On the 10th Anniversary of the 9/11 terrorist attacks we, as a nation, will certainly pause to remember those who were murdered that day. However, let’s not forget that there are thousands of 9/11 first responders who are still dealing with the fallout. Many of the firefighters, police officers and other emergency personnel who swarmed Ground Zero in the hours, days and months after the attack walked away not only with horrifying memories but also with lasting health problems.
Although I’m not a doctor, it was impossible to sit at home in front of my television that night and not fear for the safety of those wading in to the gray ash cloud that hung over lower Manhattan. Very few wore actual respirators; some wore no face coverings at all. Commentators spoke about how the steel on the Towers was supposed to be protected by fire-retardant asbestos, but few pointed out that this same cancer-causing asbestos was now flying around downtown. During those initial hours and days no safety equipment was available and few of the responders considered the potential consequences on their long-term health in the frenzy to rescue friends and family. Now we know that participation in the Ground Zero rescue, recovery and clean-up efforts has made these heroes sick, both physically and mentally.
Many first responders either knew people who worked in the Towers or had co-workers who got trapped when the buildings fell. In addition, those on the scene while the buildings still stood witnessed horrific scenes of “jumpers” from above hitting the ground or, worse, hitting those who were trying to help. Firefighters of the FDNY lost 343 “brothers” that day. Nobody can walk away from these situations completely whole.
To be blunt, the FDNY failed to adequately treat personnel for PTSD and other emotional issues related to 9/11 and, much like the US military, actively sought ways to get rid of those who had been harmed on the job.
In the immediate aftermath of the tragedy, graduate student interns from various mental health facilities were charged with counseling firefighters, providing little relief and often making things worse. These jobs lasted no more than six months, as internships ended and new students rotated through, requiring the therapeutic relationship to begin anew.
In addition, the FDNY Counseling Services Unit (CSU) did not promise to keep information gleaned during sessions confidential and was located above a firehouse, in full view of peers. These issues caused many to shun the program; only 5% surveyed indicated that they would get professional help for substance abuse problems. Which, it turns out, was a good thing, as FDNY offered very little in the form of substance abuse treatment for these workers.
Although cases of PTSD and depression were anticipated, medical professionals who were involved with treatment of 9/11 first responders noticed a gradual increase in the incidence of alcoholism and drug abuse after the attacks. Many had been self-medicating to avoid remembering the images; others suffered acute episodes after new traumas such as a death in the family. In 2004, there were 50% more FDNY firefighters and EMS workers treated for drug and alcohol addiction than in 2003. In the seven years after 9/11, twelve firefighters died from accidental overdose, and suicides were at unprecedented levels.
The Smithers Institute at Cornell University undertook a study to determine how the events of 9/11 affected emergency personnel. It found that FDNY personnel were twice as likely to develop alcohol problems than the national average and that over 25% were at risk of developing moderate to severe drinking problems. Disturbingly, FDNY brass has been accused of terminating for substance abuse violations those very same people who risked their lives on 9/11 and were self-medicating to treat their PTSD.
In 2004, right around the time that first responders were exhibiting signs of trauma-related substance abuse, the FDNY commissioner implemented a Zero Tolerance policy. Many first responders who were self-medicating with alcohol or drugs failed surprise drug tests and were told to leave quietly or risk public outing – none were given the option to enter treatment. Many were left without health insurance and with no way to get treatment on their own.
The first 9/11 Victim Compensation fund focused on providing economic support to the families of those who died and to those where injured directly as a result of the events. Cases were settled over the course of a few years and the fund was closed. However, we now know that many of the illnesses suffered by first responders took years to manifest, leaving these heroes with little in the way of compensation for their losses. Some have now lost their jobs as a direct result of their emotional scars.
Thankfully, and after much prodding, The US Congress recently passed The 9/11 Health & Compensation Act of 2010. This new fund recognizes that first responders have serious physical and mental problems as a result of their participation that were not necessarily observable before the first compensation fund closed. Congressmen from New York led the way in making this bill a reality, including the now infamous Anthony Weiner. The Act makes certain that first responders will receive specialized health care and compensation over the next five years. There are twenty-two covered health conditions covered by provisions of the new Act. In addition to respiratory issues, mental health conditions such as PTSD, depression, panic and anxiety disorders, and substance abuse are also covered. The Act also reopens the Victim Compensation Fund of 2001 and adds $2.5 billion to the bank account; as before, compensation awards will be decided by a Special Master.