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Letters after September 11
By Pat Pasick
Note: Like many of us, I handled
my distress about the events of September 11 partly by searching for a way
to help the victims and their families. In late October, the American Red
Cross in my locality received an urgent call for more mental health and nursing
volunteers to serve on the East Coast. I happened to call that same day. A
week later, with the support of my family, clients, and colleagues, I was
on my way to Philadelphia for a two-day training session in disaster mental
health, followed by a ten-day period of service. I had no idea what I would
find. Here is a sample from some letters I wrote about that experience. I
offer it in respect and remembrance of the many courageous, bereaved families
I spoke with, and in the hope that, as family therapists, we continue to stretch
our theories and practices in the service of helping families cope with loss
and trauma.
11/02/01
Dear Friends and Family,
It was a day of incongruities: seminars in disaster
mental health held in fancy hotels, barely contained hope that I be sent to
the worst areas in New York, unlearning my skills as a therapist and only
applying mental health band-aids, experienced, intelligent trainers (54 disasters
between them) admitting that they only had the faintest clues what they are
preparing us for. They had only been in New Jersey and Westchester, so far.
And the clincher: "How are you?" is a forbidden, even harmful
question to put to disaster victims.
The American Red Cross is an unabashed paramilitary
organization. I guess, in the face of terror and pandemonium, it must go into
action immediately and efficiently, and so it is totally top-down. I felt
like a foot soldier being asked to assemble her gear, without any idea where
her outfit is headed. I am not used to this much lack of control over my professional
life, which is usually dictated by my appointment book, and dictated by me.
The group here for mobilization training is diverse,
from a married pair of Ph.D. psychologists from Bozeman to a newly graduated
social worker from West Virginia. Some have backgrounds that especially relate
to the work ahead: hospice coordinators, grief counselors, ER psychiatric
nurses. Others are private practice therapists.
None of us will do what we got educated to do. We'll
do more than two sessions, for example. A session could be standing in line
with a distressed single mother and baby for 40 minutes, or walking a construction
worker back to his truck. It's brief, it has to be very attuned work,
and we bring the work to the clients, not the other way around.
And the work will be very emotional, like the story
of the woman who, after her husband's memorial service, called to ask
if she should have a real funeral for her husband if they find his remains
in the rubble. I think this story was meant to be deliberate stress inoculation.
So is the jarring statement that, as bodies are discovered at Ground Zero,
we won't have to knock on family dwellings and do death notifications.
The Red Cross freely admits that, while they have
decent models for most natural, and some man-made disasters, the World Trade
Center has overwhelmed their resources, and defies some well-established theories
and practices. The WTC disaster has baffled veteran workers, even those with
40 years experience.
I am a babe in the woods by comparison, even as
I gave myself a crash course in debriefing and defusing techniques before
I left. In one day here, even while some of the teaching is tedious and repetitive,
I have learned the basic ropes of disaster mental health in the Red Cross.
Like disaster is not an event, but a process that changes daily, sometimes
hourly. Like mental health workers in the Red Cross are at the bottom of the
hierarchy, sometimes working for administrators who, in their regular lives,
are machinists, farmers, janitors, bus drivers. We are called "technicians."
I have apprehensions, even with my eagerness to
get to work. They keep saying it will be emotional, sometimes overwhelming
so, but they—and I—don't dwell on that. I just hope it will
help. I travel to NYC tomorrow, heading for the disaster. Thank you all, for
your encouragement and support. More to come.
Love, Pat
11/05/01
Dear All,
Finally, some real contact with families. I am now
on the "J" service at the Integrated Care Team, in an office at
619 West 54th Street, and just back from a very full day of talking
to victim families on the phone. Tomorrow, I and another worker ( a nurse)
will make two home visits: one to a severely depressed man on the Upper East
Side, the significant other of a Cantor Fitzgerald victim, another, in Queens,
to a set of adult siblings who lost a sister in WTC. Everyone in the Service
Center, as the Red Cross calls it, are pretty convinced that very nearly every
survivor, or family member of a victim, is dealing with acute symptoms. Many
are not back to work, a few are suicidal.
The task is to reach as many people as possible,
as soon as possible. This creates a real sense of urgency among the workers
like myself. We huddle over phones in an office stuffed with desks and computers,
the walls covered with team names and examples of forms and scripts. I need
them all. I hesitated three times making my first call "Hello, I am
__________. I understand you may have lost someone on September 11…."
It's hard to take lunch breaks. Many people refuse to take days off.
The need is so massive.
My special project of the week is to be sure that
all of the families of Flight 93 (PA), have been contacted by the Red Cross,
been gifted their grants, and have mental health resources. I will be working
from the flight manifest. Some of the hijackers are on the list. I have not
been to ground zero yet, although I will probably be there on Friday, accompanying
a family containing a distraught granddaughter of a man who died in Building
Two.
New York could not be more community-minded these
days. There is a faint to acute somberness, depending on where you go, but
incredible energy and determination is everywhere. Strangers talk to me. I
feel part of a community of people who have been through something. In this
atmosphere, I feel oddly safe.
Love, Pat
11/7/01
Dear All,
Yesterday was my "day off." I left the
Red Cross at noon and made my way by subway to Ground Zero area, for my first
look. Eighteen hours later I am still rather shaken. As luck (?) would have
it, I was able to get beyond all barriers, even though I know I could get
excused from the Red Cross for crossing this line. Several policemen helped
me scout the best viewing area for a family I am escorting here on Monday
morning. One policeman, perhaps because he has a little baby daughter of his
own, was sympathetic to my quest. He waved me past the first, second, and
third layer of barricades. I found myself at the edge of the pile, standing
aside to let trucks and emergency vehicles roar back, protecting my eyes against
the blowing dust and smoke.
It was a ghastly sight, even as the pile has now
been reduced to ground level. Tremendous noise of the gigantic machines that
literally pluck up tons of debris and dump it into long dump trucks. Haunting,
haggard faces of policemen, firemen, and workers. No one speaks much. I immediately
thought of the pictures I have seen of Dresden during World War Two. We were
wordlessly waved us up three sets of circular stairs at a fire station. I
walked around the fire pole where, on September 11, a whole squadron of men
slid down in response to the explosion. This whole group may have perished.
On the roof were perhaps a dozen firemen and policemen
in full dress uniforms, visitors from all over the United States, here to
attend funerals, gazing out silently onto the scene below us. To keep from
crying unabashedly, I turned to a policeman, and tried to offer some support.
He lost two close friends in the disaster. Now, he leaves every morning at
4 AM, and returns at 10 PM, and never sees his baby daughter. "My wife
is handling it all," he said. " I feel so bad for her."
Love, Pat
11/11/01
Dear All,
I am writing in my hotel room, 35 floors above Times
Square, in a building that doesn't sway. Tomorrow, after my contact
with the family at ground zero, I will go to "Headquarters" to
"out-process." That basically means turning in my expense voucher,
but it will take three hours. I'll probably need the time to begin calming
myself. On Thursday, we visited two men in the far reaches of Brooklyn, men
whose wives died in WTC: one a proud, sad widower from Hungary left with a
four year-old son; the other, a frantic engineer who lost his wife. Their
marriage of seven years, he said, was the only happy time of his entire life.
The only way he negotiates with an enormous chasm of darkness pulling him
toward suicide is to focus on what he calls "stations of light."
In other words, doing the dishes, taking a walk, washing his face.
Yesterday, we made an urgent trip to see a young
widow whose husband, has not yet been found in the rubble. She can no longer
put off holding his memorial service, she said, and it will be this week.
She could more successfully put off dealing with relief agencies, she said
tearfully, because it meant opening up an envelope containing death certificates.
While I distracted her with a little gentle small talk, my colleague went
into the kitchen, unsealed it, saw what we had to see, and re-sealed it for
when she is ready. She reluctantly let us help list her expenses.
Everyone I talked to had to be encouraged to take
the money the Red Cross has to give. Most say, "give it to someone who
deserves it." Not only are money matters overwhelming, money itself
is irrelevant. By noon today I was working on the Flight 93 families and that
continued all today. Every phone call lasted an hour; each one was very difficult.
For some reason, the people I talked to later today were all dealing with
double losses: the deaths of a father and stepmother, a mother and aunt. I
listened, mainly, offering up ideas here and there, connecting people with
resources, convincing them to take the Red Cross gifts. Even in their acute
grief, they all seemed so appreciative of the outreach.
I want to remember what this father told me today,
a man who lost their daughter at the peak of her life, a woman who was among
those able to call home from the doomed Pennsylvania flight. "I count
my blessings," he said. "My wife and I, even in our darkest days,
keep trying to remember that our daughter's life was full and rich,
and that, as her destiny became clear to her, she was calm and at peace, and
able to talk to her mother. I'm sorrowful that her life was short, but
it was hers and she did some marvelous things with it."
He asked me at the end of our talk to find him a
little rainbow pin, a pin he lost at the memorial in Pennsylvania, one handed
out to families by the Red Cross. I found one at the Brooklyn Headquarters.
The chief there said she would simply take one off some worker's vest.
"This man needs it; we don't."
Love, Pat
11/13/01
Dear All,
I returned from New York City and the Red Cross
to an unseasonably warm and sunny day for places like Michigan. The balmy
weather drew me outside to our collection of small gardens where, remarkably,
some flowers were still in bloom. Blue salvia, black-eyed susans, geraniums,
and even the roses were bravely making flowers in mid-November. I left the
lone black-eyed Susan daisy, because it reminded me of the tall Shasta daisies
in that little garden gem near the World Trade Center. Yesterday, when I and
a colleague Darrin from Hawaii, made my last trip down there, to help a little
girl mourn the death of her grandfather, I could still see the flowers craning
upward , as if to compensate for the complete, crushing fall of the towers
two months earlier.
The garden therapy helped me release one of many
layers of sadness and fatigue I accumulated during my ten days talking to
families of the World Trade Center and Pennsylvania Flight 93 victims. Lucky
for me I had annuals planted among the perennials. As I eased the dead ones
out of the earth, right next to them were the living plants, the ones racing
to send down their roots where the winter frost cannot destroy them.
This was my experience as a mental health worker
in New York for the Red Cross last week. Stories of the dead are co-mingled
among those of the living. A father telling me about his wife's grief
shifts into telling me about his dead son, a daughter detailing her mother's
unpaid bills, so that the Red Cross can pay them, suddenly moves into a story
about how she insisted that her mother go to California with her aunt. Now
they both are gone from her life.
There is a profound blurring between dead and alive
in the aftermath of the attacks. Without bodies or remains, this has been,
and will continue to be, a long period of protracted and acute grief for many,
many families. Yesterday, the granddaughter, Jennifer, brought by her parents
and grandmother to Ground Zero kept asking, "But where is he?"
Standing with us by the barricade, as near as it seemed we could go, she pointed
to the lopsided, skeletal ruins. "Is he over there?" she asked,
in a tight, anxious voice. "What if he's thirsty, or hungry? Show
me the exact spot where he might be." Even more tightly she clutched
a little stuffed bear we brought her from our work site at the Red Cross.
How do you help a child understand what happens
if you are in a 106 story building that collapses in flames? We tried, her
grandmother and I, to help her reason it through. But nothing, even the biting
cold air blowing up from the harbor, could draw her attention from the ruins.
Using every bit of her mind, Jennifer was trying desperately to comprehend
the incomprehensible story that while her grandfather's remains are
probably seventy yards away,but she can't see them, and therefore can't
see him.
But the New York Police Department saw us, or perhaps,
reaching down through the wide empty spot in the sky, this child's grandfather
saw her tears. While we stood there, a frozen trio, paralyzed by frustration
and sadness, two uniformed policemen in a van watched. I approached them privately,
asked if she could have some piece of the rubble, anything to take away to
signify that her grandfather was surely there.
A half hour later, uniformed men with heart worked
some magic. Jennifer and her father were given hard-hats and escorted on top
of the rubble, right at the edge of one of the towers. It's a nearly
flat area now, and workers are burrowing under it. While they stood there
in hardhats gazing downward, a worker gave them a foot-long, twisted piece
of steel, and several pieces of concrete.
That little miracle helped her, I think. Jennifer
came back to the rest of us, her face less drawn and sad, excited to have
been at the spot where her grandfather, a maintenance worker, had given her
a tour, only two weeks earlier. She is going to keep the metal on her dresser,
maybe in a shoebox. Over lunch, she described to me how she'll decorate
it with pictures of the world trade towers. Her father wants to have one of
the pieces of concrete engraved with his father-in-law's name. I sense
she will keep moving through her grief now, and feel less stuck in ambiguity.
As I think of Jennifer's persistence in resolving
her confusion, I am moving now to the back of the garden. Just behind my daisy
plants is a rose bush I especially planted for the wedding we'll hold
here next summer for our son and his fiancée. One deep red flower was
left, only its edges seared by the nighttime frost. I couldn't bear
to cut it. After yesterday's catastrophic airline crash in Queens,
I need to keep something alive a little longer, a sign of hope perhaps. The
word, 'hope,' was so ingeniously planted yesterday as we bid good-bye
to the M. family amid the noisy jackhammers of street workers re-building
Lower Manhattan. Jennifer leaned up to my ear to shout, "I've
named my bear. His name is Hope. Teddy Hope!"
Love, Pat
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