‘Everyone thought we were going to die’: Life after flight trauma

By Carly Lewis / © 2024 The New York Times Company

In January, Shandy Brewer boarded an Alaska Airlines flight from Portland, Oregon, to Ontario, California, en route to her grandmother’s birthday celebration. She was seated in the 11th row, between her father and a stranger. Shortly after takeoff, Brewer and the other passengers heard a loud bang. She couldn’t see that 15 rows behind her one of the plane’s doors had blown off, exposing passengers to open air at 16,000 feet.

Oxygen masks dropped from the ceiling, and passengers began to pray. She thought they were going to crash. As the plane made an emergency landing in Oregon, Brewer hugged her father with one arm and the stranger with the other, wishing she could record a video to say goodbye to her mother.

Nearly 11 months on, the mental distress caused by less than 20 minutes of panic in the air is its own form of injury, said Brewer, now 30: “People say, ‘Nobody died on this flight’ — but we could have.” Brewer sees a therapist and practices breathing exercises, but she still has an occasional recurring nightmare about being on a helicopter without doors or a frame, clutching her seat to save herself from barreling into the sky. She’s also set off by loud noises. On the Fourth of July, the sound of fireworks made her feel “extreme panic,” and she had to hide indoors.

“There’s a cloud over me all the time reminding me that I could die at any second,” she said.

When people discuss fears of flying, they’re often reminded planes are quite safe. According to a 2022 analysis of commercial aviation safety conducted by the National Academies of Sciences, Engineering and Medicine, “There has been a significant and sustained reduction in airline accidents in the United States over the past two decades.” The analysis found flight safety had “improved more than forty-fold.”

But statistics matter little to a mind that can’t stop replaying an upsetting event, especially when startling emergencies continue to make the news. “A lot of people develop significant anxiety after these incidents,” said Rebecca B. Skolnick, a clinical psychologist and adjunct assistant clinical professor at the Icahn School of Medicine at Mount Sinai. “It becomes not just something that happened to them, but something that shapes the way they think about the world, and flying in particular.”

Brewer and more than 30 other passengers from the Alaska Airlines flight are suing the carrier and Boeing, the aircraft manufacturer, citing “severe stress, anxiety, trauma, physical pain, flashbacks and fear of flying and also objective physical manifestations such as sleeplessness, PTSD, hearing damage and other injuries.” According to the lawsuit, one of the plaintiffs wrote a text to their mother, believing, like Brewer, that the plane was crashing: “We’re in masks. I love you.”

‘I made it, but my life is affected’

In the past year, the air travel industry has come under scrutiny for numerous flight safety issues, such as planes veering off the runway, hydraulic leaks and tires falling off — all with passengers aboard. In May, one passenger died and 83 were injured when a Singapore Airlines flight hit severe turbulence, forcing an emergency landing. In July, on a flight from Spain to Uruguay, severe turbulence put 40 passengers in the hospital.

(Extreme turbulence requiring hospitalization is relatively rare; according to the Federal Aviation Administration, in 2023 there were 20 reported instances of serious turbulence injuries. But climate change research suggests turbulence will get worse because of increasing carbon dioxide levels in the atmosphere. One 2023 study published in the journal Geophysical Research Letters found that severe or greater clear-air turbulence increased by 55% between 1979 and 2020.)

In March, the engine of a plane traveling from Houston to Fort Myers, Florida, caught fire over the Gulf of Mexico. The plane landed safely, but Dorian Cerda, 28, a passenger who was seated near the window — close enough to feel the fire’s heat — said the experience stayed with him. On the flight, tensely awaiting an explosion that never came, he recorded a video for his wife and small children, telling them he loved them.

Now, Cerda says the incident is “always in my thought process” when considering travel, especially because he has a young family to provide for. He said he has become more of an overthinker, worried it will happen again. “I’ve been on five airplanes, and one of them caught on fire,” he said. “My odds are at 20%. I wouldn’t risk my life on a 20% shot. I made it, but my life is affected.”

Martin Seif, a clinical psychologist and specialist in the treatment of flying anxiety, said that many with plane-related fears suffer from anticipatory anxiety, meaning they’re afraid of something that may happen — or happen again — even if logic suggests it won’t. “There’s no difference between feeling anxious and feeling that you’re really in danger,” he said. “In the neurology of anxiety, there’s the whoosh of the amygdala getting fired, and then the thoughts or narratives that keep the anxiety going. When you’re in this altered state of consciousness, these thoughts feel very likely to happen.”

Skolnick added that avoiding air travel “maintains the fear, because that teaches the brain that it’s dangerous to fly.” For some, even packing luggage or browsing fares online can induce anxiety.

There is some research on how a traumatic flying experience can affect a person’s mental health — specifically on survivors of plane crashes. One 2016 study found that 47% of participants who had survived a plane crash were at risk for post-traumatic stress disorder and 35% were at risk for depression nine months later. A 2013 study found that 78% of the participants displayed emotional or affective symptoms, such as hypervigilance and difficulty sleeping, after surviving a crash.

But the harm inflicted on passengers who experienced in-flight emergencies — but did not actually crash — has not been as researched or recognized. After the engine on Cerda’s plane caught fire, the airline offered him a $15 meal voucher.

Neither the Federal Aviation Administration nor the National Transportation Safety Board has policies or recommendations regarding passenger mental health after emergencies. Mina Kaji, a public affairs specialist at the FAA, said the agency’s “number one priority is to advance the safety of the nation’s aviation system.” She added: “We are continuously proactive, consistent and deliberative in executing our responsibilities to the American public.”

‘We experience the same feelings as passengers’

Eileen Rodriguez has been a flight attendant for 38 years and is the critical incident stress management chairperson for Transport Workers Union Local 556, which represents thousands of Southwest Airlines flight attendants. If an emergency occurs on a flight, Rodriguez makes contact with the flight attendants within hours to determine how to help. “We experience horrific events,” she said. “It can take time off and a lot of support to work through that.”

Closer to the beginning of her career, Rodriguez worked at American Airlines. A turbulent flight caused her to sustain a head and back injury and a broken foot. After healing physically, she returned to work with one of the airline’s regional brands. Less than a year after the first incident, as the sole flight attendant on a small prop plane, she was involved in an emergency landing. She took six months off to attend therapy and deal with the fear of flying that had developed. She got back to work eventually, but it wasn’t a simple transition. “The anxiety was very high for me,” she said. “Any little jolt or sound or anything that was unfamiliar caused me to become scared.”

Rodriguez noted the kind of critical incident support offered by flight attendant unions today would have helped her back then. “We experience the same feelings as passengers,” she said.

Heather Healy, director of the employee assistance program for the Association of Flight Attendants union, said the general public may incorrectly believe flight attendants are immune to emotional trauma from flights. Over time, repeated events can worsen the impact of frightening experiences, just as they would for anyone else. “Instead of seeing each incident as something that builds your armor, view it instead as something that puts chinks in your armor,” she said.

While emergency workers, such as paramedics and police officers, are often offered alternative work environments where they can regain resiliency after traumatic incidents, Healy said, flight attendants don’t have that same recovery period protocol. “It’s get back on the plane or don’t.”

‘I wish I could say I’m much improved, but I’m not’

For some, the trauma endures for years, on planes and off. On a flight from Boston to Chicago in 2016, the aircraft that Emma Lazaroff was on went dark. The pilot, over the intercom, urgently told flight attendants to take their seats, and the plane started shaking and loudly rattling. It took what felt like a nosedive. “We were thrown against our seats,” Lazaroff said. “Luggage was all over the cabin. Everyone thought we were going to die.” After about five minutes of chaos, the plane seemed to ascend, and the black sky outside the windows revealed a sunset. The flight landed safely.

Lazaroff, now 32, doesn’t know what caused the incident — the pilot didn’t tell passengers, and the airline wouldn’t tell her — but it has caused severe and lasting repercussions. Shortly after the flight, she started experiencing panic attacks, flashbacks, nightmares and nausea, which persist to this day. This year, she was finally diagnosed with PTSD; Xanax helps her fly. “I’m much more irritable generally,” Lazaroff said. “I have a very exaggerated startle response — if someone puts a cup down, it’ll make me shriek.”

Jacob Morton, 35, said a 2016 flight from St. Louis to Los Angeles was “burned in my brain.” A few minutes after takeoff, he heard what sounded like an explosion. With a background in aerospace engineering and a previous job in aircraft design, he correctly guessed that the plane had hit a bird, which he knew was a benign occurrence that pilots are trained for. But when the engine stopped, and he smelled smoke, and the pilot instructed flight attendants to assume the brace position, everyone panicked — and so did he. “Ever since then, I just grip the seat and white-knuckle through every takeoff,” he said. He keeps an eye on speed and altitude, which provide comfort thanks to his knowledge of flight mechanics, but that’s all he can do. “I just grit my teeth and get through it,” he said.

Marna Gatlin, 61, has been flying since childhood. (Her grandfather was a pilot who survived a plane crash.) She said she soured on it in her 20s after two incidents — one extreme bout of turbulence and an issue with a plane’s hydraulics system that prompted the pilot to instruct passengers to assume a crash position. The flight landed “hard and fast,” she said, but safely.

The Sept. 11 terror attacks in 2001 further entrenched her fears. “That brought on a whole new psychological barrier of anxiety for me,” she said. “I stopped flying.” Not wanting her son to inherit her trauma, in 2008, Gatlin attended therapy sessions to be able to take her family to San Francisco. She was petrified, but made it.

Gatlin has tried plenty of treatments over the years, including hypnosis and a program for fearful flyers she couldn’t finish because it required boarding a short flight. She even consulted a psychic, who told her she experienced a crash in a previous life.

“I wish I could say I am much improved, but I’m not,” she said.

She now flies occasionally, but not comfortably, thanks to her own system: an Ativan before the airport and breathing exercises on the plane. She books the earliest flight possible, because there’s less turbulence in the morning, and spends the first day at her destination decompressing in the hotel.

“I’m emotionally wiped out,” she said. “And that is just the nature of the beast.”

This article originally appeared in The New York Times.