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and cancer incidence in the Australian petroleum industry. A review of human carcinogens: chemical agents and related occupations. IaRC Monographs on the evaluation of the Carcinogenic Risks to Humans. Over 40 years ago, I was a very new, junior medical officer at an RAF flying training school. On one morning surgery day, I was asked by one of the pilots and his wife to arrange for him to undergo a vasectomy. As an Aberdeen graduate, I was used to stoic farmers from the Mearns. On one occasion, when I was doing sperm counts in surgical outpatients in Aberdeen, one such stalwart had commented to me that he did not think his vasectomy had worked. He explained that when he did it to his bullocks, their testicles had swollen and fallen off—and his had not. I also had in mind the vision of a Royal Naval doctor of my acquaintance who had his vasectomy performed under local anaesthetic, after which he cycled back to work. I briefed our intrepid pilot on what was involved and how the operation was done and I arranged for the local Simon Clinic to carry out the procedure, as neither the NHS nor the RAF offered the service in our region. He had the operation and, unknown to me, returned to flying the next day. After his first sortie, he was brought to the station medical centre by an admiring group of colleagues. He was virtually unable to walk as a result of a scrotal haematoma about the size of an ostrich egg. I had obviously not reminded him to avoid activities that could induce complications such as haematoma. It transpired that his sortie had involved aerobatics and the pulling of up to 5g. Allowing a central venous pressure of 5 mmHg and a measurement from the right atrium to the scrotum of 17 inches, the normal orthostatic pressure at the level of the scrotum would be in the order of 36 mmHg. The level of centrifugal force involved would therefore have exerted approximately 180 mmHg of venous pressure at the site of surgery. Fortunately, he was able to pass urine without difficulty and the condition resolved in a few days with mild analgesia and the use of a jock strap—and abstinence from flying. But I did learn a bit about aviation medicine from that … and it did cost me a few pints of beer.

I learned (a bit) about aviation medicine from that