9/11 Tribute Ten Years Afterward

I eagerly add my name to the list of those who want to pay tribute to those who perished in the horrific tragedy of 9/11/2001, and also to those who assisted in any way, to those survivors who were spared by either chance or the dedication of the heroic people who responded and tried to help.

As a former EMT working my way through medical school and a veteran of the US Army medical corps, I honor those who volunteer to serve, and are called upon in times of extreme need.

There are many others rushing to praise the 9/11 responders, seeking glory for praising and honoring our American heroes, and it may not be a bad thing — for one level of human need.

CLOSURE

I have often told patients that validating a loss — giving it meaning — is a good way to close the book and move on. If a mourner knows that someone lived for a reason — and died for a reason — it may be easier to say “good-bye.”

For instance, early in my psychiatric career, I counseled a woman whose son died in a prison riot. She was resistant to all antidepressants known back then –the early 90s. No surprise there – this is a hard wound to heal. A prescription is not a magic bullet, no matter how much people wish it could be.

She found healing when she decided to to work with a radical prison reform association. She actually gave them a little money (people in that part of society do not have a great deal) and got through a teary ceremony naming something or other after him.

A lot of people agreed that prisoners should not die as a side-effect of altercation and she found her comfort in banding together with them and trying to make a difference.

DON’T BLAME THE VICTIMS

People died in the events of 9/11 and lots of them. I am sorry. I would never say that any of them deserved it, no matter who or what they were.

There are many more victims of that tragedy — people that did not deserve to be deprived of family members — especially minors who were left without parents.

A lot of people compromised life and health being rescuers, and we celebrate them as heroes, but they are victims too.

WORKING AS A PRIMARY RESPONDER

Although I may seem ideologically … um – “creative” sometimes, in my soul I am a nuts-and-bolts doctor-type. Even though my time as a primary responder was mostly spent if France, I was a physician in America, and before I left for France, I was an emergency room “officer” — that pitiless young and excessively enthusiastic woman who rifled the pockets and wallets of the comatose in an emergency room looking for proof of insurance.

I want a world that has less need for primary responders. I have been in my share of disaster “drills” – both in the military and as a civilian — that evoked laughter and ignorance and confusion. I have been in the trenches, working in a hospital in Oklahoma City when the Federal Building was bombed and victims were shipped in, seemingly on an endless conveyor belt.

Now, if I am anyplace, I will be standing back at a little distance from the front lines, because I am older and do not run as quickly.

THE RISKS ARE KNOWN UP FRONT

Looking back at what happened on 9/11/2001, I could write a list — but let us start with two basic ideas for today.

First — All fires and explosions, even after they have been stopped from creating further structural damage, carry other risks so high, you could almost call it a certainty. This is a respiratory risk.

Workers at “ground zero” in New York – the site of the demolished Twin Towers – were working unprotected by breathing apparatus while trying to dig out and clean up from this unbelievable disaster.

I do not know the figures on how many people are no schlepping around heavy oxygen tanks behind them, or wrestling with nebulizers on their kitchen tables, and may well be doing either or both until the end of their days.

Many have died before this tenth anniversary of respiratory failure because they breathed in the various toxic substances that were floating around in the atmosphere while they tried to help – to do their duties and fulfill their jobs.

People seem, strangely enough, to know that this happens in brushfires in southern California. I remember hearing on the radio that anyone at risk for respiratory problems (which seems to me to be anyone who owns a pair of lungs) stay indoors, or stay away, until things cooled down.

I’ve got some respiratory allergies, but I had not had more than sniffles from those in many years. I do remember sneezing mightily during the raging wildfires of 2006 when I left our place, and gasping (admittedly more out of horror than anything else) and sneezing a bunch when I saw chunks of charred remains of leaves – raining ashes like snow.

Yes, the particles were surely too large to cause respiratory distress in some folks. But if I could see so many, there were surely enough smaller ones to cause lung damage to some percentage of the masses.

First responders, and second and third and anybody who hangs out around this sort of thing, should have oxygen and respiratory protection

COMMUNICATION IS KEY

Second — First responders need a common radio frequency. Every disaster drill I have ever been part of either made sure everybody knew something before they started or had some way for them to communicate on the site, or both.

Yet even ten years after the most catastrophic disaster in our history, there is STILL absolutely no way for people responding to a disaster to know what others are doing, For example, it is a pretty sure bet that both police and fire department will be called in a real disaster. As far as I know, there is absolutely no way for these two teams, no matter how clever and dedicated and wonderful they are. They could literally trip over each other. Or they could be disregarding the same corner of the disaster where people could be saved. Nobody knows. It is hard to believe this, but nobody seems to care. Yet this was one of the first recommendations made by the 9/11 Committee – almost ten years ago.

The solution is wildly simple. The Federal Communications Commission just devotes one — just one — radio frequency to this special link between those who react to emergencies, never to be used for anything else.

Nobody, as far as I know, has hazarded an estimate as to what went wrong because this did not exist. Having it is easy to do, yet nobody is yelling for it. They would rather argue about political hot potatoes such as same-sex marriage, climate change or building mosques anywhere near “ground zero.”

EVERY AGE KNOWS DISASTERS

Third — This is Estelle Toby Goldstein, M.D. and no, I am not a primary responder now. Too old for the military, let alone medical school, and proudly unaffiliated with a lot of organizations with whom I do not agree.

My first disaster drill took place at the Amiens, France (Now Jules Verne) University Medical Center. The whole hospital center, pretty much, could be moved underground, and there was room for this and it looked great to me.

Medical students had to see the place, and learn that it was used in WWII (the WWI stuff was far more primitive) and one of my professors looked me straight in the eye and told me this was something precious in the French experience, as people like Americans had never been attacked on their own soil, and had no idea how this felt.

His belief was that we ought to lose our egos when discussing this one on the international level. I knew little or nothing about anything medical back then, but it was a teaching assistant who suggested, as we were filing out, that I sing the famous Edith Piaf song, since he knew that I was the only person in the room full of Frenchies likely to know it, that starts:

Le ciel bleu sur nous peut s’effondrer
Et la Terre peut bien s’écrouler

which means :

“The blue sky may fall apart on us And the earth crumble from beneath our feet…”

It got a laugh, and I never finished, but it was chilling. They looked pretty damn ready to me.

THE INSPIRATION TO SERVE AND PROTECT

One person to whom I shall always be grateful is Dr. I. Albert Karp of blessed memory, the family practitioner who treated our family when I was three or so, and beyond. He was also the first person I told I wanted to be a doctor.

He smiled patronizingly at first, then looked very serious.

“Most women are too emotional to be good doctors, Estelle. They can’t make good enough decisions when things are going bad — they just act nice. You will be okay, Estelle. You are a real little scientist. Just do it. You will make a fine doctor.”

Here I am, The rest of the world, not all female, has not the time or perspective, I guess, and I am still the “little scientist,” who will only speak the truth as she knows it.