Flight Attendants, Prepare for Landing

March 13, 2008

We've likely all seen the footage of the attempt at a heavy cross-wind landing by a Lufthansa Airlines pilot that made its rounds last week. As the son of a retired US Air Force pilot and now commercial airline pilot, I've always been fascinated with aviation. So, I called my father right after viewing the footage of the landing. The conversation that ensued led me to some interesting questions about the use of technology in the healthcare world.

The pun used here, please forgive me (I had to), was intended. Bear with me, and you’ll soon see why I’m covering this topic here.

We’ve likely all seen the footage of the attempt at a heavy cross-wind landing by a Lufthansa Airlines pilot that made its rounds last week. As the son of a retired US Air Force pilot and now commercial airline pilot, I’ve always been fascinated with aviation. So, I called my father right after viewing the footage of the landing. The conversation that ensued led me to some interesting questions about the use of technology in the healthcare world.

He told me that—despite the fact that airports are built so the runways have pilots landing in the direction from which the wind most commonly blows—commercial pilots can expect to be faced with very heavy gusting cross wind landings a few times in their career. If the number of "windy landing" videos posted on YouTube is any indication of their frequency, he has to be right. He also explained that there are two approaches to landings in heavy cross winds:

  1. The pilot flys in the “crabbed” position (so called, because crabs walk sideways), angling the plane into the wind to keep it moving straight toward the center of the runway, but with the fuselage "crabbed" into the wind. At the last second, the pilot straightens out the nose, and touches down; if this is mis-judged, “wing low and opposite rudder—cross wind controls” will have to be immediately added or the plane will be blown off line! This is the more common technique, and the method used by the Lufthansa pilot. Each type of commercial airplane has a limit for the strength of a cross wind in which it can land, so the low wing does not hit the ground!—about thirty-five miles per hour of direct cross wind, slightly more if the wind is from an angle less than 90 degrees. The unkown here is that when the wind is at or near your aircrafts limit, you never know if it might gust a little higher as you’re about to land... the unfortunate event that caused the Lufthansa pilot to “catch a wing tip” while he discontinued the approach and “went around.”
  2. The less frequently used method, and the one used by my father because “it just makes more sense and seems safer,” is to line the nose up with the center line of the runway about a mile from the runway, by using “wing down into the wind and opposite rudder” to keep the nose aligned with the runway throughout the last portion of the approach and landing.

I asked him why it is, if the second option above is safer, that most pilots use the first option. He explained that it’s because the first method is easier. “You don’t have to think about coordinating everything.”

This is where the first connection to healthcare popped into my head; how often do physicians, perhaps unbeknownst to themselves, practice a less effective option of a method (eg, diagnostic test, surgical procedure, medication administration, etc), because either that’s the method they were taught in med school or because it’s simply the easiest option, perhaps jeopardizing safety (the patient’s, their own, and their colleagues’). I’d love to hear your thoughts on this!

My father went on to explain that the technology does exist and is used on the C-5 Galaxy, a gigantic cargo jet used by the US Air Force, to land with the aircraft fuselage angled directly into the cross wind and the landing gear swiveled left or right to align straight with the runway! This technology uses massive amounts of hydraulics and moving parts, as the aircraft was built to land on unimproved airstrips (possibly stretches of dirt in the desert), where multiple runways to possibly avoid the cross winds (like at a normal airport) aren’t an option. So, if the technology exists to have landing gear swivel for landing in any cross wind, making such landing much safer and possible just about anywhere with a long-enough strip of flat land, why don’t commercial airlines use the technology?

The simple answer: “It would just be too expensive,” says my father. Complex landing gear with this capability would be terribly expensive, not to mention the costs and time to maintain all the moving parts—expenses the military (but not the commercial airline industry) can justify when troops and equipment must get to a certain area at a specific time, because lives are depending on it. “Hmm…lives depending on something; sounds like healthcare,” I thought when talking with him.

Here’s tie-in number two: I wonder how many healthcare technologies exist out there that would save lives while making medical procedures and tests easier to perform, but are left in the dark because of their expense? Surely there are wonderful, safe, and effective medical advancements and innovations out there that you’ve never heard of or seen. What could they be? How many are there? How many saw the light of day but were dropped due to high costs?