Category: Updates on my health

Have you ever watched the movie, “An Officer and a Gentleman?” If you have, you might remember the jet crash survival simulator. While in the cockpit simulator, the officer candidates are sent down a rail at high speed into water and then flipped upside down. They have to get free of the “cockpit” and swim back to the surface.  In a dramatic scene, one of the officer candidates has a problem and nearly drowns in the trainer. He later DORs (disenrolls on request) because of that trauma.

I had to go through that training when I was in the Navy. I was in training to be a flight surgeon. This included aviation survival training.

I worried about what the jet crash survival simulator would be like. How would I do? Would I too end up having to “DOR.” It turns out the jet crash simulator was nothing compared to the challenge of the 9D5A. The 9D5A is otherwise known as the “helo dunker”.  Both simulators were required. The 9D5A was designed to simulate the crash of a helicopter into water. The jet crash simulator was mostly just something to be endured. The 9D5A however was a real challenge. 

The Training:

There are several key things to survive a crash. 

• Believe you can survive:  The most important thing is to remain calm (not panic). This is probably the most important part of the training. The goal was to give us the confidence to not give up.  Whether you survive or fail in any situation may just depend on whether you believe you will survive or not.
• Develop a plan: You must establish a plan in advance before everything gets confusing and stressful.  We were trained to think about reference points (landmarks in the cockpit around us) and what would be our plan to get free of the helicopter (simulator).  
• Wait for all motion to stop: You must wait for the rolling and pitching of the trainer to stop. If the instructors saw us release and try to exit too early, it would be counted a “fail.” We would have to go through it again. In the real-life scenario, the idea was to have optimal timing for action. You don’t want to release early and be injured by the tumbling aircraft.
• Use your reference points: Your first step was to grab a reference point (such as a window beam or brace). We needed to plan to move from one reference point to the next. This is the key to counter the confusion and disorientation of the moment. We were to never ever be without one hand on a reference point. Losing your reference point is a sure way to get hopelessly disoriented and not survive. Before we could release our safety harness (seat belts) we had to have one hand on a reference point. We would then release and move one hand to the next as we executed our plan of escape.
• Ignore the discomfort: We needed to ignore the water going up our nose and sinuses as we were suspended from our safety harness under water. We needed to ignore the strong desire to breathe. We needed to be calm. We had plenty of air to get free in a controlled manner and swim to the surface. We had plenty of time as long as we believed that we did.
• Swim to the surface: This was the easy part. Swim up to the surface. Know that our bodies want to float, and they would naturally pull us upward. Know that victory was coming. We should not worry or despair as we ascended.

What it was really like:

We climbed up steps to a platform to enter the 9D5A (“ helo dunker”). It was suspended 15 feet above the surface of the swimming pool. We were in full flight gear. We strapped into our seats in the trainer and then we waited. I looked at the window and the window frames and planned where my hands would go – one hand after the next – to guide me out of my seat – through the cockpit and out the window.  I waited like I was on a carnival ride for the crash. My heart pounded. The suspense was enormous. 

Suddenly the trainer dropped through the air and then hit the water. As it hit the water it rolled upside down. Down we went – until we were 15 feet underwater and hanging in our seats upside down.  As soon as we hit the water I started counting. That helped to reduce the urge to release from the trainer too soon. Once we hit the count of 10, we could be fairly certain that motion had stopped. Water rushed up my nose from being suspended upside down. My nose burned from the chlorine. I ignored it. I grabbed my reference point and then with my other hand I released the safety harness. I had to shake the shoulder straps to be free of them. There was a brief moment of panic as I worried that the harness was stuck. I then moved my hand to the next reference point. I moved hand over hand as I pulled myself out of the cockpit window. 

Once free it was disorienting to know which way was up. The feeling of panic was rising inside me. I was feeling short of breath. I HAD to get a breath soon. Was I going to drown? How could I find out which way to get to the surface? I HAD to get there soon. I could feel the pull of my body which did indeed want to float to the surface. I could see the light now above me and I swam to the surface. My lungs burned for air at the surface. It felt so good to fill my lungs and breathe deeply as I treaded water in the pool. 

Victory! I did it! 

Round Two:

We all swam to the edge of the pool.  They told us it was time to climb the platform and do it again.  Really?  Really?

This time they handed us speedo goggles that had been spray painted with black paint. We were to do the trainer again but this time we had to do it without being able to see.  We climbed into the trainer (which had been pulled back up out of the water and suspended back in position). Once again we took our positions and off we went.

This time it was easier. In spite of the blacked-out goggles, I knew that I could do this. I knew exactly what to do. But even more I knew that I was able to do it. There was no panic this time. I was building confidence.

Victory (as I broke through the surface of the water)! Again.

Back up the steps again. The third time we were to do it without the speedo goggles, but we all had to exit out the main door in the back of the helicopter.  That time there was some chaos as we had multiple men kicking and squirming to get free and all get through the same exit. By now, however, I had confidence. I knew that I had time to wait patiently for all of us to file out the door. I could hold my breath. I could just deal with the burning chlorine in my nose and sinuses. I calmly pulled from one reference point to the next to the next – pausing in some places for others to pull past me – and then eventually I was free.

The fourth time was not a surprise. We once again had the blacked-out goggles and were all going out the main exit. I remember some legs kicking into me in the darkness but all in all we were fine.

We got out of the pool as victors. We felt like we could survive anything. Later that day we were in class together. All of us were sniffing and snorting from the chlorine water that had rinsed through our nose and sinuses. But we were sitting in class as victors. We had overcome the trainer and knew that if we ended up in a crisis situation, we could survive.

The Lessons:

To this day I can remember the training but more than that I can remember the confidence it gave me. It showed me that I was capable of remaining calm, developing a plan and executing the plan. I could be a survivor.

I was impressed with the way they set up the training.  They did a great job. I looked online and it looks like they may have refined the trainer some since my day. The general principles look the same, however.

What are the biggest lessons?  They are listed above in case you didn’t catch them.

The most important one is that you are capable of a lot more than you think. You can survive if you think you can survive. You can do things as long as you remain calm and convinced that you can do them. This is not absolute of course. I cannot jump out of an airplane and fly like a bird. But when faced with a challenging but achievable task, I can push through and achieve some things that might be hard for me.  When I am called on to do something hard, I take a deep breath and walk into it and just do it.  

One of our transplant directors used to have a “Wonder Woman” poster on the back of her office door. When hard things came up, she used to say that we needed to take the “Wonder Woman” pose. Before an especially challenging meeting, we went into her office and stood with our hands on our hips like Wonder Woman. We took a deep breath. I was humble enough (and thought it was funny enough) that I too participated in the Wonder Woman pose with her. As ridiculous as it sounds, it really worked. Doing that, I felt stronger. I was ready to walk into the meeting even though it was not going to be fun. One day I had a difficult patient to see. I had to tell her things that she didn’t want to hear. We had security guards in the clinic in case she became violent. The Wonder Woman pose helped a lot. I could handle this. I was strong enough. I was capable. Now just do it.

Wait for all motion to stop. Sometimes the most important thing to do is to sit and wait. This can be very hard especially when you feel yourself hanging upside down, under water, with water going up your nose. But clearly there are times when action can do more harm than good. You have time. You are not going to drown. You just have to figure out how to keep yourself calm and not act. Know that it is temporary.   

Keep your frame of reference. Do not get disoriented or lost. There are times in life when you know clearly where you are, what is important and what principles exist to guide you. Other times life will do everything it can to disorient and confuse you. As you go into the chaos, look at those reference points. Do not let go of them. Once the motion stops grab onto one and then the next and then next. Do not let go lest you become disoriented and unable to navigate your way through the crisis.

Some days I have meetings that become chaos. Things are going in so many directions that I barely feel competent to do my job. In those moments I want to run away and hide.  But sometimes I just have to sit back in my chair and wait for the motion to calm down. I look for my reference points. What are we trying to achieve? Can we remember the key principles? Once the chaos starts to quiet, I grab one reference point and then the next. With this then I can start to navigate through to what the meeting ought to achieve. It may not be all the crazy directions that were going on in the meeting. But it could be one clear direction that leads us to the exit where we are all well and good.

Of course, my reference points in life are crucial for me. In the midst of the uncertainty of a cancer diagnosis this became more important than ever. I know who I am before my Lord and Savior. I know that regardless of whatever happens, I am His. I know that He is in control and His purposes will eventually be worked out. I know that not everything in this world goes well. But my reference points are that on a much longer and broader scale things will work out. I had to grab onto one reference point and then the next. It gave me amazing strength to go forward and not panic.

Radiation Therapy

Last year I had to have radiation therapy. To properly target the radiation, I had to do a fairly sophisticated breath hold. This involved blowing out all of my breath, then taking a partial breath and holding it while they delivered the radiation. To be very precise they use a device that measures your breathing. Getting set up they brought me into the radiation therapy room to practice. First they positioned me and marked my skin. Then they put tiny tattoos on my skin as a permanent alignment mark. I asked if they could make them an anchor or a sailboat. They laughed (Yeah, and I am sure they have never heard those jokes before!) Next was the training on the breath hold machine. They put a mouthpiece (like a scuba mouthpiece) in my mouth. They put a tight clip on my nose. They put glasses (like virtual reality glasses) on me. In those glasses I could see my breathing on a graph. Up and down and up and down the line went as I breathed. Then they would activate the device and on that breath cycle I had to lock my breathing in a narrow band. 

I tried. I failed. When I failed a loud alarm would sound. HONK. I tried again. I failed. HONK. And again. HONK.

I could feel the feelings of panic rising up inside of me. My mind started going wild. I was going to be the person who failed at radiation. I was not going to be able to get this treatment. My cancer was going to recur, and I was going to die. I was going to leave my family without a husband and a father. And it was all going to be my fault because I failed! 

It felt like I had just entered into a deadly final exam. Can you pass the test? If you don’t, then you die! Or some morbid video game. You have to guide your character through a maze. If you do it successfully you get to live. If you fail, then you die (not just in the game but in reality.)

I recognized the panicky feeling. It was one that I had felt many years before in the 9D5A. It was the feeling when the shoulder straps hung up a little bit. It was the feeling when I wasn’t sure which way was up. It was the feeling that I didn’t have enough breath left to survive.

I remembered. I remembered the feeling of victory as I got the surface and swam to the edge of the pool. I remembered sitting in the classroom and the smell of chlorine in my sinuses and feeling like we were all some of the greatest persons who had ever lived. 

I could do it. I just needed to believe that I could.

We tried again. It took several tries and then I learned the technique. For the next 5 weeks I did it over and over again and became quite expert at it. I never liked it. But I could do it. I could endure.

Now

I will confess that there have been times lately when I have felt the panicky feeling inside. It is such an odd time to be locked away from people facing an uncertain threat. I am generally very calm but there are times when I wonder if I am able to cope with everything. 

The panicky feeling is a trigger however to remember the lessons from the 9D5A.  At the moment it feels like we are strapped in and waiting for the 9D5A to drop to the water. You have been given your training. Of course, you might be nervous. You might even feel a little bit panicky. That is natural. You are going to do fine. 

Someday we will be sitting together in class with chlorine dripping out of our noses knowing that we made it through this.