JN Armstrong

Born in Calgary, Alberta in 1957, JN was raised in a flying family. Both his parents held fixed wing and glider licenses and his father, Neil J. Armstrong (CAHF, 1974), also maintained his helicopter license. It is understandable that JN’s interest in aviation was sparked early on during his family’s many trips in small airplanes, at flying meetings, and fly-ins. All his siblings went on to earn their pilots’ licenses, as did he in 1974. To this he added his commercial and helicopter licenses, which he soon put to good use: JN paid for his university tuition summer flying commercial helicopters in northern Alberta, Saskatchewan, the Northwest territories, and the Yukon.

JN studied physiology at the University of Calgary and went on to earn his medical doctorate in 1981. After graduation, he worked across Canada, including at hospitals in British Columbia, Nova Scotia, and the Northwest Territories, where he established a family practice in Yellowknife in 1986. JN earned his Fellow of the Royal College of Physicians of Canada designation in anesthesiology five years later, after he and his family had returned to Calgary. He joined the Calgary Health Region as a staff anesthesiologist and, in 1992, began working as a clinical assistant professor of anesthesiology in the U of C’s Faculty of Medicine. He did so until 2004, when he was named Clinical and Academic head of the Department of Anesthesiology for the Calgary Health Region and Alberta Health Services and the U of C’s Faculty of Medicine. His duties ranged from overseeing the department’s academic responsibilities, including its research mandate and the education of its nearly 150 medical students (as well as 35 residents in anesthesia), to ensuring the provision of safe anesthesia within the Calgary zone of medical care.

JN maintains memberships in the College of Physicians and Surgeons of Alberta, the College of Physicians and Surgeons of Ontario, the Alberta Medical Association (including its section on anesthesia), the Canadian Anesthesiologist’s Society, the Canadian Medical Protective Association, the Royal College of Physicians and Surgeons of Canada, and the Canadian Owners and Pilot’s Association. He has published widely and has delivered talks as far away as Australia. Closer to home his medical work has also included serving as the physician for Canada’s national freestyle ski team, including its appearance at World Cups and the 1988 Winter Olympics in Calgary. During the 2002 G8 Summit, hosted in Kananaskis, Alberta, JN led the Anesthesia Medical Team that planned the aeromedical response program for the summit and which provided on call medical services to the leaders present for the meeting. This proved a particularly memorable experience, not least because, as JN recalls, “Despite months of preparation, including coordination with the Department of National Defense for security and clearance, it was disconcerting to discover later that during the actual G8, when positioning the helicopter at the site, a communication breakdown resulted in our helicopter entering the restricted airspace without a clearance. Apparently the AA guns only withheld their fire when they recognized our iconic red helicopter!”

Aviation has played a central role in JN’s professional medical career. In the late 1980s he joined the Shock Trauma Air Rescue Service (now STARS air ambulance), founded by fellow doctor Gregory Powell (CAHF, 2018), first as a fixed wing pilot and then as a volunteer and then captain flying the MBB/Kawasaki (now Airbus) BK117 helicopter. Over the course of his time with the organization, JN has held various roles including Senior Operations Manager, Chief Aviation Officer, Chief Medical Officer, and Vice-President of Medicine and Aviation.

As part of the organization, he managed or oversaw multiple projects, which either implemented new medical and aviation technology, advanced medical aviation services, or expanded the role of transport physicians. As Chief Aviation Officer, a position he took on in 2019, for instance, he led the team that expanded the STARS fleet of helicopters to include the AugustaWestland AW139 and then which transitioned from both the BK117 and AW139 to the Airbus H145. Neither was a small feat, but the move to the H145 was made especially challenging by the onset of the COVID-19 pandemic. (JN in fact led STARS’s aviation and medical policy development during the pandemic, a period that witnessed rapid expansion of services on account of provincial government requests for medical transport assistance.)

Between 2011 and 2012, as VP of Medicine and Aviation, JN helped STARS to expand its helicopter service into Winnipeg, Manitoba and into Saskatchewan, with bases opening first in Regina and then in Saskatoon. The Regina base was soon the site of one of the organization’s firsts: training and equipping STARS crews to carry blood on board their aircraft, a move the organization pioneered among Canadian medical aviation services. The initiative was soon implemented at the organization’s five other bases, ensuring that life-saving transfusions were available in each province STARS operates. JN similarly oversaw the addition of other technologies to better provide aeromedical transport, such as the introduction of portable ultrasound devices, in flight portable lab equipment, and the use of night vision goggles for flying (a Canadian non-military first for a program of this kind).

Working for so long at the intersection of aviation and medicine, it was perhaps inevitable that one would influence the other, and it was thanks to JN that STARS has adopted aviation style checklist procedures for patient care – the aim being to eliminate potential procedural mistakes. In a further example of cross-pollination, JN applied the same human factor principles that improved his Aviation team at STARS to medical education and front-line practice of the anesthesia department. Take the concept of standardization: thanks to JN’s experience drug trays and anesthesia machines are standardized across five hospitals. The introduction of the “Safe Surgery Checklist”, a worldwide initiative, into surgical practice in the Calgary Zone is another instance of common aviation principles influencing medical practice. Cognitive aids and checklists for the use in anesthesia abnormal circumstances, and likewise the expansion of the role of simulation in training and maintaining currency for residents and staff are further examples of such cross-pollination.

While JN was more than comfortable with his dual role as aviator and medical doctor, and it was uncommon for the two to overlap, on occasion the line was blurred. “When flying as Captain,” he recalls, “I was careful to ensure the separation of aviation and medical duties. However, on rare circumstance, when appropriate from the aviation side, I would be asked to help out with a resuscitation or the capture of an airway of a challenging patient. It often caused considerable consternation to the local hospital staff when the ‘pilot’ was asked to come and intubate a patient.”

As a long-time proponent of air medical care, JN recognized that Canada could benefit from standardized approaches to air medicine and patient care and he played a key role in pushing for the creation of the Canadian Transport Medicine Association, a national forum aimed at improving aviation transport medicine. The forum has now met several times and JN’s work within the association has focused on improving and standardizing both the level of care and operating procedures of Canadian aeromedical transport.

JN retired from STARS in 2022, but he continues to assist the organization as a Director – a fitting capstone to his career given that he served with the air ambulance from its earliest days and helped to shape it into one of the world’s leading medical transport services. With over 46 years of experience as a commercial helicopter pilot, 24 as a STARS captain, JN has been supported throughout his career by the influence of his father and wider family, including his siblings, his wife Deb (herself a STARS flight nurse), his sons Ryden and Logan, and by many colleagues, including Doctors Powell and Dobson. He remains among the select few of the most qualified private and commercial civilian pilots in Canada, maintaining his rotary and fixed-wing ATPLs certifications as well as his multi-engine IFR rating. It is for good reason that JN Armstrong is considered by his colleagues and fellow aviators to be a ‘pilot’s pilot’.