February 2009

Beware of Burnout

            When a burnout occurs in the cockpit, sometimes the consequences can be fatal.   Burnout, a term referred to when speaking of electronic components and lightbulbs, is also used in medical and psychological assessments of patients who experience long-term exhaustion and diminished interest in their work.   High stress jobs can lead to more burnout than normal ones. Although stress is subjective, people in   the customer service industry, law enforcement, air traffic controllers, emergency service workers, and probably airline pilots, seem more prone to burnout caused by stress.

            In January 2008, an Air Canada flight from Toronto to London had some trouble over the Atlantic Ocean .   I cannot recall hearing about the incident at the time, nor could I find any news reports in archives, however the inevitable investigation finally concluded in November, when many of the facts were reported.   Because the flight diverted to Shannon Airport , an official report into the incident was issued by Ireland ’s Air Accident Investigation Unit which stated the co-pilot suffered an “emotional breakdown”.   He began talking in a “rambling and disjointed” manner, then refused to observe safety procedures and was belligerent and uncooperative.   The captain ordered other crewmembers to remove him from the cockpit and restrain him for the duration of the flight.

              I could find no report which diagnosed the cause of this mans behavior other than one which described it as an “emotional breakdown”.    To be clear, nothing in this article is intended to judge or explain what occurred.   Whatever this fellow suffered from, I sincerely hope he’s been treated for it and has healed.   We all know the strict regulations faced by pilots when it comes to medical exams.   We know too that there are ways and methods to (temporarily) get around some medical issues, and that there is no definitive testing for every mental problem.

               Stress can be considered an emotional problem and a definitive diagnosis can be difficult.   Denial on the part of the patient is common.   Either he is in conscious denial of his problems, or simply doesn’t understand what’s happening.   A perfect example is where a person presents with physical manifestations such as headaches, dizziness, gastro-intestinal dysfunction, sleep disruptions, loss of appetite or unexplained abdominal pain.   Nothing of a physical nature can be found in testing, and when questioned regarding his stress level, he denies any stress in his life.   Further inquiries into his home life, job, family and financial situations may reveal a large mortgage, plumbing repairs needed, a demanding boss and work environment, two troubled teen-age children, and perhaps some big debts.   In other words, the everyday problems faced by so many people in society that we consider it all as normal.   What’s to be stressed about?

                Although insidious,   the stress is very real, and over time wears the person down, grinds away in his mind, until if untreated, burnout occurs.   His mind, similar to the light bulb, is simply unable to handle the heat any longer.     When it snaps, it does different things to different people.   The extreme has been described as ‘going postal’.   If it was the cause of the co-pilot’s behavior in the incident in this article, over 150 people were endangered by stress.  

                 I have seen patients in the burnout stage.   I’ve seen them in denial, and others who simply didn’t have a grip on what was happening to them.   And having gone through most of it on a personal level, I often ask the question, “How can the aviation medical examiner possibly screen every pilot for stress that is occurring or is likely to occur?”   My last Category 1 medical exam lasted less than 10 minutes (extra for the ECG and paperwork).   In my opinion, it’s nowhere near enough time to dig into a person’s mind and discover the early warning signs.   But does anyone have an answer to how Transport Canada could guarantee a person’s physical and mental health before issuing his medical certificate?  

                  A system is in place, and like any system, it’s not perfectly fool-proof.   If this Air Canada co-pilot broke down due to an emotional issue, it really doesn’t surprise me.   If it were a medical issue, such as diabetes, drug related, clinical depression (undiagnosed) or even a fight with his wife that caused his behavior that day in January, there is still no way to predict every possibility.   We do the best we can.   We install back-ups wherever possible, and live with the risks.  

                     One final comment would be that each of us has the responsibility to accept and cooperate with the intent of the laws and regulations that are designed for the good of all.   That means that as pilots, who have the lives of others in our hands, we don’t knowingly deny problems in discussions with the aviation medical examiners.   Several years ago, an incident involving an airline pilot who had hidden his diabetes from his employer, almost cost the lives of his passengers one night.  

                    It also means that we need to accept when the time comes that we’re no longer able to be safe in the cockpit.   Flying is a wonderful, exciting and fulfilling way to make a living.   As pilots, we’re fortunate to experience all it has to offer.   But there are other professions that can be just as rewarding, and when the time is right, we accept that’s where we’ll be.  

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