Ever wonder what’s behind all the near-misses on runways, airplane mechanical failures, and control tower mishaps?  A new documentary sheds some light on this growing problem in the American aviation industry.

The documentary may also be a factor in the makeup of the U.S. Senate in 2025.

The New York Times documentary “Lie to Fly,”  shown on the cable channel FX and streaming on Hulu, is a good, if not flawed and incomplete, look at the broken state of the Federal Aviation Administration’s medical clearance process.

The narrative arch follows former airline pilot Joe Emerson‘s mental breakdown in the cockpit, which the FAA’s current mental health policies actually contributed to instead of prevented.

The documentary interviews prominent aviation attorney Joseph LoRusso of the Ramos Law Firm and senior aviation medical examiner Dr. Brent Blue, who are staunch critics of the current outdated aeromedical process. Blue stated due to the current draconian regulations, AMEs cannot issue a medical certificate to pilots that are fit to fly for many conditions that should be considered a non-issue. They must defer the application directly to the FAA, which also immediately rescinds a pilot’s current medical, effectively grounding them from flying.

This FAA determination often takes years; and thus pilots often avoid seeking medical treatment so they aren’t lying on a government form about being diagnosed with an ailment that would ground them immediately )and potentially for years under the FAA’s current policy).

Also interviewed was current FAA Federal Air Surgeon Dr. Susan Northrup who came across as whitewashing the situation especially with her past postings as well as others tied to FAA Medical past postings on the internet outright having a discriminatory policy against pilots tagged with ADHD as children.  Dr. Northrup also understated the outright final denial number as 0.1%.   The documentary immediately cuts to LoRusso’s counter point stating that the FAA’s draconian process is so arduous that a large portion pilots give up trying to get their medicals back, but the FAA instead classifies them as still in “deferral.”  Dr. Northrup is even asked does the FAA count those that are “indefinitely differed” in that 0.1% and Dr. Northrup responds the agency does not, and she blames the pilots for giving up and having a “process that is not complete” when it’s the FAA’s arbitrary and strict policies as to why these pilots don’t have medical clearances.

The documentary goes back to Emerson’s story and that the mental breakdown started due to the recent death of his close friend and fellow pilot Scott Pinney of a sudden cardiac incident.  But it stops short of stating what caused the cardiac incident.  Emerson was concerned if he actually sought mental health treatment for his depression related to Pinney’s death he would immediately lose his medical clearance, especially since he had a past issue with his medical where he had a false positive on an EKG; at that time he had to get a full workup by a cardiologist to show FAA Medical he had no cardiac issues.

Because of the FAA’s broken policies, Emerson tried to self-medicate with “magic mushrooms,” as clips from various news agencies including CBS’s “60 Minutes” were then shown conveying the health benefits.  The mushrooms, however, led to the mental breakdown where Emerson reached for the fire suppression handles on the engines.  Surprisingly not only were the police bodycams of the arresting officers included in this documentary, but also the black box cockpit voice recorder as well.

It was pointed out the exaggeration to outright lies about the incident that were portrayed in the news over the following days and weeks as well as the incident directly leading to the NTSB Safety Summit Roundtable in December 2023. 

Left on the cutting room floor

While NTSB Chair Jennifer Homendy was interviewed specifically for this documentary (and she gave strong statements such as FAA Medical’s policies on mental health being in the “dark ages”), this is where the flaws and omissions of this documentary become apparent.

The subjectively graded cognitive assessments including the “Cogscreen” went completely unmentioned in this documentary and this includes the facts presented at the NTSB Roundtable that these tests not only lack scientific data to back up their claims but are also used beyond their design intent.

Also not shown in the documentary was the statement from then NTSB Vice Chair Bruce Landsberg stating that the data from the tests can be tortured to confess to anything especially with regards to grilling of  FAA representative Dr. Penny Giovanetti regarding her claim that the FAA’s barriers to getting a medical such as the tests being graded pass or fail based on opinion and not hard science as to only being as “perceived” instead of actually being real,  nor was the statement by Giovanetti that the Cogscreen is used by the FAA is because the test was validated by the (Soviet) Russians back in 1987.

Giovanetti’s presentation in the documentary was crafted in a way that does not reflect reality. She’s portrayed as part of the solution when she’s part of the problem.  The portrayal of Giovanetti makes her seem like an advocate for bringing on more personnel to help; all she’s really doing is increasing the size of government. If you look at the her entire presentation for the NTSB Roundtable, she was making excuses as to why the current system at FAA Medical is in place. The documentary does not show her sidestepping questions about the cognitive tests, which themselves are, along with the hand-picked mental health quacks hired as FAA third party contractors.

According to LoRusso on an episode of “The Pilots Pandemic” podcast, these supposed professionals are committing malpractice by using pre-made templates to trap the pilots into their cottage industry. It doesn’t help that pilots with stress or depression issues are being lumped in with alcoholics and drug abusers forced to go through the Human Intervention Motivational Study (HIMS). It becomes clear, with any objective analysis, that HIMS is the problem, not the obstacle, between these pilots and their medical clearances. It cannot be stated enough that using HIMS to ground a pilot has nothing to do with the safety of the skies and has everything to do with trapping a pilot in FAA Medical purgatory to hold the pilots hostage to these mental health quacks to enrich themselves at the pilots’ expense.  Regrettably, HIMS was not mentioned at all in this documentary.

Also not mentioned anywhere in the documentary is ADHD and the sizeable percentage of pilots tagged with ADHD trapped in medical purgatory.  Dr. Blue even mentioned ADHD as a “childhood disease du jour” at the safety summit where the FAA unjustly makes it next to impossible to un-tag a pilot with an formal ADHD diagnosis when the public schools were tagging children left and right without hesitation from the 1980s onwards.  The Cogscreen itself pointed out in Dr. Blue’s publications in APOA has never stopped an accident.   Even though the FAA commissioned the test, and taxpayers funded its development back in 1987, Dr. Blue stated on The Pilots Pandemic Podcast that the test’s creator, Dr. Gary Kay  is the sole owner of the test codebase and the intellectual property and is the lead author or contributing author of 80% or more of the peer reviewed articles about the Cogscreen, the last being published in the year 2000 according to Dr. Blue who also called this a major conflict of interest.  Dr. Kay also keeps the Cogscreen’s codebase in a “black box” and is litigious against anyone that tries to reveal any aspects of the test publicly.

It should also be pointed out that Kay receives a $100 commission every time the test is administered, which seems to incentivize the subjective grading of this test to keep committing malpractice by subjectively failing pilots again and again — holding the pilots hostage to this cottage industry that not only lines the pockets of this self-dealing cabal.

Multiple experts from Dr. Blue, the late Dr. Jask Hastings and the FAA’s own Deputy Federal Air Surgeon Dr. Brent Wyrick  all state that there is no real independent outside evidence that shows the Cogscreen is any form of indicator qualifying the actual aeronautical decision making by a pilot.  All three stated that using flight simulators and/or passing a checkride in a real aircraft are true indicators if a pilot is mentally fit to fly and if ADHD is actually an issue.

It gets worse: The FAA usually only gives a pilot only 30 to 60 days to find one of their hand-picked quacks and that a pilot cannot change HIMS practitioners without an act of Congress once they start with a particular one. This policy was not amended during the COVID lockdowns and many pilots are now indefinitely grounded due to being forced to do these rigged cognitive assessments with COVID protocols in place, including masking, and being forced to sit masked behind room dividers that stagnated the air.

This is important because the narrative that would move the needle is that the current broken polices and regulations that FAA medical have in place are not about the “safety of the skies” but instead maintaining a captive regulatory environment. The effect: pilots either avoid medical care and/or outright lie on their medical applications to the FAA in order to avoid getting trapped into FAA “Medical Purgatory.”

The documentary does point out that the NTSB has no jurisdiction over the FAA and can only make recommendations.

This roundtable however seemingly forced the FAA to create the Aviation Medical Clearances Aviation Rulemaking Committee to author the ARC Report. The report does make the shocking admission that ADHD was often misdiagnosed, and that there are pilots and air traffic controllers leading perfectly safe operations that were not grounded because they didn’t report ADHD on their medical forms. While it does state that The ARC recommends that the FAA reexamine its ADHD certification/clearance policies to determine the potential aeromedical effects of ADHD, this is pretty watered down from the NTSB roundtable considering nowhere in the report is the Cogscreen mentioned at all.

In contrast, the documentary seems to play up the ARC Report as to not being watered down, yet also points out that that the ARC Report is also only a series of recommendations, which the FAA isn’t in the habit of acting on.

Both Homendy and Blue state the FAA can unilaterally implement these reforms to their mental health regulations without congressional approval, but they won’t.  This is highlighted even more so that the FAA has loosened medical standards since 2020 with regards to EKGs due to COVID and the shots related to it causing cardiac issues.  The issue is apparently so prevalent that the aviation industry would risk collapse from grounded pilots were previous EKG standards enforced.

LoRusso more or less stated the same thing in the documentary regarding the FAA’s mental health standards, stating that once this generation of airline pilots ages out en masse when they turn 65, the pilot pool will be dried up because the upcoming generation will be disqualified under the current aeromedical standards before they even get out of elementary school.

Congress, however, can author legislation that forces the FAA to implement these reforms.

The documentary then touches on the efforts of the Pilot Mental Health Campaign 501(c)(4), or PMHC, lobbying Congress in March 2024.  It showed PMHC meeting and Indiana Congressman Rudy Yakym, however it focused on Illinois Congressman Sean Casten’s efforts to author bi-partisan legislation forcing the FAA Medical to reform their ways and mentions 24 legislators that have signed onto his effort.

Also unmentioned in the documentary is that one of those 24 legislators is Congressman Colin Allred, the opponent to Texas Sen. Ted Cruz who is the Ranking Member of the Committee on Commerce, Science & Transportation and was previously the Ranking Member of the Subcommittee on Aviation Safety.  Many pilots view that Cruz missed an opportunity to bake in substantial aeromedical reforms such as banning the Cogscreen and that his push the legislate the FAA to expand medical certificate requirements to balloon pilots was a step in the wrong direction.  This is especially true since Blue stated that the FAA justify the aeromedical process because the FAA claims it’s to predict sudden incapacitation of a pilot.  Blue however went on to say that if modern medicine can’t predict sudden incapacitation, why should the FAA even try and advocated in the past to eliminate at least the Third Class Medical requirement altogether.  It should also be pointed out that if Sen. Cruz himself applied for an FAA Medical in this current environment, he himself might be forced into HIMS FAA Medical Purgatory due to his past use of marijuana in college decades ago.  

Missing as well is any mention of direct oversight and control by the Department of Transportation, Secretary of Transportation, and all the way up to the President of the United States through executive order, which can also can force the FAA to reform its medical process.

In the past, the DOT Office of Inspector General, or OIG, published a report in 2011 criticizing the FAA for lacking oversight over “their party contractors” especially when they “go into business for themselves.”  If the DOT acted on that report when it was published, they could have gone after the FAA for letting the hand-picked mental health quacks committing malpractice to support their cottage industry of holding pilots hostage in FAA Medical Purgatory and even lying about their credentials, as well as letting Boeing get away with the self-inspection of the 737 Max.

DOT could also hold the FAA accountable for being punitive against pilots and for ignoring the 1987 Broderick Memorandum regarding the FAA’s medical forms for reporting being intentionally vague. Nothing regarding the DOT was touched upon in the documentary, nor was Landsberg’s statement at the NTSB Roundtable the FAA needs to stop being punitive against pilots, and only a brief statement from LoRusso about the potential consequences of lying on a government document was presented.

There have even been instances where the aeromedical process has been weaponized against pilots such as with Delta Airlines whistleblower Karlene Pettit. Delta paid hand-picked Dr. David Altman, a $74,000 bribe to falsely diagnose Pettit with bi-polar disorder and Stephen Dickson who was later nominated by President Donald Trump to be FAA Administrator aided Delta in the retaliation against Pettit. 

This in effect intimated all pilots to keep their mouths shut. It’s why you don’t see to many pilots talk about this nightmare for fear of the doctors or even the FAA punishing them.  While Altman was eventually forced to forfeit his Illinois medical license permanently, this type of action against these quacks is exceptionally rare and most still have their licenses and are making a living off their malpractice at pilots’ expense. especially since there is no doctor-patient relationship in place with the FAA mental-health contractors.  The pilots aren’t even allowed to see the records because those are also property of the FAA — and HIPAA offers no protection against this. This is another key event not  touched on in the documentary.

Symptoms, but not the cause

While communicating “how the sausage is made” to those not in the aviation industry and why there is a need for aeromedical reform, “Lie To Fly” scratches the surface well. But it is ultimately flawed by the fact producers only had an hour to work with and much of that was taken up by Emerson’s narrative for story-telling purposes.

The meat-and-potatoes of what is actually wrong with FAA Medical was unfortunately omitted only focusing on the symptoms versus addressing the underlying problem being the cognitive tests, the hand-picked mental health mercenaries, and outdated “draconian” policies that need to be eliminated from use by the FAA such as their policy on ADHD.

These underlying factors need to be conveyed to not only the public but the lawmakers that can force real change to the FAA.  There are around 10,000 pilots in Texas alone currently grounded because of the FAA’s current policies, most of them career professionals being deprived of being able to make a living.

Those pilots see Cruz’s opponent signing onto aeromedical reform legislation but so far don’t see Cruz following suit. Those grounded pilots feel they will have no choice but to vote for Cruz’s opponent unless Cruz comes boards the direct flight to FAA reform.

There is still time before the November 2024 elections to change all of the aforementioned, but not much. In this tight Senate race, does Cruz have the margin to take those 10,000 voting pilots for granted?