Open Letter to Physicians and FAA AME's
 

Open Letter to Physicians and FAA AME 's

I am so angry at the medical community in general and physicians specifically that I can barely contain my rage. Don’t worry I am not actually going to hurt you or any of your friends, but to be honest the thought of throwing one of you across your office makes me smile on the inside. Every time I go into a doctor 's office for an annual physical my blood literally boils to the point where I cannot pass a simple blood pressure requirement for a flight physical without lying down. But have you had any caffeine today? No I don’t drink caffeine and even if I did I wouldn’t need any to be on the verge of being ready for battle every time I am forced into one of you or your idiot colleagues offices. It seems that my physiological reaction to being in a doctors office is sufficient to jump my blood pressure from a normal 120/80 to a outrageous 190/ 80 reading in less than 5 minutes. I know this. I know I am going to fail your test because I cannot stand the fact that I am required to effectively humiliate myself in varying degrees depending on the doctors mood in order to receive said idiots "blessing" that that I am "healthy". What drives my blood pressure through the roof and me crazy is an apparent total and complete lack of standardization or consistent logical reasoning behind massively humiliating parts of the "standard annual physical" including the "pelvic" exam and "hernia check" and rectal exam or "hemorrhoid exam" or whatever the hell you want to call them and the total disconnect between creating trust between patients and actually improving the health outcome of a patient. Just calm down sir, just calm down. I am calm. I just really want to tell you how much I hate how you do what you do.

This year as an asymptomatic adult male I went to go to see an FAA medical examiner to have my class 1 medical. Without your class 1 medical examination you cannot fly for the airlines. Which pretty much makes it a requirement for employment. Power dynamic anyone? A 32 year old military pilot, I am in what I consider to be fine health. My knees hurt a little bit when I long run distances and my back hurts when I screw up a 300lb squat clean but other than that I generally have no complaints. So this year I go to an exam that essentially amounts to a humiliating ritual (it certainly isn’t healthcare) pay my $130 dollars and receive my piece of paper. Along the way I have to pull down my pants and expose myself so that a person who I have never met before and who has not explained to me the purpose of his examination can rub my testicles to tell me that I don’t have any lumps in them. The same practitioner proceeds to patronizingly tell me that I really should be doing my own testicular screenings. After the fact when I get online and look up what possible purpose such a humiliating examination could serve I am again reminded of where my rage for the medical community stems from. The United States Preventative Services Task Force or US PSTF (a group of peer medical "experts" who review studies of health outcomes to determine the effectiveness of specific screening tests like the testicular exam) has determined that this particular screening does not change health care outcomes (essentially because treatment options for testicular cancer are so good that early detection of said cancer makes no difference in terms of long term health care outcomes) and as such should not be done for asymptomatic individuals. Wait SO your telling me that data suggests that this humiliating practice will not help me to actually be healthy? What the actual **** are you idiots doing. What 's worse is that because of my complete lack of trust for the medical system I am never going to tell you when I actually am having problems with anything that really matters because In doing so I risk putting my career in your hands and potentially losing my job. I flat out don’t trust you to make a good decision for me. Why should I.. we just met today and you didn’t ask me any questions when you did your exam. But that’s okay because I realize that what your doing amounts to a ritual that you learned but have no evidence to support doing. But no its okay because it was once a standard of care and if you don’t do it you might get sued for not doing it. Really? I hate you.

I want nothing from you (the doctor) besides your sign off on a piece of paper that I need for some reason or another. You are an obstacle. We are not friends and I do not like you. One year I need your sign off so that I can go to flight school, join the military and follow my dreams. Another year its so that I can play football in high school. Another year its so I can fly you around to your medical conferences where you will fail to enforce standards of care across your community. But hey.. it is your practice right. What if pilots just made up how we would land the plane every time? That way you wouldn’t know what to expect. Wouldn’t that be fun.

In every case there feels like there is a ridiculous power dynamic between myself and the "doctor" aka another human being who is just as much of an idiot as myself that requires me to submit to whatever stupid ****ing bull**** the medical community has come up with on that given idiot day. It starts with the nurse having me take off my shirt so that I can wait for you in a cold room on an examination table. Hey you tried to put me up higher than you on that exam table to break down that power dynamic.. that sure was nice of you but you know its hard to feel powerful with your clothes off. Have you tried it? I could judge you as soon as you walk in and let you know what I think about your level of fitness. Lets try it. On second thought maybe we shouldn’t my wife tells me it 's not healthy to judge others.

So after we finish the testicular examination we move on to the hernia examination. At least you didn’t make me try to pull my foreskin back so that you could "visualize the meatus" whatever the **** that means like my ridiculous flight surgeon had me do last year until I was forced to explain that no I cannot actually do that and I am not going to continue to attempt it even if you are an O6 in the military. No I don’t want to play with my genitals in front of you. So you put your fingers on the sides of my hips and have me turn my head and cough so you can see if my intestines are falling out on the inside. Couldn’t you have just have asked me if I had any problems with my stomach? If I said yes wouldn’t that be the time to take a look? Why did I have to pull my pants down for this? If I had a hernia that wasn’t bothering me how would that prevent me from safely flying a plane with you on board? Is screening for a hernia really going to help me? It certainly humiliates me and many other high school age athletes. If I said no would you take my word for it? I am taking your word that you actually have a reason for what your doing. Why are your examinations different every time? Why am I made to feel like I don’t know what will happen each and every time I walk into a doctors office every time. Your failure to standardize care and to make it something that is logical, consistent and actually helpful has real consequences for real people. Please dear god someone tell me that you're not just making this up every time.

So then we finish with the hernia examination, where I could have told you if I had a problem and we move onto my favorite. The rectal examination where now with my pants down you tell me to turn away from you and bend over. Can you think of a more humiliating position? I am trying hard and I cant. And you tell me that you are looking for hemorrhoids. Great.. again couldn’t you have just asked me if I had any problems with my body. Again I could have told you if I had some and we could have had some trust that went both ways. Maybe I know when something is bothering me. I did manage to get here on time (early) and to fill out all the forms with no spelling errors or so I think. Thank god you inform me that we don’t need to do a digital rectal examination because i'm not over 40. You don’t mention that no controlled studies have shown a reduction in the morbidity or mortality of prostate cancer when detected by digital rectal examination at any age. At any age!!? Are you ****ing kidding me do you guys not read your own literature? And you think putting your fingers in my butt is going to help me? Again it feels as though you are doing things to do them rather than with any clear purpose or intention backed up by evidence related to health outcomes.


The worst of it is how I am so angry at myself for allowing you to bend me to your will. For needing something that only you or one of your colleagues can provide, something that I want. I really cant believe that I want to fly enough that I am willing to humiliate myself in front of you. From now on I will begin any physical by declaring what I will not do. I will not let you touch my genitals without asking me if I have any problems with them. I will not let you touch my stomach or have me pull down my pants so you can check for hernia without you asking me if I have a problem and I certainly will never again bend over so that you can spread my butt cheeks to check for hemorrhoids when I know that I don’t have any problems going to the bathroom. Maybe if more of us respected our own intuition and judgment we wouldn’t have to humiliate ourselves for reasons that you cant even articulate. I for one am done putting up with your bull****.

Just in case I hadn’t made it clear.

I hate you.

Anonymous Pilot

Brother, I would look for a new AME. You can do that after you make the transition and get settled somewhere. Ask around, other airline pilots, and find a good one. A long term, established relationship with a good AME is very nice to have at a minimum, and may be vital to your career if you have an issue.

Bear in mind that most AME's cannot do 1C medicals, most cater to private pilots. There is a very long waiting list to get 1C authorization and having a 1C AME over the age of 90 is not at all uncommon in some locations (I've never had one under the age of 80). So they tend to be old skool, sometimes you just have to cooperate to graduate with a system that's pretty much still in the 1950's. But it's frankly better for us than sweating a full blood-work panel every six months...

You might also want to get some offline anger counseling, don't want to arrive at airline training at a low simmer, you'll come to a boil quickly from there and that will be it for you in the airlines.

Wow, dude. Easily triggered are we?

That’s actually not just a hell of a lot worse than you go through on every flight if you don’t have KCM.

I dont think its your bp thats gona be the problem.
Simple solution.
Find another ame. For more than 20 years my visit has consisted of vision, wgt, bp, ekg evry othr visit, and peeing in a cup. That and a short conversation about work and how im feelg.

That's the mental health assessment.

This is obviously a joke. If there was a pilot with this much of a rage issue, they would have gotten kicked out of training as soon as an instructor pointed out a mistake.

His registration info actually appears legit. I try not to waste my time on hoax posts.

If he ever makes it to an airline, I am sure video of the first gate agent who challenges him will be on this site then.

The original poster sounds very much like another one-post poster in the last day who came on board threatening to punch long-time posters in the face, and do violence.

The immature attitude, complete lack of understanding and nearly incoherent rambling of the original poster doesn't speak to a military aviator, but a kid who's never had a physical and who has no idea what he's talking about.

The original poster, if actually genuine, has no place in a cockpit and should seek counseling.

We are all professionals here (except the original poster). We've all had years of medical exams for the flight physical. I think I can count on one finger the number of times I've been given any of the exam elements the original poster is describing. FAA medical exams are simple affairs, hardly invasive.

The original poster needs to seek psychotherapy before he hurts himself or someone else.

OMG... so lame...