JournalistI'm a Montana reporter who spent 4 months investigating why my state fails to provide adequate care for women who use meth or opioids while pregnant. AMA.
Dec 28th 2017 by JaymeKay • 54 Questions • 89 Points
Greetings everyone my name is Ian and 10 years ago next month I flew home from Beijing on BA 38 (https://en.wikipedia.org/wiki/British_Airways_Flight_38).
This came up during the recent AMA from a flight attendant so here I am AMA.
Here's the BBC article. There is an interview linked on the right hand side but it appears that the video is lost in RealPlayer hell.
and here's me now hiding from my in laws post Christmas.
Edit: Just taking a little break to watch the Snow Bears show on BBC 1 and the mandatory socialising. I'll be back in an hour or so to answer more questions.
Edit 2: I'm back now
Edit 3: Thanks everyone it's been fun. I'm going to go to sleep now but I'll check back tomorrow in case there are any urgent burning questions left over.
I'm a lawyer who works juvenile and Child Protection cases. The big thing that I see in my state is that resources are available, but the hard thing is to get the women connected with the resources. Most drug users understand that they are breaking the law, and fear that by going to get help they will some how get in trouble. Even if immunity is granted under the law for those who seek help, there's still that issue that the women tend to be uneducated and just don't know what community resources they can go to. These women tend to be poorer, and they tend to be in complete isolation compared to the rest of society. It's not like they are seeing a regular counselor, or are in regular contact with the state's department of health and welfare. It's only after the baby is born, and the drugs are detected that the state can get involved and start working with the women.
How do you propose we overcome this barrier?
There’s always that kid showing up in your office multiple times a week. What does this adorable human say?
ATC checking in. I was 4 months into my training at Heathrow as a young trainee ATC when I walked back upstairs from a break and was greeted to the sight of the BAW 777 coming over the fence and crashing. I probably had the best view of anyone of your near death experience! Up in the tower at first we thought the pilot was being a smart arse and trying to do a short landing to come off at one of the early exits, then it dawned on the controller in charge of that runway that shit was about to get real. There’s a good YouTube video of the ATC tape of my former colleague doing a fantastic job of co-ordinating the emergency. In it you will even hear the pilot calling the mayday and uses the incorrect call sign, he used the call sign BA use in their simulator when they PRACTICE emergencies, so they literally went into “auto pilot” mode.
It actually was a blessing that the plane landed short of the runway and in the grass, which was soft from the perpetual English rain, as it’s believed the runway surface may have caused a fire on impact. Having low amounts of jet fuel left in the tanks after a long flight also probably decreased the likelihood of fire.
10 years later, I have never seen anything like it in my career as an ATC, and I don’t wish to. The whole tower staff on duty were deeply affected for days afterwards but everyone involved from ATC, pilots, crew, ground staff, emergency services did an amazing job and turned a potential disaster into a Very British Plane Crash which caused some minor disruption, some grumbling about delays, and was mostly forgotten by the media in a matter of days.
How did it affect you afterwards? I see your sense of humour is still intact but did you have any PTSD or similar? I’m sure I’m not alone as an ATC/Pilot that has dreams about crashes or emergencies, some of which are based on my memories of your crash.
Thanks for doing this AMA
You echoed a lot of the women we talked to. It's definitely a complicated issue that will take commitment from a wide variety of Montanans to address. The biggest thing we heard from women is how important it was to have someone help them connect to all those resources. When they sought help, it was overwhelming to navigate the hospital, treatment, social services, safe housing and all the usual challenges of life and pregnancy on their own. They also said it was critical to know they had somewhere to go for help where they wouldn't face trouble or scorn. There are several pilot projects funded by the Montana Healthcare Foundation that are testing different strategies. Wrapped in Hope in Lake County has helped dozens of women, primarily by serving as navigators through those myriad services from pregnancy through a year after birth. (Relapse risk is higher immediately after birth, so it's critical care doesn't stop when the baby is born.) One hospital, mostly through cultural changes and better connections to community groups, reduced CFS removals by 70 percent and cut the length of NICU stay by more than half for infants who experience withdrawals: http://missoulian.com/kalispell-hospital-shifts-to-care-for-mothers-with-addictions-alongside/article_209d0d52-6215-5656-abd6-283e5b7d2fcc.html
What ideas do you have? Or insights you can share from your experiences?
I have a handful of "frequent flyers." When it comes to these kiddos, I try to play the long game. I chat with them in the hall and cafeteria, and make sure I get on a first-name basis with the parent(s). I see it as banking karma for when it comes time for tough conversations.
I spent my career in middle schools prior to this position, and I can say I was completely unprepared for the sheer quantity of birthday cupcakes and treats I get on a daily basis. Kids drop by my office all the time to give me a birthday treat. I have a few birthday presents (free book, bookmark, and pencil) that I hand out. I also ask about their birthday plans, gifts, meal, etc., to try and make them feel special on their special day.
You probably had it worse as you could see how bad it was. I was listening to a show called what goes up might come down. Look it up, it's an after dinner speech by an ex ATC man.
I was so glad to hear there was no fatalities in this crash, mostly due to the pilots expert crash landing. This is one of my favourite "Air Crash Investigations", did you see the episode?
The complexity of sequence of events that made the engines fail and the length the investigation teams went to try to reproduce the problem was good work all round.
Interesting. I had not thought about this issue through a social organizing lens, although that makes sense. You sparked some thoughts.
Part of the problem with drug use, or any underground culture, is that there is a community, but it's not necessarily one that reinforces societally desired behaviors. Leave that world behind, and find yourself alone or stigmatized. Stay, and face legal and health consequences. And for some people, that community is all you've ever known. You don't know there is another way to live, cope, etc.
In some ways, I think the current (relative) sympathy for opioid users stems, in part, from the fact painkillers are legal. I see some parallels with marijuana like you mentioned. (Research tidbit: More than 80 percent of today's heroin users became addicted from painkillers, although generally from misuse.) Second sidenote: The effects of pot use during pregnancy are better studied and, to way oversimplify things, are worse on fetal development than crack cocaine or heroin. Alcohol and nicotine are the best studied--easier to study legal substances-- and everyone I talked to said they're terrible, stunting brain or lung development.
Peer recovery groups have been around a long time and, when run right, can provide a kind of community for drug users and those in active recovery. Easier said then done, and they can be problematic in their own ways. One of the women I talked to was denied any recognition of her sobriety because she was prescribed buprenorphine and, in their eyes, "not clean." Montana is following states like Wyoming in expanding and professionalizing these groups, to a degree, allowing Medicaid to pay for peer recovery specialists who might get a little more training than an average NA volunteer.
A few of the women we talked to were lucky enough to get into one of the two licensed residential treatment programs in the state that take women with kids. They talked about how the community of peers kept them accountable but also have them a safe space to open up about challenges. It's tough to get the right balance of structure in those programs. Too much and it feels like prison and people shut down or hide how they're actually doing out of fear. Not enough and addict thinking takes over, finding room for lies and justifications to get back to their habit.
One last one: Look at the history of NAMI, the National Alliance for the Mentally Ill. Essentially, people with mental illness and their families were sick of the status quo and the stigmas so they fought for policy change, offered education and myth busting broadly, and organized support groups for both people with diagnoses and for family or friends trying to figure it out. They've been successful at pushing cultural changes at personal and national levels. I don't know that there's a similar group related to drug use beyond AA and NA. (There probably are, and I just don't know it.) Thinking out loud, I wonder if NAMI might extend its umbrella since the majority of drug users have cooccurring mental health challenges.
Anyway, thanks for sharing your thoughts.
What freaks me out about a crash landing is being trapped in a burning aircraft by passengers gathering their luggage. What was your reaction to other passenger's instincts to gather luggage rather than self survival?
It's tough to know. Because hospitals do not universally test the umbilical cord for drug use, we don't really have good data that would allow for an ethnic comparison. We do know the challenges are not limited to Native communities, urban or on reservations. About two-thirds of all child removals by the state involve parental drug use and the majority of those cases involve white families. And we know that Native women can face unique risks for drug use and extra barriers to care. For instance, historical trauma and the multigenerational poverty seen in some Native families can mean some people are more likely to experiences the kinds of terrible things that trigger many drug users to numb their emotions. Limited access to health care also makes it difficult to recover. Some of that is the result of federal policies and Congressional funding decisions that creates a different norm of care for some Native families. It is known that some Native women were sterilized without their consent by federal doctors decades ago, so there is particular mistrust of the health system for some families. Some of the Native women we talked to blamed the Indian Health Service for prescribing painkillers too easily and doing so instead of surgeries they couldn't offer because funding was too short, although that's difficult to track or prove. (A little unrelated, but a guy I interviewed last year needed knee surgery but it wasn't life threatening so he was prescribed painkillers for years until there was the money available to pay for it, a result of Congressional funding decisions. He had worked in construction his whole life and couldn't afford to pay the surgery out of pocket. He had to stop because of the damage to his knees and only years after that was able to get surgery.)
Medicaid expansion and special tribal provisions of the ACA have started to alleviate some of those issues by giving Native families more options for where to access care and how to pay for it. Tribes have increasingly taken on a greater role in delivering health services. For instance, the Confederated Salish and Kootenai Tribes here operates one of the state's few medication-assisted treatment programs, something that is rare in the state as a whole. In Montana, reservations also face the same challenges as other rural communities: isolation from services and job opportunities, hospitals have difficulty recruiting specialists, long drives to basic services, etc.
thank you for doing this AMA. Why would you say there's been such a rise in opioid use in America, especially rural America?
And what do you feel is the best way to prevent it?
Have you eliminated gym and recess? Do you allow the kids to play tag?
Why were you compelled to write about this topic, and especially at such great length? Do you have a personal connection with the issue?
Not the OP but i can help answer this. I’m currently in school to be an educator, and there are two sets of standards that students need to meet. The teachers themselves get to come up with the curriculum (assuming the school doesn’t come up with it for them) as long as they model it off of the state/national standards. They take standardized tests every year that their instruction culminates from. There are state standards and there are national standards. Technically, in most states the departments of education like to parade around the fact that they have their teachers and former teachers in the state help make the standards, but the elected and appointed officials often twist it to their points. This is even more prevalent at the national level, although the content area coalitions often lobby/argue against policy makers making the standards. Hope this gave you an understanding.
For many people, science clearly shows it's not simple choice to stop using like we might stop buying black socks instead of white. Drug use can literally rewire the brain and depending on the person might never go back to normal. Medication-assisted treatment is similar to insulin for diabetics. It's a way to manage a longterm health condition and no amount of will can change that biology.
I'd ask them to look at the hard facts showing which types of policies and programs actually help people recover and save the state money. Regardless of what you think addiction is, there is evidence of what works to help people recover, stay out of prison and save taxpayers money. I'd also ask them to listen to the personal stories of these women and try to consider life from their shoes. For most, drug use was not a decision to "have fun," but a coping tool they found to manage with traumas. They were timid to share their experiences because of the stigmas they faced, but ultimately hoped people would take a moment to listen. http://missoulian.com/pregnant-women-who-use-drugs-say-montana-does-little-to/article_16a4f32d-c3f4-5ba1-a4d3-441767f56b4f.html
I guess I'm not surprised that the most popular thread in the AMA is about a dildo. HA!
To be honest, I didn't ask to see it, but the teacher told me it was pretty fancy. Use your imagination, I guess.
A 2 week holiday anywhere in the world for myself and 3 friends with business class flights.
5 years of gold level membership in the executive club.
Most importantly I got to go down the evacuation slide.
I get that so much. And am totally cool with it. I have Scottish roots and am a closeted nerd who plays board games and reads sci-fi or fantasy for fun. (I must confess I haven't read or watched any Outlander.)
I was sort of named after my dad. When my parents scrapped the name "Dimond," they settled on a silly saying: Jay and me made Jayme. So clever.
My district is pretty small. The entire administrative body consists of 8 people, superintendent included, so I have a really good relationship with him. He's a straight shooter, and I appreciate that. What you see is what you get. He is really into the idea of shared decision making, so he rarely ever issues a directive without gathering our input first.
If I had to complain about something, it would be the lack of equity that happens between buildings. In most districts, the high school is the golden child. Understandably, districts are known for their HS programs, graduation rates, etc, so it's naturally the building to get the most attention (and money).
Sometimes kids are just assholes, but I wouldn't consider that bullying
So you consider students treating others like garbage and making their life miserable to the point where they don't want to go to school a non-issue?
How was it? Would you recommend it?
Didn't mean to trigger someone. Let me explain further...
What you describe is considered a material incident (that's the official language from DASA), and would therefore be considered bullying. Here's a typical example and non-example:
Let's say a kid is constantly commenting on another kid's weight. Over time (days, weeks, months - it doesn't matter), this name calling and taunting causes the victim to avoid eating lunch in the cafeteria. This would be a clear example of bullying. The behavior impacts the victim and changes his/her own behavior.
Here's another scenario: Kids are in Phys Ed. One kid calls the other a fat ass. The victim tells the aggressor to shut up, and then the game continues. The behavior is inappropriate, yes. But it's not bullying because it didn't have cause a material impact on the victim.
Hope this helps clear up my previous response.
10/10 would crash again.
I heard that the curriculum changes between schools which are found in poor areas compared to schools in rich areas. Is this true?
Did you try to put on the oxygen masks? or did you just bs right out of there?
Yes and no. All schools in the state are expected to shape curriculum to adhere to the state standards. Every school also administers the same standardized state assessments. More affluent schools have the resources to provide teachers with professional development or release time to develop curriculum, or just purchase a boxed program to use with students.
It's not that economically disadvantaged schools (and their teachers) don't care about students or that the teachers aren't as good. It's just that money makes everything easier.
I almost did, the impact dropped them but something in my mind kicked in and reminded me that it wasn't going to be much use on the ground.
Were people panicked at all, or just sorta confused and shaken up?
A mix of everything. I think confused and shaken up is the most common expression I saw that day.
Did this cause a fear of flying for you, or someone close to you?
Did you have a concern for your life?
Did the other passengers reactions make it harder to stay calm?
No I still fly now whenever I can and look forward to it.
Not at all. I was oblivious to the whole thing so by the time I knew it could have been worse it was over so nothing to be scared about.
The other passengers stopping to get their bags before leaving just gave me a clear path to the exit so I didn't spend a long time stuck inside.
My sister refuses to be on the same plane as me now. I like to think I've got a proven track record and everyone else is just untested.
Wow thanks for the answer! One more question if I may:
What did the process after the crash look like? You got off the plane. What happened then until you got home?
We walked across the grass to a guy who was gathering up passengers without getting close himself. From there we were bussed to the terminal and had to chat with the police as they were immediately investigating it.
While I was chatting with them ("Are you okay?", "Yup", "Seriously?!") the border force were determining if we had the right to enter the country. I was lucky as I had my passport in my pocket. Those who didn't (like my friend) were asked questions to determine if they were actually resident in the UK or had permission to enter.
After that we were moved to the 1st class lounge to be held there till we were ready to go. Didn't stay long as they had cleared the alcohol away and turned all the TVs off.
After my friend and I met back up we got out and met up with her parents who had come to collect us and while walking back to their car a journalist for the BBC pounced on us in the car park for an interview.
Ahhh sounds like one if the 3 friends for the first class trip anywhere
Business class. They reserve 1st class compensation for when they run out of tea on a British Airways flight.
And yes she loved the holidays. Sadly it gave her a taste for expansive hotels.
I've never understood it, I've always thought it would be a good deal to lose my luggage. In a crash. It's just a bag full of sudoku and twizzlers. But when I go to file the claim, suddenly my $500 designer bag was full of cash, new laptop, cell phone, and lots of expensive jewelry.
I could easily have claimed for a new laptop and there would have been no questions asked.
Curse my honesty.
As I recall from the news reports it had been a totally normal flight right up until the last few seconds.
1. When did you realize that something had gone wrong? 2. Describe the impact and the first few seconds following. Were people more stunned or was there a sense of panic?
I figured it was a rough landing. I just wasn't sure how rough.
There was some sense of concern. I think if you could see out a window you would have had a much better idea what was happening.
There were some people crying once we got off the plane and there were the people who stopped to get their hand luggage and a few people shouting at the crew.
The cabin crew was fantastic they got us all off quickly and safely.
Wow. Just read the article. It seems like a the problem wasn't apparent until the very end of the flight. Did the crew have time to tell the passengers anything? Did you know the plane was going in for a hard landing before it happened?
Another question I had for any pilots or anyone with knowledge about aircraft: how would water get into the fuel lines? Isn't water a contaminant in a fuel system?
We didn't even get a call to brace. I remember looking out the window (across 3 seats because I was in the middle block) thinking we were coming down a little steep. I also heard a motor adjusting something which could have been either the flaps or landing gear as the pilot was doing his best to get maximum glide time.
The sad truth is I thought we'd come down a bit hard and then gone off the side of the runway. It wasn't until we got the call to evacuate and I went down the slide to be treated to the view of our undercarriage in the distance and half an engine leaking fluid that I realised just how bad it was.
I was sitting 7 or so rows back from the wing exit and I was the second person down the slide.
In the distance there was a man in a high vis jacket waving for us to head that way so off I set. I was also motivated by the smoker who on getting out of the plane and standing next to the engine decided that then was the time to light up.
Would you credit your survival to the fact that you had your tray table up and your seat back in the full of right position?
More that the person in front did. If that had been reclined I could easily have smashed my head into the back of it.
That was sitting safely at home.
Let's be real, it doesn't matter where a Nokia phone is sitting, it's always safe.
No kidding I found it recently, battery still holds a charge.
What was the process for you like from landing to getting back home? More importantly did you get a lottery ticket on your way back?
I actually wish I had. The guy in the bank suggested it, I was in there cancelling my cards as they were still in the plane.
How do people react when you tell them about this? Is it a lot of sympathy, or shock, or disbelief? Seems like such an interesting conversation piece.
Depends on the person. Work colleagues who travel a lot are jealous of the gold card, now sadly expired. Most people start out concerned then get jealous over the holidays.
Freezing cold. I went to Harbin for an ice and snow festival, failed to order dumplings in a dumpling restaurant, tobogganed off the great wall and ate huge amounts of duck in Beijing.
Did you and the other affected persons got compensation from the air company?
I managed to get 2 holidays out of them. I was travelling with a friend and I took her, her boyfriend and my significant other on my compensation holiday and she then did the same for me.
I also got a new camera and replacement mp3 player as mine were tragically "destroyed".
Do you have an opinion of the 10 passengers that decided to file the lawsuit a year later for $1 million each? Were you ever contacted about it?
I was asked to be a witness for Boeing though it never went that far that they needed me.
I was perfectly happy with the compensation I received and while sure a big pile of money would have been nice I genuinely couldn't claim that it had such an effect on me that I would require that much money.
I wish. With me frequent flyer card I'm sure it appears whenever I check in. I once got bumped to business on a flight to Texas which was great I was sitting there watching The Revenant and realised I had a massive grin on my face while Leo was being eaten by a bear. Must have been a little off putting for anyone walking past.
Firstly this is going to sound weird but this is one of my “favourite” crashes. I for one reason or another enjoy reading up on plane crashes and I’ve always enjoyed the story of this one. Anyway my question is, what was your first thought after impact? Did you initially sense something was wrong or was there a sort of “holy shit we just crashed” moment?
"That was a rough landing, did we go off the side of the runway?"
As it happens it's my favourite crash as well.
What was your reaction to looking at the plane when you got out?
Well bugger me.
Very glad you made it through that traumatic experience. Did it go in slow-mo for you crashing? How fast did it feel? When you were falling, what were your thoughts when all of this was going on when you were going down? Are you more aware and safe how when you travel to fly? And lastly, did you see anyone overly panic or pass out through being scared or panic? Thanks.
I always read the safety card and check where my exit is. And I do pay attention to the cabin crew when they do their safety briefing in case they sneak something new in I should know about.
Spoiler alert: They haven't yet.
When the plane was landing i assume you were sitting right? So does it hurt and how big is the impact to the insides of the aeroplane?
For this one I have to assume it was about as gentle as it can be and still be a crash landing. I was sitting and wearing my seat belt. The most pain was from my hand being flung forwards into the seat in front.
I took my friends to Antigua. We learned to S.C.U.B.A. dive and drank a vast quantity to rum.
My friend took us on a tour of India.
How long were you kept in the airport afterwards? Did you need to be interviewed by anyone and how soon did the media try to get at you?
It was a few hours to get processed past the police and immigration.
After that we got jumped on by the BBC as we walked through the carpark telling my friends parents about it.
I also got the local papers and the radio calling me from the next day. I'd love to know for sure where they got my contact details from.
Yes it was all put in a taxi and sent back a few days later. They mixed my friends and my bags up so I did wonder where the lace underwear and bras had come from for a few minutes before my brain caught up.
What was the first thing your family said when you came back?
I called in at my parents house on my way home and my dad greeted me with "Saw you on TV"
My sister had to be sent home from work because she was panicking having seen the news. It was a bit pathetic on her part because she didn't actually know I was on that flight she just assumed I was.
My cat just looked at me expecting food.
What was your first distinction that made you realise something was wrong?
The grumbling noise of soil against the fuselage.