Despite decades of research and training, adverse physiological events continue to present a significant risk to pilots. This paper describes a naturalistic study of fighter pilot experiences with disorienting physiological events such as gravity-induced loss of consciousness (G-LOC), hypoxia, and spatial disorientation. We conducted a cognitive task analysis with 10 experienced fighter pilots to elicit incidents in which the pilot or another pilot in the flight experienced a physiological event, exploring how they recognized something was wrong, assessed the level of impairment, and regained situation awareness. We describe cognitive requirements, specific cues and strategies, as well as complexities associated with managing these disorienting physiological events. Implications for decision support design and training are discussed.