Prosthetics Become Source of Shame at Airport Screenings

People with medically sensitive conditions distressed by TSA treatment.

ByJANE E. ALLEN, ABC News Medical Unit
November 23, 2010, 4:19 PM

Nov. 24, 2010— -- Prosthetic devices were designed to help men and women move on with their lives despite potentially stigmatizing medical conditions, yet they've become a source of distress and humiliation during the new pat-downs by airport security agents.

There's already been outrage over the TSA agent who asked a Charlotte, N.C., woman who survived breast cancer to remove a prosthetic from inside her bra. There was also a bladder cancer survivor from Lansing, Mich., who said he was soaked in his own urine when a TSA agent's pat-down ruptured the seal on his urostomy bag.

"Do these agents have any human understanding that ostomates have these appliances because they have had cancer and the appliances are the aftermath of a battle that was won!" Thomas D. "Tom" Sawyer, a retired special education teacher, posted Monday to the Bladder Cancer Advocacy Network online support group on "I happen to wear mine with pride but I am also very private about it. The last thing I needed or wanted was to have urine leak in an airport and feel that all the world was looking at me."

Monday afternoon, Sawyer got a phone call from TSA Administrator John Pistole.

"He apologized and asked what I thought should be done," an exhausted Sawyer tweeted to his Twitter followers. "Our message was heard in Washington D.C….My job is done."

Sawyer encountered what mental health experts call micro-aggression: "an act or a situation in which a person in more power subjects a person in less power to either an assault or an insult. They're very cumulative," said psychologist Rhoda Olkin, a professor at the California School of Professional Psychology in San Francisco. They also can lead to depression and anxiety.

""The micro-aggressions that happen to people with disabilities are so ubiquitous," Olkin said in an interview with ABC News. "Now to have it when you travel, at such an egregious level, makes just one more place where you're really disadvantaged."

TSA Website Lays Out Position on Sensitive Medical Cases

TSA's website states its official position on handling sensitive medical cases: "Security officers should not be asking you to remove your orthopedic shoes, appliances or medical device (insulin pump, feeding tube, ostomy or urine bag, or exterior component of cochlear implant) at any time during the screening process… Advise the Security Officer if you have an ostomy bag or urine bag. You will not be required to expose these devices for inspection."

Yet, on Nov. 7, Sawyer was en route from Detroit Metropolitan Airport to a wedding in Orlando, Fla., when a TSA agent performed a pat-down that broke the seal on Sawyer's urine bag, allowing urine to run down his shirt, pants and leg. Sawyer said he tried to warn the agent to be careful with the device, but his words were ignored. He was left with wet urine stains on his clothing. "I was so embarrassed and so petrified of going out into the airport and people would see me and 'smell me.'" Sawyer said.

"I can honestly say this was one of the worst days of my life."

Amy Ascher Linde, an Atlanta mother and businesswoman who was born without a left hand and has worn a prosthetic since she was 11, has been through similar humiliations almost every time she's flown since the 9/11 terrorist attacks. The episodes have been demeaning, infuriating "and take your breath away." The psychological discomfort lingers, and the loss of dignity is unnecessary, she said.

When she arrived at Atlanta's Hartsfield Airport for a business trip soon after 9/11, dressed in just a suit jacket and pants, TSA agents tried to get her to remove the jacket and pulled up her sleeve to see where the artificial hand attached to her arm. She kept telling them: "I can't take this off; I'm going to be naked," as they pressed on. Had another Girl Scout mother from her troop not been nearby, "I would have broken down and just cried."

Last winter, she and two friends were taking a 50th birthday ski trip when TSA agents in Denver wanted her to go through a special scanner. She'd previously found the experience painful, because agents twisted her arm to get four different views of the prosthesis. So, this time, instead of going through the imaging machine, she offered to remove the artificial arm in a private room.

A TSA agent came in "with one of those gray trays" used to X-ray carry-ons, laptops and shoes, and left with her prosthesis. "I cannot tell you how my stomach felt – I thought the whole purpose of going into the screening room was for the privacy, not to have them take my prosthesis somewhere else. They don't dismantle people who have arms and take their limbs elsewhere. You don't have to check your arm at the door. To me, this is my arm."

"It makes you shake. It makes you become irrational. It makes me angry – the lack of control."

Humiliation has been identified as a cause or contributor to many psychosocial illnesses, "and can lead to anger, at times violence and uncooperative behavior," said Dr. Amir Afkhami, assistant professor of psychiatry and behavioral sciences at George Washington University in Washington, D.C.

There hasn't been as much research on the effects of short-lived humiliation, but Afkhami said what Sawyer and Bossi experienced is comparable to the shame and humiliation some patients feel during medical visits "because their defects and inadequacies and shortcomings are exposed." Just as they may avoid doctors, they might similarly stop flying to avoid exposing medical defects to a TSA employee.

Airport Pat-Downs: People with Prosthetics

One of the highest-profile cases has been that of breast cancer survivor Cathy Bossi, a flight attendant with 32 years of service, who was told to remove her breast prosthesis during a pat-down at Charlotte Douglas International Airport. A female TSA agent "put her full hand on my breast and said, 'what's this?' I said, 'It's a prosthesis because I've had breast cancer,'" Bossi recalled. "And she said, 'You'll need to show me that.'" Bossi said the incident was too horrific to report at the time, although she subsequently contacted the flight attendants' union.

Afkhami said these stories provide a valuable teachable moment for the TSA.

"If there's a takeaway from a psychiatrist's perspective to folks in the TSA, it is to be mindful that this is a humiliating and potentially shameful experience for patients. The first step in reducing that is to acknowledge that experience to the traveler undergoing that degree of scrutiny, to be apologetic about it, to show they empathize with what they're going through – to make it as un-intrusive as possible," Afkhami said.

Linde, the Atlanta flier, said she wondered why anyone would repeatedly single her out for extra security: "I will never be who they're looking for. I'm a middle-aged woman with three kids with a weekend bag. Any time they spend on me, they're not getting to the problem. I'm not a threat to anybody. I'm 107 pounds with one arm. Who am I going to hurt?

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