High-altitude health

Christopher Scheibler in an Air Force jumpsuit
Christopher Scheibler

Flight surgeon Christopher Scheibler, MPH ’19, makes sure that Air Force pilots are healthy and that the cockpit environment is safe. He’d like to help make flying safer for everyone else, too.

May 31, 2019 – If you Google Christopher Scheibler, you’ll find a slew of articles, photos, and videos about his stint as flight surgeon for the Thunderbirds, the Air Force’s demonstration squadron that performs aerobatic routines in F-16 fighter planes.

Scheibler, an Air Force major who’s been a flight surgeon for eight years, says that the two he spent with the Thunderbirds—helping them deal with health hazards such as G-forces, musculoskeletal injuries, and even the plain old flu—was a high point in his military career.

Scheibler likes working to keep pilots healthy and safe on the job. His affinity for the work convinced him to delve more deeply into occupational health, which led him to Harvard T.H. Chan School of Public Health’s two-year Occupational and Environmental Medicine Residency (OEMR) Program, for physicians seeking board certification. In May 2019 he’ll earn a master of public health degree—the first leg of the program. Next year, Scheibler will complete the residency by participating in clinical rotations and conducting research.

After his residency, Scheibler will work in occupational health clinics for the Air Force. When his military career comes to an end, he envisions tackling health issues faced by everyday air travelers, from dehydration to in-flight heart attacks.

Military calling

Scheibler grew up in San Antonio, Tex., the son of an Air Force officer. He wasn’t sure if he wanted a military career, but Baylor University  offered an Air Force Reserve Officer Training Corps (ROTC) scholarship, which was enticing. Scheibler applied for the scholarship and got it. There was an option to bow out of ROTC after a year, so he figured he’d give it a try.

It turned out to be a good fit. He liked learning how to deal with pressure-filled situations and how to solve problems in real time. His fellow cadets became fast friends.

Scheibler majored in math and was on a pre-med track at Baylor. He also flew with the Civil Air Patrol, the civilian arm of the Air Force. On his first flight, in a four-seat single propeller plane, he got sick. “I ate this massive buffet meal at the cafeteria before I went,” he recalled. He figured that since he was prone to motion sickness, flying fighter jets might not be the right fit. He later learned that many pilots get motion sickness and they can often train to overcome it with repeated flight exposure.

While at Baylor, he volunteered at a family practice clinic in Waco and at the Brooke Army Medical Center emergency department in San Antonio. These experiences cemented his interest in a medical career to help improve the lives of others.

After Baylor he attended the Uniformed Services University of the Health Sciences in Bethesda, Md.—the military’s medical school. He appreciated the combination of medical training and military-specific training, such as how to set up a field hospital, how to respond to a mass casualty event, and how to evacuate and triage patients.

In medical school, Scheibler was drawn to surgery. After he graduated he spent a year as a surgical intern at Wilford Hall Medical Center at Lackland Air Force Base in San Antonio. He considered specializing in orthopedics. But after observing the grueling schedules and complicated personal lives of the surgeons he worked with, he decided on another path: flight medicine.

Primary care, miles high

The title of “flight surgeon” is somewhat misleading; flight surgeons might occasionally stitch a laceration or remove a mole, but that’s about it, and they wouldn’t perform any such procedures in airplanes. Their main role is to serve as primary care physicians for flight crews and their families.

Flight surgeons regularly fly with air crews to monitor how flying affects their health and observe their primary job duties. They observe, for example, how pilots maneuver in the cockpit. “If someone comes in with an injury like a wrist strain, we need to know exactly what they have to do with that wrist to control the aircraft, and figure out if they can do that safely or whether they need to be taken off flight status,” Scheibler explained. Other in-flight problems Scheibler monitors include hypoxia, decompression illness, and fatigue.

Scheibler with fans at a 2015 Thunderbirds air show at Keesler Air Force Base, Biloxi, Miss.

After serving as a flight surgeon in Korea and Italy, Scheibler was selected as team physician for the Thunderbirds, a role he held from 2014 to 2016. He was responsible for keeping the crew in shape while they toured the U.S. from February through November, with just one day off a week. In addition to providing medical care, he also helped with public affairs.

Scheibler thoroughly enjoyed his time with the Thunderbirds. “It’s such a small unit, and you’re traveling together for months. You become like a family.”

On-the-ground safety

Another role of flight surgeons is monitoring the safety of working conditions on the ground at air bases, looking at things like chemical exposures and ergonomics. That work, combined with his experience dealing with in-flight hazards, piqued Scheibler’s interest in the broader field of occupational health, and eventually led him to Harvard Chan’s OEMR program.

At the School, Scheibler is working on projects related to flight health overseen by Eileen McNeely, co-director of the Sustainability and Health Initiative for NetPositive Enterprise (SHINE) program. He’s been working with the SHINE research team on a special issue about aerospace medicine for the journal Frontiers in Public Health. The project is focusing on a comprehensive review of current research on the health impacts of commercial flight—such as circadian rhythm disruption, decreased cardiopulmonary function, and flight anxiety—on both aircrew and passengers. In a separate project, he is helping evaluate the hazards of cosmic ionizing radiation and its effects on the health of aircrew and passengers, specifically looking at cancer risk and reproductive health outcomes.

“Chris’s curiosity, initiative, and drive motivates others inside and outside class,” McNeely said.

For a class project in a course on ergonomics taught by instructor Theodore Courtney, Scheibler evaluated ergonomic hazards faced by food service workers at Boston Children’s Hospital. “We recommended ways to improve safety for workers who had to lift and store heavy food containers, and the hospital is currently implementing our recommendations,” Scheibler said.

This year and next, in addition to participating in clinical rotations at a number of area hospitals, Scheibler will serve as OEMR chief resident. In that role, he will be responsible for providing leadership and support for key functions of the residency, overseeing logistics for all first- and second-year residents, and serving as the resident advocate in support of their education and training. Stefanos Kales, director of the OEMR program, called Scheibler “an outstanding physician” and “a solid leader.”

Flight risks

After his residency, said Scheibler, the Air Force will place him in an occupational health clinic, likely at a location where workers perform heavy maintenance on aircraft such as sandblasting and painting, and where they are exposed to chemicals. He’ll finish his required Air Force service in 2026. After that, he’d like to focus on flight safety in commercial air travel. He said it’s an area in need of solid data and research.

“If you fly at all, I’m sure you’ll notice the number of wheelchairs, the number of assisted passengers, is greater than in the past,” he said. “People are living longer, with more complicated illnesses. These folks can usually do just fine on the ground, but they can have medical complications when you take them up to 35,000 feet and keep them there for 10 hours and don’t let them move around and dehydrate them.”

Scheibler said that the lack of any required reporting system for flight-related medical emergencies, and the fact that health problems can occur during flights or days later, makes it hard to investigate and quantify risks for travelers and aircrew. “No one really knows the risks of flying, and the solutions for in-flight response aren’t good,” he said. “You might be hours away from being able to land and get somebody with a medical emergency to higher-level care, and you’re left asking, ‘Is there anybody on board with medical training to deal with this?’ It’s not a good situation.”

Gathering accurate data on the number and type of flight-related medical problems that occur each year could spur research that helps determine potential risks for future air travelers, he said. “I think this is enough of an issue for concern that the public will be interested,” he said.

The above statements are those of Christopher Scheibler and do not represent the official position of the U.S. Department of Defense or the Air Force.

Karen Feldscher

Feature photo: Sarah Sholes

Photo of Christopher Scheibler at air show: Tech. Sgt. Manuel J. Martinez, U.S. Air Force