City of Dust

by Anthony DePalma

  While Gonzalez and Kupferman continued to challenge the official line about the safety of the air at ground zero, some midlevel bureaucrats were quietly raising their own voices to question whether adequate precautions were being taken to ensure the safety of New Yorkers. On October 5, three weeks after the planes had brought down the towers, an official with the federal EPA wrote to one of the city’s top health officials to express his worries about ground zero.

  “Health and safety concerns for workers at the World Trade Center site has been a concern from the beginning of the response,” Bruce Sprague wrote in a letter to Kelly McKinney, the health department’s associate commissioner. Sprague, who was head of the EPA’s Response and Prevention Bureau in Edison, said the controlled chaos of the site threatened the safety of the workers, who were surrounded by tangled beams and monstrous machines. But that wasn’t all. “This site also poses threats to workers related to potential exposure to hazardous substances,” Sprague wrote. He explained that the EPA’s position had been to require all workers to wear respiratory protection (the portion of Whitman’s statements that had received little attention and was being routinely ignored). Despite that requirement, Sprague said, “[W]e have observed very inconsistent compliance.” Sprague pointed out that the EPA had workplace safety jurisdiction only over its own employees.

  In a memo the next day, McKinney, angry that the EPA had complained to him about conditions that he had been bringing to the agency’s attention for weeks, laid out in three pages an overview of safety at ground zero—and started a festering dispute over who was in charge. McKinney unwittingly echoed some of Kupferman’s complaints, noting that the EPA had been slow to release the results of some of its tests and had not sufficiently informed the public of the real dangers in the air above ground zero. He also raised the issue of whether the EPA’s methods of analyzing air samples had been adequate and whether the process had left the city without sufficient information to determine the level of safety downtown. Finally, the McKinney memo opened a window on the real dynamics that were pushing many of the city’s decisions at that time: “The Mayor’s office is under pressure from building owners and business owners in the red zone to open more of the city to occupancy,” referring to the zone around the trade center site. McKinney then mentioned a discrepancy within city government. Although the Office of Emergency Management believed that several more blocks north and south of ground zero could be reopened, the city’s Department of Environmental Protection believed that “the air quality [was] not yet suitable for reoccupancy.”

  Kupferman and his Broadway office quickly became the headquarters of New Yorkers who no longer trusted their government. Residents worried about contamination in their apartments came to him for help. So did office workers who feared their cubicles had not been cleaned properly. Firefighters assigned to trucks that had been coated with dust asked Kupferman whether it was safe to use the equipment after it had been cleaned. He did not hesitate to let anyone who would listen know that he did not think it was wise to bring children back to downtown schools within weeks of the attacks. Nor did he believe it was safe for residents in the blocks around ground zero to return to their apartments. Despite such warnings, Kupferman had gone back to work in his own office on Broadway while the EPA headquarters building nearby was still closed for extensive cleaning. As he continued to hound officials to reveal the truth about what was in the air, he could hear the hostess of the fancy dinner party on Long Island casually explaining the willful deception about the spill at Brookhaven Lab decades before. And when he was called an alarmist and accused of distorting the data, he couldn’t shake the image of the crusts of sandwich bread imprinted with the dark fingerprints of Worth Leather’s employees. Kupferman knew that for Mollie and Saul Kupferman’s sake, he would continue to confront the people who were supposed to be in charge of cleaning up this disaster. If there were uncomfortable questions to be asked, and if the authorities had to face the full force of the law before they would reveal the scope of the danger, even when most people would have preferred to just get on with things, he would do whatever had to be done to clear the air.

  Endnotes

  1 Ausmus, David W., In the Midst of Chaos: My Thirty Days at Ground Zero (Victoria, B.C.: Trafford, 2004).

  2 Revkin, Andrew C., “Monitors Say Health Risk from Smoke Is Very Small,” The New York Times, 14 September 2001, p. 10.

  3In the Midst of Chaos.

  4 Gonzalez, Juan, Fallout: The Environmental Consequences of the World Trade Center Collapse (New York: The New Press, 2002).

  5. A gathering storm

  Before it came to be known as ground zero, before it stood for a time and a place that made the world look on New York with a mixture of sympathy and admiration, before it symbolized the most vicious attack on American soil in U.S. history, the 16 acres where the World Trade Center stood—and fell—on September 11 was a working fire, and thus was under the command of the Fire Department of the City of New York. That clear, crisp late summer morning, after the first jetliner smashed into the North Tower at 8:46 a.m., a third alarm went out and firefighters from all over the city were mustered to Lower Manhattan. They continued to treat the unfolding disaster as a fire and rescue even after the second jet struck its target and flames leaped from both towers far above the reaches of their longest ladders. The incident quickly escalated to a fifth alarm as hundreds rushed into the doomed buildings with their firefighting and rescue gear, climbing the endless stairs even as the towers themselves came crashing down on them.

  The death toll of 343 firefighters was a savage blow to the department of 14,000 firefighters and emergency medical service workers. But in the early hours after the collapse, when the air was still saturated with dust and laced with choking smoke from burning jet fuel and charred furniture, communications went dead and it was impossible to account for everyone. In the chaos that followed the disintegration of the towers, the department’s loss was feared to be even greater than the awful tally of 343.

  Those who survived the collapse, driven by feelings of loyalty to those who were lost, and undoubtedly haunted by some gnawing sense of survivors’ guilt, threw themselves onto the pile with little regard for their own safety. In that hellish scene, literally working atop a raging inferno, they abandoned their sophisticated equipment and scraped through the debris with shovels and buckets until they nearly dropped from exhaustion. In the first 24 hours after the collapse, 240 firefighters needed emergency medical treatment. Twenty-eight were hospitalized with various injuries. Fifty received emergency treatment because, after being enveloped in the dust cloud, they were gasping for breath.

  Reports of the condition of the responders went to Dr. David J. Prezant, then deputy chief medical officer of the department and a pulmonologist at Albert Einstein School of Medicine in the Bronx. Prezant, a wiry baby boomer and self-professed techie, and his boss at the fire department, Dr. Kerry Kelly, were on the scene in the very first moments and were immediately immersed in the disaster. In the following weeks, as Joel Kupferman and Juan Gonzalez were busy raising questions about what was in the air, Prezant and Kelly got a head start on providing the grim answers. Firefighters were most exposed to the dust and smoke, and most likely to suffer from all the hazards they contained. The results of the first medical tests on the firefighters were inconclusive, but they contradicted the optimism of the EPA and city officials who had sought to reassure people about the safety of the air. Initial blood tests showed little evidence for elevated toxins, but many firefighters complained of severe respiratory and sinus symptoms. Acid reflux complaints also were unusually high, and pulmonary function tests were beginning to show declines in the firefighters’ lung capacity.

  As a trained pulmonologist, Prezant had serious concerns that the dust would cause immediate breathing problems. And it didn’t take long for those problems to appear. Nearly every firefighter developed a severe cough in the first few days at ground zero. After it rained that Friday,
and then again on September 25, washing away much of the settled dust on the streets and scrubbing lingering particles from the air, things should have improved. But most of the firefighters continued hacking and coughing. For some, it seemed constant. Others were spitting up grayish mucus, sometimes laced with solid particles of grit that shocked even veterans who’d been through many bad fires but had never seen anything like that. They complained that they couldn’t catch their breath. A few were wheezing; some had chest pains; and most had badly irritated sore throats, nasal congestion, runny noses, and acid reflux so bad that they could barely stand straight without pain. Nearly all the firefighters were feeling these symptoms for the first time. For those few with prior histories, the symptoms were significantly worse than before.

  When the coughing became unbearable, some of the firefighters reluctantly left the pile and made their way to see Kelly and her medical team at fire headquarters in the Metrotech complex in downtown Brooklyn, where Prezant examined them. After 15 years taking care of firefighters, Prezant knew how difficult it was for most of them to concede that something was wrong. They were men (and, lately, women as well) who were defined by their work. They knew that if they were sick, they wouldn’t be allowed back to the job, so they stayed away from the medical department if at all possible. Prezant did not take their complaints lightly. Right away, the similarity of their symptoms made an impression on him. Concurrence across a broad range of people often is, in itself, confirmation that something is wrong. He knew from experience that after a big fire, it was not unusual for firefighters to complain of a cough, but it almost always lasted a few days and then cleared up. In the weeks after 9/11, not just a few firefighters complained—an overwhelming majority did, and their cough persisted far longer than just a couple days.

  Firefighters came to see Prezant with sinus passages so inflamed they were a deeper red than the trucks they drove. Some complained of severe heartburn, which turned out to be gastroesophageal reflux disease, something that is fairly common in the Northeast because of diet but that Prezant was not accustomed to seeing linked to fires. Something else haunted Prezant as he tried to work through the individual cases. Every one of the firefighters who came to see him told the same story, no matter how many years they had on the job. This one, they said, was different. The smoke, the smell, even the taste of the air around ground zero was not like any fire they had been exposed to. They told him, “Doc, this smells different. It tastes different than any fire I’ve been in.” For Prezant, a scientist at heart, this was not hard data, but he had learned never to ignore subjective signs that something was wrong, especially when they came from many different sources. At the same time, Dr. Michael Weiden, a pulmonologist at the fire department, was finding the same pattern of symptoms.

  Prezant had another set of clues to help him decipher what was going on. He was experiencing many of the same symptoms as the firefighters he was treating. He had been coping with the same dry, hacking cough from the moment he had emerged from the debris of the first collapse, which had buried him and left him wondering if he had died.

  As he did paperwork at home in the Bronx on the morning of September 11, 2001, David Prezant had no inkling that the history of the United States and his unruly hometown was being rewritten by men with box cutters. It was one of the rare days when he planned to stay home, catching up on his work. Besides his position as the fire department’s number-two medical officer, he continued to teach at Albert Einstein and to see regular patients at Montefiore Hospital. It was early, and his wife, Laura, was watching television when news of the first hijacked plane hitting the trade center came across. Prezant got revved up, preparing to respond to the emergency just as he was certain many firefighters were already rushing to the scene. But as he prepped, a special insight kept him from thinking immediately that it was a terrorist attack. A few years earlier, he and Laura had taken a trip abroad. On the return flight, their jetliner had hit severe turbulence as they neared New York and had been thrown off course. He had looked out the window and seen that they were headed in the direction of the twin towers. He couldn’t tell how close they actually had come to brushing the towers, but from inside that plane, it had looked like a collision was inevitable. Passengers had panicked. He’d heard the two people in the seat behind him vomit. The pilot had regained control and, of course, avoided a collision. But the incident was fresh in his mind as September 11 unfolded. He was just about to leave home when Laura told him a second plane had hit. Now he knew it was an attack.

  As deputy chief medical officer, Prezant responded to every major incident. There was no telling what he would find downtown or what he would do when he got there. He just needed to go. He kissed Laura goodbye, got into his unmarked blue fire department Chevrolet, and raced down the West Side Highway as quickly as he could navigate through traffic. When he was unable to drive farther, he parked the car and walked four or five blocks to the temporary command center that had been set up opposite the North Tower on West Street, which is what the West Side Highway is called as it squeezes through the canyon formed by the bulk of the trade center on the east and the chunky modern towers of the World Financial Center and Battery Park City on the west, nearer to the Hudson River.

  When he arrived at the unfolding disaster, Prezant reported to the fire department command center. There was such chaos that no one paid him much attention. No firefighters had been injured yet, and although both towers were on fire, no one worried about them coming down. Prezant wanted to do something, to help someone, but there was nothing for him to do. His pent-up nervous energy made it almost impossible for him to just stand around and watch. He hated doing nothing, especially when people were in need. In the back of his mind that day was a particular image that made him more restless still. He had heard about a doctor who, in the 1993 bombing, ran into the smoking trade center to help evacuate the injured, including one very pregnant woman. Prezant didn’t know whether the story was true, but the idea of a physician rushing into a burning building to help people in need was the kind of heroic act he hoped to be able to perform if called upon that morning.

  He pestered the fire chiefs for an assignment, and they finally gave him one. The plan was for him to set up a triage area on West Street right outside the South Tower. When he was established there, the chiefs would order Emergency Medical Service personnel to bring over anyone who needed help. Because of the scale of the buildings and the fire department’s all-out effort, they believed they would need an orderly system of prioritizing care based on the severity of injuries. At last he had something to do—not nearly as dramatic as running into a burning building, but he would be helping. As he rushed toward the South Tower, accompanied by a fire marshal, he heard what he thought was debris falling from the shattered floors of the towers.

  “Hear that?” the marshal asked him. “That’s people, the noise that people make when they hit the sidewalk.”

  That brought Prezant into the gruesome reality of what was happening around him. Until that moment, he had been responding as though it were an ordinary fire, albeit a big one. But the sound of the bodies exploding on the sidewalk near him focused his attention. He had entered an entirely new world of danger. He saw one body hit the sidewalk, and then another. There was nothing he or anyone else could do for those people. So he kept moving until he was practically beneath the South Tower. The EMS chief assigned to this post, Charlie Wells, thought the area was too dangerous and wanted to shift the triage to the middle of West Street. He directed Prezant and several EMS personnel to move immediately. The technicians from six ambulance crews gathered their equipment, but suddenly Prezant saw them running away from the tower, toward the river. He knew that some of the ambulances had come from private hospitals or were manned by volunteers who weren’t used to the terrifying scope of a New York City fire. “What a bunch of wimps,” he thought as he watched them run. It was extremely noisy, with sirens blaring and debris dropping from both towers. Dismayed by what wa
s happening to the triage operation, Prezant nonetheless found himself starting to run along with everyone else. It was a natural reaction—running because others were running, the way New Yorkers rush downstairs to a subway platform if someone in front of them is taking the stairs two at a time, even though there turns out not to be a train pulling into the station.

  As he darted across West Street, Prezant was pelted by debris from the tower that was collapsing right behind him. He got hit again and again. On his head. His back. His legs. His knees. He ran faster, heading toward one of the pedestrian bridges that spanned West Street. He was then blown under the bridge, with falling concrete and rubble engulfing him. He lay flat on the asphalt as more debris fell, and he began to worry that it would become his tomb. For a while, it was difficult to move. But he did realize the futility of his efforts. He had come down to help, perhaps to be a hero. Yet he was about to die without having done so much as put a bandage on anyone. “What a f***ing waste!” he thought. No one would know what had happened to him. There wasn’t even anyone who could notify his wife that he had died there beneath the rubble that had once been New York City’s shining achievement. No achievement now, just wasted breath.