Monday Morning Crisis Quarterback

Yesterday, September 11, at about 9:30 AM, CNN breathlessly reported that Coast Guard boats and a helicopter were apparently confronting a suspicious vessel in the security area of the Potomac River, near where the President was commemorating 9/11 at the Pentagon. The reports escalated -- the vessel had been fired upon. Cable news and the Internet picked up the story.

It was a training exercise.

Let the finger-pointing begin. CNN reported an interpretation of what they heard over a scanner picking up the Coast Guard radio traffic, but apparently didn't think it odd that the report of gun fire began with the radio transmission, "bang bang bang bang." They say they called the Coast Guard and were told they were not aware of anything going on on the Potomac. Meanwhile, the Coast Guard says that they never coordinate their training exercises with other agencies, and they train like this all the time.

So what went wrong? If training exercises like this one are commonplace in that area, why did this one make national news? I bet you already know part of the answer. It was September 11. And yes, that matters, and no, it's not because we're all crazy.

The date itself -- September 11 -- is a trigger for most people in this country. The various commemorations on the news heighten that. And that's not a bad thing, necessarily. But it means we are all in a space where we are much more willing to believe that terrorists will attack the US. Most days we know it's a possibility, but on September 11 it feels like a likelihood. This exercise, and what CNN heard over the scanners, was therefore much more believable, and the lack of confirmation was less troubling. It might have been a good idea if the Coast Guard had considered this and announced the exercise, or held it on another day, or at least made sure it's own people could tell the press what was going on. There are two sides to every coin, though, and CNN should probably have known that both they and their viewers were more willing to believe the worst and more prone to panic yesterday than, say, the day before.

It's interesting to consider how long it will be before we are not so triggered by September 11. I see signs that it is fading already: A few years ago I was lambasted for holding a fire drill on that date. We had one yesterday, and no one said a thing. The edge has, at least a little, been taken off. But not so much that everyone can not worry about the impact of anti-terror exercises and erroneous news reports.

Lance Corporal Joshua M. Bernard, 21, died in Afghanistan on August 14. An Associated Press photographer embedded with his unit captured a picture of him after he was wounded and before he was transferred to a medical facility, where he died. This week Defense Secretary Robert Gates blasted the AP for publishing the picture, against the express wishes of Bernard's family.

On Friday, my niece's high school notified parents of the death of one of her classmates. Support was offered to students and guidance offered to parents, but no information was shared about the cause of death. The local newspaper reported it was a suicide.

These two events may not seem to have much in common, but in fact they capture a very common problem in traumatic situations. What happens when the powers that be, or just some random witness, have information about a death that the family does not want to share?

There are always two sides to this argument. In the case of Lance Cpl. Bernard, the AP argues that publishing the picture helps the public understand what war is really about. It says it is,

choosing after a period of reflection to make public an image that conveys the grimness of war and the sacrifice of young men and women fighting it.

Bernard's family, on the other hand, feels that the publication of the photo inflicts more pain on a family already traumatized and grieving. They prefer not to remember their son that way, and do not want others to see him that way. His father says the photo is disrespectful of his memory.

In cases of suicide, families often want to withhold the fact that their loved one killed themselves. There is a tremendous stigma in our society about suicide. Families often refuse to accept that the victim's death was, indeed, a suicide. Even if they do accept it, they fear that others will look down on them as the family, or will think ill of the dead family member who completed the suicide. It is not at all uncommon for families of those who complete suicide to hear from people trying to be "helpful" that their loved one was selfish or is going to Hell. Not surprisingly, families opt to limit the number of people who have cause to be "helpful" in this way.

On the other hand, from a high school administration point of view (and just generally from a public health point of view), it is important to talk about suicide. While no one wants to destigmatize it to the point where it is considered completely normal and acceptable, community leaders do want to get people talking about the depression and desperation that leads to suicide. The stigma surrounding suicide can prevent those who are contemplating killing themselves from getting the help they need, because they fear people's reactions if they talk about it. In a school setting, often the students know a classmate has completed a suicide, even when the administration does not acknowledge it. Not talking about it when everyone knows about it further sends the message that help is not available, and can lead to the clustering of suicides at high schools that sometimes occurs.

So, what to do? How do you weigh the educational and/or news value of a picture or a piece of information against the legitimate needs of a family in crisis? Whose needs for mitigating critical incident stress win? And whose values should we base that decision on?

We have a strong custom in this society of respecting the wishes of families of the dead. Because of this, violating those wishes provides an easy target for the natural anger that families feel after a traumatic death. I can't say that the AP made the right choice in the death of Lance Cpl. Bernard, even if I wish the family had given permission. They didn't. And I am not convinced that the picture had so much value that it should eclipse those wishes. Luckily, I don't have to make judgements like that most of the time.

As a school administrator and crisis team member, I will not disclose that a death was a suicide without family permission. But I will do two things to try to get around this. The first is that I will explain why I think it is important to share the information. Very often families are willing to hear that their disclosure may help another suicidal person, but they do not make that connection alone. School staff are also often reluctant to share this information, even if they can. We have to educate them about suicide prevention as well.

The second is, if I cannot get permission, to acknowledge when others say they heard it was a suicide. You can talk about it in the abstract even if you can't confirm. So when a child says, "I heard he killed himself" or "the paper says she took pills" I wills say, "I heard that too. If that were true, what do you think about that?" This finesses the whole question of telling when someone's death is a suicide by letting the students tell themselves. The AP could have written a story about the picture without publishing the picture, and explained that the family, who could be kept anonymous, did not give permission. This would have been a chance to talk about the impact of war on families at home, something they chose to gloss over by publishing the picture.

I think the AP, school administrators, and anyone else who has tough decisions to make about sharing or not sharing information, would do well to ask themselves what their ultimate goal is. If it's just to share information for its own sake, that takes you in a different direction than if, as in both of these cases, the aim is to educate. As the saying goes, there is more than one way to skin a cat, and there is more than one way to educate following a traumatic death.

I have chosen not to add the picture that the AP published of Lance Cpl. Bernard after his injury. I hope that the picture above is more in keeping with how the family would like this soldier remembered.

• So far, 34 people have died in today's earthquake.
• In the last 6 years, at least 300,000 people have died and 3 million have been forced to leave their homes because of their ethnicity.
• More than 1,300 children have abnormally high levels of lead in their system due to the malfeasance of 8 local factories.
• Five years ago this week, 334 people, 180 of them children, were killed following a three day hostage-taking standoff at a school.
• A kidnapped girl reappeared after being missing 18 years.
  

Now, let's be honest.  Which one of these incidents did you instantly recognize?  Which ones did you say, "Wait, where did that happen?"

"Where did that happen," is often our instant reaction to bad news.  And, on the whole, that's not an unreasonable question.  If there is a major earthquake at my parents' house, for example, I really would like to know that (and it would really be big news, since major earthquakes are not frequent in Massachusetts).  It seems straightforward and understandable that we want to know whether people we know and love may be in trouble.

If you don't have any relatives or friends in, say, California or Indonesia, for example, why do you care where today's earthquake was?  But you probably do.  There are two explanations for this phenomenon, one more palatable than the other.

The first explanation is that you simply are trying to reassure yourself that not only are your loved ones safe, but that something like this will not happen to you or your loved ones in the future.  An earthquake in California makes us feel, somewhat irrationally, like an earthquake in Massachusetts is more likely.  Certainly a hostage siege in a school in California makes us worry about security in American schools.

The second explanation, which is a little harder to swallow, is that this is not actually about location, but about "alikeness."  When things happen to people "like us" it makes us feel less safe -- and less compassionate -- than when they happen to people who we think are not "like us."  On some level, we even come to imagine that events that would absolutely devastate anyone in this country are not so upsetting to people elsewhere, particularly in non-European, non-prosperous countries.  Somehow, "they" must be used to it.  We may not say these things out loud, or even think them consciously, but they resonate with us.  Call it racism, call it xenophobia, call it American self-centeredness, but we just do not care nearly as much about trauma that happens in other parts of the world.

• Today's earthquake was in Indonesia.  It's not even the top story on CNN as of 12:30 this afternoon.  Imagine what the coverage would be if it were in California.
• The genocide in Darfur, Sudan, is something we know about but which gets next to no daily coverage, nor most people's attention, in this country.
• The factories in China have been shut down until they comply with safety standards.  It's not a "top story" in this country.
• The siege in Beslan, Russia, caught our attention as it was happening and quickly faded from memory.
  
• Imagine what the coverage would be of Jaycee Lee Dugard's story if she were in Senegal, or China, or Belize.  Imagine what it would be if she were African-American. 
  

Distancing ourselves from tragedy is a natural survival mechanism.  Sometimes, unfortunately, we do it at the expense of recognizing the value of other human beings.