City of Dust

by Anthony DePalma

  Not unexpectedly, Hirsch came under intense criticism, with Clinton, Maloney, and Nadler leading the pack. Maloney publicly raised the question of Hirsch’s independence and the city’s conflict of interests in deciding how Zadroga died. Although she had initially called on Hirsch to review the deaths of all responders who died outside of New York, a position she took after the reclassification of Dunn-Jones’s death, Maloney now called for limitations on Hirsch’s power: “The history of 9/11 should not be decided behind closed doors by one person.” There were calls for a commission to make sensitive decisions about the 9/11 memorial. For the very first time in all his years in office, Hirsch felt direct political pressure. “Let me make perfectly clear, no New York City official has ever attempted to influence my judgment on any case,” he noted. “Mayor Bloomberg has been unfailingly supportive, no elected official, nobody who works for an elected official in New York City has ever attempted to influence my judgment in any case of any sort. The only time in my career, and I would point out to you that I’ve been doing this work for 44 years, the only time in my experience that political pressure has been exerted on me is associated with the World Trade Center, and it has come from people elected to Congress and to the Senate of the United States of America. I’m not going to get any more personal than that. And I can tell you that it doesn’t make any difference. It hasn’t had any influence on me whatsoever.”

  Hirsch was born in the Midwest, and despite his many years in New York City, he still can look and sound like the old-fashioned country doctor that his mother had wanted him to be. Tall and lanky, he speaks slowly and carefully, punctuating sharp remarks with piercing gazes. He has a tendency to quote aphorisms, a habit that even he realizes can go too far. He’ll say, when dealing with bereaved families who come to his office looking for answers, that “the truth hurts, but it also heals.” On the lobby wall outside his office is a Latin saying that he quotes often and that he translates, “Let laughter and conversation cease. This is the place where the dead come to nourish the living.” When talking about the outcome of the ground zero injury cases, he concedes that “it is easier to be a historian than a prophet.” He insists that if he had been given an ultimatum about changing his scientific decision on Zadroga or James Godbee or Dunn-Jones, he would have been prepared to accept the consequences of saying no rather than compromise his standards.

  “Another aphorism, please forgive me.” His long, bony fingers start to point. “Beware of someone who is willing to compromise his standards. Because if his standards go, the principles will not be far behind. And then you become a very dangerous person.”

  Autopsies can tell a lot, but they do not speak with a single language and their results are open to interpretation. That is one reason Howard had formed a task force in 2006 to draft a uniform set of autopsy reporting guidelines to help make sense of the increasingly tumultuous ground zero aftermath. Howard knew that as the thousands of ground zero workers began to die off from a variety of causes not necessarily related to their exposure, there would be questions about their lives and their deaths. With workers spread out all over the country, the kind of differences in approach and execution that arose between Hirsch and the New Jersey medical examiner could be multiplied many times over. Howard worried that there would be doubts about the dust far into the future. He wanted a single set of national guidelines so that, in every death involving a ground zero worker, the same standards of examination and interpretation would be applied.

  Howard consulted several forensic experts, including Hirsch. Hirsch’s main concern was that slides and tissue be preserved for future examination, when more information might be available. He proposed building a database that would be useful for testing contemporary samples with prior ones. He knew from experience that “if you don’t have it, you can’t test it.” But the federal government pulled the plug on the project before a final set of guidelines could be reached. The formal reason given was that officials were concerned that results could end up being misused in lawsuits that ground zero workers and their families filed against their employers. No autopsy guidelines or reporting requirements were ever issued. The closest Howard came to achieving what he had set out to do was providing financial assistance to the New York State Department of Health to maintain a registry of the deaths of ground zero workers. By collecting such data, it was believed, the state would be able to act on erupting health issues before they could escalate into a crisis.

  Hirsch’s conclusion about Zadroga’s drug use was stunning. Instead of the hero cop whose name symbolized the dedication of first responders, Zadroga was labeled as a drug addict and, by implication, was anything but a hero, further confounding New York’s understanding of what had happened at ground zero. Bloomberg commented, “We wanted to have a hero, and there are plenty of heroes. It’s just that, in this case, science says this was not a hero.”

  Zadroga’s father was furious at Bloomberg and publicly slammed him for attacking his son. Joe simply refused to believe that his Jimmy, who had wanted to be a cop since he was a kid, was a drug addict who had been shooting up while living with him. Bloomberg later apologized publicly to the Zadrogas but did not change his mind about what had happened. “I believe that James Zadroga was a hero for the way he lived, regardless of the way that he died,” he said, “and although the medical examiner has made an independent determination as to the specific cause of death, there should be no doubt in anyone’s mind that James Zadroga served this city with distinction.” The mayor added, “I certainly apologize for my comments, and I committed to the family we will find a dignified way to honor his son’s sacrifice.”

  As with the Borja incident, and the questions that had been raised about Mount Sinai’s reporting of symptoms, the convoluted tale of Zadroga’s death reinforced the notion in the minds of some people that the entire issue of 9/11 illnesses had been fabricated or overblown, and that many people were taking advantage of public sympathies for their own gain. New York’s congressional delegation was left in a particularly uncomfortable position. The massive bill they had introduced to establish a national program to screen, monitor, and treat 9/11 responders had been dubbed the “James Zadroga Act.” Because of Hirsch’s ruling, Zadroga’s name would not be added to the city’s formal list of 9/11 victims. But there it was on the bill that the Bush White House had given no indication of supporting. Maloney and her staff knew the Borja and Zadroga setbacks had hurt the efforts to get support for ground zero workers, but because so little progress had been made under the Bush administration, they felt that the setback could be overcome. And as Senator Clinton had done in defense of Borja, the delegation continued to defend Zadroga, regardless of the unflattering evidence that had been uncovered. They argued that no matter what had happened to him at the end, Zadroga most likely would still be alive if he had not needed to take pain-killers so he could breathe after spending three straight weeks at ground zero. Even his father came around to that way of thinking. Years after his son’s death, now with a bold tattoo on his forearm of a crucifix, his son’s name, and the words “Not Forgotten,” Joe was realistic about his son’s death.

  “Even if he did, what does it matter?” Joe asked. “He was dying at that point. Nobody knows how much pain he was in.” He said his son’s lungs had become hard as leather and so enlarged that they had pushed up against his rib cage. Every breath hurt. Every breath was a fight. And a deteriorated disc made every movement agony. Zadroga was taking twelve 100-mg tablets of oxycontin a day toward the end of his life, “enough to kill a horse,” Joe said. “He was in so much pain, that’s why he did it. If he did it.”

  Hirsch’s findings spurred plenty of outrage, both from people who felt he was disgracing the name of someone who had dedicated his life to protecting the city, and from others who believed Zadroga had tried to manipulate the system. The stark differences between the New Jersey coroner and Hirsch regarding his death added to the confusion, and deepened suspicions that had been buildin
g in the city since the earliest days and 9/11’s aftermath. It seemed that even though all the world had watched the towers come down and had seen the dust rampage through the streets, even though the dangers of being exposed to the dust without proper protection had been clear from the first day, and even though response plans had been drawn up and government agencies had responded to the disaster in myriad ways, nothing was certain about the aftermath of 9/11 except that uncertainty reigned.

  In October 2008, just after the seventh anniversary of 9/11, Commissioner Raymond Kelly of the New York Police Department presented Distinguished Service medals to the families of eight officers who had died after being exposed to ground zero dust. Among them were Officer James Godbee and Detective James Zadroga. Their names would not be inscribed on the official 9/11 memorial, but they were added to the department’s wall of heroes at police headquarters in Lower Manhattan. Joe and Linda Zadroga keep a framed copy of their son’s commendation on the wall of the home they shared with him, right near the front door so they see it every time they come in or go out. And as the Obama administration took over in Washington and the Democrat-controlled Congress took a more open and welcoming look at providing steady long-term funding for the care and monitoring of ground zero workers, HR 847, the bill laying out that program, continued to bear the name of the “James Zadroga 9/11 Health and Compensation Act.”

  Endnotes

  1 Chan, Sewell and Al Baker, “Weeks After a Death, Twists in Some 9/11 Details,” The New York Times, 13 February 2007, p. 1. Available at www.nytimes.com/2007/02/13/nyregion/13health.html?_r=1&scp=1&sq=Chan%20and%20Borja&st=cse.

  2 Personal interview, 29 December 2009.

  3 Interview with Ellen Borakove, Office of the Chief Medical Examiner, 17 June 2009. Borja’s death certificate was officially filed 9 January 2008.

  4 Sisk, Richard, “FEDs Blasted over 9-11 Aid Shortfall,” The Daily News, 22 July 2005, p. 32. Available at www.fealgoodfoundation.com/original_web/Articles/Shame%20on%20feds%20for%20not%20giving%20911%20aid.pdf.

  5 Herbert, Robin, Jaqueline Moline, Gwen Skloot, et al., “The World Trade Center Disaster and the Health of Workers: Five Year Assessment of a Unique Medical Screening Program,” Environmental Health Perspectives 114, no. 12 (December 2006): 1853–1858. Available at http://ehp.niehs.nih.gov/docs/2006/9592/abstract.html.

  6 Data presented at the 2009 annual assembly of the American College of Chest Physicians.

  7 Moline, Jacqueline, Robin Herbert, Laura Crowley, et al., “Multiple Myeloma in World Trade Center Responders: A Case Series,” Journal of Occupational and Environmental Health 51, no. 8 (August 2009): 896–902.

  8 Personal interview, 15 September 2009.

  9 Personal interview, 30 June 2009.

  12. Assaulting uncertainty

  New York City was slowly being blinded by a habitual opacity about the aftermath of 9/11 and ground zero that blurred images and hid some things in plain sight. After the Zadroga flare-up, many New Yorkers shared Rep. Carolyn Maloney’s conclusion that Charles Hirsch should never have been in the position of determining who was a victim of the September 11 attacks. They looked askance at his decision to contradict James Zadroga’s autopsy and to draw a seemingly arbitrary deadline around James Godbee’s death, usually overlooking the fact that Hirsch also had agreed to add Felicia Dunn-Jones’s name to the list of victims. His strict adherence to science and logic counted for little; the denigration of belief that began in the immediate aftermath of the attacks had grown steadily more corrosive. For many, finding that Zadroga’s and Godbee’s untimely deaths, though tragic, were not related to their work in the recovery effort was a cynical move to protect the city from charges that it had acted with reckless disregard for the responders’ well-being.

  The contradictions went all the way to City Hall. After succeeding Giuliani, Mayor Bloomberg had to deal with the consequences of his predecessor’s decisions. The controversy surrounding Zadroga’s death underscored the city’s, and Bloomberg’s, greater conflict. The same mayor who would expend political capital attempting to ban smoking in public places and trans fat from restaurant menus might have been expected to readily side with those who became sick after working on the pile. But the potential liability for the city had grown too enormous to ignore.

  As tales of sickness and death added up, the $1 billion insurance policy provided by Congress seemed to be all that stood between the city and a looming financial disaster. But it awkwardly positioned the city against some of the very people who had, on September 11 and afterward, come to its aid. Bloomberg’s own thinking about ground zero illnesses had evolved slowly and taken tortuous twists and turns. When the first lawsuits were filed, he was clearly unwilling to acknowledge that damage had been done. “There’s been a lot of controversy and different studies,” he told reporters then. “Those that I’ve seen recently said that, generally speaking, people that worked there did not have any long-term detrimental effects. But it’s something you have to keep monitoring.” Bloomberg repeatedly urged caution and even expressed skepticism about links between the dust and chronic diseases, rightly pointing out—as he had on the day the big Mount Sinai study was released in 2006—that definitive studies had not yet made the case. But as the legion of responder advocates continued to grow, Bloomberg was less inclined to defend that position. And with Dr. John Howard increasingly lobbying for a greater federal role, Bloomberg came to realize there had to be another way.

  The attention to fact that Bloomberg showed in 2006 was not unfounded. He was right to point out that big studies can show trends, but linking a particular disease to a specific exposure in an individual requires a whole different level of certainty. Nonetheless, this was a politically untenable position. At around the same time he had announced the $16 million screening program for residents, office workers, and anyone else who had been exposed to the contaminated air but was not eligible to be seen at Mount Sinai, the mayor revealed a change in strategy that essentially reversed his previous position. Five years after the attacks, he set up a task force to assess the full scope of the disaster, estimating the number of people who were exposed and the medical uncertainties they faced. When the report was released in February 2007, the city was no longer denying that the dust had harmed New Yorkers. Instead, it was building a case for a city stricken. Rather than trying to minimize the impact of the dust, the city now sought to maximize it. The panel concluded that more than 680,000 people who had been exposed to the dust might seek treatment. That figure included firefighters; police and city employees; and office workers, students, and residents of Lower Manhattan, Brooklyn, and New Jersey who lived within a 2-mile radius of ground zero. The potential cost of providing services for those people was calculated at $392 million per year, which the panel recommended the city aggressively seek from the federal government. Another of the panel’s recommendations was to press Congress to reopen the September 11th Victim Compensation Fund, which would effectively wipe out the city’s legal liability, obviating the need for the $1 billion in insurance, which could then be funneled into the reactivated fund.

  That set the city on a contradictory track. While it was providing millions of dollars in assistance to people it acknowledged had been hurt by exposure to trade center dust, it continued to draw down millions from the federally funded insurance policy to challenge the accounts of sick responders who were suing the city for failing to keep them from harm. That titanic confrontation quickly escalated into one of the largest and most expensive legal proceedings New York City had ever been involved in—a mountainous and, in many ways, unprecedented courtroom offensive that would tax not only the city’s resources, but eventually also its moral fiber. Some of the most contentious issues surrounding the aftermath of the terror attacks—the questions of certainty, responsibility, and what had been said and done—along with the clashes between perception and truth that had kept the city under a confounding cloud for years would be confronted in their entirety in the polished wood-p
aneled walls of a federal courtroom in Lower Manhattan.

  The legal assault began inconspicuously enough in the middle of 2003 with phones calls from the parents of students at Fox Lane High School in suburban Bedford, N.Y., the same school that attorney David Worby’s children attended. Those parents called Worby looking for a favor. The school’s popular hockey coach, New York City police detective John Walcott, had taken the boys into the regional finals of the state championship and put Fox Lane hockey on the map, earning honors for several of his players and a Coach of the Year award for himself. The parents told Worby that Coach Walcott had been diagnosed with acute myelogenous leukemia and was having trouble getting his disability pension from the New York City police department. “Do us a favor,” they said. “See this guy.”

  Walcott was just 36 when he spent five months at ground zero and the Fresh Kills landfill in 2001 and 2002. In 2003, he felt worn out, which he at first thought was because he was running himself ragged by coaching the hockey team while also putting in long shifts on the job. When just walking left him short of breath, he finally went in for tests. About 18 months after he put in his last day working with the trade center debris, a doctor drove a long needle into his hip to extract enough bone marrow for a biopsy that confirmed his worst fears. Leukemia had sent his white blood cells on a rampage. They were growing so ferociously that they were squeezing out normal red blood cells, which his body needed. Left untreated, he was told, AML could lead to death in weeks.

  His doctors weren’t sure why he’d gotten sick, but they knew about his exposure to the dust and they thought there was a chance that the toxins—particularly benzene—that he had been exposed to at the site might have triggered something. Walcott had to undergo a brutal course of chemotherapy and a bone marrow transplant in which he nearly died.