Plane & Pilot
Monday, September 1, 2014

The White-Coat Syndrome

It’s real, it’s ridiculous, and for some of us, it’s impossible to avoid

Courtesy of my laptop, it's 0450 hours (that's in the morning, in case you missed my whining), and I'm in another airport terminal. This time, it's Albuquerque, N.M., and I'm on the return leg of yet another 24-hour trip caused by my severe white-coat syndrome. I KNOW there are others out there who know exactly what I'm talking about.

Every two years, I make the same trip: I fly to ABQ, drive to Santa Fe, see my friendly AME (Aeromedical Examiner), and sit around his lobby trying to get my blood pressure and heart rate down, so he can issue my new medical certificate, then rush back home. Worrying about this process takes a toll on me for a solid month leading up to the trip. However, I always come through with more or less flying colors, but only after a bunch of biofeedback, a little self-hypnosis and more than a few mental gymnastics. Life just shouldn't be this complicated.

This whole thing is because of a frustrating lack of body control that most call "white-coat syndrome." It's a form of phobia that causes our blood pressure and heart rate to skyrocket just because we're in the presence of a white coat that's holding a stethoscope to our arm while pumping a rubber bulb. I don't know if "normal" people have this problem, but I know for a fact that a good percentage of pilots do. For us, the cuff-and-bulb thing is a make-or-break moment. It could ground us or, more likely, lead to months of incredibly frustrating FAA-style hoop jumping.

This didn't used to be a big deal for me. In fact, for most of my life, the nurse would put the cuff on me, and I'd laugh and say, "118 over 72, guaranteed." My BP and heart rate were remarkably stable. Even on the day my brother died, everything stayed right there. Then, about 15 years ago, I had a really crazy week (I mean off-the-charts stressful) when I was doing a really complex catalog job for an advertising client while I was breaking in a big new computer system. The catalog was a serious heart-attack project in terms of deadline and complexity. The computer system was giving me heartburn while I tried like crazy to get all of the software to settle down. Then, the cable company somehow managed to fry a hard drive while doing an install, and I was going absolutely nuts. Close-to-putting-my-CPU-out-of-its-misery-with-a-Louisville-Slugger nuts. And I'm not kidding!

At one point, I started feeling bad, so I went to see the doctor, and my BP was so high it scared the hell out of me—the doctor, too. They started talking about cardiologists and serious heart stuff. To make things a thousand times worse, I had a flight physical coming up in a couple of months. I was scared! However, the computer got sorted out, the catalog finished, and the hard drive came back online. In the meantime, I had bought a blood pressure monitor and was pleased to see that the numbers had come back down to normal. But then, I had to go for my flight physical, and the trouble began.


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