A City Bombed and Demolished
Dr. Robert Remien is a clinical psychologist based in New York City who has spent years as a mental health care provider to people living with HIV and as a researcher on HIV/AIDS issues. Following is a personal e-mail letter written by Dr. Remien, to his friends and family, in the immediate aftermath of the World Trade Center disaster reflecting upon his experiences as part of an emergency mental health team working at "Ground Zero." Upon request, he has agreed to allow us to publish this letter, with minor editing.
Friday night (9/14/01)
Dear Friends and Family,
I just wanted to share with all of you some of my experiences in NYC during the aftermath of this incredible disaster. First off, I think we have all felt a tremendous amount of concern, support, and reaching out from friends and family, from near and far -- and that has been so important to us here in NYC.
There are also a very wide range of activities going on, to provide aid and support, such as blood and food donations, housing for rescue workers and families not able to get into their homes, comfort for people missing loved ones, and counseling for all of the above.
Most health-care providers and other people I know (including many of you) have been available wherever needed to help victims and their families. And strangers are being very kind to strangers everywhere. This is wonderful to see.
Last night I spent close to 14 hours as part of a mental health team sent down to "Ground Zero" at the World Trade Center site. Stuyvesant High School is set up as a triage unit and station for the rescue efforts. I have vivid images of the entire scene that will be with me forever. There was considerable confusion upon first arrival, understandable, given the enormity and recency of the crisis. There were five of us (mental health volunteers) and a Red Cross team leader. We quickly received several "mixed signals" about what our role was to be, in this triage center, from the volunteers already on sight and the other mental health workers who were there. Some greeted us warmly saying there was a great need for our expertise; while others felt that perhaps we could be better used in other locations (further uptown). Some told us that we needed to maintain a formality and to only work in a specified location; while others suggested we mingle about and see how we might be useful. It did not take me long to realize that the "counseling" that I needed to provide was essentially being available (while not intrusive) to check in with and spend time with the rescue workers and medical personnel, many of whom have been working around-the-clock since Tuesday.
They are an amazing group of people and it was a privilege to meet and spend time with them. Many had a strong need to talk and share their experiences, including their frustrations about not having pulled out live victims, yet. Each one of them is convinced that there are people alive trapped in pockets or "voids" down there and they refuse to leave until they get to them. Their dedication and perseverance is remarkable. However, this "self-initiation" and perseverance is also unhealthy and potentially damaging. Many of these men and women are working without sleep for hours on end. They are working, for the most part, without senior supervision, since they lost many of their leaders in the disaster, and/or because they arrived, on their own, from locations outside of Manhattan and NYC. I quickly learned that a big part of my job was to give them "permission" and a reason to take a break.
Most of them were firefighters, policemen, and EMS workers who have lost their co-workers in the disaster. They would walk into the shelter with totally dazed looks on their faces, covered in dirt and dust, and having trouble breathing. They would grab a cup of coffee and be determined to get right back out there, to find their colleagues who were still missing. It seemed very helpful to get them to slow down, talk about what's going on (they welcomed having a witness to their experiences), get them to eat something, and in many cases, to lie down on a cot for awhile. Some required IV drips for hydration, eye washes, and respiratory therapy. Helping them access these things later enabled them to continue to be effective workers on the front line. At the same time, let me say that most of them were incredibly resilient in their "staying power."
The other thing I was able to do was to join in and provide concrete services such as moving in supplies, serving food, and distributing clean and dry clothing. It was incredibly rewarding to provide such "hands-on" assistance. In spite of severe restrictions about moving in and out of the work area right around the collapsed buildings, a few of us took it upon ourselves to move needed supplies right down to the "front line" where they were working on moving the rubble to try to get to trapped victims -- because the supplies were needed. Needless to say, the scene was beyond belief. It does look like what we have all seen in WWII movies when they enter a city after it has been bombed and demolished. But of course it is worse to be in it, to experience the sights, sounds, and smells, as well as the visual scene of debris, several stories high, and parts of buildings looking ready for continued collapse. The streets down there are unrecognizable from what they used to look like. I kept finding myself very disoriented.
(As an aside, the main person I teamed up with and carried out a lot of the physical work with, was the actor named Michael Imperioli, who plays Christopher on the HBO series "The Sopranos." He was there because he and his family live a few blocks away from the WTC. Once his family was safe and sound in Brooklyn, he felt it was personally important to lend a hand. Mike is an extremely nice guy and a real "hands on" action-oriented type. He was the person who first turned to me and said "we gotta get these supplies down to the front line -- they need these things down there, now." [There had been a request for dry, warm sweatshirts and hot coffee.] And while Mike would be the last person to draw any attention to himself [and he tried hard not to stand out], he was a big morale boost to a lot of the rescuers who recognized him, like his work, and were so pleased that he was there to pitch in.)
A major shift was happening last night in terms of the FEMA (Federal Emergency Management Agency) and the military moving in and taking over. I'm sure this is probably necessary for a lot of reasons, but it is also resented by some of these local rescue units who have been there from the beginning, looking for their very own colleagues. My biggest fear and concern for these men and women is that they will be forced to leave the site in the near future without having succeeded in pulling out live victims. I think that will be incredibly difficult for them to live with, even though I am sure they will not regret for a moment doing everything they are doing. (Editor's Note: As Dr. Remien feared, no more live victims were recovered from the site after this time.)
I left the site during an incredible downpour, in need of some sleep and having to get to my office for part of the day, a few hours before the president was scheduled to arrive. I ended up getting a ride in a police car (along with a psychiatrist from Bellevue) all the way uptown to my home, another example of a simple and direct coming together, with people from all walks of life helping each other out.
We all have a lot of work and healing to do, for a long time forward. I plan on continuing to offer my services in a multitude of venues that are happening and still being planned. I know there will be a lot of needed "mental health interventions" for a very long time to come. I am grateful about not having lost anyone who was close and personal in my life, although I unfortunately still anticipate receiving bad news about someone that I do know. And I have several friends and colleagues who have lost loved ones. I'm sure these things are probably true for many of us. Let's all hang in there and continue to be there for each other.
As I write this I am on Long Island on my way to be with family. There is the most magnificent rainbow and bright purple and pink sky I have ever seen. Let's all hope it is truly a symbol for better times ahead. People are starting to step out in front of their homes with candles lit, a warm and encouraging site. Please hold your loved ones close and celebrate the lives we do have. Thank you all for your expressions of love and concern and for all the work and support you are providing where needed.
With warm thoughts and love,
Back to the November 2001 issue of Body Positive magazine.
This article was provided by Body Positive. It is a part of the publication Body Positive.