Ejection in hostile environments: medico-psychological aspects for the fighter pilot.

Introduction: In the French Air Force, commitment of fighter squadrons in Afghanistan revives the fear among pilots of being ejected in a hostile environment, along with the prospect of being captured.

Clinical Observations: Although ejection in a hostile environment is an exceptional event, it is what flight crews fear most strongly over enemy territory. Since the widespread use of ejection seats in fighter aircraft in the 1950s, ejection has become a means of protecting the crews' lives. Ejection is a breaking point when the pilot suddenly passes from an intense activity to a passive position in which he (or she) is often helpless and sometimes exposed to the hostility of the environment where he lands. It is always important to analyze the circumstances surrounding an ejection. Some clinical observations allow us to understand the psycho-traumatic potential of this brutal experience. In a hostile environment, ejection quite rapidly becomes a question of survival.

Discussion: The pilot is technically and physically prepared during training. He (or she) regularly trains for the use of the ejection seat and the equipment to protect himself, to report, and ensure his survival until his recovery. Because it is always a singular event, on a case-by-case basis, no psychological reaction to such a situation can be modeled with a view to predicting psycho-traumatic disorders.

Conclusion: Since 2007, there has been a medico-psychological supporting device, organized by the French Air Force, to be used after this type of event.