This is a story of aviation, risk and the heart of the pilot.  It touches most of us – more than three billion people travel by air each year. Four out of five fatal aircraft accidents are due to human error, three out of five to pilot error. Pilots are generally fitter than their peers, but illness impinges on flight safety. This is a personal and a professional story spanning the end of the Second World War to teaching cardiology in aviation on behalf of the International Civil Aviation Organisation (ICAO), worldwide. There is a brief industrial history and the story of powered flight. Childhood was spent at boarding school; the cadet force was prominent. “Corps” included RAF camp at Cranwell, Oxford and Alhorn in Germany with TAF2 – BAOR (flying in the Meteor and Canberra). There was the flying scholarship on the de Havilland Tiger Moth. This was followed by training to be a doctor, later a cardiologist.

During this period, the HS Trident G-ARPI (Papa India) disaster occurred at Staines in 1972, 150 seconds after brake-release. All on board were lost - 118 persons. The cause was mishandling, but the captain had also suffered a heart attack. In February 2015, a TransAsia ATR crashed within two minutes of take-off when an engine wrongly shut-down. Following the Papa India incident, the newly formed Civil Aviation Authority appointed a cardiological advisor - the author. A definition of cardiological fitness to fly was evolved and four UK/European Workshops (1982 – 1998) led to a scientific methodology for fitness judgement – ‘the 1% rule’.  In the UK this contributed to a fifteen fold reduction in licence loss from cardiovascular cause over 20 years.  The development of CRM (crew resource management) has almost eliminated medical cause accidents, but degraded performance is more insidious as the recent Germanwings pilot suicide demonstrated, this led to the murder of 149 passengers. In the recent decade, loss of control in flight was the most important cause of fatal accidents.

Risk and safety issues are considered in the light of fatal accident experience and the regulatory background. The content also relates travel on behalf of ICAO and the CAA, trips including India and Pakistan (the Khyber Pass), the Indonesian aircraft factory in the jungle in Bandung, and Senegal and the slave island of Goree. European venues included Genoa, Stockholm, Vienna and Santiago del Compostela - told from the point of view the pilot-in-command. Concorde and its handling characteristics are described. There are 322 pages, 52 illustrations, a bibliography, and an index.