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I helped 9/11 survivors recover. The worst part came 6 months after.

At first he didn't look suspicious, not to me anyway. A tall guy in his late 20s, sandy brown hair, glasses, wearing khakis and a blue striped button-down shirt. Just another downtown office worker, laid off and seeking a little help with the rent.

I was stationed with two other caseworkers in the center of an enormous rectangular room, nearly a football field long. A freight train of folding tables snaked down the center, throngs of people buzzing around them.

It was busy that day, and loud — hundreds of conversations, chairs scraping and banging, voices raised. Still, through the crowds and the din, my coworkers Shelley and Maria managed to peg this guy the moment he cleared the FEMA table.

He ambled along the tables, pausing at one, then the next, never staying long enough to talk to anyone. As he drew nearer, I realized what caught Shelley and Maria's attention — he was scanning the crowd like he was at the airport, looking for a friend whose plane had just landed. And he was grinning.

Once he passed us, we saw the sign.

He'd taped it to his back, a piece of plain white copy paper on which he'd written with a marker, in big black letters:

ASK ME ABOUT MY PTSD

Shelley sighed, and she and Maria exchanged a knowing look.

Trained social workers taking a break from their careers to help the Salvation Army's disaster recovery program, they were both also uncannily perceptive, like honeybees sensing a foreign bee in the hive.

"Watch," Shelley said to me, leaning in and talking in a voice only Maria and I could hear. "He's going to turn around, come back here, and say something really inappropriate." Maria nodded.

The man walked to the next table, shuffled around the cluster of people for a few minutes, and then, sure enough, turned and headed back to us.

"Did you see my sign?" he said, puppy eager.

"Yes, we saw your sign," Shelley said, "and we don't think it's appropriate."

"PTSD isn't funny to a lot of the people in here," Maria said.

"But I don't have post-traumatic stress disorder," he said, grinning wide. Then, much louder, "I have post-traumatic SEX disorder!"

He paused for us to laugh, and looked confused when we didn't.

"See, what that is—"

"That's enough," Maria said, sharp. She stood and walked around the table. All of 5-foot-2 and dressed like a sexy librarian — snug blouse and pencil skirt — Maria usually counseled homeless patients at Bellevue Hospital, the institution famous (and infamous) for treating New York City's poorest and sickest.

Her abrupt interruption had the desired effect on Mr. PTSD — she'd startled him, and he shut up. One hand on his elbow, she led him, gently, away from the tables, over to the long south wall, which was lined with huge windows that flooded the room with daylight even on the most wan of winter days.

Through the windows I could see the broad white stairs of the New York City Supreme Courthouse, made famous on so many incarnations of Law & Order. Half a mile farther south was ground zero, which wasn't smoking anymore, or filling the room with odd, caustic chemical smells. But still, it loomed.

We couldn't hear Maria, but knowing her, she probably took an approach that was 50 percent coaxing and empathy, 50 percent high school principal.

Ruin of a building after 9/11

(Shutterstock)

Likely, she reminded him that the Disaster Assistance Center was a building full of trauma victims, and asked something like, "You know what the people here went through. Do you really want to upset them?"

He looked wounded, and as Maria murmured and gestured, his head drooped lower. After a bit, the guy turned around and let Maria remove his sign. They walked away toward the end of the room, the young man now doing most of the talking.

They disappeared around the corner, where a cubicle stood, sticking out, an island rising above our sea of folding tables. That was where the crisis counselors worked.

Maria returned 15 minutes later, alone.

"Get him signed up?" Shelley asked.

"Yep," Maria said. "He had a few visits with a therapist right after, but he hasn't been back in months. I told him it's time to go back for a tune-up."

"What was up with that?" I asked.

"Borderline?" Shelley asked Maria.

Maria nodded, thoughtful. "Mmhmm. That'd be my guess," she said.

They both faced me.

"He probably has a case of borderline personality disorder," Maria said.

"Possibly brought on by the trauma," Shelley interjected.

Maria looked skeptical. "Maybe."

"He came here looking for attention, but the kind he was getting, one on one, one person at a time, wasn't enough," Shelley said. "He probably tried to engage with some clients, and that didn't get him what he needed. So he made the sign."

All three of us bore the title "caseworker," but Shelley and Maria were pros; I was not. In August 2001, I had been a freelance journalist. In October, I responded to a call for volunteers that said, "The Salvation Army needs people who can conduct interviews." Now, in March, I was in over my head.

No matter how many jobs are created or office towers rebuilt, no matter how many hours of counseling are logged, or how grand the memorial, the reformation is always founded on loss

Ours was just one of a dozen or more agencies all working shoulder to shoulder on a single floor in a building in downtown Manhattan, on Worth Street, a funky, endearing mix of shabby and grand — green marble floors and columns, a soaring ceiling, with cheap fluorescent lights and a battery of scuffed plywood teller windows.

The building's big brass doors were thrown open every day to almost anyone who suffered a loss because of the attacks of 9/11. Nearly six months on, and each day was as busy as the day before: hundreds of survivors flowing in, seeking help, sometimes for problems they were only dimly aware of.

Had I been alone at the table that day, I would have risen to the bait, snapped at the man and his sign, or given him a halfhearted mercy laugh to get rid of him. He would have moved on unimpeded, explaining what his PTSD "really" meant to unsuspecting clients, unamused caseworkers, and maybe a few silver-haired Red Cross volunteers from Idaho. He would not have confessed that he'd quit the therapy that had been helping him; he would not have received help paying for more sessions. He would have melted out into the city to deal with his problems on his own.

The truth about disaster relief: even when a community looks restored, it isn't

Emergency management experts have identified four stages that communities move through after a disaster. The first is the hero phase: Rescuers rush in with boats to pluck stranded people off rooftops; firemen run into burning buildings. After that comes the honeymoon phase, when everyone pulls together to care for and comfort one another.

For six months, we — my coworkers, our clients, me, all of us — lived in the honeymoon phase. One social worker would later describe it to me as the time when everyone is still extra nice on the subway. It's when survivors realize that's what they are — survivors.

In their relief and gratitude, people (like me) rush to volunteer to help the recovery, or flood the Red Cross with donations, or hug crying strangers on the street. It's a period of thanksgiving, and of hope.

Emergency center on Wroth Street in New York

The disaster center on Worth Street. (Kelly Caldwell)

We bathed in it. Our disaster center on Worth Street in Lower Manhattan was where you applied for aid if you had worked downtown, or lived there, or lost a job in the hospitality or airline industries.

Our clients told stories of horror, of sleepless nights, of strained marriages, of fourth-graders developing migraines and 29-year-old nonsmokers developing mysterious lung diseases. Caseworkers arranged counseling visits, paid rents and mortgages, phone bills, medical bills. We helped clients fill out applications for small business grants and referred them to special programs to replace mattresses filled with toxic dust. We argued with landlords and haggled with FEMA.

We listened.

We started calling ourselves the lucky ones, created a new meaning for those words. "Were you there?" people would ask. "Did you know anyone...?" And we'd rush to say, "No. No, I'm one of the lucky ones."

Calling ourselves lucky, scrambling to treat trauma, and blocking bankruptcies and evictions helped us hold it together. But it also concealed the truth of any major disaster: Once the debris is cleared and the wounded released from hospitals, buildings rebuilt and memorials dedicated, the community looks restored. But it's not.

It's re-formed, reconstituted. No matter how many jobs are created or office towers rebuilt, no matter how many hours of counseling are logged, or how grand the memorial, the reformation is always founded on loss.

At first there's hope. Then comes deep disillusionment.

What we call disaster recovery is more like fitting an expensive new prosthetic leg on the hip of an amputee. With work, you walk. But it's not a cure. Trauma is a phantom pain that has a way of lingering, of dissipating for a while, then roaring back again.

The honeymoon phase masks that truth; when it finally sinks in, that's when the third phase, disillusionment, begins. The urgency to find survivors, clear debris, treat the wounded, and comfort the grieving evaporates; the optimism that helps survivors face an uncertain future wears off.

What you're left with is reality.

the street after 9/11 with emergency workers

Lower Manhattan after 9/11. (Shutterstock)

For New York, that transition arrived in March around the time the city inaugurated the Tribute in Light, the first official memorial. It marked the six-month anniversary of the attacks, filling the gaping hole in our skyline with two brilliant skyscraper-size beams of light, so that every evening for one month, we went about our lives beneath the ghosts of the towers we'd lost.

It was also about the time the city set a date to finish the debris removal (and the search for bodies) at ground zero, and should have begun work on a new tower at One World Trade Center. That expectation, too, began to slip away. New York's governor and the real estate developer who held the lease (and all the insurance money) had already squared off for an epic battle over power and legacy, hiring dueling architects, choosing designs and then replacing them. Though there were symbolic starts and photo ops, construction would not begin in earnest for nearly eight more years.

Hope wanes in the disillusionment phase as money dries up, jobs return slowly if they do at all, and the rest of the world moves on.

Some people waited months to ask for help — because they didn't want to seem ungrateful

Inside the disaster center, things were winding down. A month or so earlier, the Salvation Army, the Red Cross, and other agencies (who'd received billions in donations for this disaster) began turning off the spigot of money that was keeping its clients afloat.

If you had sought help in December, you left with your mortgage and all of your bills paid; in January, the Red Cross gave thousands of clients lump-sum checks for three months of living expenses. By March, the Salvation Army was capping what it would offer at $750. You would be lucky to get anything from the Red Cross at all.

And we were relocating. At the end of the month, the charities would leave this building on Worth Street, spend one month in a former bank near City Hall, and then we'd scatter, each agency settling its disaster program into more permanent space.

For the Salvation Army, it would mean setting up in the basement of the New York City headquarters on 14th Street, in a room that looked a lot like a church rec room, complete with a stage and a piano under a dusty cover, but nothing like the grand hall on Worth Street.

Hope wanes in the disillusionment phase as money dries up, jobs return slowly if they do at all, and the rest of the world moves on

Local news channel NY1 recently reported that the disaster center would soon close, churning up a rush of last-minute applications. Among them were a startling number of people who had been out of work or displaced from their homes for four or five months but had never sought help, until now. They heard about those big checks from the Red Cross, for $10,000, $15,000. They heard about the Salvation Army approving so many rent and mortgage payments that the check writing machines couldn't keep up and we'd had to buy new ones.

Over and over, we broke the bad news, of deflating dollar amounts and new restrictions, as gently as we could. Some clients slumped over, elbows on knees, some just sighed, a few burst into tears. I found that I didn't need too much coaching to convince people to walk with me to where the crisis counselors worked — it was one place where the grants were still generous.

When these later-comers turned up, I wanted to ask them, "What took you so long?" but I didn't. Clients explained anyway. They thought disaster aid should be for people worse off than they were, they said, though some of them were downright broke. Or it felt like double dipping, accepting disaster aid when that new job was right around the corner.

More than that, though, they talked about applying for assistance as an act of ingratitude. "Who am I to complain," said a man who'd worked in Tower 2, "when so many other people are hurting worse?"

Part of the World Trade Center on 9/11

(Shutterstock)

They were the lucky ones:  lucky to have escaped their building in time, lucky to have worked a block away, lucky to be alive. Two thousand of our neighbors were murdered, an economic crisis was sweeping across our city like a rolling blackout, and we were exposed for months to toxic smoke, dust, and water, while the city and the EPA insisted our air and water, homes, and workplaces were perfectly safe. These people faced eviction, insomnia, and a low-simmering rage they didn't know what to do with. But they couldn't ask for help. That would have been akin to filing a grievance when they should be counting their blessings.

One man in particular embodied this peculiar logic. Mark had worked in IT for a company located in Tower 1, on the 80th floor. Over the months, I'd met a lot of survivors who'd walked out of one of the towers — down 20 flights of stairs, 50 flights, and a few who had, like Mark, walked down 80 flights. Their descriptions were uniformly harrowing — burning, shaking legs; dim, smoke-filled stairwells; people crying, hyperventilating, stumbling; doomed firefighters rushing past them, going up. Mark, though, was different. He was the only one I'd met who had walked down from such heights with multiple sclerosis.

MS is a progressive disease where the body's immune system attacks the brain and nerves. Your muscles weaken, and gradually stop obeying your commands. Mark's MS had affected his legs. Aside from being tall, he wasn't the kind of guy you'd normally notice, with his wardrobe of khakis and polo shirts and his nondescript, light brown hair. Until you saw him walk, that is. He moved through the disaster center in a stiff, lurching gait, with occasional jerks and tremors.

As everyone in his office started their descent, it quickly became clear Mark would not be able to keep up. The CEO of his company told everyone to go on ahead, and he stayed behind. Mark struggled to move his legs, struggled to keep his balance. The CEO kept him upright, kept him moving. After an hour or so, they were joined by two rescue workers, and together the four of them heaved and stumbled their way to the ground and out the door.

Four minutes after they left the building, it collapsed.

The hollow promise of "I survived — so can you"

The disillusionment phase is one of the most critical times in the aftermath of a disaster. While the hero phase ends and the honeymoon phase inevitably gives way, the disillusionment phase can linger, especially in vulnerable corners. Without intervention, survivors can get stranded in it. They could live the rest of their lives like it was still March 2002 — forever in the shadow of the ghosts of the Twin Towers.

Mark had written about his experience for a national health services newspaper, and he told his story to anyone at the disaster center who'd listen. He came to Worth Street with a thick stack of article photocopies that he handed out. As he did, he'd say things like, "I survived — so can you," or "We're going to get through this, we just have to keep going."

He approached me when I was between clients and gave me a copy of his essay. As we spoke, he kept emphasizing his luck — he was lucky he'd been keeping up with his physical therapy and strengthening his legs; lucky his health insurance covered his medications; lucky he worked for a CEO who'd risk his life for one employee.

Beneath the gratitude and optimism is the dream that everything can be restored

He also spoke of himself derisively.

On the long trip down, he often thought, Why me? he said. "I thought, ‘Why couldn't this happen in a building where no one has MS?'

"My boss didn't throw himself a pity party," he said. "He just told everyone else to keep going, to get out, and he stayed with me."

Mark's eyes clouded over, and for a moment, his salesman-like good nature faltered. "He could have died," he said.

Civilians in the dust after 9/11

Survivors worry about toxic air in Manhattan. (Shutterstock)

"He could have, but didn't," I replied. "And what about those two rescue workers?"

"What about them?"

"If they hadn't stopped to help you, and your boss, what would have happened to them?"

"They would have helped someone else." He shrugged. "Maybe someone who could move faster."

I looked out the window for a moment.

"Or," I said, "they kept moving up those stairs. They went higher, and deeper inside."

In the heavy silence that followed, it occurred to me that Mark, though kinder and more empathetic, was not so different from Mr. Ask-Me-About-My-PTSD. Both did not seek disaster aid until March. Both arrived wielding a piece of 8.5-by-11-inch copy paper as a thin disguise. Mr. PTSD pretended his sign would spread levity; Mark believed his essay would inspire people to persevere.

Those papers — their masks — were the crutches of two men clinging to the honeymoon phase, to the strategies that brought them this far. They weren't willing to let go of that time, and I understood it. All that generosity, that kindness, even the gratitude, it was all such a balm.

When we talk about that time, we focus on the extraordinary warmth, sometimes to the exclusion of the very suffering it eased. Insomnia, nightmares that repeatedly hauled you out of sleep or barged into your thoughts during waking hours, guilt and sadness, and a constant anxiety about the future — of your finances, your safety, your city, your home.

We repeatedly assured clients those things were normal and would eventually fade. But some survivors need more help than others to ensure that. Without it, instead of fading, the trauma sticks to them, digs in. It corrodes.

At one point, a group of Hawaiians traveled 5,000 miles to the Disaster Assistance Center, bearing hundreds of leis. They walked through, offering the leis with a hug or a kiss, and words of comfort and solidarity. But when I heard they'd be coming, I was downright grumpy about it. My clients needed jobs and help with the rent, I thought; wreaths of orchids didn't accomplish either.

Then a woman laden with pink and purple flowers approached me and asked me how long I'd worked with the recovery.

"Since October," I replied.

"Oh, my dear," she said. She draped a lei around my neck, kissed my right cheek, and enfolded me in a hug. "You are not alone." She pulled back and grasped my shoulders in her hands. "And thank you."

police car covered in dust on 9/11

(Shutterstock)

It was as though I didn't know I had frostbite till she wrapped me in a blanket. Heat flooded in, relaxed the muscles I didn't realize I'd been clenching, quieted the worries barking away in my mind. For days, I felt the traces of her hands on my shoulders.

I would have clung to that feeling, if I could. Therein lies the risk. For all the healing of the honeymoon phase, it also baits the trap of disillusionment: Beneath the gratitude and optimism is the dream that everything can be restored. Gazing back and wishing for the way it was, you are repeatedly reminded that your dreams are an illusion, and you grieve that loss all over again.

A key to healing: accepting the disaster as part of your identity, without letting it define who you are

On the other side of disillusionment is the final phase: reconstruction. You put that prosthesis on what's left of your leg. You tally the insurance payouts and build the building you can afford. You stop talking about how lucky you were, and start thinking about where you are.

Often we measure recovery by what is regained, like jobs, or healed, like broken bones and burns, or rebuilt, like houses. But reconstruction means figuring out how to adapt, to accept the disaster as part of your identity, without letting it define who you are.

This is one of the roles of disaster aid, accompanying survivors through that reckoning. Sometimes it means getting clients into therapy, or sitting with them as they come to terms with all the ways they'll never be the same. Sometimes it's as simple as persuading a guy to take the handmade sign off his back.

Eventually, my lei died. Mr. PTSD's jokes were running out of gas, and Mark's motivational speeches were too. The disaster agencies had spent their billions. The city faced a massive fiscal crisis, and no help would come from a federal government enmeshed in one war and preparing for a second. The resources New Yorkers hoped to draw on — financial, physical, spiritual — would not be coming.

One World Trade on Manhattan skyline

One World Trade Center, under construction in Manhattan. (Shutterstock)

For many people, reconstruction meant living a life in some way diminished. Nearly 3,000 people died, and the deaths would continue, in Afghanistan, in Iraq, and in New York, as both rescue workers and office workers who returned to the neighborhood succumbed to illnesses caused by close proximity to ground zero. Some survivors would live with disability or permanent illness. Some lost their homes. Some would move away.

But we weren't all doomed. When I was still working at the disaster center on Worth Street, I often fantasized about renovating it — tearing out the crap, buffing the marble, restoring it as the city had restored Grand Central Station.

Instead, after more itinerant tenants and modest renovations, the building would emergeas the city's new marriage bureau. It opened just in time for the state to lift its ban against same-sex marriage, ushering in a new era. Word around the city is that where marriages in the old city bureau were perfunctory, inside the renovated space on Worth Street the ceremonies are spirited and moving. Our shabby-grand recovery center is now at the center of not only history, but joy.

"Were you there?" people would ask. "Did you know anyone...?" And we'd rush to say, "No. No, I'm one of the lucky ones."

When brides and grooms first looked out those big windows, they would have a great view of the hole in our skyline. I wondered occasionally if they noticed the gap. Probably not. After so many years, weren't we used to that hole by now? We had shiny new towers for Five WTC and Seven WTC, and between them, just more sky than before. This was just New York City's downtown skyline, reconstructed.

Then the skeleton of One World Trade Center began to rise.

It sidled into that gap, not filling it so much as sharing it with the ghosts of the buildings that came before. I didn't realize until I saw it: All along, I'd been waiting for something to arrive, something to confirm not only that New York survived one terrible day, but that we'd kept on surviving.

One WTC does that for me still, reminds me that we re-formed our city and ourselves around our scars, and we are resilient enough, alive enough, to plant something in Lower Manhattan, to heave and hammer it, a thousand feet into the sky.

Kelly Caldwell's articles and essays have appeared in House Beautiful, Newsday, Men's Health, and Time Out New York, among many others. She worked for the Salvation Army's World Trade Center Disaster Relief program for 15 months, and still lives in New York City, where she teaches creative nonfiction and is dean of faculty at the Gotham Writers Workshop.


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