Aeronautical Randomness
When a pilot becomes incapacitated
October 8, 2015

Twice this week, a pilot of a commercial airline flight has become incapacitated.  An American Airlines pilot passed away during a red-eye flight from Phoenix to Boston.  The next day, a United Airlines first officer suffered a seizure on a flight from Houston to San Francisco.

Before I go any further, please know that my thoughts and prayers are with their families.  One family lost a loved one.  The other will undoubtedly struggle with this newly discovered medical issue.

I rarely comment on current events, but one of the purposes in starting this blog over five years ago was to educate passengers and up-and-coming pilots about the airline industry.  I also feel compelled to offer factual information to counter what people see on television.

Incapacitation is a serious situation, but it doesn’t put passengers in danger the way the media has portrayed.  Imagine you work in an office and one of your workmates suddenly passed away.  It would be traumatic and I’m sure your concerns would be with your co-worker and his or her family.

We are no different.  We work in close quarters and sometimes become good friends with our flying partners.  However, when the unthinkable occurs, we are trained to compartmentalize our emotions, take the appropriate actions and safely land the aircraft.

A pilot becomes “incapacitated” when he or she can no longer fulfill the required duties of the job.  Here are some thoughts on the subject:

There are two qualified pilots up front…

I’ve explained this before in previous blog posts, but it bears repeating.  There are two pilots in the flight deck of a commercial airline flight: the captain and the first officer.  Both pilots are fully qualified to operate the aircraft.  The captain is “in charge” and has final authority on all decisions, but each pilot takes turn flying the legs of a trip.  As a first officer, I fly every other flight from takeoff until landing.  Again, first officers (or co-pilots as the media likes to call them) fly ALL THE TIME.

So, while it is still a serious situation when one pilot becomes incapacitated, the passengers sit in extremely capable hands.

We train for these situations…

A few times during simulator sessions, an incapacitation scenario has been introduced into my training.  Before one sim, the instructor pulled me aside and instructed me to fake incapacitation when he tapped me on the right shoulder.  When I felt the tap, I leaned my head to the right, closed my eyes and stopped responding to the captain.  It took a minute, but when he realized I was out of commission, he started executing the company’s procedures.

We have procedures…

Every airline’s policy on handling incapacitation is a little different… but, the gist of it is the same:

  • First and foremost: FLY THE AIRCRAFT and declare an emergency.  An incapacitated pilot occupying his or her seat can pose a threat to safety.  If the pilot leans into the yoke or side stick, it doesn’t take an aviator to understand why that could be a problem.  Therefore, either the pilot needs to be removed from the seat by the flight attendants or placed in the most aft position with the seat belt and shoulder harness tightened. (Ideally, out of the seat so he or she can receive medical attention.)
  • Get help: Many of our flights have deadheading crew members that can assist the flying pilot to safely land the aircraft at the diversion airport.  Even if the pilot in the cabin doesn’t fly the same type of aircraft, he or she can become an invaluable asset in this situation.  Help can also be given by medical professionals on board to assist the flight attendants with the incapacitated pilot.
  • Use the auto-pilot as much as possible: Especially if left alone in the cockpit, the pilot will be very busy flying and answering radio calls.  We allow the automation to free up our workload.  It is also advised to accomplish required duties (checklists etc.)  a little earlier than normal.
  • Formulate a plan for after-landing: Usually, the incapacitated pilot can receive the fastest medical attention at a gate with a jetbridge.  With the exception of the Airbus, most aircraft can only be taxied from the left seat.  So, if the first officer was the one flying, he or she will have to change seats after landing. (It is recommended the FO stay in the familiar seat for the landing and switch after stopping and setting the parking brake.)

It’s rare, but it does happen…

Medical issues are rare because we’re under extreme medical scrutiny.  Pilots over forty visit an FAA designated physician every six months for a physical.  Once a year, we receive an EKG.  In between appointments, if any issues arise, we must self-disclose them to the FAA.  Overall, we’re a pretty healthy cross section of society.

In all my years of flying, I’ve only experienced a “potential” incapacitation while operating a flight.

One evening, on an A320 flight from LAX to Chicago, my captain became ill.  After the third trip to the lavatory and continued degradation of his digestive system, he made the decision to divert to Denver.  We were about a hundred miles southwest of D.I.A. and the controllers vectored us for the longest “straight-in” approach I’ve ever flown to 35L.

The captain returned back to the bathroom and left a flight attendant in the flight deck with me.

About fifty miles out, she asked “what if he doesn’t come back up?”

I told her that if he didn’t call in the next few minutes, we would instruct the other flight attendants to check on him.  If he couldn’t return, I’d land the aircraft with her still in the cockpit.  I showed her that I already had the incapacitation section of our manual open and was following the appropriate procedures.

“Can you land this thing by yourself?” she asked.


I’m not certain whether she was relieved or disappointed when the captain called to return to his seat.

We landed safely in Denver and the captain was given a quick check by the paramedics and released.  Once a reserve captain arrived at the airport, I continued on to O’Hare.

So, please understand that when a pilot becomes ill or incapacitated, you are in no danger as a passenger in the cabin.  The rest of the crew will take care of you and land safely at the nearest suitable airport.

Once you are safely on the ground, we then turn our full attention to our friend and colleague.

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About author

Renewed Pilot

I've endured a roller coaster career in the U.S. Aviation Industry. Currently flying the 737 on my third try with the same legacy carrier, I have also flown for a regional, fractional and start-up carrier. My piloting experience includes the 737, A320, 727, Citation Excel, Citation Bravo, Saab 340 and many light singles and twin engine aircraft. I reside in the suburbs of Nashville, Tennessee.

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There are 4 comments

  • Cedarglen says:

    Hello again Brian,
    Another excellent post and you’ve said as I’ve ever seen it written. I believe that you’ve nailed it and I agree with you on every point. The recent loss of the AA pilot as most unfortunate; our prayers/best wishes remain with his family. As you properly note, statistically, your work group is among the most healthy of populations, yet still the odd event will happen. Having TWO Fully Qualified pilots up front is essential and I hope the governing regulation never changes. As a retired medical provider and former frequent flyer, I’ve been asked to assist more than once. (Four minor events and one extremely serious event. All survived, thank God.) Despite the often truly stupid remarks made about FOs and Co-pilots in the media, most folk with functional brains fully understand that this generation’s population of First Officers a talented professionals and for God’s sake, fully able to fly and land their aircraft alone, if necessary. (Given the quirks of the airline seniority system, it is not rare to discover a FO with significantly more Time on Type than the Captain.) It does not matter, since both are fully qualified and when both are able, they work as a TEAM.
    Again sir, the recent Syracuse diversion was an exceedingly rare event, had the best-outcome possible under the circumstances and no pax or other crew member was ever in even the slightest danger. To suggest otherwise, as some media did is absolute Nuts!
    When I fly (in the U.S.) I am concerned about many things; schedules, baggage, connections and the like. I am not, repeat NOT concerned about the ultimate safety of my flight or the ability of even a solo pilot to safely land the airplane; I KNOW that they can do it. (Sure, a shower and a change of personal linen may be necessary, but we’ll make it to the ground just fine.) Another great blog post and, as usual you have nailed your topic. Best wishes, -Cg

  • Keelan says:

    Well written aritcle, my friends always say its good that the backup pilot managed to land the plane. I have to keep explaining that he is also a qualified pilot who does part of the days flying and not just someone sitting there incase.

  • Very nice summary. It is a little bit different issue for a PPL pilot. Written clear and simple. I think the long range flights can handle this for asisting. Because there are minimum 3 pilots in the cabin. But if you are flying over the ocean, and there are no close airports to land, what can you do for the incapacitated pilot? Are there any doctors on board in long range flights? Thank you for your explanation..

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