The Shoreham Airshow crash: personal reflections of the immediate medical responders

THE EVENT

As medical professionals there is an expectation that we deal with the day-today content we see and hear in our working lives and move on. On this occasion our normal coping mechanisms for dealing with external events faltered and, although we continued with our daily duties, the impact of what we experienced took us by surprise. We write this as a reference for others who go through any similar incident to demonstrate what helped us to learn and grow from this experience.

On 22 August 2015 a vintage jet aircraft crashed, killing 11 people and injuring 16 others at the Shoreham Airshow.¹ The authors provided immediate medical care and both were involved in the rescue and care of the pilot and others.² Immediately post-incident, there was a time of quiet sharing and checking on each other’s wellbeing as the depth of what we had been through began to sink in. Physically, each was exhausted; the fumes from the scene remained in our throats and the full horror had yet to sink in. That evening, in our respective homes, the day’s events came to the fore and sleep was elusive with the events remaining stark and the mind wildly active.

Aches and pains along with feeling tremendously edgy and extremely tired dominated the next day. It was difficult to share what had been experienced as the horror of the scene was too gruesome to discuss. Although intimately involved, neither of the authors had a complete understanding of what had happened. The whole incident was complex and involved many different agencies and individuals. Our roles had been part of a larger effort that we were yet to fully understand.

THE AFTERMATH

The first week following the crash was overwhelming. For Tony there was ‘a sense of lethargy and living life with a sense of mild trepidation’; both found themselves hyper-vigilant. Karen’s sleep was disturbed by vivid dreams of the crash site and images of devastation, whereas Tony found that sleep, although slow to come, was deep but short. Both made themselves watch the video footage and look at the photographs so as to understand what had happened and to protect themselves from shutting off from the incident. Both were disassociated from those around them with periods of trepidation intruding on daily life.

Thereafter, daily life brought unexpected challenges. Tony recalls feeling panicked as he drove under the flight path at Heathrow as a plane came in to land. Karen, while out jogging, experienced similar anxieties on approaching a junction, the unconscious association with the junction at the crash site intruding into the reality of unrelated activity.

As the crash was replayed in the media, the graphic imagery and supposition was intrusive and disturbing. Yet, within the media mêlée the identification of the victims became an important focus. Knowing who was there, even though they had died, brought a sense of closure. Being among them while not knowing their names was so much worse than knowing who they were.

A significant cathartic moment for Karen was revisiting the crash site, sitting next to the ditch where the pilot was found, re-running the events in her mind, and piecing it all together.

MOVING FORWARD

As anticipated, life has slowly returned to normal; the scene and the sights could be brought from memory but these were consciously obtained and not as intrusive as they had been. Meeting together to debrief the events of the crash and its aftermath was hugely beneficial. As one would expect, our recollections were similar in many aspects, with some being stark to both.

The emotions became less raw although episodes of sudden unbidden emotional turmoil would return. These could not be foreseen and arose out of everyday situations: for Karen these include the smell of burning and seeing orange high-visibility clothing. This she associates with:

‘My self-critical brain chastising [me] for not reaching a road-worker who had forearm flash-burns ...’

during the initial triage of 50 walking-wounded. Although the episodes were short and quickly rationalised, one nevertheless becomes momentarily overwhelmed with a deep sense of grief.

As normality returned life remained somewhat lethargic with a more reserved than normal approach being apparent. The opportunity to talk over events with others who had been involved and piece together the bits and pieces, so as to start to understand the events of the day, were vital. Equally so was talking together and understanding the norms of the psychological responses we experienced, because there is very little to compare against in the way of reflective articles on the internet.

Facing our memories head-on was key, and will remain so for our ongoing recovery.