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Journal Article

Citation

El-Khoury J, Medawar B. Lancet Psychiatry 2021; 8(2): e104.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/S2215-0366(20)30561-7

PMID

unavailable

Abstract

We are psychiatrists based at the American University of Beirut Medical Center, one of the largest psychiatric departments in Lebanon. Since October, 2019, Lebanon has navigated through several crises. It started with unremitting political unrest, national bankruptcy, and currency devaluation. The COVID-19 pandemic complicated the situation by stretching the health-care system to its limits. Our ordeal would culminate with one of the largest non-nuclear explosions in history.

The afternoon of Aug 4, 2020 was meant to be a typical summer afternoon, closing on a warm eastern Mediterranean sunset. At 6:08 pm, the dull sound of a first explosion disrupted our train of thoughts and made us gaze into the sky to the sight of a mushroom cloud, which we would later know had a specific and rather amusing name--the pyrocumulus. Whether behind the wheel negotiating evening traffic or from the comfort of home, our senses were alerted but still confused while attempting to decipher the level of threat. Beirut is a city used to tragedy and pain, but the amount of devastation that would befall the port and the dense urban centre surrounding it was nothing short of biblical. 3000 tonnes of abandoned ammonium phosphate stored in the harbour had turned our world into shattered buildings, street rubble, and crushed vehicles. Of course, the causes of the blast were not apparent until much later, fuelling panic and fear of air raids or coordinated terrorist attacks. A true apocalyptic silence followed by hundreds of anguished screams all around…including ours. Amidst the rubble, we went through the flight, fight, or freeze response in no particular order. It is fascinating how absurd and futile one's initial response to such events is. Still shaken and vulnerable, we were also concerned for the fate of family, friends, and colleagues. Death had never been that close, and for 200 victims it was unfortunately too close. The realisation that survival had been the result of sheer casual circumstances, such as being far from a window or having driven a minute earlier, sent a psychological shockwave that still ripples through the city to this day.


Language: en

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