E. Crew lncapacitation

Physical examinations that airmen undergo are stringent compared to those of the non-dying community. We cannot, however, deny the possibility of pilots becoming"incapacitated" during flight.
Past examples show that incapacitation can happen to pilots of all ages and in all phases of flight. Forms of incapacitation include"subtle incapacitation" which cannot be easily recognized by the other members of the crew and "obvious incapacitation" which can be recognized at once.
Degrees of incapacitation vary; they can be temporal or serious enough to even result in death. Food poisoning during flight is a form of incapacitation and such incidents have been reported in the past. In some cases it becomes necessary for the other members of the crew to discuss whether or not the pilot is acting abnormally.
In an incident described in "Flight Safety" (a JAL magazine), the copilot and flight engineer, after conferring with each other, reported to the company, the fact the captain had been speaking in a strange manner. when the captain underwent a close physical examination, he was found to be suffering from a pulmonary tumor. In this example the problem was solved before it resulted in a serious incident because of the three man crew complement.
If a pilot suddenly suffers from a heart attack, the other pilot must immediately take over the control of the aircraft but at the same time first aid must be given to the suffering pilot in order to save his life. With a night engineer on board in a three man crew complement, the night engineer will be able to attend to the problem in any phase of flight, whereas in the two man crew complement, during takeoff or landing, there would certainly be a time lapse before help could be summoned from the cabin crew. Furthermore, the cabin crew must be caued first before they can come. In a cargo aircraft even that is not possible.
There is a great difference between a three man crew being reduced to two men and a two man crew being reduced to one man due to incapacitation. Pilot incapacitation can result in dire consequences. The presence of a flight engineer is very important in the recognition of incapacitation, early first aid treatment and the continuation of flight safely.