University Times

Within minutes of the first reports of last Thursday's crash of USAir Flight 427 in Hopewell, University of Pittsburgh Medical Center (UPMC) faculty, staff and students began mobilizing to help comfort the living and identify the dead.

Presbyterian-University Hospital emergency staff stood ready to begin treating an expected 60-70 injured survivors, only to learn soon after the crash that all 132 passengers had been killed.

The dead included 13 Pitt alumni, two students and two other people affiliated with the University, according to the Office of Public Affairs. The names of those 17 victims appear on page 2 of this issue of the University Times.

Since Thursday night, Pitt psychiatrists, psychologists, radiologists, pathologists, social workers, dentists and other professionals and students — many of them volunteers, and most of them working unusually demanding shifts — have been at the crash sight, at Greater Pittsburgh International Airport, and at schools, hotels and other places where relatives and friends of victims are to be found.

A comprehensive list of Pitt personnel and students who have helped in the crash's aftermath is impossible to compile — partly because no one knows how many have served through disaster relief agencies such as the Salvation Army, and partly because some of the help isn't easily recognized as being crash-related.

Mary Margaret Kerr, director of school and community outreach for Western Psychiatric Institute and Clinic (WPIC), cited this example of unsung heroism: Weeks ago, staff from WPIC's Services for Teens at Risk (STAR) program had scheduled a training session at the Pitt Club for Sept. 9, the day after the crash. They had planned to discuss techniques of "postvention," or helping people to cope with tragedies. Knowing they would now be getting plenty of real-life experience in such counseling, the staff went ahead and met at the club with the idea that they would assign teams of counselors from there to travel throughout Allegheny County as needed.

To the STAR staff's surprise, Pitt Club personnel encouraged them to set up a dispatching center in club offices, provided telephones, and prepared box lunches in place of the scheduled sit-down meal. "For some of us, that was the only food we saw for the next 24 hours," Kerr said. "That kind of nurturance for people who are going out into very stressful work situations often goes unrecognized because people tend to focus on the relief workers, but what the Pitt Club people did for us also deserves recognition." Kerr said that some 20 STAR professionals have been working at various locations, including the airport and several public schools, to console victims' surviving family members and friends as well as distraught USAir employees.

Kerr said she began one day with a 7:30 a.m. visit to a public school and ended the day with an evening counseling session with the Upper St. Clair hockey team, whose members were mourning a teammate killed in the crash.

"Our task is to try to offer the survivors different ways to express their feelings," Kerr said. "Some of those ways are talking and listening. For younger children, who don't have the words for something like this, it may involve drawing or playing or using puppets to express themselves." Often, she said, parents and teachers ask STAR staff what to tell a child whose parent was killed in the crash. "More than telling them anything, we've found it's better to listen for what it is they need to say and ask," Kerr said. "With the children, the questions are often things like, When is daddy coming back? With older survivors, the questions can be highly technical and related to the crash itself, or they can be comments about life after death. There's really a wide range, and it's been our experience that both adults and children are most comforted when they can take the lead." Kerr advised Pitt employees and students who feel untouched by the disaster to be patient with others on campus. "People who you're working with may have known someone on the flight, but they're not talking about it," she said. "The secretary who's typing your course syllabus may have lost a friend in that accident or may have stayed up all night with a child who's having nightmares." Nightmares about Flight 427 haven't been limited to children. Workers at the crash site have suffered a wide range of emotional and physical trauma, said Ed Marasco, clinical administrator of UPMC's Critical Incident Stress Debriefing (CISD) program.

UPMC provides much of the leadership as well as financial and educational support for the county-wide CISD program, which is aimed at helping relief workers cope with the extreme stresses of their jobs.

An average of seven UPMC "debriefers" have been at the crash site around the clock since last Thursday, Marasco said. Euphemistic media accounts of body parts hanging from trees didn't begin to prepare workers for the site's grim reality, he noted. "It's just total, almost unbelievable devastation," he said, noting that some Vietnam veterans volunteering at the site told him the Flight 427 carnage was more horrific than anything they had ever seen. "At the most basic level, we're looking for signs of fatigue in the relief workers," said Marasco. "They're wearing suits designed to keep them from being exposed to potential biohazards, and those suits get pretty hot. The terrain itself is rough. One of the things the CISD team does is encourage the rescue workers to make sure they get enough rest and enough to eat and drink. Frequently, people get focused on getting the job done and they forget to take care of their basic needs." (UPMC's Airport Health Center provided rescue workers with inoculations for hepatitis B, HIV screenings and blood testing for baseline immune levels.) As for emotional needs, CISD staff talk with the workers before and after their shifts, trying to prepare them for the stresses they'll be encountering and listening as they recount their experiences. When debriefers see signs that particular relief workers aren't coping well (vomiting is one unsubtle sign; vacant facial expressions are another), they recommend that those workers be reassigned to less grisly jobs.

CISD encouraged the decision last Friday to reduce relief workers' shifts from six or eight hours to four, Marasco said.

"What makes this (recovery) effort so hard for the relief workers is that there were no survivors," he pointed out. "The first firefighters and police who went out to the scene did so with the full expectation they were going to have the opportunity to do some good in a bad situation — only to realize very quickly that nobody survived the crash. That's very demoralizing for the rescue crews." Marasco recalled a recent airplane crash that only one little girl survived. "Even though she was the only survivor, she was a ray of hope for the emergency workers. With this crash, there's nothing." Because most victims were severely burned, dental remains are essential in making identifications. Since Thursday, more than a dozen faculty from Pitt's School of Dental Medicine plus another dozen dental school alumni have been volunteering at the crash site, said the school's dean, Jon Suzuki.

The professionals have been performing complex forensic work while student volunteers have helped with administrative duties such as record-keeping and X-raying of remains, Suzuki said. "When we announced that volunteers were needed, we were expecting five or 10 or maybe 15 students to respond. But nearly 200 volunteered. Of those, we selected 65 to 70 of the seniors and juniors who were the most advanced clinically." The dentists' work has been "extremely challenging," the dean said, "primarily because we are finding almost no complete jaw units. However, we are making great progress on the remains that are available." In addition to collecting and identifying remains, the dental faculty and students have been tracking down victims' dental records. "Sometimes," Suzuki said, "it's as simple as families and family dentists offering to mail or deliver records to us. But other times, it's actual searching for records. For example, we had a guest lecturer from Germany who was flying in to speak at the medical center. In that case, we had to get the dental records from Germany."

— Bruce Steele