A View from the Cockpit: "We're Going to be in the Hudson!"

August 2022

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"We're going to be in the Hudson."

So reported Captain “Sully” Sullenberger to LaGuardia air traffic controllers shortly after take-off on a clear January day in 2009. You know the story well. US Airways flight 1549 became a glider after a bird strike that crippled both engines. The pilots chose the best option, amongst very poor ones that existed, to attempt a water landing in the Hudson.

The emergency management by the captain, first officer, cabin crew, and air traffic control resulted in the aircraft and passengers safely floating in the middle of the Hudson River. By any measure, this was a remarkable demonstration of skill, judgment, and training.

Less well known is how this event impacted the lives of those involved. Some passengers quite remarkably continued their flight plans to Charlotte that same day. The story was different for the pilots and crew. Captain Sully admitted afterwards that both he and First Officer Skiles "had PTSD for several months." Captain Sully did not return to flying for nearly half a year. Some flight crew members never returned. The air traffic controller in charge of the flight did not return to work for a month, and reported it took nearly a year to feel comfortable with his role in the event.

The contrast is striking between the duty requirements within aviation after a "Miracle on the Hudson" and the expectations that permeate our culture of medicine. While the aircraft was still floating in the Hudson, US Airways immediately implemented coordinated and supportive debriefing for all the flight team. The goal was to prepare them for the subsequent emotions and to optimize the recovery timeline. It was never a consideration for the pilots and flight crew to dry off and immediately work another flight.

A little over two years ago a viral storm appeared. This virus flew into economic, political, and healthcare engines worldwide with devastating results. These "pandemic years" have both unmasked existing healthcare pressure points and further placed relentless physical and emotional strain upon physicians, patients, and systems of patient care. Patients continue to suffer unanticipated emergencies and adverse outcomes during our care, sometimes forcing a clinical "landing in the Hudson."

We routinely press on through the stresses related to the daily "miracles" with which we have been and are often involved. Even after difficult life threatening clinical scenarios, frontline healthcare professionals are routinely expected to continue to care for patients, sometimes without time to reflect. Whether the pressure to continue is external or internal, physicians rarely take the time to care for the other patient involved, the one seen in the mirror each day.

Physician burnout, stress and fatigue are at an all-time high. The SCMA wants to raise awareness about the mental health needs of physicians and offer relief.

Your SCMA has requested $3 million in ARPA funding to provide free, confidential, and accessible mental health services for physicians and medical students to address the burnout, stress, and trauma of the pandemic. Hopefully, positive funding news will come this fall. In addition, the SCMA is working with the Physician’s Foundation and the AMA’s Practice Transformation Initiative to use interactive educational toolkits which will help physicians transform and improve their practices and diminish burnout.

Your SCMA is discussing with LLR and others to ensure that applications for licensure and employment do not stigmatize or penalize those who have received treatment for a mental health issue or burnout.

We are fortunate to have a strong partner in these efforts in our SCMA Alliance. Alliance President, Mrs. Elsbeth Chaney, has made these concerns a priority with her "Burnout, Reach Out" campaign. You will be hearing more about the Alliance efforts in the future. The SCMA is very grateful to her and the Alliance for their support and efforts on this issue.

Our profession of medicine places the patient at the center of our efforts. It is time to also prioritize our own physical and mental health. Your SCMA is exploring and working to implement strategies to enhance and sustain our own wellness in our personal and professional lives. As always, thank you for reading, and we need your voice and input. Please send your thoughts and feedback at scmayeakel@gmail.com.