The question was first posed in one of my aviation classes at UND, and has stuck with me since. It was always rhetorical, based on various imagined hazards ranging from a family history of diabetes to an industry meltdown rather than any specific, imminent threat. Early in my career any outcome seemed entirely possible, as did my imagined alternatives: Become an air traffic controller. Go back to school. Go into architecture or law. As I aged and my career became more established, both the prospect of not being able to fly and the chances of pursing an alternative course seemed increasingly remote, and the doomsday scenarios faded from my mind.
Yet here I am, in a sterile medical office, staring blankly at an anatomical poster on the wall and trying to understand what the doctor is telling me while the red master warning bell in my brain is blaring deafeningly. I wasn't expecting life-changing news today. I had a sharp pain on the right side of my abdomen last night, and grudgingly made a rare visit to the clinic on the off chance it was appendicitis. I dutifully drank some foul-smelling liquid and lay down for a CT scan, and figured worst-case scenario I'd be getting my appendix taken out laparoscopically before the day was done. And now this doctor is telling me that I have an inflamed ileum, he thinks it's likely Crohn's Disease, and I need to see a specialist to find out for sure.
I didn't know anything about Crohn's except that Dawn and I have two acquaintances with the disease, and their lives have been a living hell of torturous pain, ineffective medicine, failed surgeries, withered bodies, stunted careers, and strained marriages. I knew it was incurable. If I have Crohn's, I thought, it must mean the end of my flying career. The doctor was telling me that many Crohn's cases are mild and controllable with medication and diet, but I scarcely heard him. What am I going to do now? I thought. I looked across the room at Dawn. Despite her forcibly calm demeanor, I could tell she was thinking the same thing.
That was five weeks ago. Since then, I've gone to a gastroenterologist, consulted with several Aviation Medical Examiners, undergone a MRI, and had a colonoscopy. Crohn's is a tough disease to diagnose with certainty, and on the advice of ALPA Aeromedical, I continued to fly while the diagnosis was uncertain but I remained asymptomatic. I flew my trips in December knowing they would probably be my last in a while. And then, just before Christmas, came the final word: I do indeed have Crohn's, albeit a currently mild case. Based on past symptoms, I have probably been living and flying with it untreated for around ten years. Now that it's official, though, I'm grounded - for the time being.
The good news is that my diagnosis isn't nearly the death knell for my career that I initially imagined. Nearly 2,000 pilots currently hold a first class medical despite having Crohn's or ulcerative colitis. Most of the medicines used to treat Crohn's, including the one my gastroenterologist is putting me on (Remicade), are approved by the FAA and require only a short test period to make sure there are no severe side effects. Assuming that I don't have any, and the FAA has no objections to my case and their case load isn't more backed up than usual, I should be able to get a waiver by April or May.
Nevertheless, Crohn's is a somewhat mysterious and unpredictable malady, and despite my relatively mild symptoms thus far, it could take a turn for the worse at some point and end my flying career. I have a few things to occupy my time during my months out of work, but inevitably I'll return to the question: what will I do if at some point I can't be a pilot? I really don't know, right now. Aviation is my first love and has become such a large part of my identity that it would be very, very hard to give it up, even if I had to continue in a non-flying role. I guess I can consider the next few months a sort of trial run for an earth-bound existence. Fortunately, I have a few tailwheel-rated friends who can tag along in the C170 or the Cub when that old flying bug gets restless and starts biting again.