand hadn't inflated. I knew tions many times—more than 100. that astronauts could survive the that if I radioed my doctor, he harshness of space with just a would abort the flight. If that Continued —> FUGHTPUYSICIAN 17 September 2004

I rolled over and looked up, and there HONORING PAST PRESIDENTS OF CAMA was the balloon just roaring into space. Then, I realized that the bal- Stephen V. Blizzard, B.Sc., M.D., D.Av.Med. loon wasn't roaring into space; I was It has been the desire of CAMA President James R. Almand, going down at a fantastic rate! At M.D., to highlight past presidents in the FlightPhysician to give members an insight into their background. about 90,000 feet, I reached 714 mph. The altimeter on my wrist was unwinding very rapidly. But there The Civil Aviation Medical Association (CAMA) has been privileged to was no sense of speed. Where you de- have some of the most dedicated physicians as its leaders through the years. termine speed is visual—if you see Stephen V. Blizzard, M.D., became president in 1991 at a time when CAMA something go flashing by. But noth- needed to make some major decision about its future. Dr. Blizzard came in ing flashes by 20 miles up—there are with a vision as to where he wanted CAMA to go, and what he wanted the no signposts there, and you are way above any clouds. When the chute association to become. In his quiet way, he was able to set CAMA on a opened, the rest of the jump was an- course of growth and service to the flying public. As the torch was passed ticlimactic because everything had on to each of the presidents to-date, this dream has been moved forward, worked perfectly. I landed 12 or 13 and today, the association in nearing the 1000-member mark. Leaders can minutes later, and there was my crew only give direction; it is up to the members to see that the goals are met waiting. We were elated. FORBES: How about your right and the association provides a valuable service to civil aviation medicine. hand? KITTINGER: It hurt—there was TEPHEN BUZZARD, M.D. was Edinburgh University Air quite a bit of swelling and the blood born in Belmont, Port of Squadron flying Tiger Moths. pressure in my arm was high. But SSpain, Trinidad, West Indies Dr. Blizzard left Scotland to re- that went away in a few days, and I in 1928, the second of seven turn to Trinidad in 1954 and worked regained full use of my hand. children. His parents were both as a veterinarian for the government, FORBES: What about attempts to school teachers, and his father was fulfilling the terms of his scholar- break your record? the Headmaster of the Moulton ship. In 1958, he migrated to KITTINGER: We did it for air Hall Methodist School in Port of Canada and taught in the depart- crews and astronauts—for the learn- Spain. Dr. Blizzard won a College ment of Surgery at the Ontario ing, not to set a record. They will be Exhibition from that school at the Veterinary College, now a part of going up as skydivers. Somebody age of 11 and attended Queen's the University of Guelph. The fol- will beat it someday. Records are Royal College, obtaining the lowing year, Dr. Blizzard applied to made to be busted. And I'll be Cambridge Higher Certificate medical school at the University of elated. But I'll also be concerned that they're properly trained. If they're (Science Group) in 1946. Western Ontario, earning his medi- not, they're taking a heck of a risk. In 1948, he competed for and cal degree in 1963. In his second FP won a Trinidad Government year at the University of Western Veterinary Scholarship and was Ontario, Dr. Blizzard was one of Columnist Jim Clash is author ofTo the sent to Edinburgh, Scotland, 60 students selected for the 45- Limits (John Wiley & Sons, 2003) and where he graduated B.Sc and month subsidization plan by the a Fellow at the Explorers Club. Member of the Royal College of Royal Canadian Air Force (RCAF). Veterinary Surgeons in 1953. After graduation, Dr. Blizzard While in Scotland, Dr. Bliz- interned at the Ottawa Civic Hos- zard started his military career pital and then to the National and became a member of the Continued on page 18 /Z/G//7PHYSICIAN 18 September 2004

DR. BLIZZARD from page 17 Zimbabwe. He did post-graduate He has given presentations on training in Aviation Medicine at Aviation Medicine in Canada, the Defense Medical Centre the Royal Air Force Institute of USA, India, and Greece. (NDMC) as the first Resident in Aviation Medicine, obtaining the He is the past president of the Surgery. He spent two other com- Royal College Diploma of Avia- Canadian Association of Aero- pulsory years of service at the tion Medicine. He was then Ad- medical Transportation Systems, C.F.D. Rockcliffe Base and doing visor to the Surgeon-General in past president of the Canadian Emergency duty at NDMC. Aviation Medicine and served on Society of Aerospace Medicine, He was then posted to RCAF several NATO Committees. He Canadian Aerospace Medicine Station Moose Jaw. In addition to retired after 16 years in the Mili- Aeromedical Transport Associa- doing a full-time job as Base Sur- tary. He then worked with the tion, and the Civil Aviation Medi- geon, he did Basic Jet Training on Federal government as a Senior cal Association. He is a Fellow of the Tutor and Advanced Jet Train- Consultant in the Department of the Aerospace Medical Associa- ing on the T-33. He graduated as Civil Aviation Medicine until tion and is also a Member of Se- a Military Jet Pilot in 1968. He 1995. During this period, he was lector of the International Acad- was then posted to the RCAF In- a delegate to the Soviet Union emy of Aviation and Space Medi- stitute of Aviation Medicine as with a group of Aviation Medi- cine (membership limited to 250 Deputy Commanding Officer of cine Specialists and visited Mos- worldwide). the Central Aircrew Medical cow, including Star City (where In November 2002 at the In- Board. the cosmonauts and now Canadian ternational Civil Aviation Orga- Dr. Blizzard then practiced and American astronauts train) and nization headquarters in Montreal medicine for six years in Trinidad, St. Petersburg. He also visited the (the International Academy of where amongst other activities, he Space Centre in Baikonur, Khaz- Aviation and Space Medicine), he was a member of the Air Transport hakistan, where the space travel- was presented with the Edward Licensing Authority, Chairman ers are launched. Warner Award, the highest honor and Flying Instructor of the Light In 1978, Major Blizzard was a in the world of Civil Aviation. Airplane Club, and Headquarters member of the Medical Team on He is also an Association Mem- Commissioner for Air Scouts. He the very first Airlift of Vietnam- ber of the Airline Medical Direc- also presented the first paper in ese Refugees to Canada, Opera- tors Association and member of Aviation Medicine in the Com- tion Magnet 1 from Kuala Lum- the International Association of monwealth Caribbean "Aerial pur, Malaysia, to Montreal via Military flight Surgeon/Pilots. Transportation of Patients." In Tokyo and Elmendorf Air Force Dr. Blizzard obtained a com- Trinidad, Dr. Blizzard was the Se- Base, Alaska. mercial pilot's license in 1964 and nior FAA Aviation Medical Exam- His special interests are trans- has held Instrument and Multi- iner as well as Aviation Medical porting patients by air and pilot engine ratings. Examiner for Canada, the U.K., fatigue. Dr Blizzard received the 2004 and Trinidad. He is the author of many sci- Dr. Wilbur Franks Award for his On his return to Canada in entific papers, including Govern- significant contribution to Aero- 1975, he re-enlisted as a Major in ment publication "Patient Care in space Medicine and Air Medical the Canadian Armed Forces and Flight" and "Flight Times and Transport. served in the Middle East and Flight Duty Times in Canada." FP /Z/G7/7PHYSICIAN 19 September 2004

MEMBERS 'GONE WEST'

HEWETTE A. THIAN, M.D. 6-24-26 — 8-9-04 DR. HEWITTE A. THIAN was an Retirement Aviation Medical Examinet since 1964, and he was a member of the After completing his medical- Aerospace Medical association, as oriented obligations, Hewitte and well as serving on the boards of his wife, Dory, retired to their both the Civil Aviation Medical Rocking T Ranch in Bay St. Louis, Association and the FPA. Mo., where they raised highly prized horses. They developed a Career Highlights fine airstrip and hangar on their Dr. Thian completed his surgi- ranch, and Dory become a quali- cal residency at Charity Hospital in fied copilot. New Orleans in 1959, and he three special French Dauphine heli- Dory and Hewitte were enjoying served as a general surgeon in New copters. This would allow the trans- their semi-retirement, when Dory Orleans area hospitals for over a port of the most critically injured or got the shocking diagnosis of can- quarter of a century. He was a pio- acutely ill off-shore patients by heli- cer. She fought a valiant but losing neer in trauma surgery as the mod- copter into the finest New Orleans battle over the next few years, only ern emergency rooms evolved. medical facilities, landing on their to die in agony with intracranial Dr. Thian was an ardent and ac- hospital helipads. cancer. complished pilot with extensive As one can realize, this was a With Dory's passing, Hewitte's flight background. In the mid- major financial commitment re- own health began to deteriorate. In 1970s, he projected a unique "In- quiring broad-span logic directed a conversation just days before his tensive Care Transport" Medical toward administrative, medical, death, Hewitte complained about Evacuation service for workers on technological, and political aspects. the wet weather that was blocking the off-shore oil rigs in the him from harvesting his hay. Gulf of Mexico. He carefully He also told me, "I don't analyzed every last detail of want to die the living hell the projected services before that Dory went through. A committing to the develop- massive circulatory collapse ment of the overall program. is my choice." He visited the principals Several days later, of the existing off-shore op- Hewitte's son-in-law arrived erations that served the oil in the early evening to help rigs with helicopter trans- him with the hay harvest, port services, revealing his only to find Hewitte's trac- projections and asking for ,. tor stalled out against one of their "blessings." They ap- the massive, round hay bales, peared to believe the venture had with Hewitte collapsed over merit and would be the first of its He generally selected the Dauphine the steering wheel. kind. helicopters because they had a Hewitte got his wish! In the late 1970s, he consulted shrouded tail rotor, which reduced Hewitte was my friend! with me relative to the installation of the potential for medical personnel —Forrest M. Bird, M.D., Ph.D. his latest critical care "Military Trans- becoming critically injured while port Cardiopulmonary Systems" in off-loading. On The Horizon

AEROSPACE MEDICAL ASSOCIATION FAA AVIATION MEDICAL EXAMINER ANNUAL MEETING SCHEDULE SEMINAR SCHEDULE

May 8-12, 2005. Kansas City, Missouri 2004 November 5-7 Tampa/Ft. Lauderdale, Fla., area CIVIL AVIATION MEDICAL ASSOCIATION Neuro/Psychol/Phy ANNUAL MEETING SCHEDULE November 15-19 _ Oklahoma City, Okla. Basic October 6-10, 2004. Omaha, Nebraska, Marriott Omaha Hotel 2005 October 5 - 9 , 2005 . Charleston, South January 21 -23 Irvine, Calif. Carolina Neuro/Psychol/Phy Renaissance Charleston Hotel Historic District February 25-27 Austin, Texas Cardiology October 4-8, 2006 _ Ottawa, Canada, Ottawa Marriott Hotel March 14-18 Oklahoma City, Okla. Basic May 8-12 Kansas City, Mo. (AsMA) Ophth/Otolaryn/Endocrin June 13-17. Oklahoma City, Okla. Basic July 15-17 . Bellevue, Wash.Neuro/Psychol/Phy August 5-7. Boston, Mass. Cardiology September 12-16 _ Oklahoma City, Okla. Basic November 18-20 _ Savannah, Ga. Aviation Physiology/HF

For information, call your regional flight surgeon. To sigh up for a seminar, call the FAA Civil Aerospace Medical Institute's AME Programs Office: (405) 954-4830.

Make P'an he