WTC Ground Zero
After experiencing any disaster or trauma, a person will implement psychological defenses to prevent them from being overwhelmed with the impact and reality of the situation. At first, the person may become focused on the technical aspects, the material issues, or the concrete things so not to deal with the emotions. Then there may be the tendency to become obsessive about the technicalities of the job and the task so not do deal with the feelings. There may also be various degrees of social and emotional withdrawal as the person becomes isolated and stoical. Finally, there comes a time for emotional letting-go and beginning the grieving process. Social and community support networks are crucial during these times.
Capt. Susanne Caviness PHS-1 DMAT

WTC Ground Zero : Images from Firefighters and Steel Workers

Sep 23-30, 2001 by Capt. Susanne Caviness (US Public Health Service)

I watch the grey charred remains of a blind caught in a little tree that stands beside burned out cars in a parking lot. The blind twists and flutters in the wind; it is a reminder of that soul who once stood and looked out of a window high above the city. It is outside the clinic were I am stationed on West and Vesey Streets. Ash and mud is on the street and in the surrounding buildings. It is pulverized concrete and melted components of the buildings, combined with whatever remains that turned to ash.

The air at Ground Zero is heavy with particles. We wear hard hats and air purifiers. But the smell is always there. The PHS-1 DMAT (along with many other DMATs from across the country) was deployed to the WTC Ground Zero to staff the clinics to take care of the injured and ill firefighters and steel workers. Each team was deployed to the site for 10 days. Five PHS clinics had been established, some in tents, some in the wrecked buildings, all around the perimeter. Our clinic is on the corner across from the Pile (rubble of the WTC towers). One side of the building has shattered glass in all the windows; the other side is untouched. On the damaged side, an enormous girder is impaled in an upper floor, a result of the massive force of the blast. What was a glass atrium attached to the building is a twisted contorted mass of steel jutting into the street. It was the pedestrian walkway to one of the towers. In addition to the gigantic Pile across the street, there are many similar sites of destruction on the edges of this 1/2 mile perimeter.

My mission is to provide mental health to the patients as well as functioning as triage, assessing need and keeping medical records. We see a range of patients, including police and firefighters. The steel workers are more likely to come into the clinic with burns to their arms and eyes. The upper respiratory irritation is severe for everyone. Sometimes I just walk around and talk with the firefighters, police, and steel workers.
The following are assorted images from these conversations:
From a firefighter who has seen too much: "Two weeks after the attack, the rubble, the Pile, is still 7 stories tall. Below, in the Pit it burns like the gates of hell. It is 1200 degrees, so hot that the steel work lifted by the grapplers comes out soft. I've never seen anything like this". I am talking to another firefighter as I watch steel workers scramble high over and into the wreckage. They are cutting beams to reduce them to a maximum of 22,000 lb, 30' long twisted girders that can be lifted. I see that these are attached by cable to a crane that lifts them onto a waiting huge flatbed truck. Two men assist in the cable attachment and two assist in the loading. He continues, "This is hard, never ending work around the clock in the stifling atmosphere. The smell never goes away".
Now I have a better appreciation of what these people have endured when they come exhausted into the clinic. I am told by a firefighter resting in the clinic, "The fires are so hot in pockets on the Pile that some of the firefighters change boots 3-4 times a day. Smoke and flame come up from the Pit deep within the Pile when a piece of heavy equipment with a huge grappler pulls out a mass that allows a swish of oxygen inside".
A steel worker tells me, "Injuries are always a danger. It is much more difficult tearing this down than when we put it up". He talks of how they have to maintain a delicate balance as they work on the unstable Pile and on the rubble of other surrounding buildings.
A firefighter who has been on the Pile says in a faltering voice, "When you bring out any intact body, it's a good day". He has seen death many times this week and deals with the horror by saying, "When your number's up...... ". I ask how he manages to go on. He responds, "You just keep working and try not to think about it".
But when an steel worker finds a body or body part, then the digging stops, the firemen are called in to sift through the Pile to get the remains. We stand and watch a huge basket suspended from a crane take 5 firefighters at a time to the top of the Pile. They go down into the holes and stairwells that had been excavated in the Pile. Their mission is to bring out the remains that had been found.
A steel worker tells me, "As the days go on and on and hope for survivors fades, the digging can be more aggressive". I watch the giant machines with the 4-5 ft grappler hook sunk into the wreckage and tear out more rubble and beams, opening up more pits of fire. The steel workers are now the majority of people on the Pile.
Another firefighter sadly tells me, "When the mission changed from rescue to recovery, it was difficult on the spirits of the firefighters. They are having a hard time accepting that no more of their colleagues, friends and buddies would be found alive".
As I leave the site after one of my 12 hour shifts, I see 30-40 dump trucks lined up to come in and remove the twisted metal that had been taken down. Eventually, the metal may be gone, but the scars will remain. Memorials with photos of entire firefighter companies that had fallen, were spontaneously erected near the site. I see firefighters passing by a memorial, stop and look carefully into the photos of faces of their colleagues who are gone. They have tears in their eyes, but their faces are immobile. They stand quietly and then turn away, putting on the tough, stoical faces and go back to work on the Pile.
A foreman tells me he understood the emotional impact on the workers, "I wanted to do something for them so I arranged for a crane operator to take several firefighters at a time up in the suspended basket. Each group hovered over the Pile for a few minutes; they prayed, they cried, they said their final good-bys....".
It is raining and cold, almost midnight. No one has been found for several days. Then some firefighters' remains are located in a stairwell. A double line of firefighters carefully weaves from the opening at the top of the Pile, down the unstable wreckage, to the ground . They solemnly provide an honor line as the flag-draped remains are carefully escorted down and into the waiting ambulance. We PHS Officers, firefighters, and ironworkers stand in line on the muddy street, and pay our respects.
It was a good day.....

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