Terrorism In Nice

It is hard for me to digest the events of July 14 in Nice, France, as I feel especially close to them.

I was present at seven such annual patriotic ceremonies during my tenure as a student of medicine in a French government facility.  I loved the street-fair atmosphere, where I sang at the top of my lungs and danced with a whole heart.

As a medical student in government service, a terrorist attack would have mobilized me into service of France, a nation I can only love, which gave me a medical education essentially free of charge, asking only for me to prove on an exam that I had what it takes.

I wear a tiny Eiffel Tower around my neck — I stroke it as I write.

Our country has also known terrorism on our soil.  I was on an inpatient unit when a downtown hospital building shook from a blast that was several miles away at the time of the Oklahoma City bombing.  That evening I took to the radio — the local NBC affiliate where I had a weekly call-in show — to offer what comfort I could to a shaken and anxious city.

Terrorism works by instilling a devastating sense of fear and insecurity.  We have had all too much experience with it on our own shores, between Oklahoma City and the Twin Towers of New York.  But people from other countries have studied it, too, so academic psychiatric studies exist.  An American government agency has actually done a fairly good review of the literature.

We surely see an increase in many psychiatric illnesses defined in our Diagnostic and Statistical Manual.  Things like Post Traumatic Stress Disorder (PTSD), major depression, panic disorder, other anxiety disorders and the like.

Some people will react by having trouble sleeping, or mild anxiety, or changing behaviors, such as travel plans.

Some people will simply increase behaviors such as tobacco use or alcohol use.

The toughest people to protect from emotional reactions are the children.

I will never forget a telephone call from a teary mother at the radio station in Oklahoma City after the bombing.

Like many of the questions I deal with, there is no easy answer.  Children need a sense of security to have their brains develop normally.  The best thing to do is, with a seemingly unexplainable event, to insist on what is stable and unchanged.  “Your parents and your family will be there, loving you and caring for you.”

One thing is certain here — large amounts of people, the directly involved but also the indirectly involved, will be affected.

Authorities can acknowledge and address the events in ways that help people deal with things. Unfortunately, government authorities are not immune to intense emotionality.  My review of French language French political sites suggests they may be splintered among left and right factions as much as American politics seems splintered between conservatives and liberals and how either side feels we should handle things.

Curiously enough, the best way I can think of to deal emotionally with this sort of thing does not come from the field of psychiatry at all.

It comes from fiction writing, which often can approach human truths that are otherwise indescribable.

The “Flitcraft Phenomenon” is described by Sam Spade in the Maltese Falcon.

A person narrowly escapes being struck with a falling piano from a window while walking down the street.

Of course he is shocked and scared.  He abandons his wife and children, leaves his job.  Nobody knows where he went, so the wife hires Spade to find him.

Flitcraft learned that the world can be random, that a piano can fall on you without any cause or notice. He immediately assessed his life and his answer was to flee, move to another state and start over to live his life in such a risky, random world (this was in the 1920s and it was easier to do so under an assumed name).

But no more pianos fell from the sky and he eventually married again and had children with his new family.  Sam Spade found him, and Flitcraft said he was happy and didn’t want to return to the old life, so the detective told the wife that Flitcraft couldn’t be found.

To me, the take-home message is that after a while, Flitcraft’s life returned to normal and he adjusted to it.

Life will be normal again.

In this context, such is not a quiet adaptation, but the strongest possible defiance to a terrorist message, no matter how violent.

The Promenade des Anglais, a beautiful place where I have walked with great pleasure, will be joyous again, and there will be fireworks.

The strongest stand we can take against terrorists is to continue life oblivious to them.

We have, we can and will again, although healing takes time.

Vive la France.
Up with the U.S.A.

There is a small literature about positive outcomes from disasters.  We get closer together.  In a historical American metaphor, we get the wagons in a circle.  We hug people we love closer.  We strengthen our identities as members of groups and communities.