9/11—Plan before Bad News: Reflections on the Personal Catastrophes Some Patients Face Every Day

9/11—Plan before Bad News: Reflections on the Personal Catastrophes Some Patients Face Every Day

Richard T. Penson, MD, MRCP

Sep 11, 2013

We took off from Logan Airport four minutes before United Airlines Flight 175, the second plane to crash into the Twin Towers on 9/11. For us, September 11, 2001, started with all the heady mix of excitement and stress, a transatlantic Virgin flight, sympathetic hostess smiles, and four kids with new tartan blankets. All the kindnesses were in place.

We seemed to be traveling for too long when the captain made an unexpected announcement: “Some of you may have noticed that we’ve been circling Heathrow for a while now.” I hadn’t anticipated the detail to follow, but I had a sense that a serious issue was about to be addressed. “We have to divert to Cardiff. But, don’t worry, we’ll get you all to your destinations . . . and . . . and, I don’t quite know how to say this. It’s like a Tom Clancy novel. There has been an attack on New York City. Two passenger aircraft have been flown into the Twin Towers.”

We were all shocked, but only one person cried, a young United airhostess who flew out of Boston and who knew she would know some of the people on those flights.

Our first thoughts, like everyone who bore witness to the tragedy, was to reach for those we love, and to say exactly that. “I love you.”

A large part of the calm on that flight, after the bad news was broken, came from the pilot’s clear sense of control and the neat strategy of communicating the plan before the bad news. It drew a wry smile from me, as I thought about how some surgical colleagues would only deliver the plan and a euphemism and expect me to pick up the pieces. But we did have a plan, and we’d stick to it, all the way to safety.

That day, for us, was all threat, little fear, with no unavoidable devastation and inevitable horror. But there was a dark, somber, collective grief, and an edge of fearful uncertainty.

Later that month, in clinic, I pulled up new CT images on the screen. “I’m sorry, it’s not what we were hoping for.”

I almost said, “We have to divert to Cardiff.” I paused and mirrored her painful fear in the narrowing of my eyes. “We have to get a different plan: lots of options. I’m sorry the CT is worse.”

“I’m shocked, doctor. I thought I was doing so well.” Her gaze dropped, and she reached for her husband.

“It’ll be OK, dear,” he said. “Don’t worry, we’ll get through this; just a course correction. We’ll get a new plan.”

Inside I too cried, fully aware that on these journeys you can’t turn back time, sleep through the alarm, and miss the flight. You can’t pick a new flight; new number. You can’t disembark at a new destination. I knew exactly what this tragic flight plan held in store.

But, I could do more than just bear witness to the tragedy, hoping for the best and planning for the worst.

Leaning forward, I covered their hands with mine: “We will get through this . . . together.”

Her husband touched her tear. “I love you,” he said.



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