Sunday, November 29, 2015

Fly Baby

Ugh. I hate flying. Everything about it is extraordinarily horrible. Security lines, screaming babies, germy recycled air. I think we can all agree its just terrible. But what makes flying particularly heinous for me, is my intense fear of dying in a fiery fiery crash.

Everyone is entitled to an irrational fear or two. Ron Weasley is afraid of spiders, Billy Bob Thorton claims to be scared of antique furniture and I am paralyzed by the thought of getting on a plane. Its not a rational fear I know. I have read the statistics over and over again. It doesn’t make a difference.

My fear has gotten so intense that when Rural Prime attended a conference in Irvine last year I chose to take a 16 hour bus ride instead of a 45 minute Southwest flight. At 2am the bus stopped at a Burger King in Salinas because a woman on board was having a psychotic episode. The bus ride was so terrible and so freezing cold, that I did end up flying back with the rest of my Prime buddies. Although the flight back to Sac was smooth and completely uneventful, I buried my head in my hands the whole way—only looking up to see Steven thoroughly enjoying the whole experience.

I do not want my life to be limited by fear, so this Thanksgiving I managed to ply myself with enough wine to fly down to LA. But when it was time to fly home, I found myself stone cold sober, stuck in a backed up line waiting to find our seats right by the cockpit door—which was open. I glanced at the array of buttons and knobs and levers. The man sitting in the pilot's seat couldn’t have been a day over 25. Sitting next to him was a salt of the earth man in his late 60s—clearly a seasoned pilot.

They were discussing the vector on which to land at SFO to clear the seawall and hit the runway. I saw the young captain gesturing a turning plane with his hand. My mind flashed back to the Asiana Airlines flight which crash landed at SFO due to pilot error. Vomit started to build at the back of my throat.

What if this was his first flight as a captain?

I found my seat. Glanced at the people sitting next to me, who’s faces would no doubt be the last ones I ever saw. The cockpit door was still open and I craned my neck into the aisle to peer in. They appeared to be going through a checklist, while the older pilot sipped his coffee--like just another day at the office.

On the instruction of the older pilot, Baby Face pilot picked up the plane’s intercom and promptly dropped it. It didn’t do anything to change my mind about our imminent doom, but it was kind of cute. His Captain's uniform was just a little long in the arms and the four gold stripes around the cuff of his jacket must have been from a Halloween costume. Fumbling to pick up the dropped intercom phone, he said, “Thank you for flying Virgin America, my name is Eric and I will be your Captain.” I wonder if he had ever spoken those words before. He proceeded to recount to the passengers the wind conditions and current temperature awaiting us in San Francisco, as well as the local time—which was an interesting choice seeing as Los Angeles is and always will be on the same time as the city 300 miles to the north. He sat back down in the Captain's seat and then sprang up suddenly to adjust it.

Oh Jesus Lord, homeboy doesn’t even know how to work the God damn chair.

I watched him test the engines, first the left and then the right. Both times the engines sprang to life with his touch of the throttle. As he grabbed both to throw them back for take off, the flight attendant slammed the cockpit door closed.

We’re all going to die.

I would feel much better about things if the seasoned pilot were at the helm, instead of some little pipsqueak who probably only learned how to drive a car 6 years ago. But then I think about how we ask patients to trust us—in the infancy of our training. We ask strangers to trust us with their lives and bodies.

The fear I feel as we leave the ground is akin to what a patient about to undergo surgery might feel. Scared at having little control over the circumstances. We ask patients to put their trust in us. And in turn we go over and over our notes, procedures, resources and simulations to learn. We care about doing a good job. Being young—both in years and in training, isn’t necessarily a bad thing whether you’re a doctor or an airline pilot. We have passion and an eagerness to learn that seems to fade with the years. Everything is new and exciting and scary. And that means we’re paying attention. Plus if we never had people in training to take over in professions like these, we’d be totally screwed.

What makes me so fearful of hurtling through the sky at 39,000 feet is the same thing that I hope will make me a good doctor—the need for control. When I have to give that up and put my life in someone else’s hands—its really scary.

We need to keep in mind that patients make a choice to put their confidence in us. And we need to be worthy of it.  We must take the time to talk with patients, explain what's happening and ask for help and support from older doctors. And we must stay committed to learning and staying current in our jobs for the rest of our lives. That’s what it takes for 200 people to let you take them for a spin around the stratosphere, or lay down naked on a table under your knife.

Needless to say, the flight went well. We did not hit the seawall and touched down with the same turn I saw the Captain gesture with. As the plane emptied out and I made my way off—I couldn’t help but  pop my head in the cockpit.

Baby face was looking over his flight log.

Great flight.” I said.

Thanks,” he replied.

You’re a really good pilot,” I said.

“I’m trying to be,” he replied, “I’m still learning.”


  1. Love this. As a pilot and former flight instructor, I can definitely relate to both sides. So many similarities between aviation and medicine from the doctors (pilots) and patient (passenger) perspective!

  2. Interesting concept about docs wanting "control." I guess it's true, and maybe we're self-selected for that. Of course, a surgeon can make a fatal "oops!" mistake, and we in medicine used to be able to cause a patient's demise with a quarter-milligram of ink. (Now it's with an unimaginably small mass of electrons.) Of course, (not wanting to increase your angst, but...) we put our health and lives in the hands of others all the time. The mechanic who changes your tires might put one on loose and it might fall off, the taxi driver might make an error in traffic, and so on. I guess we have to "trust in statistics" (as in 5 out of 6 Russian Roulette players are happy). Keep up the good work, and remember, there's always somebody even more scared (or insecure, or whatever) than you are; you just didn't notice.
    - a NY endocrinologist.

    1. Excuse me...I'll be right back, just going to run outside and check all of my car tires are on securely. If we could we take all of the uncertainty out of life that would be great. Also while we're at it, let's take all of the calories out of doughnuts. :)