On an August evening in 1987, a plane schedule to depart from the Detroit Metropolitan Wayne County Airport crashed on takeoff, causing the deadliest sole-survivor aviation accident in history. Emergency physician Bradford L. Walters, MD, FACEP, was one of the first responders to the crash and participated in a search for survivors and efforts to identify the victims. Few emergency physicians will face a disaster of this magnitude in their careers, and no amount of training or planning can prepare you for the reality of being a first responder. Dr. Walters recently sat down with ACEP Now Medical Editor-in-Chief Kevin Klauer, DO, EJD, FACEP, to talk about his experience and the lessons he’s applied to his emergency medicine practice.

KK: Tell us about the crash.

BW: This was the Northwest Airlines Flight 255 that, unfortunately, lost control upon takeoff on August 16, 1987, around 9 p.m. (Detroit). The plane lost control, banked to the left, and hit a parking structure at the edge of the airport, crashing on a four-lane, heavily traveled street.

KK: Do you remember what type of aircraft it was?

BW: This was a McDonnell Douglas MD-82 (an earlier version of today’s MD-88). It had 149 passengers and six crew. One 4-year-old young lady by the name of Cecilia, was the sole survivor. The captain was John Maus and the first officer was David Dodds. I was one of the physicians who participated in the formal autopsy onsite of both the captain and the first officer.

“I’m an emergency physician. We don’t hesitate. We don’t pause. We set those things aside and we process them later.”
—Bradford L. Walters, MD

KK: You were involved in the federal National Disaster Medical System (NDMS). Were you just happening by the accident, or were you notified and responding?

BW: Neither. I happened to be at home. I saw the news event. I said, “They might need help and, in addition, this might be a chance to learn from Wayne County’s NDMS or whoever’s responding to this mass disaster.” So, I identified myself to a police officer there. I expected he was going to say, “No, I understand what you’re saying, but the area is closed off and you can’t get through,” and I’d turn around and go home, saying “I’d tried my best.”

KK: Are you that guy who drives around with an EMS bag, a cric kit, rib spreaders, and a defibrillator in your trunk?

BW: Wait, wait, wait, you also have to say that now I also carry a glidescope. I am that guy, but at the same time, I’m an emergency physician. You know that famous line from 9/11: When everyone was running out, the first responders, the emergency medical teams were running in.

KK: Did you have a blue light on top of your car or on your dashboard?

BW: I did not. I draw the line there.

KK: Back to the story…

BW: The police had stopped traffic and I just walked up to the officer and identified myself as an emergency physician as part of the NDMS team. He said, “Come with me,” and put me in a car with a deputy. They drove me to the site and told me they would take care of my car.

KK: As you were approaching, what is the first sight at the crash that you really remember?

BW: It’s really a surreal thing, but my first impression was the smell. There was a combination of the kerosene smell of jet fuel; the plane burst into flames, so you smelled the smoke and char; and then there was that smell of burned and dead flesh.

KK: Did you consider not participating at that point, or pausing?

BW: No, never thought of pausing. I’m an emergency physician. We don’t hesitate. We don’t pause. We set those things aside, and we process them later.

KK: What was your first sight?

BW: It’s multi-sensorial because there were these huge klieg lights. There were these huge spotlights illuminating the scene, but also the red on-and-off lights of all the EMS vehicles and fire trucks. Quite a bit of smoke was in the air. They had just finished putting out the last of the fires, and there were all these objects. You could see the difference between the angular pieces of fuselage and softer shapes. I realized these were body parts. I was not prepared for the magnitude of that.

Image Credit: © Paul Sancya/ /AP/Corbis
In this Aug. 16, 2012, file photo, flowers and pictures are shown at the memorial in Romulus, Michigan, to mark the 25th anniversary of the crash of Northwest Airlines Flight 255 near Detroit Metropolitan Airport. The aircraft crashed in the Detroit suburb of Romulus, killing all 154 people aboard except for a 4-year-old girl. Two people also died on the ground. In the new documentary, “Sole Survivor,” Cecelia Cichan, whose married name is Crocker, breaks her silence, discussing how the crash of the Phoenix-bound jetliner has affected her.

KK: Tell me about who you met on the scene. Who was your first contact that gave you a clinical assignment and what did you do then?

BW: The incident command center turned me over to one of the paramedics, and they got me into full bunker gear. We started going through some of the larger pieces of fuselage that could potentially house a survivor. We went through each of the large pieces of fuselage and then some of the bodies that were on the ground, and we assured ourselves that each one of them was, in fact, a non-survivor. One of the more surreal incidents was there was a relatively large piece of the middle fuselage that was still sort of intact and we climbed into it. We were walking down the aisle, stopping at each of the bodies again looking for a possible survivor, and I catch my air hose on a piece of debris. I feel my head and my air hose pull back, and I’m trying to reach back; I’m starting to panic. I’m inside the fuselage. I can see that there are a lot of gases around, a lot of smoke. It’s very eerie, and all of a sudden, I feel someone grab me from behind, and I think I screamed. I’m not sure, but the paramedic behind me saw that I had caught my hose. He grabbed me first and pulled me backwards to free my hose.

“Interestingly enough, the young lady who was the survivor actually has a tattoo of a McDonnell Douglas MD-82 on her hand as a reminder of being the only survivor of her family. I would love to meet her one day.”

KK: What did you take away from this experience that you use in daily practice now?

BW: We had to revamp what we were doing at that scene over and over again as the situation changed, as we realized that there were no survivors and now we had to collect all the bodies and try to identify them. By the way, I learned how to do a disaster identification autopsy.

KK: It’s interesting that they would put you into this role without previous forensic experience. What exactly did they have you do?

BW: Actually, they had collected the bodies. They cleared out their hangar, collected all the bodies, and brought them there. Another company brought in two refrigerated trucks so that the bodies could be placed in a refrigerated environment. When I got back to that facility, they said, “We need physicians to help us with identification,” and it was on-the-job training. It’s not that difficult. A lot of it is cataloguing the body parts, the victims’ clothing, determining sex, trying to get an idea of age, looking for any pieces of jewelry, rings, necklaces, and things like that. You try to get eye color. The FBI identification team came in and I learned how they do the fingerprints. Do you want to know how they do the fingerprints?

KK: Sure.

BW: They can’t roll the fingerprints on a corpse, particularly one that’s been damaged significantly. They actually take the hand and remove each of the fingers, and they very carefully roll the fingerprints. The FBI agent said, “this is our last and only opportunity to identify some of these people and without that, their families are never going to get closure.”

KK: Did you sign death certificates? What authority or accountability did you have for what you were doing?

BW: Actually Warner Spitz signed the death certificate, but it was on our say-so.

KK: Did you have any assistance with a critical incident stress debriefing?

BW: It didn’t exist then. I had to process this all myself. One of the other things I learned is that I would’ve done much better had I been able to talk about this, even with my colleagues.

KK: Why didn’t you?

BW: I don’t know why. I talked about it with a couple of close friends. Of course, my wife was really instrumental in being the person who listened to it. I was brought up in the era of, basically, you just sucked it up and you moved on.

KK: It’s amazing that you got to the other side of this thing intact emotionally and even intellectually. It has to be a life-altering event.

BW: I think we do such a far, far better job now with the emotional states of both the victims and the people who provide aid, as was seen with Katrina and similar events. Interestingly enough, the young lady who was the survivor actually has a tattoo of a McDonnell Douglas MD-82 on her hand as a reminder of being the only survivor of her family. I would love to meet her one day.

KK: The crash was 30 years ago. Can you tell me how many times you’ve had this type of a detailed conversation about this?

BW: This may be among the most detailed conversations I’ve ever had about this.