Even after Dr. Charles Hirsch and a team of medical examiner’s office staff, backed by voluntary pathologists, had meticulously examined thousands of remains to come up with a list of 2,749 people who had died when the planes smashed into the towers, doubts remained about whether that number was complete. Detective James Zadroga’s name may have been on the massive compensation bill before Congress, but it was not on the official list of victims, although many people thought it should be. Neither were the names of Kevin Rogers, Cesar Borja, or dozens of responders who had already died at comparatively young ages. Although they all had toiled at ground zero and then died of causes that seemed plausibly linked to their exposure to the trade center dust, Hirsch’s office did not recognize any scientific proof to back up such a link. Hirsch was the gatekeeper to the official list, and the list was the guide to the controversial 9/11 memorial. The mayor had decided that only names on the official list would be so honored, and only those deaths that Hirsch categorized as murder would be put on the list.
This situation raised complex issues of science and law, never a clear ground and now even more confused and entangled. The standards of certainty that applied to the courtroom differed, by necessity, from those that were applied in the morgue. “Beyond a reasonable doubt” was not achievable in pathology or epidemiology. Instead, doctors and scientists strived for a different standard that could be summed up in the phrase “with a reasonable degree of medical certainty,” as Dr. Gerard Breton had written in Zadroga’s autopsy report. But reasonableness and certainty were abstract terms that could be adjusted according to the views, beliefs, and goals of those who used them. Few, if any, absolute proofs could link the dust to a particular disease, especially at this relatively early point in the unfolding mystery. Thirty or 40 years into the future, epidemiologists might be able to provide strong evidence showing that a spike in a certain type of lung disease or cancer among the group of responders could be linked “with a reasonable degree of medical certainty” to the trade center disaster. But there would always be exceptions and a degree of doubt. This was a basic fact of life for epidemiologists and a constant source of puzzlement for people who had to confront the mysteries of illness. Countless people said of a loved one, “He was healthy before 9/11—played basketball with the kids and ran 3 miles every day—and now he has trouble climbing a flight of stairs. What else could it be?” Similar questions are asked all over the country whenever a cluster of illnesses is detected. Whether it was breast cancer on Long Island, or childhood leukemia in parts of New Jersey, attempts to link the outbreaks to the water supply or nearby industries were tantalizingly easy to make but frustratingly difficult to prove.
For some experts, looking for a plausible link between an event such as the trade center collapse and the occurrence of diseases in a certain group of people is similar to developing photographic film. When negatives are first placed in a chemical mix, the images appear blurry and indistinct. Only after several minutes in the developing solution do they become clear.1 The same is true of science and certainty. Initial conclusions are indistinct and suggestive. It takes time, and effort, for the shadows to fade and the outlines to become distinct.
By 2006, five years after 9/11, Zadroga’s death was the only fatality that had been linked by autopsy results to the dust. But because the findings had been reached outside of Hirsch’s office, they did not meet the standard of proof needed to have Zadroga’s name added to the official victims’ list. However, little known to Hirsch and most other New York officials, one other death had been legally ascribed to the dust. But when the case was revealed, it opened another complicated and frustrating avenue of investigation.
Felicia Gail Dunn-Jones was an idealistic young black lawyer, a striver married to a pharmacy supervisor named Joe and the mother of two teenagers. Daughter Rebecca was enrolled in one of New York’s most competitive schools, and Joe junior was a big kid with a big temper that his parents were disturbed to eventually find out was severe autism and a mild cognitive deficiency. To keep Joe junior’s emotions in check, the family had adopted schedules for everything, and they had learned to live by those routines religiously. Changing even the sequence of the smallest steps could send Joe junior into a rage.
The morning of September 11, 2001, began no differently than any other. Dunn-Jones had gotten permission to be on a flex-time schedule at the U.S. Department of Education civil rights office in downtown Manhattan, where she worked investigating rights abuse claims. She normally was the first one to show up in the morning and one of the first to leave in the early afternoon so she could get back home on the North Shore of Staten Island before Joe junior came back from his special-needs school. That morning she left their house, an up-and-down duplex where the Joneses lived on the second floor, just as the day was beginning. She did not have any interviews scheduled that day, so she was dressed casually—jeans, sandals and a V-neck aqua blue blouse. It was not yet 6 a.m. when she walked the block and a half to the corner of Crescent and Westervelt avenues to catch the number 42 bus that would take her the short distance to the water’s edge, where she would board the Staten Island Ferry for the quick trip across the harbor to Manhattan. It was her ordinary routine, even though this was not an ordinary day because of the scheduled municipal primary election. She always voted, and she planned to do so, along with all her other domestic duties, when she got back from work. When she disembarked at the southern tip of Manhattan, she walked a few blocks north to her office at 75 Park Place, one block above the trade center. It wasn’t unusual for her to stop in the towers on her way to work. Her credit union was housed there, and the gym she went to regularly was located inside the Marriott Hotel in World Five. She had worked out at the gym on September 10.
But on the morning of the 11th, she didn’t have time to stop at the gym or the credit union. When the first plane struck a short time later, Dunn-Jones and the other lawyers rushed to the window to see where the noise had come from. From the fourteenth floor, they could see the skyscraper on fire, smell the burning jet fuel, and hear debris pelting their building. No one was sure what had happened, but Dunn-Jones decided it was too dangerous to stick around. When she got to the lobby, a security guard stopped everyone, saying it was too dangerous to go outside just then. She and the others who had tried to flee were advised to go back to their offices. Dunn-Jones did as she was told. She had always believed that laws and rules were meant to be followed, which was one reason she became a lawyer. After she got back to her office, she joined the others at the windows as they watched the fires spread. Then the second plane hit. This time no one waited to be told to evacuate. Dunn-Jones headed down to the lobby and out into the street. To get back to the ferry, she would have had to walk past the towers, which she knew was impossible. Her exit route blocked, she wasn’t sure where to go, but she didn’t want to stay where she was. She made her way north, moving with the crowd away from the burning towers. Once she got to what she figured was a safe distance, she stopped to watch the disaster unfold and try to figure out what to do next. It seemed unreal, both frightening and fascinating enough to keep her from running away. At that moment, she was not far from where Mayor Giuliani was trying to establish his command center, or where Kevin Rogers was checking the grid, or where David Prezant was setting up his triage center. Then she heard the sky roar and watched the South Tower buckle and fall. Within seconds, the cloud of dust barreled toward her, moving faster than she could run.
Frightened, and thinking about her family spread out all over the city, Dunn-Jones ran for her life. The dust got heavier, and then the menacing plume of smoke and ash overtook her. She tried to cover her face, grabbing her blouse and pulling it over her mouth. She choked on the dust and was close to panicking when she ducked into a delicatessen, taking refuge there until the most blinding part of the dust cloud had passed. A few minutes later, though dust still blanketed the air, enough sunlight seeped through for Dunn-Jones to find her way. As she ran, she saw someone
fall. When she stopped to help him up, she looked into his face and saw absolute shock in his eyes. She had just bought a bottle of water when the second tower gave out. Again she was smothered by dust. It clung to her skin and worked its way into her eyes, nose, and mouth.
The buses weren’t running, the streets were filled with people, and no one knew whether there would be more attacks. Dunn-Jones was too scared to stay in Manhattan. The only option left was to get to the Brooklyn Bridge and then to her sister-in-law Joyce’s house in Fort Greene, Brooklyn. She crossed City Hall Park, but by the time she got to the foot of the bridge, the police had put up barricades and were stopping everyone except emergency responders. Not knowing how long the bridge would be shut, she headed north, toward the Williamsburg Bridge, which would get her to Brooklyn. But it, too, was closed. Exhausted from the walking and the sheer terror, she decided to just wait until the police reopened the Williamsburg. Hours later, she joined the long lines of dust people staggering across the century-old bridge to Brooklyn, all of them looking as though they had marched, fully clothed in business suits, through a desert.
That morning had begun with a similar rush and routine for Dunn-Jones’s husband, Joseph. Tuesdays and Thursdays were his favorite days of the week because he didn’t have to be at work at the Reiter and Patio Pharmacy on Flatbush Avenue near Prospect Park until 11 a.m. That gave him time to have a relaxed breakfast or to stop for a few minutes at a morning concert as he made the long trip from Staten Island to Brooklyn. The one option he didn’t have was to sleep late. Joe junior’s need for routine kept the entire family on a strict rise-and-shine schedule. So as with every other day, Jones put his son on his bus to school at the regular time, took Rebecca to the day care to wait for her bus, and then walked to the ferry terminal.
The walk is a vigorous uphill climb and then a comfortable stroll down to the water’s edge. Jones had just crossed a local park when he saw the water of New York harbor and a huge streak of black smoke cutting across the horizon. He adjusted his Walkman and heard the news. From the ferry slip, he had no sense of the extent of damage and figured it was just an unfortunate but small-scale accident, one he hoped wouldn’t interfere with the ferry’s scheduled 9 a.m. departure. Accommodating Joe junior’s obsession with routine had left an imprint on the whole family, and anything out of the ordinary presented ominous possibilities. Jones boarded the big orange and blue ferry and moved to the far end, facing Manhattan, where other passengers had clustered. His eye caught another plane coming down over the water. He was used to seeing jets over the harbor. But this was very different—low and moving fast, he recalled, like a fighter jet coming in for an attack. Against the brilliant morning sky, the silhouette of the jet was black, and Jones watched it swoop over the harbor, bank sharply, and then get sucked into the South Tower, just blocks from Felicia’s office. He thought of her gym and credit union, and hoped against hope that she had not gone to either that morning.
The 9 a.m. ferry never pulled away from the slip. The stunned passengers didn’t need to be told to go back home. Jones rushed off, hoping to get to a pay phone to call his wife. She carried a cellphone, but he didn’t. Plenty of other people had had the same idea about calling and were lined up in front of the few available public phones. Frantic to make sure Felicia was okay, he practically ran back home.
He turned on the television, watched the towers crumble, and saw the dust swallow the city. He tried calling his wife’s office and then her cellphone, without any luck. Her mother, Carmen, who was staying with them, kept trying; finally, by early afternoon, she got through. Dunn-Jones said she was scared and caked with dust, but otherwise okay. Rebecca got home safely, and Joe junior’s school in Brooklyn agreed to bring him back. It seemed the worst was over.
After Dunn-Jones finally crossed the Williamsburg Bridge, she was able to flag down a cab that took her to her sister-in-law’s house. She washed up there as best she could, rested a while, and then prepared to start out all over again. She caught a subway and then switched over to the no. 53 bus across the Verrazano Narrows Bridge, where Jones was going to pick her up. It was 8 o’clock and the sun was just setting when Jones found her at a gas station near the bridge. Even though she had washed, she still wore a stubborn residue of dust. Her clothes were stained with it, and it was all through her hair. Her feet were sore, and she said she felt like the walking dead. When they arrived home, she wearily climbed the flight of stairs and hugged her mother, glad to be alive.
What happened next is still a blur for the Jones family. Dunn-Jones worked from home until a temporary office opened in downtown Brooklyn in early October. Although that meant she didn’t need to go anywhere near ground zero and relive that horrible day, she was scarred, as were so many New Yorkers. She had a dry cough that wouldn’t go away, and she felt tired all the time. She thought it was from the stress of living through a nightmare.
As 2002 began, her cough grew worse. She didn’t see a doctor, despite her condition, in part because her doctors were located in Lower Manhattan and she wasn’t ready to go back yet. She worried about how the events of 9/11 had set off Joe junior. He was stressed out, and his behavior upset the rest of the family. At times, Dunn-Jones was the only one who could calm him. She couldn’t afford to leave him alone, even to see a doctor for herself. And she shared something at that time with many other New Yorkers. The scale of the disaster dwarfed individual concerns. She felt that seeking medical attention would be exceedingly selfish and unpatriotic. If other New Yorkers went to their doctors for such simple things, they would clog the system and monopolize services for people who were really sick.
Dunn-Jones continued to commute to the temporary office in Brooklyn, and she kept up her schedule of field visits all over New York State, monitoring compliance with civil rights regulations and investigating suspected violations. When her cough grew worse, Jones suggested strong nonprescription cough medicine. He was used to offering such advice in the drugstore. An outbreak of flu in her office made them even more wary. By early February, Dunn-Jones was not herself at all. One Saturday late in the month, she loaded the kids into the car and drove them to nearby Clove Lakes Park. While Rebecca and Joe junior played, she sat on a park bench reading. On the way home, she stopped at a Pizza Hut and sent the kids inside for a pie while she waited in the car. They came back a short time later to find her sound asleep. They thought it was odd but were afraid to ask what was wrong.
The next day Dunn-Jones grew weaker. By afternoon, she had fallen sound asleep in Rebecca’s room. When Rebecca looked in on her, she was snoring loudly. Jones took the kids grocery shopping, and Dunn-Jones was still dozing when they returned. Worried, they woke her and asked if she needed to go to the hospital. All she wanted, she said, was a cup of hot tea. Joe prepared the tea, but when he brought it to her, she had stopped breathing. They called 911. Jones and Rebecca jumped into the ambulance with her. Joe junior was too upset to come out of his room. He never saw his mother again.
The ambulance rushed her to St. Vincent’s Hospital on Staten Island. By the time it arrived, she was dead.
Jones was stricken with grief and totally mystified. “It all just came out of left field,” he remembered, still troubled by his inability to notice that anything life-threatening was wrong. He had not considered any link to ground zero. He had been too worried about what he was going to do with Joe junior, afraid he would become even harder to handle without his mother. The boy had listened to her. But now she was gone.
Luckily for the family, Dunn-Jones had a good life insurance policy, though they needed a lawyer to help handle estate questions. Dunn-Jones’s supervisor referred them to an estate lawyer in Manhattan who was willing to take on the case. Rick Bennett, who had helped Kevin Rogers, had earned a reputation for being scrupulously fair about his work. He asked Jones for copies of the insurance policy and all important documents, including Dunn-Jones’s death certificate.
Because she had died so suddenly and at such a young a
ge, Jones had asked for an autopsy to be done. Crazy things went through his head. There was that anthrax scare, and a few people had died, hadn’t they? The only symptoms that Dunn-Jones had to suggest anything was wrong were the rashes on her chest and the inhaler she used when she thought no one was watching. When the death certificate was issued in May, Jones was puzzled by what he read. The immediate cause of death was listed as sarcoidosis with cardiac involvement.
Jones had become familiar with many medical terms while working in the pharmacy, but this one he had never heard of. Neither had Bennett, who asked his wife, Kiki, who works with him, to look it up on the Internet.
What she found stopped them cold. Among the references to sarcoidosis was a 1999 scientific paper that Prezant had written about the higher than normal incidence of the disease in New York City firefighters.2 Sarcoidosis is a mysterious autoimmune disease in which small clumps of cells attach themselves to major organs, particularly the heart and lungs. Most people can live with it without any outward symptoms. But it can turn deadly. No one knows exactly what triggers it, but it has been linked to environmental exposures such as smoke, ash, and dust. The image of Dunn-Jones covered in dust on the evening of 9/11 came vividly to Bennett’s mind.
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