The Things That Stay With You

There is a strange paradigm to disasters, in my experience. Everyone sees the big events and the images that become iconic: jets flying into buildings, the collapse of structures, spacecraft shattering and streaming across the heavens before scattering across East Texas, levees collapsing and the wave of human diaspora. Those are the images shared by everyone: responders, media, those of us at home witnessing what our fellow Americans are enduring. It becomes our template of history. As a responder, I have always found that for each of those events, there is always something small and personal that happens, and for me, that becomes the trigger, my memory of the event. That is what comes back time and again.

On September the 11^th, 2001 I was the medical team manager and physician for a FEMA Urban Search and Rescue team, Texas Task Force One. We were trained for multi-mission potential, but our primary application was for search and rescue of victims of large scale collapsed structures. Ground  Zero was the Superbowl of that and we knew it. There were 28 federally authorized teams and with the attacks, all us were activated. There were many uncertainties we entertained. Would there be another round of attack? Was this a tactic intended to coalesce the response community and eliminate it, thus crippling any additional response? Was there a secondary threat? The answer to the last question, as we now know, was yes, but not in the way most envisioned.

I was told by medical leadership, by government and environmental authorities—by all those responsible for knowing—that it was safe to remove our PPE once we were 50 feet from “the pile.” It was my second deployment, and I was a novice to some aspects of environmental health, but one look at the autumn sunlight slanting through the particulates sparkling in the air and it was obvious that couldn’t be right. I met a lot of resistance from people, but I am hardheaded and acquired my own monitoring equipment. I spoke to a young steel worker and convinced him to wear the gear. The results were staggering. Toluene, benzene, styrene, heavy metals, pulverized silica and asbestos, among others. Fast forward past an attempt by EPA to suppress, a partnership with the city attorney and a freedom of information brief later and the results became a cornerstone of the  evidence supporting the creation of the Health Registry protecting responders and those near the site.

For a long time, I resisted talking about my time at Ground Zero. I refused interviews and only gave testimony when I thought it would further the support of our national preparedness or the issues for responders. That included audiences with committees and policymakers, including then Senator Clinton.

In fact, as long as any of us are alive and the lingering insult and effect of the exposures exists, that deployment will not be over for me.

But that is not what I recall. My “moment” came one night when desperate to get some momentary break from the compressed focused environment, I went outside and, on the concrete walls of the Javitz Center where we were billeted, I saw thousands of pieces of artwork created by the children of New York.  They were crayon drawings with sentiments scrawled beneath the images. Some were angry. Some were frightened. One stood out and devastated me. Her name was Rachel Pollack, and she had drawn a picture of the towers, still intact, a group of children were on green grass. She had written “I feel sorry for all the people that lost someone, because I know what it is like to be alone.” 

I am pretty good at compartmentalization. It has been necessary to function properly in disasters, but in that moment, that one little drawing and comment bypassed all my defenses and went right to the heart. It has stayed with me. I suppose it’s like wine. Some things need time to properly age and vintage. The grapes have to be crushed and then rest to reach their apex in the barreI before they are ready for the bottle. Even then, they have to breathe a bit before they are ready for consumption. I have tried to locate Rachel a couple of times. I wondered what happened to her, if her loneliness was relieved with comfort and comradery—if she had a good life. Unfortunately, between government service, professional requirements, and life, it was not to be.  All I know is that, while I hope that the continued biological insults to those impacted in that time will eventually come to an end, I pray that the impact of Rachel’s message, that connection and what it means about the vintage and viability of my own heart, never will.