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fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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“I Fell Out of the Sky”

It had happened before; the previous time, it was a phone call on a Tuesday morning. This time, the message came by email on a Friday.

“Do you remember me?” wrote the sender.

“Do I remember you?” I wrote back. “I think of you often and fondly, although it has been over twenty-five years since we last spoke, and thirty-four years since we first met.”

Writing these words, I felt a wave of intense emotion: Our meeting, on January 25, 1990, has profoundly influenced me, both personally and professionally.

It was a drizzly evening that fateful Thursday. I was exercising on the NordicTrack when the phone rang. It was my brother.

“I heard that a plane crashed on Long Island,” he said. “Are you all okay?”

“We’re fine,” I replied. Resuming my exercising, I turned on the television news.

The news was dreadful: Avianca flight 052, a Boeing 707 from Bogota, Colombia, to New York City, had run out of fuel after a failed landing at JFK Airport and had crashed on Long Island’s North Shore.

Soon the phone rang again. Annoyed, I answered. It was the hospital: They’d declared an emergency and wanted me to come in.

I’m a child psychiatrist, I thought. What can I do for the crash victims? I won’t be handling their clinical care….

Without stopping to shower, I changed into my work clothes and told my family that I’d be back shortly.

At the hospital, I joined 200 other healthcare providers. The emergency room had been evacuated; the cafeteria was now a makeshift ER, and the hospital’s elective patients had been sent home to make room for an unknown number of survivors. Our anxiety grew as a helicopter arrived bearing the first of them.

As each patient’s stretcher was wheeled into the ER, it was surrounded by a nurse, a surgeon and a Spanish-speaking translator. The injured were sent for X-rays or directly to the operating room as needed. It went astonishingly smoothly.

As the first child came in, I went to translate and to provide emotional comfort. It was terrible to see the children frightened and in pain.

Several hours later, I visited the pediatric floor and saw the director of pediatric social work. Feeling overwhelmed by the trauma surrounding us, we decided to round together for mutual support. We imagined that many people had died in the crash, but no one knew how many. Photos were taken of each survivor, and a number assigned to each, paired with a description: “ten-year-old boy”; “three-year-old girl” and so on.

In the pediatric intensive-care unit, we visited an eight-year-old girl with serious injuries. She seemed to be asleep, but as we began to move away, she opened her eyes.

“¿Puedo hacer una pregunta, por favor? (May I ask a question, please?)” she asked.

“Sí,” I responded, feeling tears welling up.

“¿Voy a morir? (Am I going to die?)”

“No,” I replied.

With a look of relief that I’ll never forget, she asked, “¿Puedo dormir? (May I go to sleep?)”

“Yes,” I replied. Walking on, my colleague and I were in tears—what a lovely child; so sweet and graceful. We wondered whom she’d been traveling with, noting that she hadn’t asked her family’s whereabouts.

After visiting the surviving children, we met with the family members of the missing passengers. These families were advised by officials to go to the Nassau County morgue to ask for information about their loved ones—an unbearably painful statement to hear.

Before I knew it, I’d been at the hospital for twelve hours. I returned to the pediatric floor to check on the children again. Some were in surgery; others were asking questions. The eight-year-old girl (whose name was Andrea, I learned) asked none.

Writing this, thirty-four years later, I appreciate anew the profound impact that this evening’s events, and meeting Andrea, have had on me.

What followed over the subsequent days is hard to describe. I contacted a physician mentor in San Francisco, Lenore Terr, who suggested that I carefully write down my experiences—what I heard, what I said, how I felt. I am incredibly grateful for that wise guidance, which I followed to the utmost of my ability. For almost two and one half years after the crash, I continued to work with twenty-one of the children and their families, seeing them on a monthly basis.

Andrea’s injuries would keep her in the hospital for six weeks, and I met with her every day and kept careful notes of our visits. Her mother and brother had perished in the crash; her father had survived, but told me that he felt unable to go on. He feared that he might harm himself.

“I can offer you a hospital bed,” I told him sympathetically. “Remember, you have an eight-year-old daughter who needs you now more than ever.”

We hugged; we cried together; and he agreed to keep on for Andrea’s sake.

Soon after this, he told me, “I need to travel to Colombia to bury my wife and son.”

I nodded.

“Can you watch over my daughter while I’m away?” he asked. I agreed without hesitation.

During his weeks of absence, I visited Andrea three times daily: before work, after work and at midday. An index card with my name and phone numbers sat at her bedside.

As a father of two children, I could only imagine how drastically her world had changed. We developed a deep bond: When she saw me coming, she would call out “Fornari!” as if cheering at a football game.

Andrea’s injuries eventually healed, and she and her father returned home to Colombia. Nine years later, they visited New York, and we had a reunion. She was seventeen, a young woman. During our meeting, she shared her desire to become a child psychiatrist; she wanted to help and support children the way she felt that I’d helped and supported her.

In the following years, I thought of her often. And each January 25th, I reflected on my experiences with the survivors and their families.

The tenth anniversary of the tragedy was commemorated with a memorial service at the crash site and a church service in nearby Oyster Bay. Survivors thanked their rescuers; families mourned their lost loved ones. In 2010, the twentieth-anniversary services took place. A generation later, survivors once more thanked their rescuers, and families once again mourned their lost loved ones.

And now here was Andrea’s email, asking whether I remembered her.

How could I forget?

She wrote that she was now forty-two, married, and the mother of two daughters, ages three and seven.

I asked whether we could have a Zoom call, and, after thirty-four years, we saw each other once again.

Andrea’s face was now that of a mature woman—but I’d recognize it anywhere.

“I can’t believe I’m speaking with you!” she exclaimed, weeping.

“I often think of you and wonder how you’re doing,” I assured her. I held up the photos of her, taken in 1990 and 1999, that I keep in my desk drawer. Seeing them, she cried again.

“I think of you often,” she sobbed.

“Why contact me now?” I asked.

“As my daughter turns eight, I imagine what her life might be like without me,” she replied. “I thought of how I fell out of the sky, and how you caught me.”

We spoke for thirty minutes. I was left feeling humbled and grateful for the privilege of having worked with this child, and for hearing from her so many years later.

We often wonder what happens to our patients, and whether we’ve made a difference in their lives.

With Andrea, I know.

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Victor Fornari is vice-chair and director of the division of child and adolescent psychiatry at Zucker Hillside Hospital and a professor in the departments of psychiatry and pediatrics at Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, in Hempstead, NY. He has received numerous honors, including the 2016 Wilfred Hulse Award for outstanding contributions to the field of child and adolescent psychiatry. “I have long been interested in writing, both as a form of expression and as a teaching method. I encourage my students, residents and colleagues to write their reflections as a means of sharing their work and describing the emotional impact of their care.”

Comments

33 thoughts on ““I Fell Out of the Sky””

  1. What a beautiful story! Your care for this young girl is what any parent would hope for under circumstances like these. Bravo. As a retired pediatric hospice physician, I am familiar with the way in which certain patient and families burrow their way into our hearts….extending ourselves to others enriches our lives at least as much as it does theirs. Beautiful essay.

  2. Victor, This is a truly beautiful piece. In addition to the wonderful story-telling, it reflects what a warm caring professional you are. I am so proud to have known you way back when and only wish I knew of your professional skills when they were needed by my family members. See you in Rhinebeck and I’ll congratulate you in person!
    Robin (Silver) Newman

    1. Thank you, Robin. I appreciate your kind and generous words. I look forward to seeing you in the spring at the reunion.

  3. These are the stories that make me proud of my choice to be entering training under such esteemed faculty, yet such empathetic human beings. These are the stories that (I feel) are lacking in our education- the real stories, the real emotions of our faculty towards our patients, that reinforces and validates the importance of our natural human emotions towards our patients, that are possibly equally or more important to the therapeutic relationship and outcomes. Thank you Dr. Fornari for sharing this powerful story!

  4. How beautiful and wonderful to read this story. We are so proud of our cousin Victor, he is so kind, compassionate and wise. Victor was also instrumental in helping us cope with a loved one’s sudden descent into dementia several years ago. Victor, you are truly the best!

  5. Victor —
    This is a remarkable and moving account. Thank you so much for sharing it, and for being such a role model for reflection, compassion, courage and supererogation — enacting the highest ideals of our profession. As physicians living in what feel like unmoored and disheartening times, we need this kind of inspiration like we need air to breathe.
    –Michael

  6. Dr. Louis Verardo

    Thank you for this amazing story, Dr. Fornari. I was part of the medical staff called into Glen Cove Hospital that night to assist in whatever medical care was needed. We all did what was needed and necessary to manage the multiple fractures and other conditions sustained as a result of the crash. What you and your colleagues did was to manage the significant psychological trauma resulting from this event; your piece describes that process in great detail, and over such a prolonged period of time. Those patients whose lives you touched were truly fortunate to have you recognize the need for that kind of long term care. In my opinion, that is the essence of the professional impact we all hope to have in the lives of the patients we treat.

    1. Victor M Fornari

      …once you dry your tears, recognize that crying is an important part of being human. I cried together with those I cared for.

  7. A beautiful, moving, and uplifting story. Actually, you saved two lives, Andrea and her father, by giving him a reason to live in the midst of such tragedy. Thank you for writing this. I loved the detail that you still had photos of Andrea in your desk many years later, and that she had the courage to contact you. I’m sure in your career you have touched many lives for the better.

    1. Victor M Fornari

      Thank you for your generous and kind comments. Allowing ourselves to be vulnerable, for the benefit of others, can be so healing. In return, we reap the rewards.

    2. Victor M Fornari

      …we often wonder what impact our interactions have. Nonadherence is the rule. People often do not listen or heed our guidance. That is their privilege. Does anything we do make a difference? We often wonder. We do our best.

  8. Deeply beautiful story of deep love for a little girl who needed you so very much and who survived because of you.. thank you for sharing this story.

    1. Victor M Fornari

      …This child survived and flourished due to the profound love and teaching her mother had bestowed upon her for the first eight years of her life. She later shared that her mother had prepared her by giving her a profoundly deep faith in G-d. Her faither allowed her to survive and now flourish.

  9. Victor,
    I don’t know if you remember me. I was a classmate of yours from high school. I am overwhelmed by your story on multiple levels. Professionally, you described Andrea’s plight with such sensitivity that my heart was instantly embedded in her life. You must be very proud of the support and care you provided for her. In today’s world, humanity appears to be taking a back seat to the efficiency demanded by corporate entities. Your dedication to your profession speaks volumes of who you are. On behalf of patients everywhere, thank you for caring –
    I look forward to seeing you at the reunion,
    Dr. Randy Todd

    1. Victor M Fornari

      Randy, Randy- Like Andrea, you question my long-term memory. We may not be young; however, we are not demented yet! Whether thirty-five years or more than fifty years, memories endure. Thank you for your kind and generous remarks. Indeed, looking forward to seeing you in Rhinebeck! Victor

  10. Victor, you’ve told me this story before, but now – seeing it in writing – I am deeply moved and have learned more than I expected. The power of writing carries so much, and so subtly different from verbal story-telling. The choices you made – what to include, what to leave out – are wonderful. In particular, I am grateful you tell us that you asked Andrea: “Why contact me now?” The master psychiatrist is teaching us all an important lesson. Deep thanks, my friend.

    1. Victor M Fornari

      Don- The power of the written word differs from the spoken one. Each conveys impact in unique ways. A well-placed spoken word can be healing and transformative. The written word allows us to read, re-read and reflect without relying solely on what we recall we heard. Why now? Such powerful two words: at a time in society when we need to be so mindful of these two words. A warm hug, my friend. Regards to your “much better half!” Victor

    1. Victor M Fornari

      …when I tell the story during a Grand Rounds, I bring several boxes of Kleenex, and begin with the disclaimer: “The material you are about to hear may be triggering.”

  11. Henry Schneiderman

    This is a great story of love and professional skill helping daughter and father and clinicians in the face of unspeakable tragedy. And it does remind us that light can be shined even in deep darkness—something all too relevant with the horrors in the world today; and a counterforce to the depression and sense of impotency that so pervades the souls of so many, healthcare workers included, as a result. Tikkun olam at work. Thank you, Doctor!

    1. Victor M Fornari

      Indeed, on that fateful night, the News-12 Camera crew were driving in the vicinity of the crash. Immediately, they used their lights to rescue survivors! Reporters instantly shifted to rescuers- demonstrating the best of humanity. The rescuers deserve our sincere gratitude.

  12. Thank you for sharing your story. It struck me that you and up your social worker colleague had the willingness to acknowledge your own vulnerability. How brave! I can feel the quiet strength you gave Andrea and her dad. It’s no wonder she maintains such warm feelings and continued ties with you.

    1. Victor M Fornari

      …and the powerful lesson learned is that when the work is emotionally intense, working in trusted pairs can be very powerful and important.

  13. This is so deep, and you (and Andrea) drew me in. Tears.
    How meaningful!
    Many blessings upon you.
    And others who learn and do this invaluable work. Children can so blossom and produce new fruit. Healthy fruit, with the right support…

    1. Victor M Fornari

      …and children around the globe, including right here in New York, need our ongoing support and understanding

  14. We’ve witnessed escalated terror and tragedy in our world.
    Your story is a big one, Victor.
    It touches on the many similar experiences of children and health workers in places of war and other violence. And is uniquely the story of you and Andrea.
    I love your eye for detail — that you hadn’t showered before going to work, that your number was on a card beside Andrea’s bed.
    Thank you for sharing it.
    You must write books.

    1. Victor M Fornari

      thank you, Janielle. Recounting the story requires the details to convey the fullness of the moment. (I have written several and hope to write more.)

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