Aeromedical Consultation Service critical to ‘Fly, Fight, Win’

Published: Friday, October 06, 2017 @ 10:58 AM

            Aeromedical Consultation Service Deputy Chief Dr. Daniel Van Syoc listens during one of four weekly case review sessions in order to determine whether or not a waiver should be recommended for an aviator’s disqualifying medical condition. The ACS reviews approximately 2,000 cases a year with an 88 percent determination of recommendation for waivers, keeping Air Force pilots safely flying. (U.S. Air Force photo/John Harrington)
Aeromedical Consultation Service Deputy Chief Dr. Daniel Van Syoc listens during one of four weekly case review sessions in order to determine whether or not a waiver should be recommended for an aviator’s disqualifying medical condition. The ACS reviews approximately 2,000 cases a year with an 88 percent determination of recommendation for waivers, keeping Air Force pilots safely flying. (U.S. Air Force photo/John Harrington)

Ever since humans took to flight, the unique physics and environmental conditions of soaring through the air have tested mankind to overcome challenges, both physical and mental. For U.S. Air Force pilots, aircrew and others, their journey to flight starts with being medically screened.

Every pilot in the Air Force who didn’t graduate from the U.S. Air Force Academy – rough 1,000 annually – has walked through the doors of the Aeromedical Consultation Service for flight evaluation, according to ACS Deputy Chief Dr. Daniel Van Syoc. The academy screens their own pilot candidates, 345 of them in 2016, according to an academy fact sheet.

“Our motto is ‘Fly, Fight, Win.’ That’s what we do,” Van Syoc said. “Everybody who wears the uniform, even (Air Force civilians), are here to directly or indirectly support the flying mission. We play a very critical role in that.”

Currently, the Air Force has 12,600 pilots and 3,297 navigators, according to the Air Force Personnel Center. The strains of flying, medical conditions and even stress can find a pilot facing a disqualifying condition for flight duties. When it does, their case goes to what’s known as a waiver authority to determine if a waiver is possible for the condition; generally this is a major command. When the waiver authority is faced with a case for which they can’t make a determination based on the medical data, it goes to the highly skilled aeromedical experts at the ACS.

A staff of about 80 psychiatrists, neurologists, pulmonologists, cardiologists, general internal medicine doctors, ophthalmologists, psychologists and optometrists, assisted by skilled technicians, carefully review all aspects of a case to determine whether or not to recommend a medical waiver to the waiver authority, the ultimate say on whether a pilot will get to fly again.

“We’re very much a world-class aeromedical evaluation center,” Van Syoc said. “There isn’t really a comparable organization in the world to what we do, that has the ability to go to the lengths that we do in evaluating military aviators.”

To say the professionals at the ACS are at the top of their game may actually be a bit of an understatement.

“I have had the pleasure of working with people who are literally the world expert in what they do,” Van Syoc said.

Today, ACS sees some 2,000 waiver recommendation requests annually. ACS staff can make a waiver recommendation based solely on the case materials in roughly 1,400 of those cases, with the other 600 requiring individuals to be physically seen at the ACS at Wright-Patterson Air Force Base.

“We get sent some of the toughest cases from the field and our job is to make sure that the air crews are flying safely,” said Aeromedical Consultation Service Chief Col. Niraj Govil. “The question that we get is ‘Is this particular flyer safe to fly? If not, if he can’t fly the airframe that he was trained for, where can he go?’ Bottom line, we’re here for the safety of the air crew. What we try to do is return them (to flying status) as safely and as quickly as possible.”

In fact, about 88 percent of the cases ACS reviews ends with a recommendation for waiver to the waiving authority.

“We send the ACS dozens of cases every year: pilots, navigators, enlisted crew members and air traffic controllers,” said Jim J. Cahill, health systems specialist with the Office of the Pacific Air Forces Command Surgeon, who manages primary oversight of all requests for medical waivers on aviators and special-duty personnel from nine PACAF bases. “One of the most important functions they perform for us is to quantify risk. They answer the question, ‘How much risk is associated with allowing this crewmember to continue to fly?’ This is priceless information when the waiver authority is trying to determine if a waiver will be granted.”

To measure that risk, it takes time. Van Syoc says that in the commercial world, a person with a mental health issue might get an hour with a psychiatrist to determine the problem. At the ACS, individuals would meet with both a psychiatrist and psychologist for upwards of 20 hours, not including the time required to review the case materials and research the medical issue. It may seem like a lot of effort, but at a cost of $3 to $5 million to train a fighter pilot, depending on aircraft, Van Syoc says every second is worth it.

“We’ve invested several million dollars in every pilot just to get them to the point where they’re mission ready,” Van Syoc said. “So, if we’re going to invest that kind of money in them and we’re going to say ‘up’ or ‘down’ we want to have covered every aspect of the case and make a very well-informed recommendation to the waiver authority.”

Even with the level of detail the ACS provides, Van Syoc says that once a case comes to them, they can often make a waiver recommendation determination within one month, including for those individuals who need to travel to the ACS to be seen.

To speed up the timeline for waiver authorities to receive a recommendation, the ACS provides specific submission information through online waiver guides – guides they are currently reviewing to ensure they are as clear and specific as possible. As long as all information requested is submitted, the ACS can make a waiver recommendation as quickly as possible.

“Every branch of the ACS, internal medicine, ophthalmology and neuropsychology, provides us with a dedicated consultant we can reach out to any time for the advice we need to support our warfighters,” Cahill said. “The doctors are available pretty much 24/7, which comes in handy considering the challenges of communicating across multiple time zones.”

Cahill says it’s truly a team effort that makes the ACS successful.

“While the docs provide the professional consultation and advice, the case managers are the unsung heroes of the ACS,” Cahill said. “People like Tech. Sgt. Blackwell, Lisa Martin and Dena Green do all of the behind-the-scenes work. They perform the initial review of all cases to ensure everything they need is included, interface with the major command and, in many cases, the referring base, and manage the endless changes to scheduled appointments for our patients.”

While the humans serving as pilots and flight crew haven’t changed much since the ACS first began screening pilots and making waiver recommendations back in the early 1950s, the way they fly has.

“Probably the biggest mission change we’ve been involved with is in remotely piloted aircraft,” Van Syoc said. “A large number of those folks are trained pilots, although not all of them have gone through military pilot training, but that’s the future of the Air Force, the unmanned aircraft. So, we get quite involved in caring for them.”

Besides varying flight missions, changing technology like maneuverable jet nozzles in higher performance aircraft like the F-22 Raptor and F-35 Lightning can subject their pilots to new stressors, according to Govil.

“I think that’s going to broaden our job,” Govil said. “Because, a lot of times we’re waiting for those specific problems that come from the field. Many times, they ask for our advice when they first see problems coming up. What we’re trying to do right now is to enhance our research publishing capabilities, because right now we’re sitting on kind of a goldmine.”

That “goldmine” is the 58,000-some cases in the ACS database reaching back to the 1950s. While ACS staff can access the information located in the database, it’s not as efficient as it could be, according to Govil. Enabling that database to be easier to mine data from is critical to providing research-based recommendations in the future.

“To look at the natural history of a condition in a large group of people, that’s how we end up giving effective advice for policy changes, as far as waivers,” Van Syoc said.

Govil said he doesn’t have a timeline as to when a new form of the database could be ready, but feels confident that not only is it possible, but once done, could be quite significant.

“It looks like it’s going to be the largest data bank of aeromedical information in the world,” he said, which would again set the ACS as the premiere aeromedical evaluation center in the world.

“Behind every pilot, behind every mission, we have people here at ACS who are doing everything we can medically to get them flying,” Govil said. “We’re a critical piece of the ‘Fly, Fight, Win’ mission of the Air Force.”

The ACS is part of the U.S. Air Force School of Aerospace Medicine, the premiere institute for research, education and worldwide operational consultation in aerospace medicine, under the umbrella of the 711th Human Performance Wing, both headquartered at Wright-Patterson AFB.

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Sunday highlights from the 2018 Vectren Dayton Air Show

Published: Sunday, June 24, 2018 @ 9:23 AM
Updated: Sunday, June 24, 2018 @ 4:24 PM

Airshow National Anthem

UPDATE @4:24 p.m.

The U.S. Navy Blue Angels are now on the ground, marking an end to the flying acts. 

PHOTOS: Sunday at the Dayton Air Show

UPDATE @3:40 p.m.

The U.S. Navy Blue Angels are now performing. WATCH LIVE HERE.

UPDATE @3:27 p.m.

The U.S. Navy Blue Angels are preparing to take flight. They are the last performance scheduled for today’s Dayton Air Show. 

>> Blue Angels thrill crowd during Saturday’s performance

UPDATE @2:40 p.m.

Tora Tora Tora, the dramatic recreation of the Dec. 7, 1941, attack on Pearl Harbor, is now taking place.

UPDATE @2:08 p.m.

The F-22 Demonstration is now taking place at the Dayton Vectren Air Show.

Next up: U.S. Air Force Heritage Flight, CareFlight dedication, Tora Tora Tora, Jet Waco and, finally, the U.S. Navy Blue Angels.

UPDATE @1:15 p.m.

B-17 Movie Memphis Belle: The movie Memphis Belle commemorates the real B-17 Memphis Belle Flying Fortress during World War II heavy bomber. 

UPDATE @1:12 p.m.

Vicky Benzing is known for her record as “Fastest Woman Racer” in the history of the Reno Air Races in Nevada.  

Today at the Vectren Dayton Air Show she was able to complete all of her stunts, though she said Saturday she couldn’t perform her opening stunt because of lower clouds.  

Today the air show is running a high show. On Saturday, only a few of the earlier acts couldn’t perform at a high level because of lower clouds.  Benzing learned to fly at a young age and has been flying for over 30 years. The Californian also has a Ph.D. in Chemistry.

UPDATE @12:45 p.m.

The U.S. Army Golden Knights have completed their act. Vicky Benzing will take to the air next. 


UPDATE @12:19 p.m.

The flag taken up by the Redline Circle of Cincinnati has dropped, and the Vectren Dayton Air Show is starting up. 

Lead pilot of Redline Ken Rieder knew he was going to be a pilot almost his entire life.

He went to his first air show in Waynesville when he was 5 years old.

PHOTOS: Images from Saturday Air Show

“My dad was driving up to Columbus for something. We saw it as we were driving by and I was excited, so he pulled in.”

At a young age, Rieder started building model planes, joined the Civil Air Patrol at 12 years old and eventually got his pilot’s license at age 21.

“From there on it was everything I could do to get flying,” Rieder said.

The Dayton Air Show is particular important to Rieder as the first large air show he had ever attended. He said he never imagined he’d be flying in the Dayton Air Show when he was younger.

Now he’s not only flying in the show, but he built the planes he and partner Ron Thocker are flying today. The team will be back later in the show. 

Flight by B-17

UPDATE @11:50 a.m.

Flying acts will begin soon. 

Watch live coverage of the acts here.



Gates are open for the last day of the 2018 Vectren Dayton Air Show.

The first acts take to the skies at noon and fly through 4:15 p.m. Gates close at 6 p.m.

>> Saturday highlights of the 2018 Vectren Dayton Air Show

Today’s lineup of feature flying acts include: the Tuskegee Airmen, P-51 Mustang, U.S. Army Golden Knights, Vicky Benzing, B-17 Movie Memphis Belle, Redline, Sean Tucker, U.S. Air Force F-22 Raptor, U.S. Air Force Heritage Flight, CareFlight dedication, Tora Tora Tora, Jet Waco and the U.S. Navy Blue Angels.

Flight by Red Tail P-51

>> RTA offers express shuttle service to Vectren Dayton Air Show

>> How to avoid traffic and parking headaches at this weekend’s Vectren Dayton Air Show

>> Parking lots in good shape for Vectren Dayton Air Show

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San Diego police shooting: 2 officers injured, suspect dead

Published: Sunday, June 24, 2018 @ 4:37 AM
Updated: Sunday, June 24, 2018 @ 3:24 PM

Suspect Dead After Injuring Two Officers in San Diego Shooting

Two police officers reportedly were shot and injured late Saturday in San Diego, California. 


Here is the latest information:

Update 12:24 p.m. PDT June 24: Homicide Capt. Mike Hastings said at a news conference that investigators were waiting for a search warrant so they could enter the condominium where the shooting occurred, The San Diego Union-Tribune reported. 

The names of the officers injured have not been released. Investigators also have not released the name of the suspect who was killed, the Union-Tribune reported. Police also did not confirm whether the man was a resident of the unit.

Update 1:43 a.m. PDT June 24: KNSD’s Omari Fleming reports that investigators are unsure whether the suspect died from a self-inflicted gunshot wound or was killed by officers. 

KSWB’s Andrew Luria tweeted that “hundreds of rounds may have been fired” in the shootout.


Update 1:07 a.m. PDT June 24: The San Diego Union-Tribune is reporting that the suspect is dead. According to the newspaper, “a police dog went in and bit the suspect on the leg” after a robot searched the apartment. 

“After getting no response from the man, police determined he was dead shortly before 1 a.m.,” the Union-Tribune reported.

Update 1 a.m. PDT June 24: According to KSWB’s Andrew Luria, one of the wounded San Diego police officers “is currently in surgery with a life-threatening injury” after being shot in the chest. The second officer suffered a gunshot wound to the shoulder but is “expected to be OK,” Luria tweeted.


Update 12:26 a.m. PDT June 24: According to KFMB reporter Steve Price, the shooting suspect “appears to be down” and has “head trauma.”

KSWB’s Andrew Luria reported that the suspect had been “wearing body armor.” Officers sent a robot into the apartment where he had been hiding, police said.

The San Diego Union-Tribune reported that the suspect was “possibly deceased.”

The wounded San Diego police officers’ condition was not yet known, Price tweeted.


Update 12:01 a.m. PDT June 24: According to the San Diego Union-Tribune, police said a gunman shot at officers through a wall at an apartment complex off Rolando Court. A SWAT team was at the scene, where the suspected shooter was still inside the building, police said.

The newspaper reported that officers had taken another man into custody about 11:20 p.m. PDT but “ascertained within moments that he was not the shooter.”

Emergency personnel rescued a firefighter from the building after the two wounded police officers “and at least one firefighter were pulled out of the building on a ladder,” the Union-Tribune reported.


>> Read more trending news 

Please return for updates on this developing story.


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Sarah Huckabee Sanders' tweet about restaurant eviction violates law, ex-ethics chief says

Published: Sunday, June 24, 2018 @ 2:29 PM

White House press secretary Sarah Huckabee Sanders was asked to leave a Virginia restaurant Friday night.
Win McNamee/Getty Images
White House press secretary Sarah Huckabee Sanders was asked to leave a Virginia restaurant Friday night.(Win McNamee/Getty Images)

The former head of the U.S. Office of Government Ethics said that White House press secretary Sarah Sanders’ tweet Saturday about being kicked out of a Virginia restaurant violated federal ethics laws, The Slate reported.

Walter Shaub, the federal government’s top ethics watchdog for five years until mid-2017, said the tweet was a violation of the law because Sanders used her government account -- instead of her personal Twitter account -- to address the issue.

“Sarah, I know you don’t care even a tiny little bit about the ethics rules, but using your official account for this is a clear violation of 5 CFR 2635.702(a),” Shaub tweeted. “It’s the same as if an ATF agent pulled out his badge when a restaurant tried to throw him/her out.”

Sanders was asked to leave the Red Hen restaurant in Lexington, Virginia, on Friday night. She confirmed the incident with her Saturday tweet.

>> Sarah Huckabee Sanders kicked out of Red Hen restaurant

Sanders’ tweet from her official @PressSec account noted that the restaurant owner’s actions “say far more about her than about me.”

Shaub later tweeted that Sanders used her official government account “to condemn a private business for personal reasons.”

Former White House lawyer Ian Bassin said on Twitter that Sanders’ tweet would have been acceptable under her personal account, but not from her White House one.

“I think there’d have to be some argument that it was in service of the American people and not me personally. But read Sanders’ tweet. It doesn’t claim to be about public; the whole thing is ‘I’ and ‘me.’” Reads like it’s personal, which is fine from a personal account, not WH one,”” Bassin tweeted.

Red Hen owner Stephanie Wilkinson said she personally asked Sanders to leave the restaurant.

“I’m not a huge fan of confrontation,” Red Hen owner Stephanie Wilkinson told The Washington Post. “I have a business, and I want the business to thrive. This feels like the moment in our democracy when people have to make uncomfortable actions and decisions to uphold their morals.”

When asked to leave, Sanders’ response was immediate, Wilkinson told the Post. “‘That’s fine. I’ll go.’ ”

The Red Hen’s Facebook and Yelp pages were bombarded with reviews from people from both sides.

While some praised the restaurant, many others said the owner was being “intolerant.”

This comes after Homeland Security Secretary Kirstjen Nielsen bolted from a Washington, D.C. Mexican restaurant after protesters confronted her at her table -- with the blessing of the manager.

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Jordan: GOP leadership to blame for immigration bill failure

Published: Sunday, June 24, 2018 @ 2:43 PM

By Jack Torry

Washington Bureau

WASHINGTON – Republican congressman Jim Jordan of Urbana blamed House GOP leaders for the collapse of an immigration overhaul last week backed by conservatives but opposed by Republican moderates such as Rep. Mike Turner of Dayton.

In an interview Sunday on CBS’s “Face The Nation,” Jordan complained “if our leadership” had energetically pressed Republican lawmakers to support the conservative bill “it would have passed.”

“It was that close to passing,” Jordan insisted.

The House defeated the conservative version Thursday, 231-to-193, as 41 House Republicans joined House Democrats in opposing the measure. House Speaker Paul Ryan, R-Wis., then postponed a vote on a compromise measure designed to win the votes of moderate Republicans.

“The compromise bill was pulled because it was going to get a lot less votes,” said Jordan, who along with GOP conservatives opposed the compromise measure.

The conservative bill almost certainly would have reduced legal immigration and called on employers to use an internet system known as E-Verify to make certain they were hiring legal employees.

The conservative bill did not offer a chance for citizenship for Dreamers – people brought to this country as children by illegal immigrants. Instead, they would have been provided temporary status by applying every three years for renewable legal status.

By contrast, the compromise measure would allow as many as 1.8 million Dreamers for a chance to become citizens and authorized $25 billion to enhance security along the border between the United States and Mexico, including a border wall demanded by President Donald Trump.

Most analysts believed that neither House bill had enough support to pass the House. Turner said he backed a bill which would “keep families together, strengthen border security, implement a merit-based immigration system, and allow” those eligible for the Deferred Action For Childhood program – often called Dreamers – “to stay in the U.S.”

Jordan insisted “we want to welcome folks who come here for legitimate reasons who want to … who follow the law.”

But Jordan said “the mandate from the 2016 election was real clear — the American people made Donald Trump president; made Republicans the majority in the House and the Senate — to build a border security wall, stop chain migration, end the sanctuary city policy, reform our asylum laws, get rid of the visa lottery and then also deal with the” Dreamers.

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