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Surviving Tragedy: The Various Paths Beyond

NEAL CONAN, HOST:

This is TALK OF THE NATION. I'm Neal Conan, in Washington. While funerals and memorial services continue for those killed by bombers in Boston and a fertilizer plant explosion in West, Texas, we want to talk today with survivors of traumatic events like those, from car accidents to hurricanes, and ask how you deal with the range of emotions and the range of questions - maybe newfound appreciation for life or survivor's guilt, maybe even blame.

It's harder - is it harder if the bolt from the blue affects only one or two people, or if a tornado wrecks an entire town? If you've survived a sudden, unexpected event, call, tell us about the aftermath. Our phone number is 800-989-8255. Email us: 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, NPR's Richard Knox joins us to discuss the latest on the bird flu. But first, life after surviving a sudden and unexpected traumatic event. Craig Potts is a five-time Boston Marathon runner. This year, he was approaching the finish line as the first bomb exploded and was hit by some debris. He joins us now from his office in Austin, Texas. Good to have you with us today.

CRAIG POTTS: Well, good to be here. Glad to hear you.

CONAN: And, first of all, how are you doing?

POTTS: Well, I'm doing OK. I'm kind of trying to recover from this upper respiratory infection that I had during the marathon, and I'm getting a little bit better every day. It's still kind of a blur. I'm still trying to process everything that happened that day.

CONAN: And I guess that's not so easy. It's going to take a while.

POTTS: Yeah, that's - from what I hear, it's going to take a while. And, you know, it sure seems to be the case.

CONAN: What - do the events keep running through your mind?

POTTS: Yeah, they do. It's - it's something that I can't - I've had a hard time completely getting it out of my mind. It's something that's kind of in the background all the time. I think it's getting the last day or so, but, you know, so many people are still asking about it, and I have questions about it every day. I just haven't really been able to put it to rest yet.

CONAN: And where were you when the bombs went off? Obviously, close enough to get hit by debris.

POTTS: Yeah, I was about somewhere between 50 and 75 feet to the right of the explosion. I was just about to cross the finish line when I saw the blast out of the corner of my eye. So I was in pretty close proximity.

CONAN: And if you were suffering from a respiratory infection, you were presumably a little slower than you might normally have been, and, well, all sorts of things - why were you exactly there at that moment?

POTTS: Yeah, that's really - there's a lot of irony in this whole situation, and I - normally, I would have finished the marathon about 45 minutes to an hour before I did. And I did pretty good up to the halfway point of the marathon. I was pretty much on pace to finish in about three hours and 30 minutes. But then I just - my throat started getting really bad.

I started coughing, and I just really struggled the last half of the marathon, which unfortunately, put me at the finish line at - when there was 4:09 on the clock, which was the time of the first explosion. So that was kind of ironic. And also, normally, in the other Bostons that I finished, I always crossed the finish line on the left side of the road, which was the side closest to the explosion.

And this day, for some reason, on Monday, I decided to cross the finish line on the right side of the road, when I turned onto Boylston Street, and I still have no idea why I decided to do that. It just seemed like the thing to do at the time. So there were a lot of coincidences that occurred that day that normally don't happen.

Of course, you never wake up in the morning expecting anything like that to happen.

CONAN: Sure. And, you know, then you get into questions of: Well, why them, not me?

POTTS: Yeah, exactly. I mean, and that's ran through my mind a million times. You know, there's just no rhyme or reason to it.

CONAN: Is there - as you think about it, a million things could have changed to make you either safer or put you at greater risk. You had control over many of them, but the fact is you didn't know it was going to happen.

POTTS: Yeah, absolutely, and because the fact that I didn't know what was coming, I really was at the mercy of just whatever occurred. And, you know, I would have done a million things differently if I'd known what was going to happen. Of course, I know a lot of other people would have, too.

CONAN: Sure. And as you look back on it, some people may say, you know, wow, for whatever reason, I made it through that day. Maybe - does this give you new purpose in life?

POTTS: Well, the one thing it did was it made me really realize what a gift life is. I mean, it really truly a gift, and we're truly blessed to be able to be here, and I think it should never really be taken for granted. And for me, now, I think every day is going to be special. I don't think there's any ordinary days.

CONAN: No ordinary days, and there's a certain new, I guess, vividness to everything that happens.

POTTS: Yeah, absolutely, you know, and I think that's going to be even more the case once I have a little bit more time to process all this.

CONAN: Well, we thank you for joining us today, and I know it's a trial to be asked about it over and over and over again. But does it help to tell your story?

POTTS: I think so. I mean, I think I've really been blessed because I've got a lot of really close friends that have taken a lot of interest and were very concerned. I had dozens and dozens of text messages waiting on me when I got back to my hotel room after the race. And obviously, a lot of people had seen it on the news, and they knew more about what was going on at that time, I think, than I did, because it took me a while to get back to my room.

So I greatly appreciate all my friends and all my loved ones and those that are close to me. They've made the whole process a lot easier.

CONAN: And it's a long time between now and then, but do you plan to be back in Boston next year?

POTTS: Oh, absolutely, absolutely. I've talked to some of my running buddies. We are ready to go. We're already qualified, and we're going to be there, and we can't wait. We're real anxious. The people of Boston are just absolutely incredible, and we love that area, we love that race, and we have nothing but respect for the people of Boston.

CONAN: Well Craig Potts, thanks very much for joining us, and good luck next year.

POTTS: Well, thank you very much. I enjoyed it.

CONAN: Craig Potts, a five-time runner in the Boston Marathon, joined us by phone from his office in Austin, Texas. Richard Tedeschi is a professor of clinical psychology at the University of North Carolina, Charlotte, where he specializes in the areas of trauma and personality change and growth, and he joins us now by Skype from his office in Charlotte. Nice to have you with us today.

RICHARD TEDESCHI: Thank you, Neal. It's really good to be here.

CONAN: And as you were listening to what we were just hearing from our guest Craig Potts, I assume those are the same questions that occur to a lot of people.

TEDESCHI: Well, they certainly are. And one of the things that Mr. Potts said that I'm particularly interested in is how these events can change people so that they have a different perspective on living.

CONAN: Well, for example, what kinds of stories have you heard?

TEDESCHI: Well, I've certainly heard stories from people going through all kinds of traumatic events, and there are certain things that seem to come up that people report as these changes. One is this kind of appreciation of life. You know, Mr. Potts said there's no ordinary day. So that's one perspective change that you sometimes see.

Another is how people treat others and how they handle their interpersonal relationships with more compassion, perhaps, and more closeness. Another is recognizing how strong they were to get through whatever it might have been. Sometimes you hear people talk about spiritual or existential sorts of changes. And people talk about sometimes changing the direction of their lives and seeing new opportunities in things.

CONAN: That this is a gift, and they shouldn't waste it.

TEDESCHI: Right. Exactly.

CONAN: We also hear a lot about survivor's guilt.

TEDESCHI: Well, you know, it's - it is hard, as Mr. Potts said, to figure out, you know, how these things happen to some people and not to others. You know, why did someone else suffer more than I did? And so that's - you know, that's a question that's just hard to find an answer to. I mean, sometimes you can look at specific circumstances and learn something about that - for example, what happened in a car wreck or on a battlefield. But ultimately, it's a hard question to ever come to a conclusion about.

CONAN: Do people come to different answers, depending on if it's a manmade event - a battlefield, for example - or a tornado, or something like that?

TEDESCHI: Well, when it's manmade event, sometimes it's easier to find someone responsible. So that can be different. In a natural disaster or something, there's no one ultimately responsible, except for perhaps some people can talk about Mother Nature or God. And yet when it's - you know, it's like this bombing at the marathon, there are obviously people responsible for this, and that, you know, throws a different light on things.

CONAN: We want to hear from those in the audience who have survived sudden traumatic events, and call and tell us what the aftermath is like: 800-989-8255. Email: talk@npr.org. David's on the line with us from Flagstaff, Arizona.

DAVID: Hello, Neal. How are you, sir?

CONAN: I'm good, thanks.

DAVID: I survived - my parents, actually, were killed in a commercial airline crash, back in 1987. And now here it is, 25 and a half years later, and it still affects me almost every day.

CONAN: Were you on that same flight?

DAVID: I was not. I was not. There was only one small child - she was, I think, 18 months old, 2 years old - that survived that crash.

CONAN: But obviously, you were a victim.

DAVID: Absolutely, absolutely, and I remember it just like yesterday. And whenever I, you know, see a show that has a plane crash, or a movie, it brings you right back to where you were the day that it happened.

CONAN: I wonder: Did you ever get in touch with that small child years later, after she grew up?

DAVID: She has kept fairly private, and we've respected her privacy. She did just give an interview for a documentary film that is being made about people who survive - lone individuals, sole survivors of plane crashes. But I haven't been in direct contact with her. But she does, you know, post on different forums, you know, that she's doing well and is happy and healthy.

CONAN: And is there a community of people like you, relatives of those who died? Do you keep together? Do you talk to each other? Do you support each other?

DAVID: There is. There is a foundation, a National Air Disaster Foundation that not only brings together families and survivors, but also lobbies Congress for improved safety, you know, regulations in the airline industry.

CONAN: All right, well, thanks very much for the call, David.

DAVID: Thank you.

CONAN: And I wonder, Richard Tedeschi, is it - you would think after all the experiences we've had of people telling us support groups are so important in many contexts - if there's a natural constituency, a natural support group, you would think that would be a benefit.

TEDESCHI: A benefit for people like David?

CONAN: Yes.

TEDESCHI: Well, the natural support group, of course, is who's already in your family and who are the friends around you. You know, Mr. Potts earlier was talking about how he found himself being supported a lot by the people he knows. So that's the natural support group, for a lot of people.

But not everybody is that fortunate. And then, of course, the other form of support comes from people who have experienced something like you have, and David was referring to that. So those are the two different kinds of support that people find - who are already close to them, and then people that they get to know because they've been through something together that they can identify with and...

CONAN: We're talking about surviving a sudden, unexpected event. If that's your story, call and tell us how you've dealt with the aftermath: 800-989-8255. Zap us an email: talk@npr.org. Stay with us. I'm Neal Conan. It's the TALK OF THE NATION, from NPR News.

(SOUNDBITE OF MUSIC)

CONAN: This is TALK OF THE NATION from NPR News. I'm Neal Conan. Boylston Street in Boston reopened early this morning, nine days after bombs blew up near the finish line of the Boston Marathon. It's one sign the city is starting to move on, though the investigation continues, and the people injured in the bombing - more than 250 according to the Boston Public Health Commission - are mostly on the mend.

But as their physical scars heal, the mental ones for the injured and also for witnesses and other survivors may take longer to deal with. If you've survived a sudden, unexpected event like the one in Boston or the fire and explosion in West, Texas, call and tell us your story. What's it been like after the event?

800-989-8255. Email us, talk@npr.org. You can also join the conversation on our website. That's at npr.org. Click on TALK OF THE NATION. Richard Tedeschi, professor of clinical psychology at the University of North Carolina, Charlotte, is our guest. And joining us now is George Bonanno, professor of clinical psychology at Columbia University, author of "The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After Loss." He joins us from a studio at Columbia University. Good of you to be with us today.

GEORGE BONANNO: Hello, thank you for inviting me.

CONAN: And I understand you conduct longitudinal studies on this topic. What have you learned about how people deal with surviving unexpected and traumatic events over time?

BONANNO: Well, we look at, in our research, lots and lots of different people. So we - and we try to look at a range of different kinds of events, and I think the dominant lesson is that there's a tremendous diversity in how people react to these events. There is not one typical type of response.

CONAN: Even people who are in the same event.

BONANNO: Even people in the same event, absolutely. In fact surprisingly, we see the same basic kind of prototypical outcome patterns across a range of events, even though we look at lots of different events. The most common pattern is that people basically are OK, despite how severe some of the things they've gone through might be.

CONAN: Basically OK. I mean, you would - to some degree right after a horrific incident like that terrible explosion in Texas or the bombings in Boston, you say nothing will ever be the same again.

BONANNO: Exactly. The reactions that we have are very intense, and pretty much everybody has a strong reaction to life-threatening events, but it can last anywhere from a few hours to a few days to a few weeks for many, many people, and then it gradually goes away. And most of that time, people are continually able to function.

For example, Mr. Potts, who you interviewed at the beginning of the show, he's been affected deeply by the event. He's still thinking about it; he's still wondering about it and perhaps ruminating about it, has images. But it sounded like he's functioning fine, and he's ready to go run another marathon next year.

That's a very typical pattern that we would see.

CONAN: And he says every day is individually vivid. It is not the nature of - it is not human nature for that to continue.

BONANNO: No, it's not, and it's extremely adaptive. It's one of the things I think that we're coming to in our research, that the intense stress reaction we have when something really nasty happens is extremely adaptive. It helps us cope in the future. There's a kind of a learning process that goes on. Replaying these events in our minds is probably for a pretty good reason in that we learn, we think about what happened, how it happened, why it unfolded, and that's a learning experience.

CONAN: And do you see any distinction between people who suffer their trauma as individuals, in other words a small event like a lightning strike, or people who have a lot of company?

BONANNO: Well, there's a lot of variability, even in that. An event like the Boston Marathon bombing has certain qualities of that that are likely to help people deal with it in the fact that it was widely shared by so many people. Only a relatively small group of people were affected personally, and lots of people shared the event.

And I don't mean, in any way, to minimize what anybody went through at all, but then you take something like a natural disaster, which lots and lots of people are also exposed to, but in this case there's damage. There's damage to the infrastructure, there's damage to the networks of support people have with other people. And that's in a way harder to get over, because there's less to rely on after an event like that.

CONAN: Let's get another caller in on the conversation. Again if you've gone through one of these dramatic, sudden events, call and tell us how you've changed afterwards, 800-989-8255. Email us, talk@npr.org. And let's go to Noelle(ph), and Noelle's with us from Lawrenceburg in Indiana.

NOELLE: Good afternoon.

CONAN: Hi, go ahead, please.

NOELLE: I was telling the gentleman on the phone that several years ago, my husband and I attended a dance, and there was a shooting there. And a woman and the two people that she was living with at the time were killed by her estranged husband. And the event itself was very traumatic. There was a lot of aftermath with the trial and news media, et cetera.

And you kind of get caught up in it at the time that it's happening. But overall it seemed like, you know, life just went on without any of the major changes that some of the people had mentioned.

I was called to jury duty about eight or nine years after the fact, and in the course of questioning for the jury, they asked had you ever served on a jury before. And at the point that he asked me that, I got very choked up and unable to answer his questions and got very emotional on the stand. And it was - you know, after it was all over, and I was driving home - they excused me from duty.

But it seems very odd to me that after so many years that I would have that kind of a very, very strong reaction.

CONAN: That's interesting. And yet you were surprised all those years ago, immediately after the event, how quickly things seemed to get back to normal.

NOELLE: It didn't - I mean, when you listen to some of the things that you've talked about so far, as far as spirituality or emotion or, you know, trauma, those kind of things didn't happen.

CONAN: Richard Tedeschi, let me ask you about that. The late echo that Noelle is talking about, is that something you observed?

TEDESCHI: On occasion yes. That's not, perhaps, the most common reaction that people have, but, you know, Noelle may never have had that reaction if she wasn't placed on the stand and had to reflect on this in this way. So people, to some degree, keep things, psychologically, in compartments. And the door to that compartment was opened up, and there was a lot more emotion there than she had realized before.

CONAN: Noelle, have you talked to somebody about this?

NOELLE: No, no I didn't.

CONAN: It might be a good idea.

NOELLE: It might be, at some point, to explore it. But, you know, I think you get to a point where sometimes going back over an incident like that almost seems selfish. I mean, it didn't happen to me, and it wasn't my family. So you almost feel guilty that you have any kind of - you know, it seems to me, kind of, like a bystander, you're not actually experiencing the event.

CONAN: It's interesting, so you weren't damaged enough to justify, you know, anything like treatment or anything like that. Of course, it happened to you, too. You were there, the shock was there, you saw your part of it.

NOELLE: You know, you start to see that when you hear other people's stories, but those kind of incidents don't - you know, unless it's a big event like we've experienced as a nation, lately, it seems like the overwhelming - the large events that the media puts out, you know, there are a lot of people - these kind of things happen all the time, unfortunately, and I - yeah.

CONAN: You're right about that. Well thank you very much for the call, appreciate it.

NOELLE: You, too, thank you.

CONAN: George Bonanno, as you were listening to Noelle's story, I was wondering, that's a reaction over a long period of time. Do you find other people like that?

BONANNO: I think it's actually quite a normative reaction, and I'd actually would like to suggest that she doesn't see anybody about the event.

CONAN: OK.

BONANNO: I think that it's quite normal. Memories are - memories do not go away. We keep all kinds of memories. You can pick up a toy in an antiques store and suddenly be flooded with a particular memory from your childhood. And, you know, that's really kind of the same phenomenon.

This - the experience that she went to, even though she got over it relatively quickly, it was still a disturbing experience and still a threatening experience, and it's stored somewhere in the neural patterns in her brain. And it was activated. I think that's really more or less what happened.

CONAN: Here's an email we have from Benjamin(ph): When I was 16, I was in a submerged vehicle accident. My life was largely unchanged. However, the older I get, the more I seem to relive the moment. By and large, I've gone s long periods of time without thinking of the incident until I had my own child.

Now I have panic attacks and moments of anxiety when I consider the fragility of her life. So I guess that's some degree of transference there. Let's see if we can go next to Steven, and Steven's on the line with us from Jackson, Wyoming.

STEVEN: Yeah, hi Neal.

CONAN: Hi.

STEVEN: I was in an avalanche several years ago, actually 15 years ago - just a couple of days ago. And I was climbing up, and an avalanche started above me and hit me, and literally carried me over 2,000 feet. And during the fall, I broke my back and I dislocated a knee, and tore ligaments in the other knee. And - but I was not buried. I ended up surviving the initial fall. I was alone, and I wouldn't be expected back.

So I had to sit with how to survive the night out, and that was not easy with no warm clothing and no shelter, sitting on the snow. So I got through that. And, you know, at the time, it was interesting, because I was just, you know, really focusing on what's the one next thing I can do to survive, trying not to get overwhelmed with the entire situation.

CONAN: Which would have been easy. I would think it would also be easy to start blaming yourself: you idiot, what were you doing out here in this position and this slope by yourself? Any number of things you could blame yourself for.

STEVEN: Definitely, that was a possibility, but I was trying to keep it positive because of what I had to deal with. And I knew that it was going to be quite a long, long cold night. And I ended up just sitting down on the snow and breathing really fast to get my blood flowing and circulating in my body. And I got through that night, and then was survived - excuse me, rescued the next day.

And I spent the next nine months in physical therapy and working hard to get back, because it was my intention, after about a week, to return to the mountain to try and complete what I was unable to do by making changes, you know, changing the mistakes that I made. You know, I went alone. I didn't check the forecast. I wasn't willing to turn around. You know, I had blinders on, essentially, and summit fever.

So I went back after getting through all these surgeries and physical therapy and ended up, after two more attempts, climbing the mountain and making the first descent to the face on a snowboard.

CONAN: Which mountain was it?

STEVEN: Mount Owen in Grand Teton National Park.

CONAN: And you're in Jackson. You see that mountain a lot.

STEVEN: Yes, yes. Pretty much every day, I see it. And, you know, it's interesting because kind of the opposite of what you mentioned earlier about beating myself up for being there, it's like I survived. I don't know why.

You know, I just had a friend die a month ago, and he was in an avalanche, and it was a lot less of a fall, you could say. It was half the distance, but he ended up not surviving and hitting a wall, where I shot over the cliff instead of smashing into it. And, you know, you miss him, but it's the risks we take to be in the mountains.

And one thing that I do now is I'm grateful every day for having survived, and I don't know why I did and others don't. Those are unanswerable questions. So what I do is I work as a keynote speaker, and I try and benefit others by sharing this story and letting them know how I got through this experience, you know, which was quite traumatic.

And I don't know why I was able to get through that when I have - you know, what if I have to do some really basic things like tidy the kitchen? That could seem overwhelming compared to this, but I think that's just day to day at work.

CONAN: Well, thank you for sharing it with us. It's a dramatic story and an instructive one. Appreciate it.

STEVEN: Thank you, Neal. Bye-bye.

CONAN: We're talking about surviving sudden and dramatic events. You're listening to TALK OF THE NATION, from NPR News.

And let me reintroduce our guests. Richard Tedeschi is a professor of psychology at the University of North Carolina, Charlotte. Also with us, George Bonanno, professor of clinical psychology at Columbia University.

Let's see if we can get one more caller in, and this is Donna. Donna's on the line with us from San Antonio.

DONNA: Hi. Yes. Good afternoon, everyone. And I'd like to send my condolence to the individuals who lost their families in Boston, and I wish everyone a speedy recovery for the injured. I'm an Iraqi veteran, and I can relate to some of the experiences in regards to anger, and also survivor's guilt.

I remember during my time period in Iraq, the convoy that I was on, we had got attacked. And the vehicle that I was driving, they shot it. They shot at my vehicle. Thank God we didn't get injured, the individuals in my vehicle. Myself and my other individual, we did not get injured.

But during that time period when we had to take action against the enemy forces, my thing - I did not experience fear. I experienced anger. My traumatic event turned to anger. It did not turn into fear, or anything like that. And then the other...

CONAN: Was that because you had somebody you could blame for it, those people right out there?

DONNA: Right, right. So - but - well, at that time period, they - it was a - we called it the unseen enemy, because you don't know who it is. It could be the person waving at you today, or it could be someone you talk today, and the next day, they're you enemy. So we have somebody, like you said, to blame, but you really don't know who's the individual that's...

CONAN: Yeah. You...

DONNA: ...doing the attack, unless you capture them.

CONAN: Yeah, yeah.

DONNA: And then...

CONAN: Go quickly. We just ran out of time here.

DONNA: And the other event that I experienced was one time they asked me to go on a convoy, and I decided at last minute I didn't want to go. And that convoy came under attack, and it got blown up. So I experienced survivor's guilt because I'm...

CONAN: Oh, I can understand that.

DONNA: Yeah. So the thing about it is that the difference is when these events happen to us as service members, we don't get to come home unless you're injured. So there's stuff that we still have to hold onto and deal with till we get home.

CONAN: And I don't mean to cut you up, but I wanted to give George Bonanno just a few seconds. Have you worked with veterans on issues like this?

BONANNO: We have done quite a few studies. Yes, with veterans.

CONAN: And is anger easier to deal within the kind of survivor guilt she's talking about?

BONANNO: I don't know if I can answer that, because it's not something that we tend to get into very much. And fighting wars is a very complicated business, and I think anger and a sense of the opposition is very much part of that experience. But one of the things, I think, is probably more important is actually flexibility, and that is that the situation changes constantly, particularly in a military context, and that there are times when the - when anger may be more appropriate, and there are times that other kinds of reactions may be more appropriate.

CONAN: Donna, thanks very much for your call. Hang in there, OK?

DONNA: Thank you.

CONAN: Appreciate it. And our thanks again to George Bonanno at Columbia University, and to - here's the piece of paper - Richard Tedeschi at the University of North Carolina, Charlotte. Thanks to you both. When we come back, we'll be talking about the flu. It's the TALK OF THE NATION, from NPR News. Transcript provided by NPR, Copyright NPR.