Or, The Idea That Had Its Genesis On Andrea‘s Wall, But Became Much Too Big For There, Here, And Everywhere
(Warning: This post is about three times what I consider an approximately “average” length – so either settle yourself in for a long and winding read, or close this page in your browser and do not look back – unless, of course, you are curious about the daily life of a pillar of salt.)
Just did some research on the necessaries for obtaining a private pilot’s license. The word discouraging doesn’t even begin to encompass what I discovered. I suspected that it wouldn’t be good, but it was so much worse than even I anticipated. Here we go.
So as far as restrictions go, for a private pilot’s license (emphasis in place so that all of you know that the pilot flying your commercial aircraft is subject to a much more rigorous examination and review – at least I would imagine and hope so, I didn’t actually look up the specifics of a commercial pilot’s certification), you have to be able to pass an exam given by a Federal Air Surgeon, who then issues you a Third-Class Airman Medical Certificate.
Do you think that you know where this post is going? Because you may have a vague idea, but I (and I suspect you, my readers, who don’t spend a great deal of your time thinking specifically about moi and all the associated. . . special issues that come part and parcel with being moi), was actually really knocked down by the complete and total locked and inescapable labyrinthine construction of the system.
Once more, with feeling. . .
So to begin with the bright work, I could likely get a Discretionary Issuance for my Neurologic issues (yes, I know that the proper term is neurological, but the government says Neurologic, and at this moment, and in this regard, they are the flight gods). A Discretionary Issuance is, to the best of my understanding, a sort of waiver that the Federal Air Surgeon grants one when, “. . . [a] person. . . does not meet the provisions. . .” delineated for a Third-Class Airman Medical Certificate, but is not judged to be a risk. I have not had any psychogenic non-epileptic seizures in approximately three months. *knock wood* Another nine months – I thought it was a year, but actually, as I look further, it seems to be entirely discretionary, the Federal Air Surgeon may say I’m clear after a year from being, “. . . reasonably. . . expected, for the maximum duration of the airman medical certificate applied for or held, to make [me] unable to. . . safely perform the duties or exercise the privileges of the airman certificate applied for or held.” Or he could be a dick and say I have to be clear from the PNES for two years or more.
Moving right along. My next strike is, of all things, Substance Dependence. This term means, “a condition in which a person is dependent on a substance, other than tobacco or ordinary xanthine-containing (e.g., caffeine) beverages. . .” Well, guess what I ingest into my body every single day? Pretty high doses of Klonopin (clonazepam) and Valium (diazepam) – there are other medications as well, but I’m thinking these are the ones that would freak out anyone evaluating me as “safe” to fly a plane, if they didn’t know me and my level of functioning (which they would not, based solely on a medical exam). Yes, these are medications which a doctor prescribes to me, but there is no listed exception for a situation such as that.
In any case, my “dependence” would result in, “A verified positive drug test result.” Which would also negate the possibility for me to be medically certified. Unless, of course, I stopped taking these drugs which prevent me from going totally fucking off the rails crazy, so I could show, “. . .established clinical evidence, satisfactory to the Federal Air Surgeon, of recovery, including sustained total abstinence from the substance(s) for not less than the preceding 2 years.” I would say my sanity is totally worth that, wouldn’t you? Except for the obvious part, where I would not be able to maintain my sanity for the necessary two (perhaps two-plus) years.
Which, of course, brings us to the elephant.
Oh, but here we’ve come to the very best part, the one that is listed very prominently on every single goddamned site I checked out, and I didn’t have to look very hard, either, because it is a major, ‘give up all hope now, because you are so totally fucked, don’t even think another thought about flight school,’ prohibition. You all have to know what’s coming by now. I (I will admit), actually did not. I thought that this would not be a complete and total blanket disqualification from getting a private pilot’s license because of two words, one diagnosis (military or commercial, yes but not private). Bipolar disorder. Ten points to you who guessed what I did not. I assumed, of course, that this would be an issue, and a very major one, but my expectations were all regarding symptomatology. Specifics of disease course and manifestations. No. I have “A bipolar disorder.” That’s all. And that’s everything.
I could have completely and utterly obliterated/destroyed/hidden/snowed/disqualified – just pick a verb that you are especially fond of - the idea of this illness about five or six years ago. But I now have the indisputable, written diagnosis made by five individual psychiatrists and two independent psychologists (I know, two ain’t quite so impressive as five, but the italics are necessary for continuity of style), as well as a licensed clinical social worker – I’m pretty sure the LCSW put at least a “possible” diagnosis of bipolar down in writing – this was not her area of expertise and she was not properly qualified to “officially” evaluate, nor to treat me (she sent me down to psychiatrist row, which mostly I very much appreciate her doing, but there are moments in which I could hate her intensely for it). In addition to these eight trained professionals, pretty much all of whom I would give credit for being knowledgeable in the area of bipolar disorder (regardless of whether I like them), I am currently on SSI (a.k.a disability, properly expanded to Supplemental Security Income), a stipend granted to me by the government, specifically for the debilitating effects of my bipolar disorder. Which actually adds to the total count one more psychiatrist – the one appointed by the state – and a judge, who presided over my case and granted me the SSI (the count of professionals who have “signed-off on,” or “endorsed,” if you like that designation better, my diagnosis is now up to ten, plus “the government,” but I don’t actually have any idea of their designated numerical significance at this particular moment).
It’s funny, for the past handful of years, my primary care doctor would always write “depression” as my psychiatric complaint, he would never, ever write “bipolar disorder.” I always figured it had something to do with insurance, and that he was being sweet and kind and protective. Never did the potential incidental ramifications of that label enter my mind. At least not then. The unparalleled naiveté found solely in the incredulous human.
Even now, I’m certain that I could hide my symptoms from any doctor, be it a psychiatrist or a Federal Air Surgeon. Or if nothing else, I could find someone who has the letters MD after their name, and Psychiatry as their “area of expertise,” who would be willing to “clear me” – in exchange for God only knows what. If I were lucky, it would just be a large sum of money, under-the-table. *creepy wink* But I would never, I could never, do something like that. More to the point, see the overwhelming support of my bipolar diagnosis listed above. So let’s put the last few nails into that coffin and hammer it tight.
But wait! It is potentially not that cut-and-dried. Hooray. There is another form of governmental certification. ”At the discretion of the Federal Air Surgeon, a Statement of Demonstrated Ability (SODA) may be granted, instead of an Authorization, to a person whose disqualifying condition is static or nonprogressive (sic) and who has been found capable of performing airman duties without endangering public safety.” Translation, if I can be “steady-state,” “stable,” – “healthy,” is what I ultimately think they’re looking for (or “euthymic,” to apply the correct psychiatric term for those with mood disorders who are not episodic) – for a period of at least one year, then I may be granted a Statement of Demonstrated Ability.
If I were given a Discretionary Issuance for my PNES, a possibility which I actually could be pretty optimistic about, that’s one hurdle down. As far as my Substance Dependence, I would think if I had made it so far along in the process that someone was going to monitor my moods for the span of a year to decide whether I was euthymic (and not a public safety hazard), whoever was doing the evaluation would have to have spent at least a bit more time around me, and hopefully seen that these prescribed medications, as far as I react to them, in no way interfere with the skills and aptitude necessary to fly a private plane. I am much more pessimistic about that barrier. People see medications and dosing, they rarely look at the effects on the person. Playing devil’s advocate to myself, though, let’s say that while properly monitoring me over a year’s time, they waive the dependence issue. That would also nullify the implications of “A verified positive drug test result.”
So I’m pretty golden at this point. I’m cruising along, I’ve cleared nearly every roadblock. All that I have to do is keep steady-state for one year. One year is not very long, when you’re looking at the span of the average life. But when the longest period of stability which you can document for yourself is three months (that’s one-quarter of what’s being looked for, in case you didn’t think of it in those particular terms) – three effing months out of the 14+ years which I can identify as actively exhibiting bipolar, without question or doubt – three months non-symptomatic? A year may as well be ten, or even an entire lifetime.
The End (except not completely, because I thought, What the hell, why not throw every disqualification that applies to me into this post? It’s already twice the word count of an average post).
“A psychosis. As used in this section, “psychosis” refers to a mental disorder in which. . . [t]he individual has manifested delusions, hallucinations, grossly bizarre or disorganized behavior, or other commonly accepted symptoms of this condition. . .” Been through that one before.
“No other personality disorder, neurosis, or other mental condition that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds—
“(1) Makes the person unable to safely perform the duties or exercise the privileges of the airman certificate applied for or held; or
“(2) May reasonably be expected, for the maximum duration of the airman medical certificate applied for or held, to make the person unable to perform those duties or exercise those privileges.”
Aside from the bipolar obvious – grandiosity, impulsiveness, impaired judgment, lack of insight, etc. – I also carry diagnoses for panic disorder and post-traumatic stress disorder. When those bastards kick in, and they often do so without any apparent trigger or overt warning, you enter something akin to flight-or-fight mode (no pun intended) and cease to be able to think rationally or even follow simple directions. Since I’m writing about flight, I’ll specifically draw your focus to the inability to rationally recall the basic mechanics of keeping a plane aloft and level. You also lose most (if not all) of your ability to listen and focus and follow directions from (in this case) your co-pilot or the flight control tower. I would bet on this paragraph alone, I would be classified as “. . . unable to safely perform the duties. . .” Et cetera.
And because I am so obviously in a mood to guild the lily: Though I do not carry a formal diagnosis of Impulse Control Disorder, I would bet anyone dollars to donuts that I am stuck with that one, too. Maybe I don’t fit in the more extreme, often dangerous classifications, such as Kleptomania, Intermittent Explosive Disorder, or Pyromania (and for that I am grateful). But my tattoos, my spur-of-the-moment cross-country road trips, and my credit card bills – along with a few other things I won’t detail – are vivid reminders that I consistently do things with an inexplicable internal driving force, and absolutely no thought to consequences. I honestly believe I have never been diagnosed simply because I have never asked or been asked the appropriate questions about my habits and behaviors. Or maybe I have and I’ve lied.
Just an FYI: ”An Impulse Control Disorder can be loosely defined as the failure to resist an impulsive act or behaviour that may be harmful to self or others. For purposes of this definition, an impulsive behaviour or act is considered to be one that is not premeditated or not considered in advance and one over which the individual has little or no control.” (source, Forensic Psychiatry .ca)
Due to the fact that bipolar disorder and impulse control disorder occur so frequently together (co-morbidity), it becomes difficult to tease out the strands of which precipitated what.
That’s a very good behavioral profile for a pilot, isn’t it?
Oh, but merely look and you will see a faint light on the whole wanting to be a pilot thing, because that was what precipitated my deeply personal, cathartic, and largely self-punitive diatribe. ”In determining whether an Authorization or SODA should be granted to an applicant for a third-class medical certificate, the Federal Air Surgeon considers the freedom of an airman, exercising the privileges of a private pilot certificate, to accept reasonable risks to his or her person and property that are not acceptable in the exercise of commercial or airline transport pilot privileges, and, at the same time, considers the need to protect the safety of persons and property in other aircraft and on the ground.”
Well damn, that clears the slate for me! I’ll be flying high in two shakes of a lamb’s tail.
Moral of the story: This is what is referred to as a ‘downward spiral.’ All of you got to read it as it happened. You were here. Now to find a way back up. . .
All regulations quoted above regarding medical certification for private pilots, disqualifying disorders and conditions, special considerations, exemptions, etc. – let’s just go with everything quoted but not sourced in the body of the post – can be found in more detail at the Electronic Code of Federal Regulations page.
***I wrote this post, in its entirety, in one sitting, with no interruptions at all over a period of a few hours, four days ago. I didn’t publish it immediately (as is my usual method when blogging), because after I finished it, I was convinced that in re-reading it I would find it utterly nonsensical and potentially an exhibit of my own psychosis. These fears grew with each day. Today I decided to just face it, and was actually very relieved. It needed basic editing for grammar and consistency of style, as all my posts do, but aside from that I didn’t have to alter anything. I actually found it quite readable and easy to follow, though hardly one of my best posts (I do have an advantage as far as understanding, of course).***
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