Romeo And Juliet

To pen these articles, aiming to advise my fellow aviators on how to live their best, healthiest, and longest lives, I rely on a visit from my Muse. 

Yes, the kernel of an idea may come from a pilot’s medical question, a topical health issue, a disease awareness month and so on, but like muscles need a skeleton, I need a framework on which to hang the narrative, to engage and hopefully amuse, to reform and improve thinking; for medical information delivered without context may, instead, bemuse.

Today, that framework is the concept of nominative determinism, that one’s name might influence a future career. Young John Baker might be destined to produce bread, Jennifer Styles may find her future as a hairdresser, Helen Ross’s initials may dictate her career in Human Resources. Or, as on the Jimmy Kimmel show in 2017, we met a volunteer firefighter from Sun Prairie, Wisconsin, Lieutenant Les McBurney (less burning beds), Dr. Chip Silvertooth, who, you guessed it, is a dentist, and Paul Schwinghammer, who is a contractor. Also—take a deep breath—arrested for possessing cannabis were Gregory and Timothy Weed, and when discussing this with my fellow AOPA contributor, Professor Ken Stahl, he pointed out that his was not a great surname for a pilot!

So, I thought I would consider what’s in a name; does it matter what things are called? For instance, given I am writing this in the tenth month, we know what to expect at an Oktoberfest celebration; lederhosen, beer, bratwurst, and German music. We know what to expect when ordering a hamburger or lasagna, and meeting someone and expressing romantic interest, we associate their name and characteristics; mere mention of their moniker will evoke a positive, Pavlovian response. Names matter. In Shakespeare’s Romeo and Juliet, Act II scene II, Juliet bemoans her beloved’s last name, which makes him an enemy of her family: “What’s in a name? That which we call a rose by any other name would smell as sweet.” So, considering obesity, or diabetes, for instance, they are not just names, they have implications as mortal enemies to you and your loved ones. I don’t give a fig about ruffling a few feathers, all I care about is giving you, my readers, my fellow aviators, the best possible advice.

The context of words matters; I live near the Tower of London, a landmark that evokes thoughts of torture and sorry ends, yet in around 1,000 years of history just 22 people died there. The number of times I am asked by pilots with trepidation about accessing their medical records and tell them, “What part of it’s your medical record do you not understand?” Your medical record is a living, breathing document, not a museum piece. Ensure it is kept up to date by having words with your doctor about regular check-ups and needed screening tests.

Your life is the best gift, and you have the power to protect it, not just by eating well, exercising, and so on. One name that really matters is that of your healthcare provider, yet most people accept whoever the health plan suggests. When seeking a new primary care or specialty physician, be as diligent as if researching a complex instrument approach, as both can impact your health. Ask friends for recommendations, read reviews and credentials online, and, most importantly, seek an initial get-to-know-you session with the doctor to ascertain if you feel comfortable before embarking on a professional relationship.

Doctors often discuss time dedicated to explaining medical jargon to our patients; words that they see in online portal reports, yet do not understand. Inevitably, these cause confusion and concern; as pilots, a higher lifeform, think how easy it is to confuse lower forms of life about aviation merely by using our unique lexicon, a methodology to convince them we are more than mere bus drivers—not that being a bus driver is to be derided! For instance, you might discover that your doctor believes you have goat’s milk ice cream–induced sphenopalatine neuralgia; sounds dreadful until you know that means “brain freeze from eating a dairy dessert!” Or you have a sore joint due to prepatellar bursitis, otherwise known as “housemaid’s knee,” a common condition caused by kneeling and leading to swelling of a fluid-filled sac or bursa at the knee cap. And being told one has bursitis, the location is important behind or in front of the knee; after all, Paris could be in France or Texas! If a passenger flying with you was baffled by your radio calls, complaining it all sounded Greek or Turkish, you would explain in simple language. So, if you do not know what a word means, for goodness’ sake, ask!

As we sail toward sunrise on Thanksgiving morning, Americans will consume vast quantities of turkey, sweet potatoes, and pecan pie, somewhere between 3,000 and 4,500 calories. Bearing in mind an average male should usually consume 2,500 and an average female, 2,000 to maintain weight, this is a good opportunity to think about how foods are labeled. Any container of food might list calories contained, but ensure you are looking at per container, not per ounce.

Marketing wisdom states that there are four “P’s:” Product, Price, Place, and Promotion—what is it, how much does it cost, where do you sell it, and how do you let people know about it. Product names might be descriptive, characterizing exactly what they do, a noise-canceling headset or turboprop aircraft for instance. Often a descriptive will be preceded, or followed, by a proper name, such as the inventor, company, or an associative, aspirational, or mythical figure; think Piper, Mirage, Lear, Blackbird, Seagull, Mustang, or Gremlin. Some names are neologisms, created for that product alone—think Kleenex or Google. It is important in healthcare to understand what words mean, and interesting to know from whence they came. And if not obvious, again, please ask!

Product: When dealing with doctors, always ask what you are getting, and demand to know about the alternatives, risks, and benefits for any treatment plan; if headed to a restaurant with a loved one you would surely offer a choice of cuisine. Medicine should be no different and for instance, drugs have two names, one is the chemical entity (for instance, acetaminophen) another is the trade, or product name (in this case, Tylenol).

Price: Find out which your insurance may cover; an FDA-approved generic will have the same active ingredient as the trade name drug. Of course, always remember to ascertain if a new medication impedes your right to fly.

Place: This can matter for medical treatments; always check what your insurance covers, this doctor or that doctor, for instance. And if you need a procedure, location might impact price, whether at a doctor’s office, ambulatory surgery center, or hospital. Of course, always place safety at the top of the list when making such decisions but check to see what your insurance covers.

Promotion: I have written about this topic before; beware of aggressive marketing tactics in healthcare, often the modus operandi of those who peddle pseudoscientific cure-alls. FDA has strict guidelines about what can and cannot be said, so please, check out any new or different therapy for validity before accepting such treatments.

In 1953, the Four Lads released a novelty song, “Istanbul (Not Constantinople)” on the 500th anniversary of the fall of that city to the Ottomans. Sometimes different names mean the same thing. Conversely, a homonym is where a word has two meanings; for instance, musette is either a small bagpipe or a petite French oboe and with one letter changed, Musetta, a character from La Bohème.

In aviation we have taken steps to ensure clarity; “taxi into position and hold” means just one thing, and we use call-and-response practices. In medicine the consequences of misunderstanding are profound, so please, always ensure you and your healthcare provider are on the same page and that on the pages of your medical record, issues are reported accurately. In Woody Allen’s 1997 movie, Deconstructing Harry, the lead character states 'The most important words in the English language are not 'I love you' but 'It’s benign'. My column is titled Fly Well, an obvious double entendre; such things are acceptable and fun here, but in medical practice words really matter!

You can send your questions and comments to Dr. Sackier via email: [email protected] and listen to his weekly podcasts at:


Jonathan Sackier

Dr. Jonathan Sackier is an expert in aviation medical concerns and helps members with their needs through AOPA Pilot Protection Services.

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