Wednesday Wisdom Series September 4, 2019
 
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September 4, 2019

Here is your Wednesday Wisdom series from the Family Assistance Foundation, reminding you that a fully-integrated approach for assisting survivors of traumatic loss involves a balance of head and heart. Wednesday Wisdom is written and copyrighted by Carolyn V. Coarsey, Ph.D., and distributed by the Family Assistance Education & Research Foundation Inc., www.fafonline.org. Reprint is available with written permission from the Foundation.

The Crash of USAir Flight 427: A Case-Study of How Passage of Time May Not Predict Healing

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       September 8, 2019, marks the twenty-fifth anniversary of the crash of USAir Flight 427. Reflecting over the years since the accident, I remember the complications of the investigation and ultimately, the challenges in the healing/integration grief process for family members. Mrs. Merrilee Morris generously provided insight into the many challenges that she faced in the aftermath of the longest investigation in the history of the National Transportation Safety Board (NTSB). Merrilee's son died along with all 132 passengers and crew on board.    
 
The Complicated Accident Investigation 
    The Boeing 737 departed Chicago O’Hare’s International Airport with a stop at Pittsburgh International Airport and a final destination of West Palm Beach, Florida. The aircraft crashed while on approach to Pittsburgh, in Hopewell Township, Beaver County Pennsylvania. Due to the severity of the crash impact, the bodies of the passengers and crew were severely fragmented, leading investigators to declare the site a bio-hazard, requiring 2,000 body bags for 6,000 recovered remains. The conditions of the crash site resulted in another first for the NTSB. The crash of USAir Flight 427 marked the first time in NTSB history where investigators were required to wear full-body bio-hazard suits while inspecting the accident site. 
    The NTSB released its final report on March 24, 1999, slightly more than four and a half years after the accident. The aircraft's rudder malfunctioned and went hard-over in the direction opposite to that commanded by the pilots. This malfunction caused the plane to enter an aerodynamic stall from which the pilots were unable to recover. 
    While not all officials agreed with the Board’s findings as to the probable cause of the crash, several changes resulted from them—and history bears out the success of the changes. A major one required that Boeing redesign the rudder for all iterations of the 737. A second resulted in a requirement that pilots receive specialized training on how to fly the aircraft out of a stall like the one the pilots of USAir Flight 427 encountered. And a main recommendation by the NTSB required airlines to add four additional channels of information into the flight data recorders—pilot rudder pedal commands. [1]   

Complicated Grief
    Fragmentation of the bodies of the passengers and crew made positive identification more than challenging. In 1994, DNA was not universally used in the identification of remains of those who died in such devastating tragedies. To help identify her son, Merrilee was able to send the medical examiner Chad's footprints, taken from his baby book. The prints were matched to his adult foot. As sad as this task was for Merrilee, it meant that she knew for sure that her beloved eldest son was indeed on the flight and died in the crash. With the help of USAir's special assistance team, Merrilee and her family were able to gather with his wife and other family members, hold funeral services, and begin adjusting to a life where her son was no longer physically present. The lengthy investigation and mystery surrounding the cause of the crash made further adjustment to his loss much more complicated than it might have been under different circumstances.  
 
The emotional pain of the loss increases when one’s reactions are considered pathological.             
    The problem for many survivors of aviation and other technological accidents where the cause of death is not immediately known involves reactions from others. Well-meaning people in the survivor’s social circle innocently ask questions such as, 'when are you going to be yourself again?’ or 'how long do you plan to grieve?’. Those who make these remarks are often influenced by what many professionals consider the normal time for grief and mourning. This lack of understanding by family and friends, despite their good intentions, is not helped by what medical/clinical providers view as normal and abnormal, i.e., Pathological Grief Disorder. Looking at definitions of prolonged grief disorder from two major international resources provides insight into how family survivors of USAir 427 experienced additional suffering due to a lack of understanding by others.   
    In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a resource that U.S. health care providers use to diagnose mental health issues, the condition of prolonged grief is known as persistent complex bereavement disorder (PCBD). The DSM-5 defines PCBD as severe and persistent grief and mourning reaction that is experienced for at least 12 months post-loss for diagnosis. The World Health Organization (WHO) uses even shorter time criteria (six months) for what they refer to as prolonged grief disorder. The International Classification of Diseases (ICD-11, WHO’s diagnostic tool) defines prolonged grief disorder as "persistent and persuasive grief response. This grief is characterized by a longing for the deceased or persistent preoccupation with the deceased accompanied by intense emotional pain." That family members were preoccupied with the crash and how their loved one died, to most would seem normal. For Merrilee and many other survivors in the Foundation’s research, their intense grief lasted far longer than 6 to 12 months. Yet to those who understood their circumstances, their long grief cycle did not seem abnormal.   

What Helped Merrilee as She Awaited Findings of the Probable Cause of the Accident 
    During the long investigative process, communicating with other survivors and attending annual memorial services where she could meet and support other families of USAir 427 gave Merrilee something to look forward to and plan for each year. Also, attending support group meetings and getting to know families from other crashes helped. Following the crash of ValuJet Flight 592, May 11, 1996, where 110 lives were lost, a group of family members began meeting monthly in Atlanta, Georgia. Since Merrilee lived in Atlanta, this gathering was convenient and proved to be very therapeutic for her.  
    Merrilee valued meeting other mothers, fathers, siblings, and all who came together to share and receive support. She also joined a local Toastmaster’s organization where she could practice speaking about her grief experience in the presence of others. Merrilee frequently spoke at airline family assistance team member training sessions and Family Assistance Foundation workshops and seminars. Merrilee also journaled regularly—a coping strategy highly recommended by trauma therapists. 
    In Handbook for Human Services Response[2], I wrote a great deal about Merrilee’s story, including her profoundly moving poem about the site of the crash. Merrilee shared the letter she wrote to the airline about the compassionate services she received from the call center representative that assisted her and other family members in the post-crash activities. During the time that Merrilee waited to learn about the cause of the accident that took her son’s life, her love for others and deep faith in God carried her. 
    In correspondence this past summer, I reminded Merrilee about a quote from her that I plan to use in a book I am currently writing. Merrilee shared with me that in her third year of her grief, she made a decision—she decided to devote her life to those she loved that are still on earth. In her response, she acknowledged her original comments and followed with another story. This example further illustrates the challenge she and other family members continually face in their long-term recovery. The commitment to live in the present vs. living in the past, especially for parents who lose a child, never ends as this quote from her email illustrates. 
I want to go to Pittsburgh on the 25th anniversary of the crash in September. I want to visit the monument and the crash site. On the other hand, I have two great-grandsons in Minnesota I would love to hold, read stories to, color with, and get to know. I wish I could do both, but again, I choose the living.

Donna and Families Survivors of United Airlines Flight 585 
    In writing about long and complicated mourning, related to the mystery surrounding the cause of an accident, UAL Flight 585 must be included. The June 2019 issue of QPR Quick Quotes featured an article about depression and family survivor, Donna Lucero. Her daughter, Anita was the senior flight attendant in the crash of UAL Flight 585, March 3, 1991, where all twenty-five passengers and crew died. While the NTSB was unable to determine the cause of UAL Flight 585 at the time, the investigation was re-opened in parallel with the investigation of USAir Flight 427. The cause of UAL Flight 585, was later also attributed to the malfunction of the rudder system.             
    I met Donna in the ninth year of her grief. This meeting occurred after the findings of the UAL Flight 585 were published. Donna stated that only when the probable cause was identified, was she able to move forward with her life. Before that time, with no answers about what had caused the crash, no changes were being made to prevent future accidents. Donna felt there was an absence of meaning in her daughter’s death. Donna felt stuck in her grieving process. Once the mystery of the accident was solved, the B-737’s rudder system redesigned, and the older 737's were retrofitted with the necessary repairs, Donna’s pro-longed grief process ended. Her life took an entirely new and healthy direction. 
    Before that time, she, like Merrilee and many others, was considered to be a victim of abnormal grief. However, those who understood the suffering surrounding the crash that killed her daughter, realized how these circumstances complicated her recovery process.   

[1] Details of the investigation are from the NTSB Accident Report (https://www.ntsb.gov/investigations/AccidentReports/Reports/AAR9901.pdf  [2] Coarsey, C.V., Handbook for Human Services Response, 2004. 


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    During the first few weeks following the crash of USAirFlight 427, aviation employees and experienced travelers feared that the Boeing737 had a structural problem that might go undetected—and un-repaired. After all, the cause of the crash of UAL Flight 585 at that time remained a mystery. Fortunately, that was not to be the case, thanks to the diligence of the NTSB, FAA, and pilot investigators. 
    Leadership at USAir recognized the stress these two crashes imposed on employees whose jobs involved flying and servicing the aircraft type involved. For several weeks following the accident, counselors were available on-site for employees who felt the need to express their fears and concerns to professionals who could help support them. 
    While no employee was expected to meet with the mental health professionals from the Employee Assistance Program (EAP), this action on the part of leadership was beneficial. The fact that management acknowledged the anxiety and fear expressed by some of the employees helped the airline move forward in its recovery as a business. As with survivors like Merrilee and Donna, employees who work for an airline where a crash has occurred also go through their grieving process and need time to adjust. Kudos to the airline's management team for understanding this and taking steps to support their employees.             

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