A cardiologist whose heart lay in flying

When I was seven, I would visit the Raja Sansi airport at Amritsar and stand for hours watching aircraft take off and land. The dream to fly probably got ingrained at that tender age. However, life had different plans and I joined the Armed Forces Medical College in 1989 with the passion to become a doctor. As professional qualifications kept driving one, I became a physician and then trained to become a cardiologist.

It was only after travelling the long winding road of medicine and 46 years that I got the time to pursue my dream to fly. I enrolled myself at the Pinjore Flying Club under the aegis of the Haryana Aviation Association.

While training and learning the terminology, I noted that there were many words that cardiology had picked up from aviation. I would have loved to say the reverse but the timelines fail to support me.

In cardiology, we have words such as ‘take-off point’, from where a vessel emerges and it is the same in aviation where an aircraft leaves the ground. Landing zone is the point where the edge of the stent will lie and it is the same in aviation where the aircraft will touch down. During the last stage of stent deployment, we often ‘flare’ the stent, which again is one of the last manoeuvres before a smooth landing.

To ensure safety during critical cardiac procedures, there is redundancy of commands and they are repeated by the ‘first assistant’ quite like the ‘first officer’ in the cockpit. Phrases such as ‘wire is mine’ by the cardiologist are repeated as ‘wire is yours’ by the first assistant to ensure that the wire inside the coronary artery is never unattended. This is so similar to the phrase ‘my controls’ by the pilot-in-command, echoed as ‘controls are yours’ by the co-pilot.

Stent designs have ‘aspect ratios’ and ‘strut’ design and thickness is similar to the aspect ratio and strut support of wings of the aircraft.

During critical emergency, life-saving ‘bailout’ stenting is performed, similar to ‘bailing out’ from an irretrievable emergency in an aircraft.

Many other words such as dissection ‘flaps’, burr ‘stalling’, and stent ‘threshold’ are often used during procedures in interventional cardiology, making this association so exciting.

Even the procedures of cardiology are so similar to aviation. The first to strike is the similarity in hand-eye-foot coordination. Interventional cardiology necessitates a sharp vision, ability to rove between parameters on monitors, angiographic screen and progress of the coronary hardware within the blood vessel. This is analogous to the scanning of vital instruments such as airspeed, altitude, vertical speed indicator, engine and electrical parameters and navigational aids. The hand-foot-eye coordination and skill is an integral part of high-end cardiology procedures as radio frequency ablation and rotablation, analogous to the landing procedures in flying. I found it especially true during crosswind landings by the ‘crabbing’ manoeuvres.

The awarding of the private pilot licence and a degree in cardiology has not only given me an insight into the unparalleled joy of flying and the practice of cardiology, but also a unique and rare experience to perceive the skill, incisive and lucid analysis, that too at ‘lightning speed’ necessary in both professions.

I feel privileged and humbled being a soldier, cardiologist and pilot to don the flying suit and be a flying doctor!

LIFE-SAVING ‘BAILOUT’ STENTING IS PERFORMED SIMILAR TO ‘BAILING OUT’ FROM AN IRRETRIEVABLE EMERGENCY IN AN AIRCRAFT