It was as the oxygen masks began dropping that Margaret McKinnon first thought, “I’m going to die.”
McKinnon was 26 and married only four days when she and her husband boarded Air Transat Flight 236 at Toronto’s Pearson airport in late August 2001 en route to Lisbon for their honeymoon.
About four hours into the transatlantic, overnight flight, after Chocolat, the Academy Award-nominated movie starring Johnny Depp and Juliette Binoche, was over and the flight attendants began clearing away breakfast, an announcement came over the loudspeaker telling people to prepare for an emergency ditch landing at sea.
With 293 passengers and an 11-member crew on board, the jet had experienced a massive fuel leak over the Atlantic Ocean.
The sickening feeling of certain death lasted a harrowing 25 minutes as the plane’s engines shut down. “They were announcing that the plane would be ditching into the ocean. There were countdowns to get into the brace position,” McKinnon recalls. People were screaming and praying; just as terrifying were the alternating moments of eerie silence. At one point, the entire plane went silent after losing power. McKinnon could see the rooftops of houses out the window. She was terrified the plane was going to crash into the houses before it veered back over the ocean.
Now, in an unprecedented study, McKinnon and her colleagues have probed the psychological impact of believing with absolute certainty you are going to die, only to be miraculously spared.
With both engines gone, the mammoth wide-body Airbus glided to an emergency landing at an airstrip in the Azores islands, about 1,500 kilometres west of Portugal. The plane bounced once and then slammed into the ground again. The impact blew out almost all of the tires after the loss of antilock brakes on the wheels. The landing tore up the runway and the landing gear caught fire. When a flight attendant couldn’t open a door passengers panicked and rushed towards a second door. People jumped down the emergency exit chutes and ran through a wet field of high grass as firefighters told them to run, fearing the burning plane would explode.
No one died.
Imagine your worst nightmare — that’s what it was like
Now, McKinnon has used the near-death experience for an unprecedented study into post-traumatic stress disorder, or PTSD. The study of 15 Air Transat passengers is being described as the first to involve detailed interviews and psychological testing of a group of people collectively threatened with imminent death in which the “moment-to-moment” sequence of events are known from official records and the firsthand experience of McKinnon herself.
Half the people in the study were diagnosed with PTSD.
The experience was career altering for McKinnon, now a psychologist in the mood disorders program at St. Joseph’s Healthcare in Hamilton, Ont., and associate co-chair of research in the department of psychiatry at McMaster University. She began the study when she was a post-doctoral fellow at Baycrest Health Sciences’ Rotman Research Institute interested in dementia and aging.
The terrifying Air Transat incident re-focused her attention on mental health, and the impact of such traumatic events on memory.
Flight 236 didn’t crash into the Atlantic. Capt. Robert Piche and co-pilot Derk DeJager glided the aircraft for thousands of metres without thrust or hydraulic power to a military-civilian runway on the Portuguese island of Terceira.
“Imagine your worst nightmare — that’s what it was like,” McKinnon said in a statement released with the study. “This wasn’t a close call where your life flashes before your eyes in a split second and then everything is okay.”
Of the passengers, six met criteria for PTSD.
All passengers were asked to provide a detailed account of three personal events: the AT disaster, their experience during the 9/11 terrorists attacks that happened only three weeks later and an “emotionally neutral” event from 2001.
“People were first asked, ‘tell me everything you can remember,’ and then specific questions about, ‘what were you thinking, what were you feeling, who were you sitting beside, what was the lighting like in the cabin’ to help guide them through the search for memory,” McKinnon said.
The researchers took those memories and classified them as either “episodic” or “non-episodic.”
“An episodic detail is something that you can re-experience,” McKinnon explained. “So if I asked you about your first kiss, you could probably go back in time and re-experience the thoughts, the feelings, what the room was like, how your body felt during that time.”
Non-episodic memories are more factual. “You might say I was in high school in Chatham at that time.”
An AT survivor might say, “I was attending graduate school at the time” of the near miss — a factual detail not related to the event itself. It could also include making repetitions or editorializing.
Not surprising to the researchers, regardless of whether or not someone developed PTSD, the AT passengers had a much stronger memory of the terrifying flight than they did for Sept. 11, “which was a highly emotional but not personal experience for them.”
But they also found that AT passengers who developed PTSD recalled a higher number of “non-episodic” or external details for all the events they were asked to remember, not just the threat of death on Flight 236.
That suggests that it’s not just the memory of the traumatic event itself that matters but rather “how” a person processes memories for events in general, McKinnon said.
People with that specific memory “signature” and who have trouble shutting out external details may be more vulnerable to developing PTSD.
The findings suggest “that it is not what happened but to whom it happened” that determines who develops PTSD, said senior author Dr. Brian Levine.
McKinnon developed symptoms of PTSD herself after the harrowing flight. She suffered nightmares and startled easily. “But I was very fortunate to receive treatment.”
With PTSD, “it’s important to intervene as soon as possible with as much care as we can offer.”