Sunday, January 31, 2010

Norwood Hockey Gets Ready to Skate Again

The Norwood Senior High School hockey team in Norwood, Massachusetts, can be forgiven if they feel a little nervous getting out on the ice this coming Wednesday.  Last Saturday, Matthew Brown, a sophomore on the team, broke his neck in an accident during the team's game against Weymouth.  His condition was upgraded yesterday from critical to serious.  On Wednesday, the team played a game dedicated to Matthew.  A moment of silence was held in his honor before the game.  Late in the second period, senior Christopher O'Brien fell on the ice, unconscious.  He had suffered a major concussion and was out for five to six hours.  He was released from the hospital on Thursday night.

I give two thumbs up to the staff at Norwood Senior High School for how they appear to have dealt with this situation.  In addition to the entire community rallying to support Brown and his family, including raising money for medical bills for what is sure to be a long recovery, the school recognized immediately that the first accident was a crisis for the student community and that the second one, despite being not as serious, needed to be taken very seriously from a psychological standpoint.  The school had counselors at the ready and the Principal made a point of suggesting that the kids use them.  They sent the hockey team out to breakfast together on Thursday morning and postponed two of their games to give them time to regroup.

All of this may sound like a no-brainer.  It seems pretty sensible to me.  You'd be amazed, however, how often adults, when bad stuff happens to kids, either don't do enough or do way too much.  Many schools and coaches would tell the team to buck up and get out there and win one for Matthew on Wednesday, and then tell them to win one for Christopher on Thursday, oblivious to the double-whammy the team has suffered and the fact that, after two players are seriously injured in two games, their teammates have to be wondering who will be next.  Others, on the other hand, would cancel the whole season.  I'm impressed with the balance this school found between the very real need to keep things as normal as possible for the kids and the very real need for the kids to process and heal before they try to move on.

Of course, the team aren't the only ones who are traumatized by all this.  There are a lot of students and adults who were at both games and watched both accidents.  One was awful.  Two was unthinkable.  One student who had been at Wednesday's game was interviewed by the Boston Globe and commented on the prospects for the rest of the season.  She said,
It's fine with me if they never play again.

I don't doubt that's how she feels, and both playing again and watching them play again may be the hardest things these kids have ever done.  Until they do, however, they won't be able to realize that what happened really is a freakish coincidence and that they are not in any more danger right now than they were last Saturday when they first took to the ice.  I hope they have a great game on Wednesday.  They deserve it.

Thanks to frequent Quarterbackers Abe and Colleen for the tip about this story.

Friday, January 29, 2010

37 Minutes

It took a jury in Kansas 37 minutes to convict the murderer of Dr. George Tiller of 1st degree murder, a crime which carries a life sentence.  Tiller, you may recall, was a doctor who performed late-term abortions.  He was murdered in church last summer.  The gunman also was convicted of assault with a deadly weapon for threatening two other people at the church.

The question of who shot Dr. Tiller was never in any doubt -- the shooter admitted it frequently to the news media and in court filings.  The purpose of the trial was not to determine whether the shooter had done the shooting, but rather whether it was a crime, and if so which one.  The gunman first proposed a "necessity defense," saying that he did what he did to protect unborn children.  The judge refused this argument on the grounds that, by law, fetuses do not enjoy legal protection and hence defending them is not a necessity.  The perpetrator then mounted the argument that he in good faith believed he was acting out of necessity, and that therefore this constituted manslaughter.  The judge eventually instructed the jury not to consider manslaughter but only 1st degree murder.  Deliberations were very, very brief.

I have been trying all week to figure out what this trial must have felt like to George Tiller's family.  Families of murder victims often talk about "getting justice for" their loved one, or "making sure the truth comes out."  The arrest means the bad guy is off the street, and the conviction is punishment not only for the murder but for trying to get out of taking responsibility for the murder.

This case, however, is different.  This shooter didn't try to lie his way out of the situation.  He didn't claim he hadn't done it.  The truth didn't need to come out -- it was already out.  The trial was a question of law, not of fact.  I suppose had the killer not been convicted it would have represented and absence of justice for Dr. Tiller, but the fact of the conviction hardly seems a great victory for the justice system.  Not if deliberations only took 37 minutes.  It was too easy.

I wonder if this doesn't create another set of issues for the Tiller family to process.  In some sense, the fact that the shooter was so proud and so open about what he did makes dealing with this death harder, not easier.  Convicting him and sending him to prison isn't a deterrent to those who think as he does -- they still believe what they are doing is right, just as he does.  It sends no significant "message" that the killer will ever really hear.  He will not and cannot be made to have remorse for what he did.  There is no satisfaction in saying, "See, you couldn't get away with it!" to someone who didn't even try to.

George Tiller is dead.  His wife has lost a husband and his children have lost a father.  The man who killed him and his supporters are dancing on Dr. Tiller's grave.  The fact that the shooter is doing so in prison doesn't make his loss any easier, or his behavior any less painful for the people this murder left behind.

Thursday, January 28, 2010

Crisis Communications When Communications are Down

It's been more than two weeks since a major earthquake reduced much of Haiti to rubble.  News stories suggest that Haitians are, understandably, getting more and more desperate, more and more angry and, possibly, more and more violent (although this last point is somewhat in dispute).  For two weeks, many Haitians have not had reliable sources for clean water, food, shelter or medical care.  Perhaps most importantly, they haven't had reliable sources of information, either.

I say that this may be more important, because people can tolerate a lot of hardship if they know if, when and how it is going to come to an end.  Without decent information, rumors take control and people are frightened by the uncertainty.  People who are hungry, for example, can stick it out if they know that food is coming the day after tomorrow.  If there's any likelihood that food is not coming for weeks or months, hungry people need to do something about that now, before it's too late.  They can't wait for weeks or months to see what happens.

The antidote to uncertainty is information, and on any normal day there are a number of methods at the disposal of the authorities to get out that information.  Following a massive disaster, it's a little more tricky, and when the information infrastructure wasn't in great shape to begin with, it's that much harder.  The two mediums that seem to be available to get information to large numbers of people right now are radio and loud speaker.  Not ideal for a reasoned discussion of the situation.

The how of crisis communication is, of course, only one part of the issue.  There's also the what.  One of the reasons that Haitians don't know when they are going to get help is that the people helping them don't know, either.  Even if any given agency or government knows how much help they are sending and how fast they can get it to Haiti, they can't tell any given person whether that aid will make it to them, and that's under the best of circumstances.  Delays at the airport, red tape and the simple magnitude of the need create uncertainty for the very people who are trying to be reassuring.

The message also needs to include something that indicates that those communicating know how bad things are.  People who are desperate or angry need to know that they are being heard.  Hungry people are not going to stick anything out if they think that no one even cares that they are hungry.  The yelling sometimes simply means that people don't feel they have been heard.

This week, the U.S. embassy started trying to disseminate the message that most Haitians, even those with relatives in Haiti, were not going to be getting help from the embassy.   Ambassador Kenneth Merton got on the radio to deliver a message the Christian Science Monitor summarized as,
The US is providing unprecedented amounts of assistance to Haiti. . . but the embassy is only serving the legitimate needs of American citizens. . . . Haitians’ needs would not be attended to at the embassy.

This harsh message was made necessary by the growing crowds of people gathering outside the embassy, trying to get to the United States or to get assistance from the U.S. government.  The embassy was understandably concerned that there would be a riot, and they wanted people not to come there.  It seems to have worked.

The fact that it worked, however, doesn't change the level of need for assistance, nor does it change the need for decent information and a little empathy.  I wish the United States had taken a page from Crisis Management Briefing techniques and issued a statement saying that they were helping as many people as they could as fast as they could, that they understood that it wasn't enough, that they were going to keep trying, and that people needed to understand the difference between what the embassy could do and what the United States was doing.  This may sound like the same message, but it has some important differences.  It's one thing to say, "We've already given you people a lot, and we're looking out for our own," and quite another to say, "We understand, we want to help, we really are doing the best we can, but unfortunately there are some things we just can't help with."  The latter might not only have averted a riot, but actually made people feel just a little better.

Wednesday, January 27, 2010

Two Haiti CISM Deployment Opportunities

In the last 24 hours, I've received two requests for CISM responders to work in Haiti and/or with Haitian-American communities.  If you are CISM trained and interested in helping in the aftermath of the Haiti earthquake, please read the two letters below:

Opportunity #1:  Medishare deployment to Haiti
Dear Colleagues,

We are organizing a planned mental health support team for Haiti with the first deployment potentially scheduled for February 2, 2010 with rotations following thereafter. The mental health teams will be partnering with Project Medishare, a non-government organization that has been in Haiti since 1994 providing health and other much needed services.

Project Medishare staff will be our on the ground support and will be providing the lodging, sustenance, transportation, security, and translation for our team.  Mental health teams will provide support at Project Medishare's sites. The teams will be working with children and their caregivers so I am looking for a wide range of skills. Psychiatrists, psychiatric nurses, and other mental health professionals, and clergy. If you are NOT a mental health professional but have responded to a National disaster in the past, please provide me with your information. Deployment will be for 4-5 days.

What I am hoping to do is have enough people interested to be able to send people down in rotation with teams overlapping throughout for several weeks. I will also designate a lead person/coordinator for each team when I can't be there.  Project Medishare has private planes that have been donated for their use that leave from Miami daily to Haiti. We are currently working with airlines and other organizations to get team members to Miami. At this point we do not foresee a cost to the team member for transportation. If you know of other mental health professionals who have expressed an interest in deployment who have been trained in a disaster/crisis response model (ICISF-CISM, NOVA, or TLC) please forward this email to them.


For those wishing to GO TO Haiti to volunteer time/skills please e-mail:
1.  Full name
2.  Contact #
3.  Home address
4.  Date of birth
5.  E-mail address
6.  Languages spoken
7.  Title/ profession/degree
8.  Specialty/skills
9.  Country of citizenship
10. Passport # with exp date
11. Mental Health/Medical License #
12. Crisis response training/deployment history
13. Availability
14. ICISF Membership
15. ICISF Certificate Of Specialized Training (COST), preferred but  not required
16. Medishare is advising you should have a current Tetanus Shot and  Hepatitis “B” shot

Samantha Madhosingh, Psy.D.
Project Medishare in Haiti

Your point of contact shall be:
Samantha Madhosingh, Psy.D.

Opportunity #2:  Green Cross Deployments

Memo:  To All current and former ICISF members
RE:   Opportunity to join Green Cross and be available to deploy to assist with Haitian Earthquake event
Date:  January 27, 2010
From:  Dr. Charles Figley, Founder Green Cross
             Mary Schoenfeldt, Board President Green Cross

Many ICISF members have expressed interest in deploying to assist victims and communities affected by the earthquake in Haiti.  As you know ICISF is NOT primarily a deploying agency.  Deployment however is a core function of Green Cross Academy of Traumatology.  Another core function is providing certification in Field Traumatology through a variety of levels.  Much more information on the levels of certification and the over mission of Green Cross can be found on the website.

Green Cross and ICISF have always had a collaborative relationship and in fact, the majority of Green Cross founders, board members and members either are or have been ICISF members.  Green Cross got it’s beginning in response to the OKC Bombing when it became evident that our field needed a new entity to Certify Field Traumatologists and then maintain a mechanism to deploy them when they are needed.  Dr. Charles Figley was the visionary force behind the formation of Green Cross and actually unveiled the new organization at an ICISF World Congress in Baltimore.  Since then Green Cross has sent teams to New York after 9-11, Sri Lanka after the Tsunami and New Orleans after Katrina and to countless other communities that needed our services.

With the urgency of the need in Haiti and other communities affected by the earthquake, Green Cross has now begun to deploy teams to a variety of settings, some in the United States and not on the ground in Haiti.  One example is we are working with a labor union in Florida who has asked us to provide services and support to their members and their staff who have lost family members.  Our initial assessment is that we could be in for a large and long deployment possibly with this organization and with others.  As you can see Green Cross deployments have a range of locations, conditions and clients.  The one constant, is that Green Cross provides Compassion Fatigue relief and Field Traumatology services where needed.  Our deployments range from a few days to 2 weeks.  If the assignment is longer than 2 weeks, we will rotate in a fresh team.

The backbone of Green Cross is in our philosophy.  First, we are a Compassion Fatigue and FIELD Traumatology team and will come where we are needed when asked.  We also ask our host agency to pay the expenses of our volunteers (through reimbursement quite frankly may take some time).  One assigned role a Green Cross team member will take on is that of Compassion Fatigue Specialist for OUR team.  Their job is to ensure we are doing as we tell others about healthy self care.  We also organize using an Incident Command Structure so we can easily fit into local emergency management.

So how does that impact you? If this piques your interest, how do you get involved?  First, go to to see what we are doing.  Secondly, follow these simple steps:

In addition to having a current ICISF Membership, become a member of Green Cross, if you are not already. The membership fees are a low $65 if you want a basic membership and only $95.00 if you also want to receive the Journal of Traumatology as a benefit of membership.

Look for the section called Certifications and click on that.  You will see a number of certifications available.  The one we are most interested in for this effort is Field Traumatologist.  You will see requirements for certain courses to be completed as well as other criteria.  GREEN CROSS AND ICISF HAVE A RECIPRICAL AGREEMENT TO ACCEPT EACH OTHERS COURSES.  IF YOU HAVE ONE OF ICISF’S CERTIFICATE OF SPECIALLIZED TRAINING, you have met many of the basic requirements to be certified.  You will see a Certification fee of $25.00 … For the Haiti response Green Cross will waive that fee for ICISF members.  IF YOU DO NOT HAVE A CERTIFICATE OF SPECIALIZED TRAINING BUT HAVE COMPLETED ICISF COURSES, THOSE WILL BE ACCEPTED ALSO.  As part of the application process you will be asked to fax copies of certificates and licenses (if you have them).  Please read the website to get more information.

We will also be asking those people interested in deployment… either within their own region, the US or internationally, to complete 3 FEMA courses if you have not already done so.  Those courses are IS 7 – Citizens Guide to Disaster, IS 100 – Incident Command System and IS 700 – NIMS – National Incident Management System.
To further support your knowledge of field work you also will be asked to take a Just in Time Training (JITT) on line with an overview of Compassion Fatigue and Field Traumatology.  We will provide the link to that training when you indicate your interest to be involved.

The question has been asked of how do CISM skills within ICISF differ from CISM skills of Green Cross.  They differ only in the addition of Compassion Fatigue and Field Traumatology with an arsenal of skills for psychological first aid and disaster stress management.  In many typical ICISF team assignments, the “incident” is over and the goal is to put people back to work.  With a Compassion Fatigue and Field Traumatology focus, the “incident” is still on going and the goal is to keep people working until it IS over.  The melding of ICISF work and Green Cross work extends the continuum of services and support available from beginning to end of an incident.

Please go to the Green Cross website at for more information or email

Thank you for doing what you do… caring for people who are hurting and working to help them manage and recover.

Please consider sharing your skills through Green Cross. The response to the Haitian earthquake will be going on for an extended time.  The need for our services will span the globe and not only be centered within the devastated country of Haiti.  We expect to have teams in Haiti, in Miami and other locations.  Please join us.

Dr. Charles Figley, Founder
Green Cross Academy of Traumatology

Mary Schoenfeldt, Board President,
Green Cross Academy of Traumatology
Deputy IC, Green Cross Haiti Earthquake Response

If any Quarterbackers out there join these deployments, please pop me an email and let me know -- I'd love to offer you this space to share your experiences.

Tuesday, January 26, 2010

VA Tech Student's Body Found, and It's a Whole New Ballgame

A body which appears to be that of Morgan Harrington, a 20 year-old student at Virginia Tech, was found today, more than three months after and a few miles away from where she was last seen after a concert in Charlottesville, Virginia.  She disappeared on October 17 and was last seen walking alone down a nearby road.  Human remains were found today on a farm southwest of Charlottesville, and investigators are pretty sure they are hers.

Two weeks ago, her mother wrote in her blog:
I pray that the truth of this crime shows itself while Morgan is still alive. I have no interest in recovering a body. I would rather not know and always have some morsel of hope.
The discovery today is a direct blow to what her mother wanted and must have known might happen.  At the same time, I'm not sure any of us can really know what outcome, other than finding her alive, would be better unless we've lived it.

Whether or not finding Morgan's body is better or worse for her family, it certainly does represent a new chapter in their efforts to deal with her disappearance.  Having a family member disappear is an ongoing event.  Whatever peace you make with what has happened comes slowly.  It is traumatic and awful, but it is not final. 

Now that her body has been found, however, Morgan's family will have to take everything they've come to understand and deal with about what might have happened to her and combine it with the new knowledge that she is never coming home.  That inevitably will bring with it new questions, doubts and fears, and with them will come new post-traumatic symptoms (or recurrence of the old ones).  Effectively, this is a new trauma.

At some point investigators may figure out what happened to Morgan Harrington.  If and when that happens, it will represent yet another new chapter in her family's recovery.  The new information will need to be processed and dealt with and understood, and the images and thoughts associated with it will be intrusive for a while.  The arrest and trial of a suspect may bring new feelings once again.

So, in that sense, maybe Morgan's mother was right.  Maybe it would be better not to know, because at least that was a steady, unchanging fact even if it left a lot of uncertainty.  Now that certainty is here, on the other hand, the next phase of healing can begin.

Monday, January 25, 2010

Another Plane Crash, Another Reason Not to Notice

A 737 with 90 people on board crashed shortly after takeoff today.  So far 21 bodies have been recovered.  The rest are all presumed dead.

If you hadn't heard about this crash before reading this post, you probably find the description above really unsatisfying.  Where was the plane taking off from?  Where was it going?  Who were the people on board?  Why did it crash?

All this brings me to a bigger question.  Why do you care?  Why does it matter where this happened or who was on board?  No matter where or how, 90 people died on that airplane.  Shouldn't we be equally interested in the story without knowing anything about them?

The quick answer to that, however, is no, and the reason is actually very simple.  When we ask where the plane was, who was on board or why it crashed, we are actually asking something much more personal -- could it have been me or someone close to me? 

That may sound callous and self-centered, but it actually makes a lot of sense.  At our origins, we are animals and we are wired for survival.  When something happens to someone else in the "pack," we automatically assess whether the danger that affected them is also a danger to us.  If it is, we want more information -- we'll follow the news more closely -- because we want to learn all we can to avoid it happening to us.  We'll also be more upset, because it will remind us that the danger is real to us.

How we assess whether this could have happened to us, however, is somewhat more problematic.  The fact that we do or do not fly on 737's, for example, is unlikely to make much of a difference, because we generally tend to assume that if there was something wrong with the plane it was limited to that plane.  We might be more inclined to make a judgment based on the route the plane is flying, but even that isn't terribly predictive.  For example, a major plane crash in, say, St. Louis is likely to scare Americans even if they've never flown to or from St. Louis.

What we tend to rely on, unfortunately, is the characteristics of the people on board.  This is why news organizations routinely report whether there were people from the country the media outlet is based in on board.  We judge whether it could have happened to us by whether there were people like us whom it happened to.  And we have a fairly narrow view of who is "like us."

Which brings us around to the particulars of this crash.  The 737 was an Ethiopian Airlines flight from Beirut to Addis Ababa.  It took off in bad weather and crashed into the Mediterranean very shortly thereafter.  For the vast majority of Americans, that description is actually a relief -- the majority of Americans don't, unfortunately, think of Ethiopians as "like us" and we don't fly from Beirut to Addis Ababa.  While that reasoning makes sense, it is disturbing to realize how easily we characterize people -- by nationality, by race, by economic status, by location -- and easily that leads to changes in how much we pay attention.

Saturday, January 23, 2010

You Don't Have to Live in Haiti to be Traumatized

Today's New York Times has a really nice article about a Catholic school in Queens, New York.  The vast majority of the children at the school are from Haitian and Haitian-American families.  Large numbers of them have lost relatives in the earthquake.  Others haven't been able to find out what happened to their families.  Many of them spend summers in Haiti, one was living there during the earthquake and another's father was killed.  All of them feel a close connection to Haiti, even if they were born here.

It would be a fairly straightforward assumption that children who were in the earthquake are traumatized, those who had relatives die are less so, and those who did not lose a loved one are not traumatized at all.  This article makes it clear that the situation is not that simple.  First of all, there are few if any Haitian-American children did not lose a relative or other loved one in the quake.  It also makes clear that all of them are trying very hard to understand what happened and figure out what it means for them.

The picture at the beginning of the article is of a girl at SS. Joachim and Anne drawing a picture with the dictated words, "I want to build homes for the people in Haiti."  The picture is of a house with three people in it.  One of them is clearly dead.  The story talks about a boy who was in Haiti at the time of the earthquake, and was worried for the safety of friends and family in New York, because the earthquake was so big he thought it must be shaking New York as well.  As much as the adults can barely understand the enormity of what happened, these kids have that much less of a framework into which to fit this event.  They are trying to make sense of it the best they can.

Perhaps most heart-wrenching, in some sense, are the stories about the older children.  The middle schoolers are old enough to really understand the destruction and to have expectations about how adults will act in moments of crisis.  In many cases, they are one step more removed from the situation than their parents, who are severely impacted.  This leaves them in the difficult position of trying to comfort and reassure their own parents, and of being impacted not only by the earthquake itself but by their parents' reactions to it.

So, what is a school to do?  It sounds like SS. Joachim and Anne is doing a lot of great stuff.  They have counselors working with the kids.  The children are drawing, which is very important because kids can often express in drawings much more complex thoughts and emotions than they can just talking.  They are using developmentally appropriate lessons to teach the children the science behind earthquakes, which aside from being a useful curricular tie-in also gives the kids an understanding of how this happened and real information about how likely something like it is to happen again -- in Haiti or in New York.  They are coming up with constructive ways to help.  As a religious institution, the school is also talking to the children about God's role in protecting and comforting them and their parents.

There are things the article doesn't mention that probably would help.  I have no way of knowing whether these are things the school is doing that just weren't mentioned or whether they're not being done, so this is more of an intellectual exercise for the benefit of Quarterbackers than anything else.

First off, folks need to be careful in balancing how they talk about God in this situation.  It is fine and appropriate to share the church's theology on these questions and to encourage the religious practice that is appropriate in that context.  However, adults, in an effort to comfort children, sometimes wind up saying things about God that even they don't believe, or which are confusing in their simplicity to children.  Saying, "God will protect you," for example, might sound good, but for kids who have seen their families destroyed it is confusing to hear this and know that somehow their families were not protected.  Telling kids to pray for those affected is fine, similarly, as long as there is room for them to also talk about it and express their feelings.  Our simple reassurances shouldn't be the end of the conversation.

I also hope someone -- in the school, the church or the community -- is helping those older kids understand their parents' anguish.  I hope someone is telling them that it is not and cannot be their job to keep their parents from falling apart.  Someone older and more detached needs to take that burden off of the children.  Seeing your parents that upset is hard enough without feeling responsible for it.  There needs to be a third party helping mediate that.

Mostly, I hope there is lots of opportunity for these kids to visit and revisit their feelings and their understanding of what happened.  That girl in the picture needs to draw a lot more, and she needs the chance to tell someone about her picture.  Who is that who died?  What happened to them?  What will happen to them next?  What will the two people who are alive do?  And perhaps the most poignant question of all, where do you see yourself in this picture?

Friday, January 22, 2010

The Death of Montana Lance

Montana Lance died yesterday.  He apparently hung himself in the nurse's bathroom of his school in The Colony, Texas.  A staff member found him and emergency personnel responded, but he was pronounced dead at the hospital.  His school was Stewart's Creek Elementary School.  Montana Lance was 9 years old.

We all have somewhere in our minds, whether the front or the back, the knowledge that people kill themselves.  We probably try not to think about anyone we know completing suicide, and certainly not our offspring.  But even though we know that this is something that can happen, I doubt that any of us, when we imagine a person who would even attempt suicide, imagine a 9 year-old child.  The result is that this story seems at one and the same time truly horrific and truly surreal.

That surreal feeling is reflected in the comments readers have been leaving on news stories about this tragedy.  A blog post from the Dallas Morning News website has numerous comments from people who flatly refuse to believe that this was a suicide.  They say that no problem this child could possibly experience at this young age could lead him to kill himself.  Implicitly, they are saying what we all want to be true, which is that we don't want the world to be such that a child kills himself.

The fact is, while suicide in pre-teen children is not nearly as common as in older children, it does happen.  The rate of suicide among children under 12 is 0.8 per 100,000, compared to a rate of 7.7 per 100,000 for children aged 15-19.  The reported rate of suicide for children under 12 has doubled since 1979.  However, it is not clear how much of this represents an actual increase and how much represents people's willingness to acknowledge that a death is a suicide and to report it as such.
At 9, children have a limited understanding of death.  Many have some grasp of the idea that it is final and irreversable, but others do not.  They also do not fully grasp the consequences of their actions and often have difficulty thinking a difficult situation all the way through.  What this means is that if a young child contemplates suicide and, as some do, "rehearses" it, he may end up dying when that was not actually his intent.

We all want to believe that the world is kind to children.  We do not know, and probably never will know, enough about Montana Lance to know in what way the world was cruel to him.  It seems likely, though, that there is a backstory to this news -- there usually is.  And without knowing that backstory, it really isn't responsible to say that he cannot have completed suicide.  It seems, from all evidence, that he did.

As an educator, I have heard children as young as 7 threaten to kill themselves.  Blessedly none of them has made a serious attempt, and we've always been able to get appropriate help for them.  The staff at Stewart's Creek was not so lucky, and I feel for the person who discovered Montana in that bathroom.  That is a sight they will never forget and will take a long time getting over.

Thursday, January 21, 2010

Beware of Exploding Tefillin

A USAirways flight from New York to Kentucky was diverted for an emergency landing due to a "disruptive passenger" causing "security concerns" today.  A teenage boy had tied an unidentified object to his head and another to his forearm, alarming a flight attendant.  The items turned out to be tefillin.

Roughly 95% of you, at least before today, had no idea what tefillin are.  If this is the first time you're hearing about this story, you may still not.  Tefillin is a word of Aramaic origin which is usually translated as "phylacteries."  There, don't you feel informed?  It is little wonder that, shortly after this story hit the news today, "tefillin" and "phylacteries" were two of the five most googled terms on the Internet.  If you're still wondering, tefillin are leather boxes with biblical passages inside which are affixed by observant Jewish men to their heads and arms during weekday (but not Sabbath or holiday) morning prayer.  The picture above gives you an idea. News reports indicate that the boy tried to explain what he was doing, but not only did that not satisfy the flight attendant, the pilots were not convinced.  They decided to "take no chances" and land the plane in Philadelphia.

I cannot begrudge the flight attendant not knowing what these were.  Unless she was Jewish, she would have had no reason to ever have seen them or even heard of them before.  It was certainly worth a question to the passenger involved, who appears to have been saying his morning prayers because he was on a plane at the appropriate time.  To those of us who know what tefillin are, and for whom they are an unusual but not unheard of sight, the notion that the plane was diverted, however, is at best silly and at worst offensive.  However, I try to look for understandable motivations when people do strange things, and so, although I think this could have been easily avoided, I can understand, from a trauma reaction perspective, what happened.

As you all know, on Christmas day someone with explosives in his underwear tried to blow up an airplane.  If you work as a member of a commercial airline flight crew, that has to have affected you particularly strongly.  It's one thing for those of us who fly on planes, even frequent flyers, to contemplate that someone is trying to bring one down.  If you're on a plane daily or several times a day, it has to be that much worse.  Mathematically, your chances of being on the one plane that blows up greatly increase if you're flying that much, and that's just the rational view.

People who are recovering from a trauma often find themselves alarmed by things that don't bother other people.  For example, someone who was exposed to gunfire may flinch every time a door slams.  Soldiers returning from Iraq report having difficulty walking past lines of cars in parking lots because they reflexively fear that one is a bomb.  This all makes sense, and as a short term reaction it's pretty typical.  So, given the recent attempted bombing on an airliner, the fact that the flight attendant was somewhat more easily alarmed and suspicious makes a lot of sense.

That having been said, there is a difference between saying that someone's reaction makes sense and completely indulging it.  There is a difference between understanding that car doors make someone jump, and so perhaps closing the doors more gently or giving warning, and driving with the doors open to accomodate the person.  Similarly, the fact that this flight attendant was alarmed does not really excuse the rest of the flight crew from the obligation to decide whether there actually was something dangerous going on. It may be understandable that people are a little afraid.  That doesn't actually mean we have to give over all rationality to hysteria.

Wednesday, January 20, 2010

California's Apocalyptic Weather

Yesterday afternoon, a headline appeared on Google News that read, "Parts of LA Under Tornado Warning."  This did not particularly grab my attention, so I was surprised when, a few minutes later, a list of the most popular stories also included this one.  What, I wondered, could possibly be so interesting about a tornado warning in Louisiana?  Then I looked more closely at the sources for the various articles and realized that, in this case, LA was not the postal abbreviation for the state of Louisiana, but the acronym for Los Angeles.

Context is everything.  I read the headline as being about Louisiana simply because it was much more plausible.  Louisiana has tornadoes.  Southern California has earthquakes and wildfires.  That's how the world works. If I was thrown for a loop by yesterday's weather in Los Angeles, I can only imagine what Angelenos themselves are thinking.  Today is bringing another storm and mudslides with attendant evacuations.

Storms like this are never fun, no matter where you are or how often they come around.  But if you live in an area that gets them a lot, tornado warnings and the like become a part of life.  Even here in southeast Michigan, where we have at most three tornado warnings a year, school children drill for them and my own kids know exactly where the "safe room" in our house is.  We are used to severe thunderstorms and flooded basements in the spring and summer, and bitter cold and snow in the winter.  That's how the world works.

A tornado in Los Angeles, on the other hand, feels about as likely as a major earthquake in Michigan -- it could happen, but nobody thinks it will.  After the Eureka earthquake I wrote about how whether an earthquake is "big" depends a lot on your previous experience with earthquakes (and of course, little did I know that I'd soon be blogging about another big, much more devastating one).  Whether or not a tornado warning feels particularly scary or traumatic, similarly, has a lot to do with whether you have them all the time. 

A kid in Los Angeles isn't as likely to know where the safe room is or to have practiced for severe weather in school.  On the other hand, my children haven't a clue what to do in an earthquake and would be terrified by even a modest tremblor. So, in addition to being more and less accustomed to certain things, we also are more and less prepared for them.  Preparation gives a sense of safety and lessens the traumatic impact of a crisis -- it's much more scary to have a tornado nearby if you first have to figure out what to do and only then can take cover.

We all have expectations for how the world works.  The more those expectations are violated, and the less we are prepared, the more traumatizing an incident is going to be.  So if it's all the same to Mother Nature, let's keep the earthquakes in Los Angeles and the tornadoes in Michigan.  That's the way the world works.

Tuesday, January 19, 2010

Bottleneck at the Port-au-Prince Airport When Every Plane is the Most Important One

Doctors Without Borders/Medecins Sans Frontieres (MSF) put out a press release this afternoon regarding their difficulties getting medical supplies to their workers on the ground in Haiti.  A plane carrying supplies to Port-au-Prince has been denied landing 3 times since Sunday night.  In all, 5 MSF planes carrying 85 tons of supplies have been diverted to the Dominican Republic since last Thursday.  In the release, MSF quotes one emergency coordinator as saying,
We have had five patients in Martissant health center die for lack of the medical supplies that this plane was carrying.
MSF also posted this release to their Facebook page and highlighted this quotation.

If you've been following the news, you know that there has been a stubborn bottleneck at the Port-au-Prince airport since shortly after the earthquake.  Port-au-Prince is a relatively small airport and a very large number of planes are trying to land.  The United States military took over operations there last week and delays were reported to have decreased.  However, reports today indicate that the United Nations directed that priority be given to landing U.S. troops, and that this has caused relief supplies to be delayed.

I have no doubt that Martissant health center did die for lack of supplies, and that those supplies were on that plane.  That is a tragic situation.  It is easy to get caught up, as it appears the press did today, in the details of MSF's difficulties.  MSF is the good guys, and the good guys are trying to do good things, and they can't.  That's bad. 

The problem is that MSF's press release is only one view of a very complicated situation.  We can be pretty well assured that while MSF's planes have not been able to land, that is because someone else's planes were landing.  Without knowing for sure what or who was on the planes that did land, it's hard to say that MSF's planes should have been allowed in first.  For example, what if one of the planes that did land carried supplies that saved 50 lives?  The impression left by the military getting priority is that security is coming before medicine, but that may well not be true.  For example, U.S. troops are tasked with getting shelter and water to survivors.  Is that less important than medical supplies?  I'm glad I don't have to make that call.

In a crisis, it is natural to see very clearly what needs to happen right around you.  You know what you need, and what you need to meet the needs of those you know you can help.  It is understandable that people in a tense situation where time is of the essence demand that they get what they need, for themselves or others, quickly.  This is one of the big reasons why, particularly in a major incident, someone not on the ground needs to be given the job of seeing the whole picture and making the tough calls.  Everything is important, but not everything can happen.

Every plane landing in Port-au-Prince right now is critically important.  Undoubtedly some bad calls will be made, and undoubtedly some calls that seem bad now will turn out to be good, and vice versa.  The simple fact that a certain number of lives could have been saved by a decision being made a different way does not by itself mean that decision was wrong.  All we know for sure is that, once again, the limitations of time, space and resources are causing suffering.

Note:  As you know if you've been reading the Quarterback over the last week, MSF is one of my favorite charities.  It still is.  I don't mean in any way to be disparaging of them or their point of view.  It was just a very good example of what often happens in a crisis, and so I chose to use it for illustrative purposes.  I hope you'll continue to support MSF and the many other organization scrambling to save lives in Haiti.

Monday, January 18, 2010

The New Normal for 9-11 Rescuers in Haiti

The New York Times website has an article today about a team of first responders from New York who are working to find survivors in the rubble of Port-au-Prince.  There are eighty people from an urban search and rescue team there right now, pulling the living and the dead from the ruins.  Yesterday they found four survivors.  The article points out the direct parallels between their work looking for survivors of the collapsed World Trade Center and their work now.

Some of the things the searchers have to say are very familiar to those who have experience with traumatized people.  One firefighter commented,
I can’t forget the smell of death from New York, and I can smell it right now. Sniff in the air. That’s it. Once it’s in your head it doesn’t come out.
What this man is describing is a strong sensory memory.  You've probably heard the adage that smell is the sense most closely linked to memory.  I don't know if that's true, but it certainly is true that, at moments of great stress, our senses are heightened and much more likely to make it into our long term memory.  This man isn't just saying he smells death, he's saying he smells death and associates it with New York.  This is quite understandable.

Later in the article, another firefighter remarked,
When you have your head in the hole, you forget where you are.  You could be anywhere really. And that person you’re looking for could be anywhere. It’s real simple though. You want to get them out alive.
Certainly this sentiment is admirable.  But I suspect that his description of forgetting where he is isn't for dramatic effect or poetic impact.  People who go through traumatic events who are then placed in very similar situations, or in situations their minds have encoded as being similar, can experience disorientation.  When things are similar enough, you actually aren't sure whether you're in the previous event or the current one.  And if you're not ready for it, it can be extremely scary.

I don't know how much the current search, rescue and recovery operation is actually triggering these responders and how much it is just reminding them of their past experience.  There is a difference, and one is much more distressing than the other.  I hope that when they return to the U.S. there is a good CISM team ready to help them, both with what they're seeing now and with what it brings back about what they saw 8 years ago.  Both are real.

Saturday, January 16, 2010

Tainted Tylenol Causing Flashbacks

If you, like most of us, have either been riveted to news of the disaster in Haiti or avoiding the news altogether, you may have missed the fact that Johnson & Johnson has issued a recall of an enormous number of its products, including Tylenol, Motrin, Rolaids and Benadryl.  It appears that a chemical called TBA, which is used to treat wooden pallets that the medicines are shipped in.  TBA is not all that dangerous, but it has been causing a moldy smell to the packaging and sometimes the medication itself, and in some cases has caused nausea, vomiting, and diarrhea.  According to the FDA, Johnson & Johnson knew it had a problem with this as early as September 2008 and didn't notify them until September 2009.  An initial, much smaller recall was issued in November, and was expanded yesterday at the urging and, frankly, scolding of the FDA.

This is a big story but not a particularly scary incident in and of itself.  No one's life is in danger and it never was, at least from this particular problem.  It is more interesting to consider whether or not Johnson & Johnson acted quickly enough and whether, had this been a life-threatening situation, they would have acted faster.  That is probably the real news value in this story.

At the same time, I suspect that these procedural issues are not what is catching people's eye and capturing their attention as they scan the headlines.  For those of us who were around in 1982, tainted Tylenol has a whole different, more sinister meaning.  We remember the days before medications had tamper resistant seals, when capsules (not "caplets") were still sold over the counter and seven people died after someone laced Tylenol capsules with cyanide.  The killer has never been caught.

If the headlines yesterday and today read, "Aspirin Recall" or "Tainted Tums" we might be interested, but we wouldn't be sucked right into the story.  Headlines like "Major Tylenol Recall Sparks Fear Among Consumers," aside from being unnecessarily sensationalistic, bring us back to those days 27 years ago when we were eying everything we ate, drank or ingested with suspicion.  We know this case is totally unrelated and totally different, but the notion of Tylenol not being safe is a trigger, however small, for us.  Most of us will look through our cabinets to see if we have anything that's being recalled (a full list is here).  A lot of us will also eye the tamper-resistant seals on the medicine we're opening just a little more carefully today than we would have last week.

Friday, January 15, 2010

Is It Better to Make This Earthquake Personal?

Almost as soon as the earthquake struck Haiti this week, stories started appearing about various well known people who were in Haiti or had family in Haiti.  There were multiple stories about Jimmy Jean-Louis, "The Haitian" on the television show "Heroes," and his search for his family in Haiti.  They have been found and are safe.  Today, word came that Haitian Rapper Jimmy O died in the earthquake.  On a smaller scale, I have received information about various missionary groups and the like and their fate, and friends have voiced their fears for friends in Haiti.

All of this is very understandable.  When something big happens, we naturally want to hook it into something we understand.  Thousands of people dying is too big to really wrap our minds around.  Jean-Louis looking for his parents puts a face on the situation and helps us connect.  For those with friends and relatives in Haiti, it is natural to be concerned for the people you know and love.

At the same time, there are dangers to putting that personal face on this tragedy.  On the one hand, if the particular person you have been following is, indeed, dead, you set yourself off for a much bigger psychological reaction than if you had not tied your understanding to a particular individual.  On the other hand, if they are found safe you risk minimizing the sheer number of people who have died.  We hope that those we care about are safe, but we can't forget that so many are not.

All of this is just another indication of how hard it is to wrap your mind around a disaster of this magnitude.  We are scrambling to figure out what the numbers mean, what the devastation means, and how we can be useful when we're feeling so helpless.

Attention CISM-trained Personnel

ICISF has put out a call for the contact information of certified CISM providers who speak French, French Creole or Haitian Creole.  If this describes you, please send an email including the following information:

State/Province – Country:
Fluent in:  French   -   French Creole  -   Haitian Creole
E-mail Address:
Contact Phone Number:

to Pete Volkmann, ICISF Region 2 Liaison (New York, New Jersey, Puerto Rico) at

At this time, ICISF is not deploying personnel to Haiti.  They anticipate a need for personnel serving the Haitian-American population and American personnel assisting with the rescue effort, as well as telephone consultation and the like to Haiti.  Your information will be included in a database for possible use as the situation unfolds.

Thursday, January 14, 2010

The Brutality of Limited Resources

There's an article about the earthquake in Haiti on the front page of today's New York Times.  It begins like this:
“I just want my wife’s corpse,” said Lionnel Dervil, pleading in vain to bury his wife in his home province. But no one at the Doctors Without Borders compound paid much heed to the stricken Mr. Dervil, 38, a money-changer and father of four children. Instead, doctors were frantically tending to those still living who had streamed in.
As someone whose specialization is the psychological impact of traumatic events, my first reaction to this description was pretty negative.  Mr. Devril wants to bury his wife.  He is traumatized and grieving and he wants to exercise some small measure of control in a situation that is totally out of control.  Burial is a ritual that restores normalcy.  Why on earth wouldn't someone help this man with a very typical, understandable and healthy request?  Doctors Without Borders is one of my favorite charities -- surely they understand that this is important.

Quick on the heels of that initial reaction, however, came my (delayed) understanding of the other side of the story.  The question in the scene the Times reported was not whether Mr. Dervil getting to bury his wife was important.  The question was whether it was more important than treating people critically injured and in danger of dying themselves.  Clearly, the answer to that is no. 

Given an infinite number of people with infinite time, Mr. Dervil would get his wife's body and all of the injured would get the care they need.  Surely we can all agree that, short of not having the earthquake in the first place, that would be an ideal situation.  But this is the real world, not an ideal situation, and the number of people and the amount of time are both finite.  Priorities have to be set, and in a mass casualty disaster, those priorities can be pretty harsh.

Maslow's hierarchy of needs tells us to take care of physical needs before helping with psychological ones.  Sometimes that seems cruel.  The reason often given is that people can't process their emotions when they're worried about where their next meal is coming from or where they're going to sleep tonight, and that is true.  It is also true that resources are always limited, and if everyone, even those who specialize in the psychological, concentrates whatever talents they have on the physical, it will be that much faster that those resources can go to the psychological and the second stage of healing will begin.

Once again, I'd like to encourage the Quarterbackers to make a donation of any size to an organization doing relief work in Haiti.  Yesterday I talked about Doctors Without Borders and American Jewish World Service.  I'd also like to add that if you text the word "HAITI" to 90999, $10 will be billed to your cell phone and the money will be given to the Red Cross for their relief efforts.

Wednesday, January 13, 2010

More Than We Can Imagine

There really isn't anything a blog about trauma in the news could cover today besides the earthquake in Haiti.  As most of you know, a quake registering 7.0 on the Richter scale struck just off the coast.  Communications are sketchy, and it will certainly be a while before we know the full extent of the damage and deaths.  Estimates put the loss of life at 30,000 to 100,000 people.  Pictures coming out of the country show entire neighborhoods of buildings collapsed.

Every tragedy has a potential to really "get to" us.  Anything bad that happens could strike us in a particularly poignant way.  Similarly, some things that upset most people may not bother any given individual.  Everyone is different, based on their own past experiences, and different elements of traumatic events trigger different people.  This earthquake has certainly gotten many Americans' attention, as it should.  Whether or not it "gets to" you, this one is bad enough that even understanding it intellectually is enough to know it's really, really bad.

This earthquake was not getting to me last night or most of today.  This afternoon, however, CNN sent out a breaking news update (which I have gotten via e-mail since 9-11), that read,
President Rene Preval tells CNN that Haiti lacks capacity to hospitalize quake victims, asks for medical aid.
Now, I certainly knew that Haiti was a very poor country.  I also knew it was very small.  But something about the idea that the entire country lacks capacity to care for the number of injured they have struck me. 

If there is a major earthquake in San Francisco and the hospitals are overwhelmed, help comes from Los Angeles and Sacramento or from neighboring states.  The idea that something would happen that is so bad that we as a country would not be able to handle it is not even on our radar screen.  That is the privilege of living in an affluent, large country.  That is also what made the response to Hurricane Katrina so shameful -- we have the means if we have the will.

Haiti does not have the means.  They are on a tiny little island that they share with the Dominican Republic.  78% of Haitians live on less than $2 a day.  They had nothing before the quake.  Now they have nothing and they are injured.  Something about that, coupled with the closeness of Haiti to the United States, really gets to me.  They are less than 700 miles from Miami.  They are closer to the United States mainland than Puerto Rico is.  They are our neighbors.

It will be a long time before it's appropriate to start trying to help with the psychological impact of this calamity on the survivors of the earthquake.  Right now, all that's relevant is keeping people safe and getting them healed.  It's interesting to consider what the psychological impact on us here in the United States will be, if any.  It's also interesting to consider that it may be, morally or ethically, better to suffer that impact than it would be to not feel it at all.

Many fine charitable organizations are already on the ground helping in Haiti.  Two of my favorites are Doctors Without Borders and the American Jewish World Service.  If you are able to, I hope you will make a donation to one of these or one of your choice.  The help is truly needed, and the time is short.

Monday, January 11, 2010

Hong Kong Acid Attacks: the Likely vs. the Possible

Six times in a little more than a year, most recently on Saturday, someone has dropped a bottle filled with acid into a crowded street in Hong Kong.  Nobody knows who is doing this or why.  No demands or threats have been made.  But every once in a while, a jug full of acid lands in a crowd, and people are seriously hurt.  Thirty people were wounded on Saturday, and more than 100 have been in all.

CNN ran a story today in which the reporter investigated how hard (or easy) it would be for someone to pull off an attack like this.  The reporter discovered that it was extremely easy to get to the top of the apartment building that witnesses say the bottles came from.  I guess you could limit acid attacks by making it harder to get onto tall buildings, but that's probably using a very blunt instrument for a relatively limited problem. 

CNN also ran a piece over the weekend on acid attacks around the world, in which we discover that acid is rarely used as a weapon in western countries but more commonly used in south Asia.  There are serious cultural reasons, which CNN chose not to tackle, why acid is used as a weapon against women in some countries, but the attacks in Hong Kong seem very different.  These are impersonal.  No one is throwing acid in other people's faces.  They are anonymously dropping it from above.

I have often said that we live our lives by what is likely, not by what is possible.  We don't like to think about the million things that could go wrong every day in the course of ordinary business.  We don't contemplate the possibility of a strong wind blowing a tree onto us or the roof collapsing.  We trust that, for the most part, the other driver isn't actually trying to crash into us and a knife left in a kitchen will be used to dice vegetables. We know that bad things happen, but they aren't very likely, and to dwell on them would prevent us from living our lives.

So most of us, when we go out to run errands, don't give a whole lot of thought to whether someone might drop acid on us from a tall building.  It could happen, but it's so unlikely that it's not worth our stress.  Then, from time to time, a story like this catches our eye.  We still know it's only possible, not likely.  But once in a while our eyes drift up to the rooftops above us, and we catch ourselves wondering, until we give ourselves the time to forget that this is possible, or remember that it's not likely, once again.

Sunday, January 10, 2010

How Big a 6.5 Earthquake Is Depends On You

Yesterday evening, an earthquake measuring 6.5 on the Richter scale struck off the coast of Northern California, near Eureka.  To refresh your memory, the Richter scale is logarithmic, which means that every increase of 1 on the scale means the earthquake is 10 times more powerful.  So by way of comparison, this earthquake packed about 1/5 the power of the one that struck San Francisco during the World Series in 1989, and about 1/2000 of the one that caused the tsunami in the Indian Ocean the day after Christmas, 2004.  On the other hand, it had more than 30 times the power of the atomic bomb that was dropped on Nagasaki, Japan.

It's hard for your average person to get a good feel for earthquake magnitudes.  The difficult math of a logarithmic scale is only part of the problem, however.  The other big part is what your previous experience with earthquakes has been.

Residents of Eureka have been quoted in the press discussing the earthquake.  Reactions range from the alarmed, as demonstrated by Phil Burns, a cafe owner in Eureka, who said, "It was a monstrous one," to the more relaxed Cole Machado, who told CNN, "I thought my TV was going to fall over."  There are also those who try to explain how the earthquake felt, like Chris Durant, a reporter who explained, "We are used to feeling small ones, but after the first few seconds, we looked at each other and said this is not a small one."  Jessica Tucker of Ferndale said, " "It rolled and rolled and then it slammed."

Notably, none of these people were experiencing their first earthquake.  This is important for two reasons.  First of all, they all have a frame of reference.  They talk about this one in relation to other ones, and they have vocabulary with which to describe it.  Second, not one person I've come across said they were afraid they were going to die.  Believing you are going to die is a strong predictor of post traumatic stress and PTSD, so this is a good thing.

Compare this to what would have happened if a 6.5 earthquake hit in, say, Boston, where a "big one" might be 3.0.  First of all, the damage would have been much more severe, because Boston is not built for earthquakes the way California is.  But the fear would also be much more severe, solely based on the earthquake without the damage, because most people in Boston have never been in an earthquake of any remarkable size.  The reactions we are hearing out of California probably compare to what we would hear from Boston in a 5.5 or 6.0 -- 1/10 to 1/5 the size of this one.  If a 6.5 earthquake hit Boston, people would believe they were going to die, in part because they would be more likely to, and the amount of stress symptoms you would see afterwards would be much higher.

I've been in two sizable earthquakes in my life -- both 5.6 on the Richter sale.  I'm from Boston.  I was scared.  My husband spent his teen years in the San Francisco Bay Area.  It's not that he didn't have a healthy respect for these two earthquakes, but he knew they weren't "big ones" much faster than I did.  Life in California is, in part, about pre-earthquake inoculation.  By experiencing small ones so often, the bigger ones just aren't as terrifying. 

Friday, January 8, 2010

Does the ABB Shooting Make You Look at Your Coworkers Funny?

An employee turned up at the ABB transformer manufacturing plant in St. Louis yesterday armed with at least four guns and a fanny pack full of ammunition.  He opened fire in the parking lot and continued into the plant.  He killed three coworkers, injured five others, two of them critically, before he shot and killed himself. 

There are two aspects of this case that are different than what we've come to expect from workplace shootings.  The first is that we don't really know why he did it.  He was suing the company over pension fees, but that was old news. While the trial started recently, the suit was filed more than 3 years ago, and it was a class action lawsuit, meaning that there were plenty of other people involved in the same dispute.

The second unusual fact is that this was not a former employee, but a current one.  We are accustomed, when we hear about these things, to hearing about how the gunman was a disgruntled former employee.  We read that he was recently fired, or he left a long time ago and blamed the company for something.  Or he was never an employee at all but had a dispute with someone who worked there.  Not this time.  This guy showed up for work armed to the teeth and killed the people he worked with.

Certainly no one (except, perhaps, police officers) expects to be shot at while at work.  However, most of can think of people more likely to shoot up our workplace than others.  If we let ourselves imagine the worst, we think of the person who was fired or left "under a cloud."  We think of the angry client who cussed us out the last time we saw them, or the evil ex-spouse of a coworker.  Most of us do not think of the person in the next cubicle, or the person down the assembly line from us.  For the most part, we may not like our coworkers, but we don't think of them causing us harm.

That is what makes this shooting particularly disturbing.  If no one knew this guy was angry or dangerous and he opened fire at his job, what does that mean about the people we work with?  This messes with our understanding of when and with whom we are safe.  This is not the way things are "supposed" to work.  Honestly, I still can't imagine any of my coworkers doing something like this.  But I'd be lying if I said today I'm not just a little concerned that maybe I'm fooling myself about that.

Thursday, January 7, 2010

Guest Blogger: Concerned Engineer

I came across your website while reading the article on the tragic death of 14 year-old Anna Marie Stickel. My deepest sympathy goes out to the family and friends of Ms. Stickel. No parents should ever have to bury their child no matter what the circumstances are, but please bear with me while I shed some light on the growing number of trespasser fatalities.

As a Locomotive Engineer, we leave our homes each day not knowing what we are up against. There are no grade crossings, streets, walkways or footpaths that cut across any of the tracks from Boston to Washington, DC. Off corridor, all tracks are protected by gates and cross bucks that are often disregarded by impatient reckless drivers.

The fatalities on the corridor are often people who choose suicide by train because it is quick and painless (I hope). Then there are the teenagers that think it is cool to smoke drugs and drink close to the railroad track, knowing that their parents could never find them down there. They often play chicken on dares with the trains traveling 110-135 mph packed with commuters and families, or  they'll place debris on the rail often causing delays and extensive damage to the equipment. On one recent southbound trip, I passed 3 teenage girls walking in the gauge of the northbound track as if it was their railroad. I blew the horn continuously and they flipped me the bird and kept right on walking. This is sad...VERY SAD. In the location where Ms. Stickel was struck, it is a common shortcut and hangout for teens.

Trespasser fatalities are an Engineer's worst nightmare. No one ever ever thinks of what becomes of that Engineer the day after and how we cope. Our lives are forever changed...sleepless night, inability to perform our jobs without flashbacks and nightmares, months of counseling, divorce, anxiety, suicide, etc.

As a reminder, Amtrak railroad tracks are private property. Parents, schools and the community should educate their children about the dangers of using the railroad as their own personal avenue. Let them know that "that regular shortcut" across the tracks to spare a few minutes can often cost you your life.

I hope that Ms. Stickel's death will not be in vain. 

Thank you,

Concerned Engineer

I received these comments in response to my recent post about the death of Anna Marie Stickel, the 14 year-old who died on Tuesday after being hit by an Amtrak train in Maryland.  They are published here with the author's permission, and I thank her for the inside look at trespasser fatalities on the train crew.  Click here for additional Quarterbacking on train crashes. -- Naomi

Wednesday, January 6, 2010

The Death of the Holocaust Museum Shooter

The white supremacist who opened fire inside the entrance to the United States Holocaust Memorial and Museum in June, 2009, has died.  He had been charged with murder in the death of museum security guard Stephen Tyrone Johns, who was shot in the incident, as well as various other crimes including hate crimes.  He was 89 years old, and probably didn't figure he'd come out of the museum alive in the first place.  He was undergoing competency testing at a prison hospital prior to his death. His lawyer, public defender A.J. Kramer, commented, "It is a sad end to a very sad occurrence."

The shooter in this case was a Holocaust denier.  That is to say, he believed that the Holocaust was a lie.  He thought, and taught others, that 6 million Jews, as well as gays, Roma, people with disabilities and other groups, were not systematically murdered by the Nazis during World War II.  He said that Anne Frank: The Diary of a Young Girl was a hoax.

Since I first wrote about this in June, when it happened, I've had some opportunity to reflect on the theme I proposed back then -- that for Jews such as myself this incident was personally traumatic.  At the end of December, I took my 11 year-old daughter for her first visit to the museum and experienced again through her eyes as well as through mine.  We noted the small but tasteful memorial to Officer Johns in the lobby, which says that he was killed protecting the public from the very hate the museum seeks to dispel.

I've decided, though, that I think the hate is only one part of the issue here.  For Jews who lived in Europe during World War II, the Holocaust was, for obvious reasons, a direct trauma. It also represents, in many ways, a secondary trauma for the rest of the Jewish community.  Even for those of us who were not alive at the time, the fact that someone sought to systematically exterminate every person like us, and succeeded about a third of the way, is viscerally frightening.  It represents a danger that no one likes to think about.  Everyone can and should be horrified by the images of the concentration camps and the ghettos, but Jews also see themselves in those pictures.  They see buildings and objects that are specifically familiar to their lives.  For both my daughter and myself, for example, the most upsetting part of the Holocaust Museum is the display of Torah scrolls, torn to pieces and piled up on top of one another.  We know on a gut level what that signifies in our lives.

The fact that this shooter was a white supremacist and anti-semite, therefore, is actually somewhat less distressing than that he was a Holocaust denier. Denying someone's trauma is a particularly pernicious thing to do.  People who have been through a trauma already have a feeling of unreality, like this can't possibly have really happened, and yet they know it did.  To tell them it didn't is asking them to seriously question their own sanity.  It takes away the one thing the person can call their own, which is their individual experience of the trauma.  Telling millions of Jews that they didn't go through what they went through, that their families weren't killed, that the damage to those scrolls and the scenes in those pictures didn't happen, tells them that they are crazy.  It's just plain evil.

So now the shooter is dead.  As his lawyer said, this is the end of this occurrence.  With his death, however, the Jewish community lost the opportunity to say in some formal way that what this man believed was wrong, that the Holocaust did happen, and that shooting people to prove they made it up is not what the civilized world is about.  Yes, we know that most of America doesn't think the way he did or condone the actions he took.  On some level, I think it would have been healing to some of us if he had been forced to know that, too.

Tuesday, January 5, 2010

Amtrak Accident: Sorry This Tragedy Inconvenienced You

Anna Marie Stickel was walking to school this morning in Middle River, Maryland, when she was struck and killed by an Amtrak train.  She was 14 years old.  A friend with whom she was walking got out of the way in time, and called 911 after the accident.  It's not clear whether she was crossing the tracks as part of her usual route or if the girls were walking on the tracks where they shouldn't have been.  Whenever someone is hit by a train and the reason isn't completely obvious, people have a question about suicide in the back of their minds.  The publicly available details are sketchy enough that there's no way to know whether that's an issue in this case.

As frequent Quarterbackers know, "trespasser fatalities" are quite common on railroad tracks.  There are more than 600 such deaths every year.  A large number of these are suicides or suspected suicides -- sometimes there's no way to know.  Every one of these deaths is a tragedy that affects the family and friends of the deceased as well as the train crew, who may experience several of these incidents over the course of a career.  The passengers on board the train may also be impacted once they learn what happened.  Unlike the train crew, there are no systemic supports set up to help them process any reactions they may have.

With an average of almost 2 trespasser fatalities per day in this country, it is not surprising that most do not get much attention outside of the local area where the accident occurs.  I would love to be able to tell you that this one made the national news because Ann Marie was a great kid, or because of her age, or because of any factor that had anything to do with her.  That is not the case however.  This story made the news because the location of the accident was such that Amtrak service was significantly disrupted through its entire Northeast service corridor.

Certainly such a delay is news.  It also makes sense to report on the cause of the delay if you're going to report on the delay at all.  But imagine if you are Anna Marie Stickel's parents, teachers or friends.  This child whom you care about has been suddenly and shockingly killed.  The details are horrific.  You are going to have nightmares and be afraid of trains and have trouble eating.  Press coverage never helps in these situations, because no matter what the media reports they can't possibly capture who the victim was in life or what she meant to you, and because reporters can really be invasive in these situations.

This incident, however, is even worse than the usual problems with press coverage.  In this case, not only is your loved one's death splashed all over the news, it's not even because people care that she died.  It's because her death caused a problem for a bunch of people taking trains.  And let me tell you, at this point, you really and truly do not care whether people's trains were on time today.  It's bad enough feeling like you have just stepped off a cliff and the rest of the world hasn't noticed.  It's even worse when they did notice, but only because you got dust on their shoes.

Monday, January 4, 2010

Boy, 9, Stabbed in his Uncle's Home, So Why Didn't You Hear About It?

Anthony Maldonado, a 9 year-old from New Jersey, was visiting his uncle in Manhattan over the holidays.  In the wee hours of Saturday morning, he was playing video games with three other people when two of them decided to go get something to eat.  This left Anthony alone with the 25 year-old son of his uncle's partner.  Just after 3:30, he staggered to his uncle's room and collapsed, bleeding from multiple stab wounds.  He died later that morning.

We all have a basic understanding of what we believe to be the threats "out there" to children.  Children are killed in car accidents.  They are killed by predators.  They are killed in the crossfire of disputes between adults.  Once in a great while, they are killed by family members as part of a family annihilation murder.  They are killed in mass shootings. 

We tend to operate under the assumption, however, that children are not murdered by adults who are not predators, are not trying to wipe out the family, and are not shooting at random.  That is, kids aren't targeted for things like drug disputes, love triangles and business deals -- the kinds of situations that get adults killed -- nor are they generally targeted for robberies and muggings.  We know that children die, and that's bad as it is, but we assume that young children don't die because someone, put simply, is gunning for them.  That explains the fact that, in New York City, about two percent of murder victims last year were under 10. (Kudos to the New York Times for reporting this statistic in its coverage today.  Context is important!!)

So what happened to Anthony Maldonado?  It seems that the man he was left alone with suffers from schizophrenia and has a history of violence.  He was released from prison last summer.  As recently as Christmas, he told his mother he wanted to kill someone.  His statement to police about the stabbing was, from published reports, fairly incomprehensible.  He said that Anthony provoked him, but it's not clear how.

There are plenty of people we can point the finger at here, from the justice system to the parole system to his mother to the uncle to Anthony's mother.  None of that will bring this young man back.  No one should be unsafe with family.  It offends our sense of order in the universe.

This story has all the makings of front page news.  You would at least expect to see it picked up as a side story in the national press.  We have a dead child, killed in an incident that is completely out of the ordinary.  It ought to get coverage.  But if you do a Google News search for "Anthony Maldonado" you find lots of stuff in the New York and New Jersey press, and basically nothing anywhere else.  Even in the New York Times, this story ran on page 22 in the local news section.

Why didn't Anthony Maldonado get our attention?  My guess, and that is all that it is, is that there were two factors.  First, Anthony's family is Latino and speaks Spanish.  While that shouldn't matter, you need only look at the coverage of the crime to know that it does -- both the Times and the New York Daily News, for example, felt it was necessary to specifically state that his mother's comments about the crime were made in Spanish.  Second, Anthony died north of 123rd Street in Manhattan, in a housing project.  Somehow, our society believes that deaths in these neighborhoods and projects are less gut-wrenching than the same things happening elsewhere.

I don't know which stories should get our attention or tug at our heartstrings.  I don't make decisions about what page stories run in the paper or how far down they are in the news cast, and I'm glad I don't have to.  I do suspect, however, that if Anthony Maldonado had an Anglo name and was murdered at 86th and Park Avenue, we'd probably have heard a lot more about him.  That's a tragedy all its own.

Sunday, January 3, 2010

Arizona Teen Runs Over Brother, and Assigning Blame Isn't So Simple

Dwight J. Brock, Jr., age 17, died on Saturday evening after being hit by a car driven by his sister, Nicole, 16.  Nicole had just dropped him off at a Mesa, Arizona mall and the two were goofing around.  Dwight would jump in front of the car and Nicole would slam on the brakes.  During one such interchange, she couldn't stop in time and ran him over.

This is an unbelievable tragedy for the Brock family, I think we can all agree.  Losing a child is awful to begin with, regardless the cause.  But this situation is really complicated.  I don't know the parents, but it seems likely that they, like most parents, would have told their kids not to play this game, and this accident shows why.  However, I also think they probably, even if they saw their kids doing this, could not fathom that one of them would lose their lives playing this game.  They way this story is "supposed" to end, at worst, is with some kind of minor injury that teaches the kids a lesson, and the parents say, "See, I told you so."

The online comments on this incident, as usual, are all about blame.  Here's a sampling from the local ABC affiliate's web site:
  • This girl should be charged with a crime and made an example of.  Ignorance of the law is not an excuse.
  • This foolish child may well be on the road again. Do you really want to be anywhere near a kid who thinks the vehicle she's driving is a toy?
  • Why is this any different then a kid getting killed by a gun? Where is the demand that the owner of the car be held accountable for allowing kids access to this dangerous weapon?
  • If she would have hit your child, mother, husband, wife, or grandma, what would you say then? It sure wouldn't be "Oh she's just a child, it was an accident." I don't think so, you would be screaming to have her locked up.
  • Do you feel pity for someone who plays Russian roulette and loses? That's essentially what they did and he lost.
  • The blame should rightly rest with the parents also, because the parents should have taught and insisted on them driving responsibly. Problems with kids today are a result of terrible parents.
These comments represent a very all-or-nothing view of the world.  Someone is either guilty or innocent.  Parents are good or bad.  Someone is to be vilified or pitied.  You can never have both.

The problem is that this incident is all about the gray areas in between.  The parents are most likely furious with their daughter and want to support her.  They are livid at their son, but they mourn his death.  Nicole feels terribly guilty and she has also just experienced a tremendous trauma.  Simply saying she's bad (or she's not) will not resolve those tensions.  Whether or not the daughter should be charged, that won't be the end of the story.  I suspect the whole family is going to need a lot of help for a long time to come to a place where they can make sense of what happened and look each other in the eye.

Science tells us that teenagers do not have a fully developed frontal lobe of their brain.  This means that they cannot fully appreciate the consequences of their actions.  All of us did stupid things when we were teenagers.  However, the fact that doing stupid stuff is age-appropriate doesn't mean we don't try to teach kids to do better.  Just as we teach our toddlers not to bite at the same time as understanding that biting is developmentally appropriate for their age, we try to instill in them the idea that people can get hurt playing games like this.  Sometimes they listen, sometimes they don't.  Rarely, they pay the ultimate price.  When they do, "I told you so" just isn't helpful.

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Naomi Zikmund-Fisher
is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at
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