Interdisciplinary medicine: lessons from the cockpit

In aviation, the right seat is typically reserved for the instructor. In medicine, it’s the role of the diagnostician, the mentor, the gatekeeper. I once piloted a T-37B “Tweet” trainer from the right seat, not as a student, but as someone trusted to guide. That experience shaped how I approach clinical decision-making, interdisciplinary fluency, and the choreography of care.

During a military training program, our squad faced a simulated obstacle: an electrified “bridge” over a deep “ravine.” The goal was to cross safely and deny the “enemy” access. Time was running out. That’s when I asked the referee, “How deep is the ravine?”

“Very deep,” he replied.

“Knock one side of the pole off the bar and let it drop!” I shouted.

We dumped the poles, untied the rope, and beat the clock. The referee grinned: “The dumping of the poles was brilliant.” I wasn’t the strongest or fastest, but that day, I earned respect, not for muscle, but for asking the right question at the right time.

Team clinics: proximity isn’t partnership

In medicine, not all teams are teams.

• Multidisciplinary clinics often gather clinicians in one location, but each sees the patient individually. There’s no shared plan, no synthesis, just parallel tracks. The sum is often less than the whole of the parts.
• Interdisciplinary teams go further. Each clinician sees the patient, then the team meets to compare findings. In my own practice, I used different colored pens to annotate DSM-IV and DSM-5 criteria, each color representing a contributor to the final diagnosis. The result was a table of criteria met or not met, with clear attribution. The whole became greater than the sum of its parts.
• Transdisciplinary teams, especially in early childhood settings, take integration to the next level. I would sit in sessions with other team members, observing and supporting. One clinician (often the one the child gravitated toward) would lead the interaction, completing tasks handed off by others. To my surprise, one toddler saw me as “dad-like” and sought to engage with me. I adapted, stepped into the unfamiliar role, and performed superbly, according to the team’s post-session conference.

That training served me well. I learned to perform the ADOS-2 like a professional psychologist. I could administer the STAT-MD with ease. These transdisciplinary skills weren’t just academic; they reduced waitlists for autism evaluations and brought evidence-based care to families who had waited too long.

Color-coded diagnosis: operational clarity in autism evaluation

In both aviation and autism diagnosis, clarity isn’t optional, it’s operational. During my years providing second opinions in Illinois and at Madigan Army Medical Center, I became the trusted judge. Families, clinicians, and institutions turned to me not for reassurance, but for resolution.

To ensure transparency and precision, I developed a color-coded annotation system for DSM-IV and DSM-5 criteria. Each color represented a different contributor (psychologist, speech-language pathologist, occupational therapist, parent or teacher or myself). In my diagnostic tables, criteria were marked as met or not met, with attribution. The result wasn’t just a diagnosis, it was a ledger of clinical reasoning.

This system allowed me to thread interdisciplinary input into a single operational arc. It clarified who contributed what, where consensus emerged, and where divergence required adjudication. It was especially powerful in interdisciplinary teams, where findings needed synthesis, not just parallel reporting.

These transdisciplinary skills served me well. I learned to perform the ADOS-2 like a professional psychologist. I could administer the STAT-MD with ease. And because I could do both, I reduced waitlists for autism evaluations. That’s not just efficiency. That’s equity.

The Tweet and the transfer of control

At Randolph AFB, I flew the T-37B “Tweet” (a 6,000-pound dog whistle built by Cessna in 1959). It was the perfect system to convert JP-4 jet fuel into hearing-threatening noise. My pilot was a seasoned instructor. As we strapped in, he warned: “If I say ‘Bailout, Bailout, BAILOUT!’ eject immediately. By the third call, you are the aircraft commander. I’ve already hit the silk.”

At altitude, he turned to me: “Your controls.”

I jostled the stick to confirm. Then I flew:

• Aileron roll, a full 360° spin on the longitudinal axis.
• Barrel roll, a helical loop-and-roll hybrid.
• Loop, vertical ascent, over the top, back to heading. I hit the artificial horizon mark perfectly.

I pulled enough Gs to feel lightheaded. So, we skipped the parabolic arc (the “Vomit Comet” maneuver). I made a silent vow: I will not throw up in my oxygen mask. Many classmates did.

We landed without incident. I thanked the pilot for the chance to take control of a jet. I had done something my father never did: taken the controls of an aircraft and flown basic maneuvers.

Interdisciplinary medicine: lessons from the cockpit

Flying taught me what team clinics later confirmed: precision, improvisation, and communication save lives.

• Checklists and algorithms: Pilots use checklists. Clinicians use algorithms. Both are tools, not substitutes for judgment.
• Pattern recognition: Whether identifying a stall or a misdiagnosed mood disorder, pattern recognition is survival.
• Operational improvisation: Dumping the poles. Asking the right question. Skipping the parabolic arc. These aren’t detours, they’re decisions.

Legacy and ledger

I’ve flown cockpits and clinics. I’ve led teams in simulated combat zones and pediatric hospitals. I’ve trained fellows, reviewed abstracts, and written memoirs. But that day in the right seat taught me something elemental: Leadership isn’t about being in command. It’s about knowing when to take the controls, and when to let others fly.

Ronald L. Lindsay is a retired developmental-behavioral pediatrician whose career spanned military medicine, academic leadership, and national advocacy for dignity-centered neurodevelopmental care. His NIH-funded work with the RUPP Autism Network helped define evidence-based approaches to autism and related developmental disorders.

He directed the LEND Program at The Ohio State University and founded JBLM CARES, a $10 million autism resource center for military families. His writing spans clinical scholarship and long-form fiction. He is the author of The Mercy Directive and the six-novel Cassandra series, a completed political and medical fiction saga tracing the rise of the Cassandra system from its origins to its national and international legacy. His forthcoming memoir, The Quiet Architect, examines how conscience and structure collide in modern medicine.

He shares updates on LinkedIn.