MIAMI —  I’ve never been found unfit to fly before. I was attempting to work an international trip only weeks after my airline’s biggest tragedy—TWA Flight 800—that had claimed the life of my fiancée Susanne. She was one of 230 passengers and crew onboard a Boeing 747 in 1996 when it exploded in flight. So, instead of flying to Milan as planned, I was introduced to an entire, seemingly clandestine, department that was operating within my airline—Special Health Services—when the captain of my scheduled flight suddenly threw me off our trip.

As the anger inside me welled, during my long trek from the cockpit of my flight that would depart without me, to the office of my boss—The New York Chief Pilot—I began a personal mental health odyssey through both corporate and federal oversight that required me to deal with my extreme grief and survivor’s guilt, but that eventually allowed me to return to my airline career.

Looking back, I realize now that I would not have sought my airline’s assistance voluntarily. Like many pilots, I felt that mental health counseling carried a stigma of weakness. I am here to tell you that I was wrong, even though that stigma was very real, and it still needs to be further dismantled in order to encourage more pilots to seek help, or empower fellow co-workers to nudge each other in the direction of professional assistance.

Unfortunately, many pilots still struggle with deep personal issues alone, and perceive any intervention as a threat to our hard earned, yet fragile careers. It seems the Germanwings Flight 9525 first officer considered his flying career over when he tore up the medical leave notification he’d received. I don’t believe he fully understood there were methods of treatment available that could potentially allow his career to continue, after whatever level of healing he required. If a pilot can cause the deliberate destruction of his aircraft and trusted passengers in response to the threat of losing his ability to fly, the Germanwings tragedy begs the question: what can be done when a pilot comes undone?

I am a commercial airline pilot with first hand knowledge of how a major airline handles mental health issues. I was hired by my first regional airline in 1986 and my first major airline in 1988. In those days, most pilots had no idea what resources we had available to assist us with stress, our personal lives, and mental health issues. We were a stoic bunch (occasionally even arrogant) who prided ourselves on self-reliance. No problem was too big. But even during that era, we maintained an informal, collective watch over each other. Pilots are a group who collectively don’t just go to work—we live for our time in tiny cockpits capable of moving through three-dimensional open space, and we dedicate the bulk of our adult lives to this noble profession.

Pilots fear and loathe being grounded. We have to take check rides and pass FAA mandated medical exams every year, and either one could clip our wings. And as a stoic group, we tend to secretly resent placing our own well-being in anyone else’s hands. But I learned though personal experience that the people we can be forced to see—when our personal and/or professional worlds turn upside down—have as much interest as we do in helping return us to the cockpit—but only when we are ready.

So, where did I go after I was grounded? My airline had an administrative leave category named GMF Hold (General Manager of Flight – Hold) that allowed my schedule to be cleared, while my paycheck continued to arrive. I was a first officer at the time, and my job became meeting with a psychiatrist instead of meeting up with a captain. My journey became an internal odyssey instead of external trip.

I was not happy about my new situation. After I sat in an intimidating office (compete with an oversized desk, diplomas, and plenty of open space—not the cramped comfort of a cockpit that I was used to), my appointed psychiatrist inquired, “Mark, why do you think you are here?”

I replied, “Obviously, I didn’t volunteer. This was TWA’s idea. I didn’t do anything except try to do my job and I got grounded. I’ll be honest, I’m pissed off about it.”

He was not initially reassuring. Here is an excerpt from my memoir 13,760 Feet—My Personal Hole in the Sky that reveals that initial meeting with my career flashing before my eyes:

“It is good that you are being honest,” the doctor said, “and I will be honest with you. Do you know that your career is now in my hands?” For a split second I envisioned him as President Harry S. Truman, a wooden plaque with The Buck Stops Here displayed on his desk. Then I returned to reality, and our regularly scheduled program. He was serious. Ever since my fiancée Susanne died, everything had taken on a surreal quality. “You cannot go back to fly until I allow it. How does that make you feel about our meeting today?”

“Even more pissed off.”

“Yet you are here. I have nothing on my schedule except to speak with you for the next two hours. Your airline feels it is important that we spend some time together and investigate your feelings.”

Two hours? I had figured forty-five minutes, max. In fact, after passing the countdown test (he made me count backward from 100 by sevens, as an initial test of my cognitive ability), I thought I’d be out the door with a back-to-work pass in ten more minutes, tops. Investigation is the word that really made me mad, and more than a little nervous. People are investigated for things that they’ve done. I didn’t do a damn thing except receive the news that Susanne had died. My job was now in jeopardy and my mental health was in question. As a pilot I felt I could fly through anything, even emotional trauma. (It’s worth repeating), most of us are hard-wired that way.

“Tell me doctor, why do I have to have my head examined because my fiancée died?” I asked. “What did I do? Exactly nothing, that’s what. The woman I love most in the whole world died, and because it’s on one of my airline’s airplanes, I’m not allowed to fly them anymore? What kind of bullshit, vindictive logic is that?”

“Mark, that is what we need to explore,” he explained, inching his chair away from his desk, crossing one leg over the other as though he were David Letterman’s next guest. “You have been delivered a great wrong. Life isn’t fair and you do not need me to tell you this. But if you want to examine your situation, look at it from your chief pilot’s point of view. The airline knows you are suffering, and I can see that in you right away—it is in your face, your flat affect, the mask that tries to hide your feelings—but would he be doing his job to provide safe air travel if he did not first offer you all the help at his disposal before returning you to work?”

I leaned in and squared my shoulders in what would be an aggressive stance, except that I was sitting. “So this is a liability issue then? My chief can’t let me fly until someone signs off on me? He’s worried about the airline’s insurance premiums more than the needs of one of his own pilots? I’m an employee, and I’ve now lost more than anyone can ever be expected to suffer on my company’s aircraft, and right now I want to, I need to, go out and go flying.” I thumped his desk to punctuate my point. “I’ve had enough taken away from me. I’m not giving up my wings too.”

“If it makes you feel any better to look at it that way, then yes, I am the one who must risk deciding if you are OK to fly. Someone has to be liable for you, and your company is paying me a good sum of money to take that responsibility. Is that not what you also do? Do you not accept the responsibility of every passenger’s life when they board your airplane? So you and me, we are the same in that regard. We are decision-makers and others accept our judgment as part of our job. Other people look to us to act in their best interest, but let us look at this another way. You receive a checkride occasionally, do you not?”

“Twice a year—once in the simulator and once on the line while flying passengers. Also every time I upgrade or transition into a new seat or aircraft type.”

“Well then, you are not so foreign to this concept. Consider this discussion to be an oral check ride, just like you have to do with the FAA when you learn a new airplane.” 

I began feeling conflicted. Part of me was still angry that I had to face his tribunal at all. Another part of me admired the way he was asserting his authority with references that I could relate to. I sat back to think this through. “You seem to know a lot about my job. Are you a pilot?”

“I am a licensed psychiatrist; that means I have been to med school, not flight school. But I am also a Zen Master in Japan and the chosen authority for your airline’s mental health. You are not the first pilot to sit across the desk from me—far from it, in fact. And, I have sent a great deal of them back to work—when they are ready.”

“I’m ready now. I’ve told you that.”

“You are only ready when I have made that call. We have much to talk about.”

“So what are you planning on doing next, make me count backwards using only prime numbers?”

“Would you like to do that?”

“Hell no.”

“Good, because there are other ways.” He pointed to a glass case full of every assortment of pill I could imagine. It looked like the Lite-Bright toy I played with as a child, with little colored dots of various sizes and shapes. Except these must be prescription narcotics and other mind-altering capsules. I had no interest in a trip down the rabbit hole.

“I’m not taking any pills. You can forget about that. I already told you, I didn’t do anything and I’m not going to be drugged for any reason. Even my job isn’t worth that.”

The only pills I’d taken were sleeping pills the first couple weeks after the crash—over-the-counter Unisom that my friend Chip recommended. Before I tried them I couldn’t relax; I just stared through the night. If I did sleep, I think my eyes were still open. I wasn’t going to admit any of that to Dr. Oshiro (a pseudonym). All I wanted was his signature on the proper line and to be done with this interrogation. I would cooperate in order to graduate, except I was careful not to give him any excuse to label me unfit to fly.

“Well now you know why you were sent to see me specifically. If I give you any of the drugs in this case, as I often do with my non-pilot patients, you cannot fly while using them and for a good deal of time afterwards—in many cases a minimum of one year.

“To hell with that idea.”

“Exactly, Mark. That is why for pilots there is another way. We must break through your subconscious block, but without using drugs. Do you know how we can do this?”

“Sorry, Doc—no clue. I’m sure you’re going to tell me though.”

“Not exactly. You are going to tell me. What is the one thing that you can do while you are awake or while sleeping?”

“Think about sex.”

“Very clever. I knew your mind was working, but think again. This is a physical thing. We all do it without thinking, and we can control it when we do. We are both doing it right now.”

He followed up that statement with an exaggerated deep breath. I almost laughed when it occurred to me this was like an open-book test. He was feeding me the answer.


“Precisely.” He made a one-finger silent snap in the air, like an orchestra conductor signaling a cymbal strike, to emphasize his point. “I would like to teach you how to do it better, more deeply, with your chest and your gut. My American medical degree taught me how to change the chemicals in the brain, but I prefer the natural Eastern ways if my patients are willing to work hard at learning them. It is your choice. Would you like to learn how to restore your emotional balance through breathing, or with a prescription?”

I let my face droop with an almost sleepy expression, as if I’d just sat through a record-length lecture. “OK, give me the yoga lesson and send me back to work.”

“Mark, you may be skeptical, but keep in mind that we both know you are deeply grieving. It is now part of your life. I need you to learn to do it well. When you fly, you feel it and you fly well. Everything in life that you do, you must do well. When you shit, a primal need, shit well.”

This caught me by surprise, but he was serious. He continued, “To accept your life again as it is now, you must learn to grieve well.” He was staring at me to make sure I received his message. “I want you to take the next few weeks to learn and practice breathing exercises and call me if you have any questions or concerns, then come back and see me. I do not need you to be free from grief to return to flying. I only need to know that you are on your way.”

“I take it you aren’t letting me fly to Europe this week.”

“No, but I am prescribing my breathing workbook. I am going to show you the basics now to get you started, then read what I have written and let your internal journey begin.”

The emphasis of this excerpt is to show that there is already a mechanism to assist emotionally struggling pilots with our mental health while continuing our careers, but even more needs to be done to educate pilots to the process. You’ll notice the doctor said, “I do not need you to be free from grief to return to flying. I only need to know that you are on your way.” And this was all the way back in 1996. Now, the airline I fly for has a greater awareness of its pilots’ needs, and the available mental health resources and printed handouts are taught and distributed during each recurrent training cycle.

 Airline pilot mental health moved to the forefront in June 2011 with a program of trained volunteers called Project Wingman. This is a joint venture between my company and the pilot union. It’s led by Captain Charlie Curreri, who also a licensed professional counselor. The Project Wingman team helped establish a 24/7 confidential emergency mental health hotline in case a pilot needs to address a mental health issue about him or herself, or is concerned about another crewmember’s psychological well being.  This program’s success is measured though numerous success stories. Names are withheld in confidence, but Project Wingman Director Curreri assures me that many pilots have received the help they’ve needed without fear of reprisal or loss of license, especially when it came to taking medications for mental health reasons.

While some are approved, other prescription medications may still keep pilots out of the cockpit for a while; but new features like shared sick leave (pilots can donate some of our vacation time to another pilot-in-need in order to increase the length of his/her sick leave pay) demonstrate how much of a fraternity (ladies included) our profession still is. The emphasis is on giving each pilot the time and resources to cope with his or her issues that may interfere with cockpit duties. But I don’t know if this level of resource has spread yet to every airline.

For the most part, commercial pilots are self-policing for continued mental health, but as I have demonstrated, at-risk pilots need to be identified when they are off his/her game, and introduced to Project Wingman—our pilot-advocating-system that is already in place. Word still needs to spread among pilots that the primary goal of aviation mental health professionals is to assist us with our overall career, even if that requires temporary removal from the cockpit.

Fear of the unknown may have contributed to the absolute despair that the co-pilot on the Germanwings flight might have experienced when he perceived his imminent medical grounding. We’ll never know for sure, but he could have perceived that his medical certificate suspension equated to losing his entire aviation dream. But if we educate even our newest pilots right from initial training that there is a caring team of mental health professionals waiting to assist us should we need it, perhaps the natural reluctance against seeking help—taking an internal journey of self-discovery and healing—can be somewhat diffused.

We do have advocates who can treat us on the ground so that we can be our best while up in the air, but we need to learn more about them—and the grounding/reinstatement process—before all pilots feel comfortable engaging the process when needed. The traveling public should be re-assured that flight crew mental health is not a subject that is being ignored by the world’s airlines. Dealing with depression, grief, and other mental challenges, and then successfully returning healthy pilots to the cockpit, is an evolving process.

Under the spotlight of our recent industry disaster, the focus on pilot mental health programs will hopefully help serve to make pilots more open to therapy and/or prescribed medication. To prevent another Germanwings tragedy from occurring, airlines and federal regulators need to continue developing special health services, and through promoting successful treatment, continue earning the trust of the entire pilot profession. 

Mark is an MD80 Captain and former Check-Airman. He is also a regular contributor for Airways magazine. His memoir 13,760 Feet—My Personal Hole in the Sky is available in paperback and Kindle formats and is about to be released as a full-production, 15-hour audiobook (infused with 41 original companion songs) on His author website is:

Lufthansa released the following statement Tuesday:

The co-pilot of Germanwings flight 4U9525 interrupted his pilot training at the Flight Training Pilot School for several months. Thereafter the co-pilot received the medical certificate confirming his fitness to fly.

To ensure a swift and seamless clarification, Lufthansa – after further internal investigations – has submitted additional documents to the Düsseldorf Public Prosecutor, particularly training and medical documents. These also include the email correspondence of the copilot with the Flight Training Pilot School. In this correspondence he informed the Flight Training Pilot School in 2009, in the medical documents he submitted in connection with resuming his flight training, about a “previous episode of severe depression”.

Lufthansa will continue to provide the investigating authorities with its full and unlimited support. We therefore ask for your understanding that we cannot provide any further statements at this time, because we do not wish to anticipate the ongoing investigation by the Düsseldorf Public Prosecutor.