HOLY S--T! Sorry for the outburst, but this is the pilot's greatest fear. Even beyond enemy aces, missile batteries, or parachuting into a sea of sharks with frickin' laser beams attached to their heads!
If it sounds cool, it's a secondary effect. There are some really cool ways to earn them, though. The main way is usually via your name and if there's a way to make it sexually suggestive, it usually happens (up until about 10 years ago).