Mark S. Komrad MD
[Fall 1998; Vol.25 No. 2]
The start of a day doesn’t tell you much about how it is going to end. In late July I flew to Miami with my wife and nine-month-old son and boarded the Carnival cruise ship, “Ecstasy.” We had just pulled out of port, gone through the lifeboat drill, and returned to our cabin to relax before dinner. We lay in bed and thought of the relaxing week ahead at sea and points abroad, when I started to smell smoke. At first, I thought it was just the smell from the smokestack, but that seemed unlikely. I went to the door and looked into the hall to see billows of black smoke coming down the hallway. We grabbed our baby and ran up to the back of the ship where the smoke was even thicker, and there were huge licks of flame. Fearing that the entire ship may be afire, we ran towards the front of the ship to find the air there clearer. I called the bridge as soon as possible to report the fire, which we later learned started just beneath our cabin. People were pulled out of their cabins and we were all asked to assemble again for the lifeboats--this time it was not a drill!
Many of you probably had a better look on the live TV news at the mounting flames from the back of the huge ship than we had. We did see a huge amount of smoke, and many decks became too dangerously smoky to enter, as ventilation on a cruise ship is far worse than in buildings where windows can be opened. Our fears of a general panic and stampede were unrealized and the crowds remained calm but anxious. We stayed at the lifeboat station for a couple of hours, looking at the highly turbulent sea below, uncertain whether we would evacuate the ship into the lifeboats. Fortunately, we were only a few miles from port, so the Coast Guard was finally summoned to help with the fire that the crew alone could not control. We had nothing but the clothes on our backs and, thank God, our lives and health.
It took almost three hours to combat the blaze and the ship was towed back to port by tugboat over the next five hours. By the time we disembarked and were brought by Carnival to a hotel on Miami Beach it was 5:30 a.m. Our cabin, which had been in the thickest part of the fire, was quarantined during the official investigation for the next few days. We tried to continue our vacation in the Florida Keys, where we learned a week later that all of our possessions had been destroyed in the fire.
At the time of this incident, there were some moments of great anxiety, particularly in the first few minutes when it appeared that we might be trapped in a floating, flaming prison. Memories of the movie Titanic were certainly fanning the flames of my imagination, not just below deck in the smoke, but above deck amongst the crowd--uncertain about whether a general panic would result in a dangerous stampede. At the time, I certainly was not a detached psychiatrist, a “participant-observer.” However, in retrospect, I gleaned a few important lessons from this frightening experience that I have processed and integrated into my professional understanding.
First, as anybody who does psychotherapy would acknowledge, “knowledge is power.” This principle was proven quite true that day. Every 3 minutes, the cruise director gave the passengers assembled at the lifeboat stations an update as to the current situation. I believe that this was the single most instrumental factor in preventing panic. The status of the fire, the Coast Guard activity, the idea that evacuation wasn’t imminent but on “stand-by”, all produced a sense of an external-locus of control that the passengers (myself included) were able to internalize. Though anxious, nobody around us seemed over-the-top in panic.
Second, a “disaster” looks very different from the inside than from the outside. Media reports, helicopter news footage, and post-incident interviews from the press were loaded with distortions and exaggerations (e.g. the crew was in a panic, nobody spoke English, the passengers weren’t informed about what was going on, lifeboats were deployed, etc.). On arrival back in port, we were deluged by hundreds of reporters (at 3:00 am) who were extremely suggestive and provocative in their interviewing style. I felt that there was a strong likelihood that this kind of suggestive interviewing, in the context of an emotionally arousing circumstance was going to produce some “false memories” on the part of passengers being interviewed. Indeed, some of the interviews I heard on TV in the subsequent few days related the events differently than I personally remember them, and, unlike most passengers, I was at the site of the fire when it started. Another “inside” observation that impressed me was the rapid development of relatedness, solidarity, and helpfulness among people involved. There were passengers offering us extra diapers for our baby (we rushed from the room with no supplies), some had snacks for those who were hungry, passengers tried to entertain one another with singing, etc. to keep up each others’ spirits.
Third, I learned that families with babies have a special standing in our culture. We were given an extra measure of assistance from fellow passengers, crew, and cruise representatives back at port because of our infant child. This was a measure of kindness which we, new parents, hadn’t anticipated and were surprised at how compassionate people were towards those with young children in circumstances of hardship.
Fourth, there are some real silver linings in near-disaster. For us, thank goodness, this is a story to tell, rather than a tragedy to grieve. However, it reminded us how unpredictable life is and how quickly delight can turn to danger. This existential shake-up lead us to celebrate our lives and our relationship as a family, a feeling actually heightened by the loss of our material possessions.
As physicians and psychiatrists, we often deal with people who have experienced crisis, disaster, or near misses. Sometimes it is these experiences which drive patients to seek out psychiatric help. Sometimes, they occur to those whose lives we are already in the progress of treating. Hopefully we can help them see new perspectives and knowledge that emerges from their experience.
I have the Chinese ideogram for “crisis” on the wall in my office. It consists of two linked characters--one smaller that means “danger”, the other, larger, means “opportunity.” I find myself having penetrated that compelling Chinese insight in a way that helps dispel for me some of the irony now lingering around the name of the cruise ship, “Ecstasy.” These are insights that I can now more effectively share with patients in crisis. Since the cruise, I also find myself reminding them to change the batteries in their smoke alarms!
Dr. Komrad, a nationally known commentator on psychiatric issues, is a staff psychiatrist at Sheppard Pratt Hospital and is on the faculty at Johns Hopkins School of Medicine.