I have a medical history of high blood pressure. It's not surprising, even though I'm only twenty-eight years old. My parents were both hypertensive, as were my grandparents. The life-style that I live doesn't help much either. On my days off I drink beer and smoke marijuana, both to excess. I smoke cigarettes and drink coffee every day. I don't get much exercise either. My doctor has given me some pills to keep it down and for the most part they work pretty well; except for in one particular instance.

I'm a pilot for a skydiving company. I fly the big, twin-engine plane that takes up loads of beginning skydivers and the instructors that accompany them. As a pilot, I'm required to take a physical every two years to maintain my license requirements. Six years ago when I stumbled across this job (intending to do it for a year or so until I found something better), Skyflight Skydiving School was owned by a jovial, hard-partying man named Rod Pilfer. Skydiving back then was largely unregulated and Ron, who'd burned more than his share of greenbud with me and tipped back several hundred cases of beer with me over the years, didn't worry himself over things so petty as certifications and medical checks of his employees. I could have been unlicensed completely and Ron wouldn't have given a shit, as long as I showed up to work each day and flew the damned plane. When I needed a new "yellow card", as the medical certification card was known, I would simply fill out the required FAA forms, entering any information that I wished, and a physician friend of Ron's (who was also partial to greenbud, beer, and free skydiving) would simply sign off on it. Everything nice and legal though the spirit of the law had of course been grossly raped.

But times change, the one constant in life I guess. Several preventable skydiving accidents in the Western United States brought increased regulation of the industry. In addition to this Ron sold the company two years ago to a national corporation, traded on the stock exchange, that started it's existence by swallowing up more than fifty independent skydiving schools around the country. We were now corporate employees and though my salary didn't increase any, and though nobody bought a new plane or new equipment for the school, we all quickly discovered that there was a vast difference between working for Ron and working for a corporation. Everything was impersonal; money was the bottom line.

One significant thing to change was the manner in which our pilot physicals were done. We were required to go to a local medical clinic when the time came for re-cert. It is rumored that the clinic in question was owned by a subsidiary of the parent corporation. I don't know if that is true or not, but the first time I went there, shortly after Ron had sold out, I found that they most certainly were not friendly, perpetually stoned Dr. Young. They put me through a thorough exam, following the FAA checklist step by step. I passed in all regards except for my blood pressure, which had been 170/110, well outside the passing range prescribed by the FAA.

I squeaked through by applying every ounce of charm and persuasion that I possessed to the elderly nurse that had taken it. I told her that I was on medication for the blood pressure and that I monitored it regularly and that it was never that high, that I had a phobia about having my pressure taken when the results meant my job. That was certainly true in all respects. My pressure that morning had been a sedate 136/74. But as I drove to the med clinic and as I waited in the waiting room to be called I'd done nothing but think about what would happen if my pressure was outside parameters. My body flooded with nervous tension as I considered this and, sure enough, it became a self-fulfilling prophecy. The nurse, fortunately for me, took pity on me and marked down 158/88 on the form, just two points on both numbers inside the guidelines.

I left the clinic elated, knowing that I was safe for another two years. But two years passes quickly. My card was approaching expiration once again and the dweeb that ran SkyFlight called me into his office about two weeks ago. Dave Pelican is a thirty-five year old accountant the corporation sent out to run the place. He's never skydived in his life, despite many offers from the instructors to show him how to do it. He's respected by his employees about as much as the LAPD are respected in South Central LA and is probably wise not to go up and give the business a whirl. I'm sure that somewhere in accounting school they teach you not to allow people who don't like you to toss you out of an airplane wearing a chute that they've packed.

"Bob," he told me when I reported to his office that morning, "according to the computer your medical exam card expires in twenty days." "Sure does, boss," I told him. I knew the fact well and had been worried about it for the last two months. I'd come to a plan of sorts in my mind to keep the pressure down for the exam. Now it was time to see if it worked or not. Dave slid a pre-printed, corporate form across his desk to me. "Here's the authorization form for your new physical. Be sure to have the copies to me before your expiration date."

"You got it, boss," I assured him, taking the form.

"Thanks," he said absently and then moved on to another subject. "I've been going over the cycle time for drops and it's been creeping up again. Now I've talked to the instructors about this already but you're the one who is in control of turn-around time. The industry standard, as you know, is fifty minutes between cycles. Your times have been averaging..."

He said a lot more but I tuned him out. I'd heard this lecture before. I nodded and gave uh-huhs in all the right places and shortly he released me. Later that day I called the med clinic and made my appointment.

Two days before the physical I called my doctor's office; a huge HMO-based conglomerate with more than fifteen physicians and twenty PA's. I told the faceless person I talked to on the phone that I had to take a flight on an aircraft the next day to go to a funeral and that I had a phobia about doing such things. Could they maybe prescribe something to keep the anxiety down? I was gambling that nobody would look deeply into my chart where it plainly said that I was a pilot. It was a gamble I won. Two hours later I was picking up a prescription for two Valium at the neighborhood pharmacy.

The day of the physical itself I took three of my blood pressure pills in the morning instead of the usual one. I drank no coffee. I smoked no cigarettes. A half-hour before leaving I popped both of the Valium. I figured that all of that would probably do the trick. My blood pressure before I left the house was 112/60.

Despite all of this however, I felt anxiety creeping in as I drove to the clinic. What would happen if it were high again? I obviously could not count on sympathy from the nurse as a given factor. What would I do if I lost my pilot's license? I didn't know how to do anything else. I'd end up a street bum or worse.

I checked in at the front desk of the clinic and sat down to await being called. The Valium was working on me; I could feel it trying to mellow me out, but the anxiety was stronger. I willed myself to relax. If my pressure was low at home, it could be low here too. The only thing working against me was my own traitorous body, which was pumping adrenaline out into my blood like I needed it to live.

The anxiety worsened once I was called and placed in an exam room. I sat on the table, looking around at my surroundings, fidgeting nervously. There were anatomical charts posted everywhere, drawings made by small children, a sink, a box of gloves, examination instruments. I tried to focus on some of these things, willing myself to relax but it was to no avail.

The nurse entered to take care of the portions of the checklist that didn't require the doctor. It was not the kindly, elderly nurse from before but a young, attractive oriental with a heavy accent. She wrapped the blood pressure cuff around my arm and applied her stethoscope. As she inflated the cuff I took a deep breath, willing my pressure to go down. I could feel the beating in my arm as the cuff deflated. Her eyebrows raised a tad as she listened. When she was done, she frowned slightly and reinflated the cuff, taking the pressure again. When she was done with the second one, she looked at me pointedly. "Your pressure kind of high," she told me.

"What was it?" I asked, sighing resignedly. All my careful planning for nothing.

"One sixty-four over one hundred six," she answered. "That too high."

"Yeah," I said. "I know." I took a deep breath, moving on to plan two; friendly persuasion. "Listen..." I said, and began explaining to her about phobias and lost jobs and becoming a street bum.

She listened to my spiel but was having none of it. She seemed quite appalled at the suggestion that she write down a number a little lower than what she'd actually gotten. "Doctor will talk to you," she told me firmly, ending the discussion. She took my pulse, checked my eyesight, and sent me off to the bathroom with a urine cup for the diabetes check. When this was all done I went back to the exam room, undressed to my underwear as I'd been instructed, and put on the little gown that barely came to my upper thighs. I sat modestly on the exam table, feeling like a condemned criminal awaiting execution.

The doctor came in about five minutes later. She was about forty-five years old, slightly chubby but not grossly so. Her face was plain, her head topped with a mop of short, mousy brown hair. She wore gray scrubs underneath a white lab coat. Her eyes appraised me as she entered, carrying my chart in her hands. She closed the door behind her.

"Hi," she said. "I'm Doctor Jovy."

I returned her greeting while she peered closer at my chart.

"An FAA physical huh?" she said, more to herself than me. "Your blood pressure is too high. It's outside of parameters."

"I know," I said, nodding. "I have this phobia about having my blood pressure taken you see. Usually it's..." I went back into my spiel again. Maybe the doctor would have a little sympathy.

She listened to my tale of woe, her face giving no indication whether or not she pitied me. When I finished she said, "Well, let's do the rest of the physical and then we'll retake your pressure. Maybe it'll come down a little and I can pass you."

That was kind of a vague declaration, one that only increased my anxiety, but events were clearly outside of my control. She ran me through the standard regiment of tests; listening to my lungs and heart, checking my hearing and peripheral vision, checking my reflexes, making me run in place to check my exercise pulse rate. She had me stand and drop my underwear while she probed my scrotum with a gloved hand and checked me for hernias. All of this I passed with flying colors. Finally the last test was done and I pulled up my underwear and sat back on the exam table. She told me to roll up my sleeve once again.

She applied the cuff and took my pressure herself, frowning as she did so. "One sixty-two over ninety-eight," she declared. "A little better but it don't quite ring the bell."

"Damn," I muttered, frustrated, angry with my body, which couldn't relax itself.

"I'll tell you what," she said. "Why don't you lay back on the table and relax for a few minutes. Think happy thoughts, try to will your pressure down. I'll come back in a few minutes and take it again and we'll see what happens from there."

"Okay," I nodded, feeling miserable.

I tried to do as she said but it was hopeless. I was now facing the very real possibility of losing my job and livelihood. I couldn't have been tenser if one of the wings had suddenly fallen off of my plane at ten thousand feet (after all, I was an accomplished skydiver too, a benefit of employment, and I never went up without a parachute on).