September 11 Revisited

This is an article I published in the Syracuse Post Standard May 30, 2002: "I don't want to talk about what I saw and I'll never forget what I saw."

That was a quote from a New York City cop who was exhausted after wading through the death and debris at the World Trade Center. Of all the pain on that day of tragedies, my heart goes out to the hundreds of firefighters and cops who rushed to help those trapped in the Twin Towers only to have it collapse on them. I can't imagine what it must have been like for their brothers and sisters listening on the radio as their screams plunged into silence . Those who survived have full awareness that it's a slim line between victim and survivor.

"My eyes have seen only dozens but my heart knows there are thousands". That was a quote from a triage worker when asked about the extent of the casulities. He, like the rest of the initial rescue workers, was prepared for an onslaught that never came. He was caught in a surreal lull between worlds of chaos.

Who's going to help the helpers?"

I am amazed at their courage. The pictures are so vivid. While civilians were running from danger, they were running towards it. When they arrived, even if they were physically unscathed, the carnage they witnessed and the destruction that swirled around them took a toll. Seeing them stunned and covered with soot, it becomes clear that most words fail.

Cops and firefighters live middle-class lives while inhabiting worlds of tension, terror and trauma that we are aware of primarily in theory. I'm trying to imagine what it's like going home, physically spent andyour mind racing with one vision after another of hellish sights that defy description.

This year we commemorated the Memorial Day nearly nine months after the attack. The recovery and cleanup are over. Thoughts turn to rebuilding and renewal. My fear is that many cops and firefighters are still haunted by Sept. 11. I hope this day reminded us of our oligation to them.

In the May issue of the American Journal of Psychiatry, a report focused on psychiatric disorders in rescue workers after the Oklahoma City bombing. Thirty percent developed psychiatric disorders. Rescue workers had less depression and post-traumatic stress disorder than the victims. Surprisingly, one-quarter of the rescue workers developed an alcohol use disorder. That is a 250 percent greater rate than the primary victims of the blast. Alcoholism and alcohol abuse skyrocketed among the firefighters after the bombing.

Though the debris of the World Trade Center, the Pentagon and the Oklahoma City federal building are gone, damage remains. Now the alcoholism field should ask itself: What do we have to offer these heroes? Unless they can process and grieve the events and their aftermath, sobriety is unlikely. Our challenge is to offer them a way to express that which is nearly beyond expression.

The same impulse that allows firefighters and cops to work the World Trade Center scene, knowing that hundreds of their colleagues lie dead in the rubble, also makes it hard for them to let others into their personal world. The pain is almost too hard to describe, the emotions too intense, and the fear is that no one could understand.

Ernie Kurtz provided the best description of Alcoholics Anonymous: "The shared honesty of mutual vulnerability, freely acknowledged." Perhaps that is what we can wish these heroes. They deserve to be able to grieve the loss of their colleagues. They deserve to acknowledge their fear and guilt and be told they are not alone with those feelings. They deserve a camaraderie that moves beyond macho posturing and toward self-awareness. Without that care and support, a drink must look pretty good.

My enduring image of Sept. 11 is of a firefighter offering a doctor a few breaths from his ventilator as smoke billowed over them. I hope we, as treatment providers, are equally willing to reach out to the rescuers, now that the smoke is gone and the dust has settled