Now Only Health Worries
By Megan Finnegan
With passage of 9/11 health law, Mt. Sinai docs and patients are no longer concerned about money
The World Trade Center Health Clinic at Mount Sinai Medical Center has been treating the first responders of the Sept. 11, 2001, terrorist attacks for almost a decade. But it wasn't until earlier this year that the doctors who run the program could look to the future and know that they would be able to continue caring for the people who are still suffering from the horrible events of that day.
Since 2002, the center has operated by the grace of grants and piecemeal funding to address the ailments that have proven all too common among those who were near ground zero in the immediate moments and subsequent months after the towers fell. So far, the clinic has seen 20,000 individuals in their screening, monitoring and treatment programs. After a drawn-out battle in congress, the James Zadroga 9/11 Health and Compensation Act passed both houses last December and was signed into law in January, opening a Victim's Compensation Fund and allocating federal money to centers around the country treating rescuers-firefighters, police officers, emergency medical technicians-and recovery workers from the ground zero site.
Dr. Michael Crane, director of the program at Mt. Sinai, talks of the effects of the Zadroga Act with obvious enthusiasm. Not only does it ensure funding for the next five to six years, but it allows the doctors who run the programs to spend less time on reapplying for grant funding year after year and focus on planning ahead and assessing the data they have collected.
"We get to look sort of longer term, at the bigger picture," said Crane. "There's actually research dollars in there. So questions that are coming up now about things like cancer and other types of illness can be answered."
Currently, the funding only covers treatment of illnesses that are generally agreed to have been caused by the conditions after 9/11; cancer is not included.
"Over the years, the concept of World Trade Center-related illness was established. When doctors looked at the populations, saw the patients and wrote up their experiences, doctors here, doctors in the fire department, doctors downtown were all seeing the same thing," said Crane. The most common conditions have been chronic respiratory ailments, like nasal irritation, sinus problems and asthma, and gastroenterological issues such as acid reflux, as well as a high incidence of mental health conditions like post-traumatic stress disorder, anxiety disorders and depression.
"If you don't have that illness or those types of illnesses, up to now we've had to say, 'listen, this is not covered, you have to go see a private doctor,'" said Crane. "Now under Zadroga, there's a mechanism by which a guy like me in the clinic sees somebody and thinks, boy that's a strange-looking thing, and then maybe I see two more of those two weeks apart, I can say, 'These are really strange illnesses, we shouldn't be seeing this.' I can petition the World Trade Center administrator and say to Dr. [John] Howard, head of the National Institute of Occupational Safety and Health, 'I think these conditions may be related to World Trade Center exposure.'"
John Williams, a retired NYPD detective who now lives in Westchester County, makes the trip to the Mount Sinai center to treat his chronic respiratory problems that sprang up only recently, years after he arrived on the scene in the days following 9/11.
"We were assigned to the landfill in Staten Island, sifting through the debris that was brought to the site, looking for human remains, personal property, identification, whatever we could find," said Williams. Until last year, he was in the monitoring program at Mount Sinai, just going in for checkups and testing. But last year around Thanksgiving, he got sick with something resembling the flu, and respiratory problems only became compounded from there.
"I couldn't breathe for, like, a month and a half," he said. Williams has nothing but praise for the doctors at the center, and said it's a help to have access to a place dedicated to treating the 9/11-specific ailments that medical professionals and scientists are still struggling to understand. "I've been getting treatments and tests ever since."
New York representatives Peter King, Carolyn Maloney and Jerrold Nadler sponsored the Zadroga Act, named after Detective James Zadroga, an NYPD officer who developed severe respiratory problems after 9/11 and died in 2006. Though the bill's authors represented bipartisan cooperation, it was hotly debated by the rest of congress, criticized by the right as bloated government spending and by the left as not going far enough. Ultimately, because the cause of cancer in any form is difficult to prove, the sponsors decided to leave it out.
"This bill was passed by Congress only days before the Christmas holiday-a feat that very nearly did not happen," Maloney said. "If we had put a presumption in the bill that required cancers to be covered, it would not have passed."
A study in the British medical journal The Lancet released last week found that firefighters who worked at ground zero are 19 percent more likely than their peers who were not at the site to develop different types of cancers. While the doctors behind the study are cautious not to leap to conclusions, Crane and others are hopeful that the results will allow Howard to consider adding certain cancers to the coverable illnesses under Zadroga.
"We carefully crafted the legislation to allow opportunities for cancers and other not-yet-covered ailments to be added once they had passed the burden of scientific evidence," said Nadler. "Anyone familiar with the ailments of responders and survivors of 9/11 knows that cancer has become a huge and mounting problem."
"Here are people-all of a sudden they are in the middle of this toxic mess," said Crane. "There's fibers and there's asbestos and there's metals and there's dioxins and there's all kinds of aromatic hydrocarbons and all this God-knows-what awful brew that is known to cause cancer. That stuff is carcinogenic."
Crane stresses that there is a lot still to be discovered about how 9/11 affected rescuers and responders, and that it's better to be scientifically certain when covering new conditions. The good news is that there is now funding to determine what types of conditions should be included.
Williams recalled speaking to one of the doctors on a recent visit to the Mount Sinai clinic. "He was talking about it, [saying,] 'You just don't really know what the next 10 years are going to bring.' For me that was kind of sobering," said Williams. "I've got these things going on now, but where is my health going from here? Nobody knows."
Dr. Michael Crane, director of Mt. Sinai's Zadroga Health Clinic Center. The center recently received federal funding for treatment of first responders to 9/11. PHOTO BY andrew schwartz
Instead of Eateries, Zagat Compiles Accounts of 9/11
Tim Zagat is best known for his eponymous restaurant surveys, which he co-writes with his wife Nina. Zagat is taking a departure from the culinary world with the recent publication of his book 9/11: Stories of Courage, Heroism and Generosity. The work is a compilation of first-person accounts of Sept. 11, 2001, and its effects, from many noteworthy contributors including Downtown Alliance President Elizabeth Berger and restaurateur Daniel Boulud. In the opening piece, former Mayor Rudy Giuliani and then-Gov. George Pataki recount their experiences of that day and those following.
Pataki described the deliberate choice to make Giuliani the public point person in the days after 9/11: "Rudy was tremendous at the public aspect and I didn't want competing voices or messages. So he became, appropriately, the public face of the response, while behind the scenes, both teams [city and state] worked incredibly hard to make sure that everything that needed to be done was done."
9/11: Stories of Courage, Heroism and Generosity is available at Barnes and Noble.
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