Ask Captain Lim

Dear Capt Lim,

I have spent a few hours reading your highly interesting and informative website about aircraft and flying. I like to recommend this site to all my friends. I always like flying, but unfortunately I am now only eligible to fly as a passenger, which I did on numerous occasions with Malaysia Airlines and others. In your website which I visited with interest, I was more interested in the technical aspects of an aircraft, such as its take off, cruising, and landing speeds, weight of an aircraft, fuel consumption, force, thrust, the energy expended by a jet engine, nature and caloric values of the fuel, fuel consumption, dangers of flock of birds in the path of an aircraft, meteorology, aerodynamics, physics of flying, navigation, instrumentations, cosmic rays, ozone depletion, air and noise pollution, acid rains, oxygen deprivation, medical effects under hypoxic environments, sleep deprivation and circadian rhythms, haemodynamics, cardiac and pulmonary functions, hematological responses, bone marrow, and spleen feedback mechanisms, ventilations and pulmonary diseases, and Legionnaire’s Disease by Legionella pneumophila, on the incidence and epidemiology of neoplastic diseases (cancers and tumors), and degenerative disorders among pilots and crew members due to free radical damage and increased cosmic rays exposures.

Other areas I have in mind are the problems about congenital defects and the mental intelligence of babies born to pregnant air-stewardess under chronically low oxygen tensions, and cosmic rays damage. Then we also have the problem of deep vein thrombosis (DVT), neuro-motor responses, mental and psychological functions with rapid time changes, and sleep deprivation, all other medical as well as aircraft emergency situations, and much, much, much more I could list out the entire night till morning. Unfortunately not all these aviation dynamics, and medical problems I was so keen in, were posted in your website. Do you want me to help you in the medical areas? It is very easy for me.

You see I was a Government medical scientist and a research doctor. So all these technical and scientific information about piloting, about aircrafts, also intrigue me tremendously. Because of my scientific background, I have great love for physics, astronomy and mathematics, besides medical research and medicine. In fact physical sciences like physics, mathematics, astronomy, space travels, problem-solving scientific and mathematical puzzles are my very, very, hot passions in life, not those cool, and sissy subjects like biological and medical sciences. It is very unfortunate an ill wind blew these disciplines into my face.

Congratulations for your very informative and great work. I spent hours reading them, and was grossly engrossed in your aviation dynamics, and not in patho-physiological dynamics or haemo-pulmonary dynamics of medicine or physiology.

I think being a pilot is a tremendously responsible and exciting job, more noble than being a doctor or a biological / medical scientist. As a pilot, you have the lives of hundreds of people sitting behind you who are all going to depend on you, your skills, and your experience in bringing them all up to 10.6 km (35,000 feet) into the air, hurtling them like a missile at near 1,000 km per hour, and yet you must pilot them safely to their destination in the most assuring, shortest, and fastest possible way. What a noble, responsible, and dramatic profession that is ! The lay public hardly can see this, and recognize this great responsibility. As a physician myself, only one life at a time depends on you, and if a doctor makes a mistake, only that life is lost. It will not affect others. There is nothing great about that, or being a doctor. It’s very boring job, especially when we sometimes get abusive, demanding, uncooperative and ungrateful patients. But being a medical researcher at the same time, our responsibility spirals even far, far, higher than that of a jet plane. The burden is even far more extensive and heavier than being just an ordinary practicing doctor or even a pilot.

Imagine this scenario. A research doctor or scientist who is supposed to be far more intelligent, more brilliant, and has much higher thinking power and qualifications, would be far more responsible. Think now of this picture. A medical researcher was asked to investigate on a certain problem about a certain drug, or a certain modality in the treatment protocol. But, he made a wrong design, or a fatal move in research and discovery. He then publishes the findings in a prestigious scientific / medical journal, and the editor did not even reject his paper. That piece of work is going to enter into all the medical libraries around the world, and that method or discovery is going to be taught to all future practicing doctors by universities around the world. The repercussions are like a nuclear chain reaction. The researcher’s name is going to appear everywhere. He is being hunted by every newspaper, radio, television and popular magazine. His work is going be quoted and quoted over and over again in the references of subsequent medical and scientific journals. He is being sought after everywhere. He is invited as a very eminent guest speaker, and a paper presenter everywhere, and at every international scientific conference. He appears at public forums and at invited talks. His work is being discussed in the academia, and in the scientific / medical circles. He becomes an extremel glamorous personality, perhaps admitted as a Fellow of a Royal Society, or even a Nobel Laurate. He becomes an icon in the high towers of the academia, and yet ironically he is not being recognized and appreciated as somebody by the lesser, and much lesser informed ordinary man-in-the street, who obviously being not in the scientific circle, do not know all that. But unfortunately his findings was faulty and to a large extent wrong.

You can now imagine the repercussions this will have on the lives of, not just one patient, but on billions of people and patients around the world who are going to be subjected to that method of treatment or discovery that is going to be administered routinely by their future doctors. The ordinary and common doctors themselves are all going to depend on that piece of erroneous work, and information published by the researcher. No where else can doctors get scientific information except from published work in the journals, although unfortunately these days, extremely sad to admit, many of the less informed doctors and even physicians, depend entirely on drug companies, and drug salesmen who seem to know much more than them, to brain wash them with their products. The doctors are being impressed, and brain-washed by these ‘evidenced-based’ data, but wrong data ? There is no way they can check. Their training and mind-set is like that. The result is devastating, and I need say no more.

So the responsibility of a research scientist is obviously far, far, far, far, higher and greater than that of an ordinary practicing doctor who does only routine work based on all these information. The only exception are the university professors and senior lectures and readers of medicine who are well-informed. The public does not realize this. The only safety valve we have here is that, the method is going to be checked and verified by other researchers many times over in terms of safety and efficacy before it is approved and recommended for practice. So there are some consolation here. These are safety features we can depend on, just like those safety features in an aircraft w e can rely heavily on. All these, plus the very heavy responsibilities of an airline pilot, the ordinary people in the street cannot see and appreciate. At least the safety of a life-saving procedure, whether in medicine or in aviation is being checked, and rechecked by many other people on the ground who are highly qualified, skilled, and critical. I think in this context, aviation physiology and aviation medicine as applied in space travel is the most exciting field of all sciences I can ever dream of.

But in the case of an airline pilot, we have no choice once we are in the air. We have to be contended with just one pilot, one or two first officers, an air-worthy aircraft, and then have hundreds of passengers sitting behind a large aircraft, like the Boeing 777 you are now flying. They will all be flying at the mercy of that Captain. You are in command of that aircraft as a Captain, with your first and other flight officers only second in command. If the captain makes a gross mistake, or does a insane act, or purposely wanting to crash that plane for some ill-informed religious beliefs, or hearing mad voices, well, all those few hundred lives, including the pilot, and all his colleagues are going to be lost into eternity.

Back to being a pilot. All those lives in the plane are going to depend on just that handful of cockpit crew, with the Captain bearing a very, very, heavy responsibility, short of some lunatic people in the plane. Under ordinary situations, if that aircraft and all the lives in it are lost, it is all because of some ill or misguided information (like wrong research data), wrong flight instructions, instrumental or mechanical failures, so I believe.

Your job as a Captain, I believe, is a very saluting, and a very noble one. I have always wanted to take off in life as a pilot, but somehow very high velocity cross-winds blew me off course, and very powerful head winds slowed me down. I wished there was a tail wind encouraging, and speeding me forward. I could not navigate back despite steering against these natural forces. It only forced me to make an emergency landing on the wrong runway at the wrong airport. So that’s where I landed. Now I find solace only in seeing a plane taking off majestically like a huge screaming bird, and sometimes sitting inside only as a passenger. Otherwise, my only joy in life now is doing astronomy as a hobby if the sky is clear. In some ways, positional astronomy is very absorbing like navigation, and direction finding by the stars. My other joy is in music as an amateur violinist, my involvement in symphony orchestras, and to a very small extent, giving some comfort and assurance to my patients. These give me some peace.

I think being a pilot is a first class profession, other than me wishing to be an astronaut, an astronomer or a concert violinist.

Lim Ju Boo

BSc, Postgrad Dip Nutr (Lond), MSc (R’dg), MD, PhD (Med), FRSH (Lond), FRSMed (Lond), DSc (Int Medicine)
Malaysia

Dear Dr Lim,

Thank you for the lengthy email and your opinion as to the responsibility and nobility of the pilots profession. I think the medical profession is even more noble - look at Dr Carlo Urbani who sacrificed his life for the recent SARS research.

You have mentioned a long list of topics which were not included in my Website. Unfortunately, I have very little knowledge in some of them, especially those related to the medical field. So far, no one has asked me on some of the areas that you wrote about. My Website is meant generally for the average air travelers who want to know the intricacies of some basic topics related to flying. You are the first medical scientist whom I have come across, to show so much enthusiasm about flying. I am afraid, I am unable at the moment to cover some of the topics that you want to know. Thank you for your offer to help me out on Aviation Medicine. I will come back to you again when I get a question that I am not able to explain from a medical point of view.

Once again, thank you for your insight on the responsibility and nobility of the pilot's profession.