Upfront: From the Editor-in-Chief

State of the art


State of the Art

Jason S. Slakter, MD

While waiting in an airport for a plane that would take me from Indianapolis back to my home in New York, I witnessed an example of diagnostics in action that would certainly grab the attention of any retina specialist. I arrived at the airport well in advance of my flight and participated in what has now become the routine in security screening. I continued to the assigned gate for my flight and was pleased to see that the aircraft, a small commuter jet, was indeed parked at the ramp. Things seemed to be going well, until I noticed that one of the gate agents had proceeded down the ramp and out onto the field and was staring at the front end of the airplane. I asked the remaining agent if there was an issue and was told that, although the arriving pilots had not reported any difficulties, the new flight crew had noted some irregularities in the paint on the nose of the plane and were having it evaluated.

Soon after my initial observation of the scene below, a van arrived, carrying two appropriately uniformed members of the airline maintenance crew. They performed a visual inspection of the nose, carefully looking and then touching the areas of concern. They returned to the van and brought out what I initially assumed to be some type of high-tech imaging or measuring device that would assess whether this was simply a piece of chipped paint or more serious damage to a sensitive area of the airplane. What they carried, instead, was apparently a small digital camera or camera phone, which they used to take pictures of the problem. They proceeded back to the van and uploaded the photographs for outside evaluation. (I must say that this action was encouraging because, as retinal specialists, we are used to the concept of digital imaging and telemedicine.)

This photographic assessment, however, was apparently not adequate, as the two maintenance men were soon joined by a “chief mechanic” and “flight supervisor.” The group gathered around the front of the aircraft, took additional photographs, and pondered the situation carefully. Finally, one of the maintenance crew stepped forward and performed the ultimate test of structural integrity: he actually rapped his knuckles on the area of concern, much as one would have kicked the tires on an old car.

Now far be it from me, as a nonaviation expert, to conclude that this was not an adequate test of the airworthiness of the aircraft, but as a retinal specialist, I am used to a somewhat more detailed analysis of a problem before a “treatment decision” is made. Apparently, for air travel, what I had witnessed was, in fact, state-of-the art diagnostics.

As a trained physician, I carefully weighed the risks and benefits of the situation and made what I thought was an intelligent decision. I spoke to the gate agent and asked to be rebooked on a different flight, which was fortunately accomplished without incident. I had an uneventful flight home, arriving safely back in New York. As it turns out, that original flight was eventually cancelled. I guess they must have heard something unacceptable after all.