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The best medical care possible from a doctor who knows the rigors of flying

Doctor Molby

Capt. (Dr.) Nick Molby, a 71st Medical Operations Squadron flight surgeon, sits on an exam table he uses to asses the health of Team Vance's student and instructor pilots. Recently, Molby had a unique opportunity to trip-turn in all three Vance airframes in one day. First flying the T-6A Texan II, then the T-38 Talon and finally the T-1A Jayhawk. (U.S. Air Force photo/ Tech. Sgt. James Bolinger)

VANCE AIR FORCE BASE, Okla. -- Team Vance instructor pilots fly up to three sorties a day. For most IPs, that means working 12 hours a day, five days a week and sometimes weekend cross-country adventures so students can practice their navigation skills.

Few other Airmen take to the skies over Northwest Oklahoma, with three exceptions – the flight surgeons who work for the 71st Medical Group.

Flight surgeons ensure that pilots receive the best medical care possible from a doctor who understands the rigors of flying. They frequently get behind the stick to gain valuable, physical experience to better understand what pilots go through.

“Trip-turning”

The cumulative effect of briefing, flying and debriefing for each sortie can sometimes lead to significant fatigue. This fatigue can be hard for pilots to describe to a regular family practice physician, who has likely never felt the effects of “trip-turning” – flying back-to-back-to-back sorties. 

Recently, a Team Vance flight surgeon got first-hand experience in flight fatigue after flying in all three Vance aircraft in one day.

Capt. (Dr.) Nick Molby, a 71st Medical Operations Squadron flight surgeon, started his 12-hour day in the T-1A Jayhawk, before zooming above the clouds in the T-38 Talon, and the T-6A Texan II.

Flight fatigue is real, said Capt. Caleb Becker, a T-6 instructor pilot and 71st Operations Group executive officer. After a pilot flys two or three times in one day, instructs for three or four hours and is physically buffeted by maneuvering the T-6 or T-38, flight fatigue happens.

“In my experience, flight surgeons do a great job responding in real time to physiological incidents,” he said. “Having their expertise available immediately after landing is a big reassurance.” 

Molby felt fatigue set in after the T-38 sortie. The T-1 flight at the beginning wasn’t too bad, but by the time the T-38 briefings and flight itself wrapped up, the midafternoon slump was starting to creep in, he said.

Then, having to repeat another brief and get ready for the T-6 flight at the very end of the day was grueling, he said.

“I can understand why if you trip-turn in the T-38 or T-6, or you do a really long T-1 flight, you could be pretty exhausted by the end of the day,” said Molby.

But the fatigue didn’t dampen the doctor’s excitement of flying in all three planes in 12 hours.

“At the end of the T-6 flight, other than the fatigue itself, was more a feeling of excitement that holy smokes I did this. I flew all three in one day,” said Molby. “It was a pretty cool experience.”

Flight surgeons vital since the dawn of Air Power

Understanding physical and physiological stressors is vital to continued air and space dominance.

During World War I, many pilots did not return from sorties. They were often shot down, experienced accidents, or suffered medical conditions that developed or were exacerbated while in flight.

There was very little understood about how the human body was affected by flying, creating a need for aeromedical research and treatment specialized for pilots.

Gen. Henry “Hap” Arnold, a founding member of the modern U.S. Air Force, saw the need for a flight surgeon to be included as a member of the aircrew so that the budding American air forces could have a better understanding of what pilots were experiencing in flight.

The role of this first-hand experience could then be applied to not only medical standards for future pilots, but also improve the current aeromedical knowledge and aid in the medical evaluation and treatment of aircrew.

A dream fulfilled … sort of

For Molby, the best part about being a flight surgeon is flying.

“I wanted to be a pilot when I was younger before considering medical school, but found out I was color deficient and would not be able to fly,” said Molby. “Ironically I was granted the opportunity to become a flight surgeon, and now I get to fly as a rated member of the aircrew.

“While we don't do surgery while flying -- as many of my friends from medical school have asked -- this term has carried over from a time when military physicians were also battlefield surgeons,” said Molby.

“I enjoy my job, and the experiences I have been able to have with all of the pilots I have flown with from the T-6 to the F-16,” he said.

Looking to the stars

Molby recently returned from a trip to Holloman Air Force Base, New Mexico, and Luke Air Force Base, Arizona, where he spent several weeks learning about and flying in the F-16 Fighting Falcon. However, his new dream is out of this world.

“I would love to make a trip to Mars,” said Molby. “A career with NASA as a flight surgeon-astronaut is my number one goal. However, there are quite a few hurdles to jump. I would definitely go for it!”

If Molby can’t jump through all the hurdles and make it to Mars, his back-up plan is more down to Earth.    

“I really enjoy the challenge of medicine and taking care of my patients,” he said. “I am considering pursuing either orthopedic surgery or sports medicine after I leave Vance. Then I plan to do flight medicine either as part of a Guard/Reserve unit in addition to my orthopedic/sports medicine specialization.”