They, Too, Are Victims

They are the emergency workers who, in this case, faced the gruesome task of clearing the debris and human carnage from the site of the Cerritos air disaster in August. And with the job came the stress: Some were left with nightmares, some couldn’t sleep, some lost their appetites, some had bouts of nausea. These problems, though rarely permanently disabling, are serious enough that they have produced a team of mental health specialists--a team whose challenge is to help the workers deal with their feelings.

There’s the county Fire Department chief who remembers the Mary Jane shoes that were still buckled to a little girl’s feet.

The Red Cross volunteer who went home the evening of the crash and scurried out the front door again when she realized her house was under the flight path of the big jets.

And the firefighter who woke up one night a few weeks ago after a horrible dream about a backyard barbecue.

They, too, are victims--at least temporarily--of the Aug. 31 crash of an Aeromexico DC-9 and a small private plane that killed 67 people on the planes and 15 on the ground in a quiet Cerritos neighborhood.

One More Than Enough

They are emergency workers whose job it is, day in and day out, to deal with smaller-scale disasters. With luck, there will be only one Cerritos in their careers. But one can be more than enough.

Similar disasters in recent years--plane crashes in San Diego, New Orleans and Dallas--have shown that police officers, firefighters, coroner’s staff and paramedics who have to deal with the gruesome aftermath face considerable psychological stress.

Even the most hardened, the most macho fireman or officer can have problems--dreams, nightmares, loss of sleep or appetite, according to psychologists and other mental health specialists .

Usually these problems are not permanently disabling, but they are serious enough that they have produced a new speciality for psychologists and psychiatrists called Critical Incident Crisis Debriefing, which was put into practice hours after the Cerritos disaster.

A team of Los Angeles County mental health specialists were pressed into service to help emergency personnel. They conducted hours of interviews and counseling sessions with 200 people, and have concluded that there have been no serious psychological problems--at least, not yet.

Psychologists talked with coroner’s staffers who had the painful task of collecting and identifying body parts; sheriff’s deputies who stood guard over burned-out houses; county firefighters and paramedics who put out the fire but found no survivors; Red Cross workers who tried to help Cerritos residents who had lost their homes but had been away at the time of the disaster, and private ambulance crews who raced to the scene only to find there was practically no one to rush to nearby hospitals.

Talk About Feelings

Marianne L. McManus, a psychologist who works as a consultant to the coroner’s office, explained that she and other mental health specialists started, that very first night, to help workers “get in touch with their own feelings--the sights, the sounds, what they thought about.”

She said last week that reactions were somewhat varied, but similar to those of emergency workers involved in past disasters.

“People would say, ‘My God, you can go so quickly,’ and wonder what it would be like to be strapped into a passenger seat of a plane and know you’re going to die in 10 seconds, or say ‘I saw a body of a little child and it reminded me of my kids and how much I’d hate to lose them.’ ”

There were physical reactions too, McManus said.

“There have been complaints of sleeplessness, nightmares, flashbacks to Vietnam for those who were there--some minor, some more intense. There were cases of repeated nausea for the first week after Cerritos, some people couldn’t even look at hamburgers being barbecued or eat barbecued chicken.

“When you’ve picked up hundreds of pieces of human beings, it’s natural to lose sleep, suffer from diarrhea and muscle cramps . . . lose interest in sex temporarily.”

McManus said she and other mental health specialists warned workers against the temptation to use “alcohol and pills to cut the pain or cut the memories, or to wind down.”

Instead, the psychologist urged workers to accept that all this adds up “to a normal reaction” and “to permit themselves moments of happiness.”

“A lot of people wouldn’t smile, or go out to dinner with their families, or enjoy a magazine article or a television show. We stressed the need to know about relaxation exercises, to turn your mind to something else when you get home, to use humor, even gallows humor, which is not meant to show disrespect for the dead, but is a very healthy thing that reduces stress.”

Toughened to Death

Stress was particularly a problem for coroner’s investigators, pathologists and autopsy technicians who, for several weeks after the disaster, worked long hours to identify the victims, she said.

Coroner’s staffers are toughened to death by the very nature of their jobs, but the Cerritos experience was more intense, McManus said.

“It was unusual in that they had so many body parts to deal with--it gets to all your senses, your eyes, your nose. And though they are used to long hours, they’re not accustomed to two weeks of 14- or 16-hour days in order to help grieving families who needed the identifications for insurance and burials.”

Jerry Gold, a psychologist who worked with sheriff’s deputies, reported law enforcement officers “handled it (Cerritos) well and nobody had any major problems.”

Gold attributed that to the deputies’ tendency “to be supportive of each other” in times of crisis and to their experience in dealing with smaller-scale tragedies.

“Deputies run into all sorts of traumas. The same kinds of reaction can result from a single death, a baby dying, or the loss of several lives in a tragic car accident. Peace officers deal with tragedy all the time and are perhaps more able to handle it than most.”

Marguarite Jordan, the county Fire Department’s health programs coordinator, said the firefighters who had to deal with the plane crash are, today, “by and large, mentally healthy. They’re coping with it very well. There’s been no adverse reaction that we’re aware of.”

Memories Have Lingered

But some emergency workers say the memories have lingered.

Samantha Ridout, a Red Cross administrator, encouraged her volunteers to attend a county-sponsored debriefing session after she realized that “three or four days after the crash, I was thinking too much of things I had seen.”

“The first night I went home I walked into my house in Hacienda Heights and immediately walked out again when I heard a plane fly right overhead and realized we were under the flight path to the airport. I felt for the first time my home wasn’t really secure,” Ridout said.

“My reaction to my family--my husband and children--was I’d better not go to sleep angry, I’d better not go to work angry, because I might not ever see them again. I give my kids an extra kiss at night, an extra hug; I realize how very fortunate we are to be alive.”

Ridout said the county mental health specialists helped her see that her reaction was “totally normal, as long as it diminishes with time, and that talking about it is normal and that it will diminish.”

Cindy Nix, a supervisor with AME Inc., a Whittier-based private firm that sent nine ambulances to the crash scene, worried about the impact of Cerritos on the young crew members, whose average age is 21.

“As we drove to the scene, our Adrenalin was flowing, we were thinking of setting up a priority system (to transport the worst injured first), but when we got there, there wasn’t much we could do. . . .

“The first thing our first crew on scene saw was a baby who had been killed. We had to cover up bodies and body parts. We hadn’t seen anything on this scale of destruction before. We were devastated.”

Nix said it was obvious the next day that the ambulance crews had been deeply affected. “Our people weren’t talking about what they had seen and what they had gone through.”

Debriefing Session

She asked the county mental health specialists for help and a group debriefing session was quickly arranged. “We were encouraged to talk about whatever we were thinking and we got it off our chests--the things we had bottled inside for a day.”

County Fire Department officials made a concerted effort within hours of the collision to minimize the emotional effects on their firefighters.

The fire was put out quickly and by evening only about 15 firefighters were left at the scene in case of a flare-up, officials said. Even earlier, the first wave of engine crews was replaced by a second. The first group of firefighters was physically tired, Division Assistant Chief Morris Gregory said, but officials were also worried about “the emotional part of the situation.”

“By bringing some fresh crews in in relief, we increased the number of people who were going to see it (the carnage) but we thought that was a worthwhile risk to take.”

In other words, fire officials decided to spread the emotional risk around, said Gregory, “because though our people are trained how to handle the technical part of plane crashes, I don’t know of any training to prepare them for the mental impact of what they’re going to see.”

All firefighters were run through a series of debriefings and were told how they could telephone to obtain free, private psychological care without the knowledge of their superiors. The telephone service was emphasised because Gregory and other department administrators “feared that there might be some machoism involved. A man may not want to admit in front of his peers that he is really upset about this thing; you don’t want to be the one who appears to be weak.”

Battalion Chief Matt Kearns, Gregory’s second-in-command at the crash scene, has a theory about why firefighters have handled the stress. Kearns thinks the Cerritos disaster was not as emotionally difficult for firefighters as it could have been.

No Survivors

“We had a situation that was overwhelming in its magnitude, but not in terms of emotional trauma to the firefighters. I think we would have been in a worse . . . state if we had arrived on the scene and found few deaths and a substantial number of injured survivors. There was no eye-to-eye contact with survivors.”

Kearns’ men tend to agree with him.

“If we had survivors screaming and yelling and moaning, it would have been worse,” said firefighter-paramedic Greg Hill. “That’s the kind of thing that sticks in your mind. It’s when you later start to hear the voices, then you think there’s something wrong with you.”

But in Cerritos there was only what another firefighter-paramedic, Eric Minlschmidt, called “bits and pieces, burnt gray, not recognizable.”

Firefighters like Hill and Minlschmidt said they have been, in effect, hardened to the Cerritos disaster by experience.

And yet some of the frustration and memories linger.

“We (the Fire Department paramedics) expected to find people who needed (medical) help, but we didn’t,” said Minlschmidt. “So I started to help fight the fires. When the smoke cleared, I was really surprised that there wasn’t anybody to help. I kept asking, ‘Did anybody make it? Was there anybody still alive anywhere?’ ”

“I did pull out the body of one child from the rubble, mostly intact,” said Minlschmidt softly, “but it’s part of my job.”