Experience Is Uniquely Suited To Communicating Complex Physiological Problems

An F-16 Fighting Falcon’s sustained 9 g-force break turn is no small matter on a normal day. Imagine yourself there. Your head weighs 180 pounds and your arms are pinned to the stick and throttle; let go of your breath the wrong way, and you watch the world fade from gray to black in an instant. Now add to this situation a corset-tight upper vest built to restrict lung inflation and an oxygen hose with half the normal flow rate – on purpose.

This is the situation Maj. Justin Elliott, Air Force Strategic Policy fellow, experienced for two weeks in 2015 while trying to identify the array of physiological problems affecting Defense Department fighter pilots.

Currently working South Asia strategy for a deputy assistant secretary of defense, Elliott’s flight experience is uniquely suited to communicating the complexity of physiological problems affecting the DoD’s fighter fleet.

A graduate of both U.S. Air Force Weapons School and Test Pilot School, Elliott has flown over 2,000 hours and 255 combat hours in more than 30 aircraft from the MiG-15 to the F-15SA Advanced Eagles. His flight test experience spans from early F-22 Raptor “work of breathing” testing to managing the development and testing of the Air Force’s first “smart” cockpit pressure gauge, fielding this year.

In a powerful statement of transparency, Air Education and Training Command officials decided to put Elliott’s experience to good use. “The punchline is that we do not have all the answers yet,” Elliott said. “But, the best doctors, flying physicians, physiologists, engineers and pilots in the world are working on this every day. And right now, I am going to catch you up to the state of the science.”

Following a recent series of unexplained physiological events, Maj. Gen. Patrick Doherty, 19th Air Force commander, capitalized on Elliott’s expertise, asking him to share his experiences with AETC’s T-6 student pilots and instructor pilots. During a two-week period, Elliott briefed all of AETC’s flying training wing members. The briefing was one he initially presented to AETC senior leaders during a cross-tell event Feb. 8-9, 2018, at Joint Base San Antonio-Randolph, Texas. “We want our aircraft back in the air, but our priority is making sure our aircrew are safe and smart in the aircraft, confident in themselves and their equipment,” said Doherty. “I took the brief from Maj. Astro Elliott at the On-Board Oxygen Generation System Conference. His flying experience and knowledge is invaluable to our Air Force, and I knew it would be critical for our young officers to hear what he had to say, so we sent him out to talk to T-6 Nation the following week.”

This visionary move by Air Force leaders is a positive departure from the way physiological research was communicated to pilots during the F-22 Raptor investigations in 2012. Instead of dictating procedural changes to pilots from an isolated group of researchers, Air Force officials are opening joint communication lines across all platforms and career fields involved in addressing this critical problem. “It is heartwarming to see this kind of transparency from our leadership,” Elliott said. “It will go a long way in keeping the faith with our aircrews. Though these issues are new to T-6s, they are very familiar to me given my life as an experimental test pilot who happened to be at the right place at the right time,” said Elliott, who built the core of his brief in 2015 with outreach and culture change in mind.

Three years later, the brief has grown to include collaborative anecdotes from F-35 Lightning II, T-45 Goshawk, the international fighter community and even the Air Force’s elite pararescuemen.  “Woven together, these stories teach lessons that will last well beyond the mechanical ’smoking gun’ we are certain to find and solve in the T-6 fleet,” said Elliott.

Elliott recommends pilots use the following “do no harm” approach to change their psychological mindset in the air to arrive home safely. “Do not try do diagnose yourself at 500 knots – or 316 knots in your case,” Elliott emphasized, “Just get to a safe space.

“Imagine yourself again in the 9 g-force situation – but you did not put yourself there in a controlled flight test,” he said. “Instead of focusing on breathing and cognitive abilities, imagine you are focused on a target lock or an aerial gun attack when you suddenly feel dizzy and unable to think straight. Many of my friends have been there, and it creates a mental stress not comprehensible at 1G and 0 knots. At least six physiological issues we know of can compound to put you in this situation on any given day. We have to teach people how to get out of it.”

He also said, “Unnecessary mental stress of realizing something is affecting you beyond classic hypoxia – especially when no one has told you what it is – can lead to subconscious hyperventilation that makes a bad situation worse.”

By education alone, aviators can take an important step towards safety. The good news is, while the causes of physiological symptoms vary dramatically, the solution is the same. “Go to Colorado or to Bagram Air Base, Afghanistan, where I landed every day at 5,000 feet,” Elliott said. “No matter what your jet was doing to you before, breathing ambient air calmly at these altitudes, at a normal rate and depth, will work you toward recovery. There is no need to rush home in a panic and land a jet at the peak of your cognitive problems. Just descend to a safe altitude and relax.”

A group of experts in medical, physiological, aviation and engineering called COPE Fighter has been refining this solution for the past two years. “COPE will solve the mechanical issues across our current fleets, rewrite our syllabi to educate aircrew, change checklists and cross-flow solutions across platforms,” said Elliott. “We are not focused on one platform. COPE will work to ensure we design our future systems with the physiological state of the science in mind. That means aiming sensors at humans so the pilot never has to think about breathing again.

“What we have been hearing over the last few weeks has been word of mouth, so it was nice to have someone informed on the situation talk to us about it,” said 1st. Lt. Joseph Uhle, 37th Flying Training Squadron upgrade instructor at JB San Antonio-Randolph.

Since briefing AETC personnel in person, Elliott’s briefing was recorded and is now being integrated into student undergraduate pilot training across AETC bases.

(Image provided with USAF news release)

FMI: www.af.mil