With lessons learned from 9/11 so widely, recently and painfully recounted, the story of suffering and loss that continue for more than 100,000 fellow Americans must not be forgotten. We cannot lose sight of it as if seeing it through a rear-view mirror, fading in the distance. We need to keep these fellow citizens front and center.
According to Time magazine, the World Trade Center Health Program, founded in 2010 as part of the James Zadroga 9/11 Health and Compensation Act,
currently serves 112,042 members nationwide. Their membership includes 64,429 general responders, 17,031 firefighters and 30,582 survivors. Of these, 65,307 members have at least one certified debilitating health condition and remain badly in need of care. Some, even with treatment, will never recover.
Among the Fire Department of New York’s 15,000 World Trade Center Health Program enrollees, 11,300 have at least one certified physical or mental health condition because of their service on and after 9/11. These conditions run the gamut from upper respiratory conditions to multiple types of cancer, as well as PTSD, depression, anxiety and substance abuse. Time reports, “Nearly 3,900 of the total group have at least one form of cancer; more than 4,300 have a mental health condition.”
If we are to learn anything about the long-term health consequences of the World Trade Center attacks, it is how the survivors and responders were faced with what has been referred to as the “double impact” of not just toxin exposure, but psychological trauma. According to Dr. Adriana Feder, the associate director for research at the World Trade Center Mental Health Program at the Icahn School of Medicine at Mount Sinai, dealing with mental and physical injuries at the same time can feed into each other over time. “Chronic pain can worsen PTSD, which in turn can lead to inflammation, heart problems and other conditions,” she says. Among those enrolled in the federal WTC program, mental health problems are listed as the third most common category of certified conditions.
Within all the media coverage, which is important and often overlooked, is the plight of various first responders and others exposed to the site over a long period of time after the attacks. Also lost in most discourse, is how long the rescue and recovery efforts lasted — well into the summer of 2002. As Dr. David Prezant of the Fire Department of New York who was onsite at 9/11 and is now its chief medical officer explains to Time, the fires continued to burn through the end of December, releasing more vapors. “During the rescue and recovery efforts … as you’re digging and uncovering crypts, that releases the same gases that were there on the day of 9/11.”
“While some of the illnesses connected to 9/11 developed immediately, others, like mesothelioma (a type of cancer that occurs in the thin layer of tissue that covers the majority of your internal organs), can take years to emerge,” says John Howard, the administrator of the WTC Health Program and the director of National Institute for Occupational Safety and Health. “As our members age, I think we’re going to see interactions between conditions that occur in an aging population and the 9/11 conditions.”
There is also something quite miraculous that has emerged from the tragedy of 9/11 that should also not be overlooked. Unexpected resiliency found in the face of illness, disability and impending death.
As recently explained by Kaiser Health News reporter Michael McAuliff, Ray Pfeifer and Luis Alvarez’s, men whose names are on the federal 9/11 legislation that establishes benefits for first responders and who fought to ensure Congress passed it, did so while they were dying of cancer. “They had another thing in common,” says McAuliff. “In spite of it all, they were content.”
“I am the luckiest man alive,” Pfeifer, a former New York City firefighter, told McAuliff in 2017. Two months later he would be dead from cancer linked to his time working in the ruins of the World Trade Center. “It was something he said often,” writes McAuliff. “I love doing this,” Alvarez, a retired NYC police detective, told McAuliff just 19 days before he died on the night before he was to testify before Congress.
“Having to run into a toxic scene of chaos and destruction, as New York City firefighters and police officers did on Sept. 11, 2001, and getting sick because of it, may not seem like a recipe for any sort of happiness,” writes McAuliff. “But a new report released by the New York City Fire Department finds that Alvarez and Pfeifer are not rare cases. Indeed, ever since 2006, when doctors and researchers in the department’s World Trade Center Health Program began detailed tracking of the mental health status of its responders, they found a remarkable fact: Even as 9/11 responders’ self-reported physical health has declined over the years, they have consistently reported their mental health-related quality of life as better than that of average Americans.”
George Bonanno, a professor of clinical psychology at Columbia University and author of the book “The End of Trauma: How the New Science of Resilience Is Changing How We Think About PTSD,” tells Kaiser Health News that, while it is not exactly clear why a group of people might experience improving outlooks on life even as they are increasingly struggling with health problems, a distinct survivor effect seems to emerge within first responders. “The suffering has a reason, it has a purpose, and your pain is in the context of you did something remarkable,” he says. Also factored in is the support networks first responders have, especially in the Fire Department, where the care offered covers both physical and mental health problems.
During interviews for his book, Bonanno points out that with those who fled the burning towers, nearly every person interviewed recounted stories of “the firefighters going up the stairs while they went down, reassuring evacuees along the way.”
In the divisive world we now live in, such selfless and humane acts are important to remember. And as for the care of survivors, they should be abundantly compensated.