Witnessing Tragedy: How Lives Change

Guests

Dr. Comilla Sasson, University of Colorado Medical Center
Gregory Thomas, CEO, Alan Thomas Security Group
Robin Gurwitch, clinical psychologist, Duke University Medical Center

Traumatic events — from car crashes to mass shootings — can dramatically change the lives of witnesses. Victims, first responders and those who see a tragedy unfold may find their lives profoundly changed.

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NEAL CONAN, HOST:

This is TALK OF THE NATION. I'm Neal Conan, in Washington. As funerals continue in Newtown, much of the attention remains, appropriately, on those killed and their families. But there are other victims, too: the witnesses, the survivors, the first responders and medical personnel.

Yesterday, Macai(ph) called into this program. He was shot in the leg at Columbine High School in 1999.

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MACAI: I myself was injured, and many of my friends. And I witnessed, you know, the murder of young people, the sirens. And, you know, I've had an opinion about it, and I don't share it often, but when something as horrific as this happens, I, you know, I feel like I - it's important to speak up.

CONAN: If you've been a witness to a tragic event, how did that change your life? Give us a call: 800-989-8255. Email: talk@npr.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.

Later in the program, the legacy of Senator Daniel Inouye of Hawaii. But we begin with Dr. Comilla Sasson, an emergency room doctor at the University of Colorado Hospital, one of the attending physicians the night of the movie theater shooting in Aurora that killed 12 people earlier this year.

Dr. Sasson joins us now by phone from her office at the hospital, and it's good of you to be with us today.

COMILLA SASSON: Thank you so much for having me.

CONAN: I know you see a lot of terrible things in the emergency room. What was different about that night?

SASSON: You know, I think horrific is one of the words I've been using quite a bit in the last six months, much more than I think I ever would have during just the course of any normal emergency medicine career. You know, I think the thing that makes something like a tragedy that happened in Aurora, Colorado, July 20th so different than anything else I've ever experienced is just the sheer number of people who came in who were so critically wounded in such a short period of time.

And probably the thing that I think resonates most with most of the folks who were working that night is how young these people were. And so I can only imagine - you know, my heart breaks every single hour of the day since Friday, thinking through, gosh, you know, the youngest people we were taking care of were six years old, all the way up to 52. But the fact that there were so many younger people who had died so unnecessarily on Friday, I think that's where it's - the wounds are really fresh right now, and this just brings it back.

CONAN: And it - you know, it's going to every time one of these things happens.

SASSON: It will. I think, you know, we want to believe that we're moving forward, and many of us are trying to get back to some sense of normalcy here. But, you know, if it's not Portland, it's Newtown, Connecticut. It's Anywhere, USA. And I think that's where, as an ER doc, I'm just kind of sick of it. You know, I take care of folks every single day who have gunshot wounds. And I talk to my colleagues in Japan and Singapore, and they say, man, what does it look - you know, what does it feel like to take care of a single gunshot victim? Because I've never seen it before. And unfortunately, my course of my career, I see it almost every day.

CONAN: Are you trained for that?

SASSON: You know, we were always trained for taking care of the most critically ill patients, and I trained at Grady Hospital in Atlanta, Georgia. So, yes, I'm very much, I think, skilled to take care of gunshot wound victims. I think the thing that made it so different that night in July was that you don't normally get 23 people showing up on your doorstep in the backs of police cars in the span of two hours.

And so many of those folks ended up going to the ICU or having to go to the operating room right away. So I don't think anything ever really prepares you for that.

CONAN: How much notice did you have?

SASSON: That night, we had about four minutes, and we thought we were going to get three to four patients, and we got 23: one ambulance that came to our doorstep, and the rest all came in the backs of police cars or private vehicles.

CONAN: And did you get counseling afterwards?

SASSON: You know, I did. I went to the sort of debriefing sessions that our hospital put on. I actually hosted one at my own house with the folks that were working that night. But, you know, one of the things I've realized from the wake of this tragedy is you never quite go back - you're never going to be normal again.

And so every day when I'm working, I see people from that same night, and we're in this inexplicable club of people who have been forever changed. And, you know, I'll be honest: There's days that I walk into the emergency department and go, I don't know if I'm ready for this again.

CONAN: And the - there must have been some particular reason you wanted to have one of those sessions at your house.

SASSON: You know, I did. And it was - I think it's hard for folks to realize just how much this really affects you. And I have a psychology undergrad degree, and I think I had some really good insight into sort of, man, you know, this - I'm not sleeping. I'm not eating. I'm not working out. I'm crying. I'm having nightmares in the - for, you know, one month after the fact. And so it really - when I would go and see my colleagues in the emergency department, I would see that they hadn't slept, either. And it just, it was my way of trying to sort of reach out to people and say, look, you're normal. This isn't pathologic. Like, this is a normal grieving reaction. And I think we were better because of it, but man, it's a challenge every day.

CONAN: And how long do you worry this may go on?

SASSON: You know, I worry that this may be the rest of my career. You know, I really do. As an ER doc, you - it's interesting. I end up having those sort of post-traumatic stress disorder symptoms sometimes, even just when I walk into that room and go, gosh, do you remember when, you know, just a few months ago when this place was splattered with blood?

And so I don't know. You know, I don't know if - I know it's affected me. It's affected my other colleagues. We talked to other first-responders, policemen all throughout, you know, throughout the city that have responded to this tragedy. And I don't know if anyone ever really goes back to being the same. And even listening to the gentleman from Columbine, you can tell he's not the same 16-year-old he was.

CONAN: No, he's not. And I wonder, is it to the point where you want to consider maybe moving to another place to get away from the specific location, or even - you know, insurance is a good business.

(LAUGHTER)

SASSON: Are you offering me a job?

(LAUGHTER)

SASSON: No, you know, I think, you know, at the end of the day, I really do love taking care of people. And it's, you know, it's sort of the thing - this Friday, when I was watching those horrible pictures coming in and seeing those vigils and seeing those pictures of people with - you know, standing in front of teddy bears and handwritten notes, all those memories came flashing back. And it was just like we were back in Aurora, Colorado, watching that on TV.

And I think, you know, unfortunately, what I've realized from this weekend is that you can't escape this. I mean, this - if it's Portland. It's Connecticut. It's Colorado. I mean, it's all over the world. And until we can really do something to change that, to change a mental health system that's broken or to figure out how to get, you know, guns out of the hands of people who shouldn't have them, I don't know if there's - you can't escape this.

CONAN: Dr. Sasson, thanks very much, and good luck in your insurance career.

(LAUGHTER)

SASSON: You know, I appreciate it. And thank you so much for bringing this very important topic up. I think it's important for folks to know that this process is not something that will go away in three or four weeks. This is, really, a life-changing event.

CONAN: Comilla Sasson is an emergency room doctor at the University of Colorado Hospital. She joined us by phone from her office there.

This email from Millie(ph): My mother was fatally injured in a blast or fire on the farm. I was the only witness, and was just a toddler. I've spent a lifetime working through the pain. It did not keep me from succeeding in school or much else, but the pain was horrible, especially on Mother's Day, no thank you to Hallmark.

The most significant thing for kids who are witness to a violent accident or shooting is for the adults not to react like lunatics - sobbing, screaming or becoming totally dysfunctional - and for the children to be allowed their feelings. Also, children don't want to feel that they are odd because of a death or having been there for the disaster. It doesn't make the child weird, and they need to be left to their usual pursuits, unless they want to talk. Keep the kids off the news. They don't need that.

Let's see if we can get a caller in on the conversation. This is Steve, Steve with us from La Porte, Indiana.

STEVE: Hi. How are you today, Neal?

CONAN: I'm well. Thank you.

STEVE: I was relating. I was in an office shooting in 1995 in Asheville, North Carolina. We shared one(ph) space with a company called Dormer Tools, and one of their employees had been terminated on Friday, and everybody said God, he's going to come back Monday, and he did, with an M-1, and killed three men, wounded five others.

And I was in customer service. I was a trainee. So I was at the front desk. So I was literally at the front line of all - you know, CNN was on the phone with me before a SWAT team had apprehended the shooter. It - I'll never forget it. I had never heard an automatic weapon. It was the first hot day. We thought it was the air conditioning compressor.

And then we heard screaming, and my boss said shut the door, shut the door. It just - it was a blur. And then I was at the switchboard because we had eight lines, and every second, the phone rang. And the news had incorrectly reported it as our parent company, where the shooter had worked. And the information that got out there was so incorrect, so horrible.

You know, just trying to get people into the lunch room so that they could be debriefed, trying to find out who had actually been hurt. The company had just been acquired by a Swedish company. So just trying to find out the basics, like who's your insurer, where is the CEO, who was traveling, all those things.

What's indelible in my mind are two things, and that is how fleeting life is. Two of those men killed I had just talked to the night before. And I'll never forget that my mother always said, you know, life is short, like how fleeting life can be.

The second thing is how ghoulish were the media, how relentless. They camped out for four days. This is, again, 1995. We didn't have cell phones. We didn't have as much digital communication. So they wanted real stories. They wanted people who had seen blood. They even asked those questions. And I think it's just gotten worse.

But, you know, they were going to the hospital. They were calling people at home. They were trying to get other employees to give the names of people who'd been in the line of fire. And to my boss' credit, he didn't allow that. He counseled us. We had a grief team. But I will just never forget how rapidly national media was literally on our doorstep in a pretty small city.

And what they were after was horror stories. They didn't care about, you know, that this was a tight-knit community. They didn't care about the fact that we were organized. They didn't care about the fact that some guy at the front desk found all of the key response team members so that we could cope with this.

CONAN: I'm not trying to make excuses for the media, and it certainly got a lot of facts wrong with Newtown, but I don't hear that same ghoulishness.

STEVE: Yeah, I think that it's - I don't - in the case of Newtown, because it was kids, I think there was more respect. I think also that since there have been so many horrific subsequent incidents like this, that perhaps the line of questioning by reporters is a little less, a little less sensational. You know...

CONAN: Well, Steve, thank you very much for the call. We're going to leave it there. Appreciate your calling us. We're talking about witnesses to tragic events and how that witness changes their lives. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION, from NPR News.

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CONAN: This is TALK OF THE NATION from NPR News. I'm Neal Conan. When tragedies occur, when a gunman open fires in a classroom or a football player ends his own life in front of his coaches and general manager, when a car hits a pedestrian, the victims rightly lead the news. But witnesses suffer, too.

Today we're talking about how traumatic events like those continue to play out in the lives of those who survive them. And we want to hear from you. If you've witnessed something tragic, how did that change your life? 800-989-8255. Email talk@npr.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION.

Joining us now is Robin Gurwitch, a clinical psychologist at Duke University Medical Center, a member of the National Child Traumatic Stress Network. She joins us by phone from the Raleigh-Durham Airport. Good of you to be with us today.

ROBIN GURWITCH: Oh thank you for having me again. I wish it were under different circumstances.

CONAN: So do we. We are talking with people who witnessed crimes, and given the context of the situation in Newtown, how is it different when children are the witnesses?

GURWITCH: Well, I think certainly when children are the witnesses, it becomes harder for adults and for the kids because we do really wish we could protect them from events such as this. And they have a different understanding about what the event means, particularly very young children, trying to make sense out of something that seems so senseless. They don't have a frame of reference in which to put this.

CONAN: You're on your way to Newtown, as I understand it.

GURWITCH: Yes, sir.

CONAN: And what's your priority there? What will you be doing?

GURWITCH: Well, I think first would be to find out what's going on on the ground. There are wonderful there and great responders right now working, and our goal going in is to really help support the current work that's being done, to provide any insight that we can on what we know about how children who have been through traumatic events cope, how to help families support them, how to help families cope with the grief and the loss that's affecting everybody in that community and certainly across our nation.

CONAN: And this is not a one-time event. These kids are going to know each other at least all the way through school, most of them.

GURWITCH: Yes, I think you're right, and I think there are a couple of ideas that we need to keep in mind for children that have witnessed this type of event or any type of traumatic event that involves loss of life because what you have is not just the trauma that they have witnessed but also the grief that they experience. And it's that twofold whammy, if you will.

The good news is that for children who have experienced traumatic grief, for those - and not only that witness it but also those that are grieving their friends, that are grieving family, we know that there are exceptional interventions for children and families that have experienced both the trauma and the loss.

CONAN: I know you also worked with some kids after the Oklahoma City bombing. All these years later, how are they doing?

GURWITCH: Well, I wish I could tell you that they're all doing great, but the reality is I don't know. Oklahoma City was one of the very first times that anything like that had ever happened with a lot of children impacted. And for the first time we began to take a better understanding of how children are impacted by it. And I think we've come a long way, but at that time there really wasn't a systematic follow-up of those children simply because it was so new, and the field was just beginning.

I think we're going to have a better idea in terms of long term as we come out of the terrorist attacks of 9/11. But what we do know is for children who lose someone close to them, and if it's in a very traumatic way, that what we need to do is help them not only process the trauma but also help them understand and cope with the grief.

And our goal is not to help children get over it, I don't think any of us, adults or children, ever get over something like this, but to get through it in a positive way, to become resilient on the other side.

CONAN: Resilient, we hear that often used to describe younger children. Is that accurate? Are they more resilient than older people?

GURWITCH: Well, I think for children, certainly we know what we can do to help grow their resilience and enhance their resilience, and for children I think we have so many people who are willing to help support that. I think it is worrisome if we say oh gee, they're children, so they're resilient, and we don't need to do anything.

I think for any of us, whether it's adults or children, we have to take a step back and figure out how do we support that.

CONAN: Well, we all wish you the best of luck in Newtown.

GURWITCH: Thank you for having me.

CONAN: Robin Gurwitch, a clinical psychologist at the Duke University Medical Center, a member of the National Child Traumatic Stress Network, joining us today from Raleigh-Durham Airport, where she's on her way to Connecticut. And joining us now from our bureau in New York is Gregory Thomas, CEO of the Alan Thomas Security Group, former executive director of school safety for the New York City schools. He was in that position on September 11th, and good of you to be with us today.

GREGORY THOMAS: Yeah, it's good to be here. Thanks for having me.

CONAN: And as I understand it, you went immediately, as soon as you could, down to the schools closest to the World Trade Towers on the morning of September 11th. You were a witness, too.

THOMAS: Yeah, in some respects, and, you know, as a first responder once removed, I'll put it that way, because in my role, I was not expected to be down there to evacuate children. The ones who were doing their job, as they do every day, as they did also in Newtown, where the principals and teachers in the school, the staff that quickly evacuated the eight schools that were down near the World Trade Center Towers, there were eight schools there with 9,000 students and staff, and all were rescued without any child or staff person missing, killed or injured because of fire drills and because of teachers and principals in those schools.

CONAN: And as you went through this, all these years later, what sticks with you?

THOMAS: You know, I'm down there often enough now in other moments, and I look around, often, to see how close the closest schools were. We had in fact two high schools about 50 yards south of the South Tower. And it amazes me to this day that the staff in the schools and the school safety agents from the NYPD that were involved, as well, that they all worked together and united to focus on one thing: children, and getting them out of there safely.

And this also parallels what happened up in Connecticut, too, because the stories of what we're hearing that happened there that were tragic, unfortunately they need to be matched with the larger story about those students that weren't injured because of the risk that the teachers took to save them.

CONAN: Yeah, the - and the follow-up that Robin Gurwitch was telling about, is has that been done, so far as you know?

GURWITCH: Well, I guess in some respects it is a little early, and to Robin's credit, I know Robin well, and I sat here as - I was listening to your interview, smiling, knowing that she's on her way because we are longtime friends. So it's good to know that people like her with experiences are bringing it up to Connecticut because one thing we have to really focus on more often than not is the fact that a lot of these things mimic or mirror other events.

THOMAS: And it's important that we don't start from scratch, and we rely on people like Robin and others to give us expertise to make sure we can get a jumpstart on healing.

CONAN: Let's get another caller involved in the conversation. We'll go to Matt, Matt's on the line with us from Denver.

MATT: Hello.

CONAN: Hi, you're on the air, Matt, go ahead please.

MATT: I just wanted to give a comment. Some of my teammates and I were SWAT officers in 1999 and did go to Columbine. And, you know, I think it's typical for police officers to want to be able to save the day, and that was a situation where we got there, and we - really the damage was already done. The tactic was so much different then than it is now, with the advent of rapid deployment and other types of tactics.

But again, in this case, this damage happened so quickly that even when we get there in time to even have a confrontation, sometimes even two, three minutes is too late.

CONAN: Too late, that's got to stick with you.

MATT: It is, and it's - again, as public servants and people who want to protect the public, we want to be able to be there to make the intervention and save the day, and it just is so unbelievably frustrating. And to see the images of those young kids, you know, still fresh in my mind, I can only imagine what those, you know, what those SWAT guys in Connecticut, when they went in and saw that damage, you know, that's something that they'll absolutely never forget.

You know, we see a lot of damage to adults and significant gunshot wounds and things like that, and we've become a little bit, as police officers, desensitized. But seeing those wounds in children is something that you never forget.

CONAN: And what have you been doing since Columbine?

MATT: I have moved on. Now I now - I still work as a police officer. But we did have other officers that were SWAT officers that resigned from the team and that felt like they couldn't continue in that line of work. Certainly they went on to other parts of the division, patrol or detectives or the traffic team, but, you know, they felt like that it was so traumatic that they kind of projected their own kids into that kind of mental image that they couldn't continue on the team.

CONAN: Well, thanks very much for the call, Matt. Appreciate it.

MATT: Absolutely.

CONAN: Gregory Thomas, you were, I guess, in something of an analogous situation. You've been assistant commissioner of the New York City Fire Department and knew a lot of the people who responded to the World Trade towers as well. And I wonder then, the survivors of that, too late? They didn't do what - it was probably impossible - but the frustration that we just heard in that caller's voice, that must be something familiar.

THOMAS: Oh, it is. And, again, in that respect, most of the people that perished, you know, including the 300-plus firefighters, some of them I knew personally also. But the command staff, they were colleagues of mine on a regular basis. We met every morning at an executive staff meeting. So then, you know, to see the first deputy commissioner perish, who I reported to directly, and the other chiefs that were in the department perish, it was tough to deal with.

But, you know, again, to the caller's point, you just keep going, and you have to make sure that once it does calm down, to the extent that it does calm down, that you focus on your personal needs because, for me personally, in addition to me responding and colleagues being lost, my wife is a member of the NYPD, and she was involved in that response as well.

So what I learned from that is that we have to be careful that we don't ignore the healing that needs to be given to first responders. And I know there's a lot of opportunities out there to forget them, but they need not to be forgotten.

CONAN: And obviously police officers, SWAT teams are working to react faster so they don't suffer that frustration of being two or three minutes late. Obviously there are lessons learned also from the experiences at the World Trade Center. Yeah, get everybody to have the frequencies the same on their radios, but what about those emotional damage? Have there been lessons learned about that?

THOMAS: Yes, there have been. I think one of the lessons learned - and it's become more prevalent now in the field - is they use what they call psychological first aid, where you're basically honing in on the needs of particular people as opposed to a group of people, because in the past there were times when firefighters or people that were in the first responding (unintelligible) you know, brought together in a room and basically asked what they thought was going on in a group type think, and that has tended, over time, to become detrimental to healing.

So I think a lot of that was learned after 9/11 because at that point there were a lot more people that were suffering because of those who were either in the buildings, got out there late, or those who couldn't get there and watched their colleagues perish and felt guilty about that.

CONAN: Guilty not only because they couldn't help them, but because their friends and colleagues died. They didn't.

THOMAS: Yes.

CONAN: Survivor's guilt. Yeah. Let's see if we get - let me just reintroduce our guest. He's Gregory Thomas, CEO of the Alan Thomas Security Group and former executive director of school safety for the New York City schools; also, as you mentioned, former assistant commissioner of the New York City Police Department. You're listening to TALK OF THE NATION from NPR News.

And let's get Linda on the line, Linda calling us from Myrtle Beach in South Carolina. Excuse me.

LINDA: How are you today? Thank you so much for taking my call.

CONAN: Sure. Go ahead.

LINDA: I've been listening to all the callers, and I was involved in a very bad vehicular accident in 1974 when I was a young girl and watched the horrific thing unfold and was injured myself quite badly. And back then there wasn't really any help for things like that. I mean I went through something very traumatic, and I'm so glad to see the professionals coming down the side of the children to walk them through the fear.

Number one is to ease the fear. I had a fear of driving with anybody. I had a fear and survivor's guilt that, you know, nobody wanted to really talk about what happened to us. And so that made it a shadowy bad thing. And it wasn't until years later, when I was having nightmares and just going through a whole bunch of PTSD stuff, that I realized that I really needed some help and went for counseling, and then realized that it was OK.

And I imagine these little children and their families who are going to go through things at a different pace, and I'm so glad for them that the world has changed and that we're going to recognize that fear or recognize that need to be safe. And I think that's the first thing that we have to talk about, is that the children are going to be afraid. Any child going through anything like that, it leaves a fear that you don't get rid of.

And, you know, just because you don't talk about it or you say it's going to be OK, doesn't mean it goes away in their little hearts. And I think that the mind-body connection is important. You know, their little hearts are broken. My heart was broken, but nobody wanted to address that. They addressed my physical needs and need to get past it, is what they said.

But to really delve into what I was feeling about my, you know, surviving the accident, watching my friend go through the windshield, was never really addressed. And there is still sometimes a tendency for parents and people to not talk about it, and I hope that that doesn't happen, you know, as if not talking about it makes it go away or makes it better.

CONAN: No. It's always going to be the most vivid thing in your memory.

LINDA: Absolutely. Absolutely. I'm so glad to see so many people coming and lending their expertise to those families for all of the people that were affected in Aurora and in - where the mosque shooting was and other places. I mean it's just so important to deal with the fear and the right now.

CONAN: Linda...

LINDA: So I'm just so happy to see that happening.

CONAN: Thank you very much. Appreciate it.

LINDA: Thank you. Bye-bye.

CONAN: And let's see if we can get one more caller in. This is Alex, and Alex is on the line from Clarksville, Tennessee.

ALEX: Thanks for taking my call. So a lot of the comments your first guest made resonated with me a lot. I was a soldier who was deployed, and I think dealing with some of the domestic issues that we have over the years, like these school shootings, it's hard to process the information when you're here.

But I think as a part of the conversation, we should also keep in mind that the PTSD type of things that the doctor described are the same things that tens of thousands of soldiers have been dealing with for decades - or a decade now, with the conflicts we're in. And being an adult who had some type of preparation for the environment I was going to, I can't imagine what the children, who aren't as emotionally developed, are having to deal with.

And I also kind of want to thank that doctor for her service. You know, I thought about myself and the 12 months that I was there dealing with that environment. But when you think about an ER doctor who deals in that same type of environment for decades at a time, I'm sure it really takes your toll - its toll - and one of the questions you ask is, you know, how do you get past it and how do you deal with it.

I think once that bell is rung, it can't be unrung. And the way that I describe it for myself personally, try to compartmentalize things, and I recognize that it was 12 months that I'd be it(ph) a few years ago and when I'm a much older man it'll be the year that I did a while ago. I look at it as like - some of the issues surrounding it as a box of junk that you put in a hallway closet. I know what's in the box. I know where the box is. I don't - I personally don't dig through it very often, but not everyone handles it in the same way.

And honestly, today was probably the first out of the couple of days that this news story has been going that I've actually stopped to take time to listen to it a little bit. I've intentionally tried to avoid it. But I appreciate you guys doing the show, and thanks.

CONAN: Thanks, Alex, for the call. We appreciate that. And our thanks as well to Gregory Thomas, with us from our bureau in New York, the CEO of the Alan Thomas Security Group. Appreciate your time today, sir.

THOMAS: You're very welcome. Thank you for doing this.

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