AN MD80 CAPT ARRIVING TUS DESCRIBES THE DIFFICULTY IDENTING THE ARPT AND OTHER ACFT DURING A NIGHT APCH. COMS WITH ATC AND UNUSED NAVAIDS CONTRIBUTED.

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DURING APCH TO RWY 21 AT TUS; UNDER ADAR VECTORS TO RWY 21 I BECAME VERY DISORIENTED AS TO THE RWY LOCATION. CONTRIBUTING FACTORS WERE MANY AND I'LL DO BETTER NEXT TIME (2 MORE SCHEDULED VISITS THIS MONTH) BUT I WANTED TO RPT THIS 'CAUSE IT MAY HELP ANOTHER CREW. FACTORS: NO INST GUIDANCE TO RWY 21; NIGHT OPS; DAVIS MONTHAN AFB PROX TO TUS CTLR VECTORING DIFFICULT TO FOLLOW AS TO INTENT/SET-UP; CTLR SPD CTL TOO FAST FOR CONDITION OF FLT; MULTIPLE ACFT CTL BY CTLR; DID NOT TUNE IN VOR; GPS NOT IN 10 MI SCALE; AND ON THE HUMAN FACTORS SIDE; THIS WAS THE END OF LEG #4 OF A MUCH DELAYED DAY OF FLYING (FLT OF 8.53). I HAD A MEDICAL ACFT X EMER (PRECAUTIONARY) PAX ON BOARD; BUT DID NOT SO STATE TO ATC AS I ASSUMED THAT THE FLT WAS WELL AHEAD OF US AND WE COULD EASILY FOLLOW RIGHT IN TO THE RWY. FOR SOME REASON; EITHER CTLR SET UP OR ACFT X ERROR/DISORIENTATION THE X FLT WAS TOO HIGH TO MAKE THE APCH AND REQUESTED A L 360 DEG TURN TO RESET UP FOR THE APCH/LNDG. ATC APPROVED AND VECTORED US TO THE W. NOTE AT THIS TIME WE HAD RWY 21 IN SIGHT AS WELL AS X AND THE ACFT FLT TO THE W. AS WE FOLLOWED VECTOR INSTRUCTIONS WE LOST SIGHT OF THE RWY AND EXECUTED THEIR 360 DEG TURN AND WE WERE VECTORED BACK TOWARDS THE ARPT AND OSTENSIBLY RWY 21. DURING THIS MANEUVERING; I/WE JUST COULDN'T SEE THE RWY AGAIN AND SO STATED. THE CTLR GAVE THE ACFT FLT PRIORITY. I STATED OUR MEDICAL EMER SITUATION AND HE RE-ESTABLISHED OUR PRIORITY. I TRIED A TURN TO THE E BUT WAS AGAIN VERY CONFUSED BY THE RWYS AT DAVIS MONTHAN AND JUST COULDN'T PICK UP RWY 21. THE CTLR SAID WE WERE 8 MI FROM THE RWY. I ELEVATED MY SCAN; PICKED UP RWY 21 RIGHT AWAY; AND CONTINUED IN. ASIDE FROM ROLLING OUT LONGER THAN I WANTED; WE CONTINUED TO THE GATE UNEVENTFULLY. THE PAX WAS CARED FOR BY PARAMEDICS AND I PONDERED HOW TO 'DO THIS SITUATION DIFFERENTLY/BETTER.' LESSONS LEARNED: STATE THE MEDICAL SITUATION TO ATC AND TAKE THE PRIORITY; SLOW THE ARR SPD AS NECESSARY (WHICH WE DID); TUNE THE STATION NAVAID EVEN THOUGH IT'S NOT FOR THE RWY IT MAY HELP RESOLVE AMBIGUITY; USE GPS 10 MI SCALE TO AID SITUATIONAL AWARENESS; ASK CTLR FOR DISTANCE FROM TARGET/RWY TO AID IN SCAN SCOPE. THE VISUAL CONDITIONS WERE PERFECT AND WE HAD THE RWY UNTIL WE HAD TO DELAY FOR THE TFC REPOSITIONING. THE REACQUISITION WAS BRUTAL. HOPE THIS CAN HELP SOMEONE. I KNOW I'VE REVIEWED THE BASICS AND WILL BE BETTER FOR THE REVIEW AND EXPERIENCE -- THOUGH I HATE TO LEARN THIS WAY!