New York’s 9/11 first responders are battling a new kind of mass trauma

For our endeavor to mark the 20th anniversary of the Sept. 11 attacks, John Yang spoke to first responders and medical workers who have lived and worked through both the attacks and have also more recently seen the mass trauma from COVID-19 in the city that was the epicenter of both: New York.

Read the Full Transcript

  • Judy Woodruff:

    As we continue to report on the human toll of the COVID-19 pandemic, we're also marking the 20th anniversary of a very different kind of mass trauma, the September 11 attacks.

    John Yang spoke to first responders and medical workers who have lived and worked through both in the city that was the epicenter of both, New York.

    To John Episcopo…

    John Episcopo, 9/11 First Responder: Good morning, handsome.

    Jack Delaney, 9/11 11 First Responder: What's up, beautiful?

  • John Yang:

    … the door of Jack Delaney's Long Island home is always open. They share an unbreakable bond forged in the smoke and flames of the World Trade Center.

  • John Episcopo:

    This picture was taken about 30 seconds before Tower 2 collapsed. In the front there leading the way is Jack, and I would be back here.

  • John Yang:

    Twenty years later, the memories are still vivid.

  • Jack Delaney:

    When I got back from Ground Zero, that was actually in my jacket pocket.

  • John Yang:

    They were among the New York-Presbyterian Hospital paramedics who raced downtown from Manhattan's Upper East Side.

  • John Episcopo:

    It seemed like the top of the building kind of tilted, but then the entire sky went gray. And there's just a moment where we all kind of looked at each other and kind of gave each other permission to do whatever we needed to do to survive that.

  • Jack Delaney:

    We ran for our lives as the buildings were coming down. Tremendous dust. You couldn't see in front of your face. But I was trying to find the rest of my staff.

  • John Yang:

    The remains of two of them weren't found for months, Mario Santoro and Keith Fairben.

    Both Delaney and Episcopo nearly lost their lives as well, injured as the debris of the collapsing towers rained down on them. After freeing themselves, neither wanted to leave.

  • Jack Delaney:

    During the day, people were like, dude, you got to get out of here. You're hurt.

    And — but then two of my guys actually…

  • John Episcopo:

    Physically removed you.

  • Jack Delaney:

    … gave me no alternative and removed me from the pile and took me by ambulance back to Cornell.

  • Dr. Antonio Dajer, New York-Presbyterian Hospital:

    We could see it and then we heard it.

  • John Yang:

    A few blocks away, Dr. Antonio Dajer and his team were told to prepare for mass casualties, but they couldn't begin to imagine how many or how serious they would prove to be.

    Dajer was the attending E.R. physician at this hospital that bright blue September morning. He was expecting nothing more than a routine Tuesday. Then a nurse ran in with the news that changed everything. Just a few blocks away, a plane had flown into one of the Twin Towers.

  • Dr. Antonio Dajer:

    The first badly injured patient I remember was a young woman who came in flying solo in a stretcher that I thought it was — that I was seeing wrong. But, as soon as I saw her, I knew we were in for mass trauma.

  • John Yang:

    And when the first tower collapsed:

  • Dr. Antonio Dajer:

    I have this vivid memory of a 10-story-high dust cloud barreling towards me.

  • John Yang:

    The chaos eventually gave way to silence.

  • Dr. Antonio Dajer:

    So many families were coming around with posters and fliers for their loved ones. And that was the sacred moment of, you just needed to absorb it. You just needed to be quiet and try to bring them in and do what you could for them.

  • John Yang:

    So busy doing what they could for their patients and the families of victims, Dajer and his colleagues hadn't begun to process their own emotions.

  • Dr. Antonio Dajer:

    Coming out of that was probably more traumatic for me.

    Seeing it on TV and seeing the worldwide reaction was — it was the first time I broke into tears. That was coming out of that isolation or that sense of intensity of this one place with these people that I'm with and then reentering the world.

  • John Yang:

    The first responders at Ground Zero reentered the world as changed people.

  • Jack Delaney:

    I had to remain the rock. So, I literally took my emotions and put them to the side. And I had to be there to talk to staff that wanted to talk. I had to interact with the families. And I didn't realize how deeply I pushed my emotions away.

  • John Yang:

    Jack Delaney's physical injuries forced his retirement, and both he and John Episcopo still deal with the mental toll of that day.

  • Jack Delaney:

    I always had flashbacks and nightmares.

  • John Episcopo:

    I used to have the dreams on a consistent basis. I have woken up a couple of times with the smell.

  • John Yang:

    For Episcopo and some other first responders, seeking treatment for post-traumatic stress wasn't easy.

  • John Episcopo:

    Speaking to a therapist that's not in the business is difficult, because there's certain — it's like talking a different language. I have to explain everything.

    But it definitely helped. It kind of gave me the permission to feel the emotions that I felt. At I think — at least with 9/11, I think the stigma behind the mental health has been taken — has been diminished.

  • John Yang:

    New York-Presbyterian Hospital psychologist Dr. JoAnn Difede has worked with 9/11 survivors to overcome that stigma.

    In September 2001, she was treating burn patients with PTSD. After 9/11, her work became all the more urgent. Difede pioneered using virtual reality therapy to transport her patients back to the sights and sounds of that day.

  • Dr. JoAnn Difede, New York-Presbyterian Hospital:

    Many people will tell you even to this day, on a September day, and the sky gets a certain blue cast to it, they will think of the World Trade Center.

    They learned that the blue sky was associated with a terrorist attack and something horrific and unimaginable.

  • John Yang:

    By confronting their trauma, they were able to overcome it.

  • Dr. JoAnn Difede:

    So, the whole idea in these trauma simulations is, you go over your trauma as if it were happening again in the present tense, so that your brain starts to learn, it's a September day. It's not — it's not 9/11, 2001.

  • John Yang:

    For many, the pandemic has meant a new kind of mental stress, trauma that can be especially acute for front-line health care workers.

  • Dr. Antonio Dajer:

    And I think 9/11 was such a short event, at least for us. It didn't test our endurance the way COVID has.

  • John Yang:

    As a paramedic on Long Island, Episcopo has seen that fatigue first-hand.

  • John Episcopo:

    This pandemic is this generation's 9/11. The stress is overwhelming, the — seeing death in many levels. It's the same type of experience.

    So, there's no doubt in my mind that the co-workers of mine and friends that were in the height working the street of the pandemic will end up developing PTSD.

  • John Yang:

    Difede is working on a virtual reality program to treat front-line medical workers' trauma.

  • Dr. JoAnn Difede:

    The enemy was invisible, unlike the World Trade Center, where it was, at least in one element, more visible.

    If you think about our health care workers, some of my colleagues worked around the clock seven days a week for a very, very long time taking care of people who were gravely ill, many of whom died. They saw death more frequently than they had ever seen in their entire career.

  • John Yang:

    Episcopo and Delaney have lasting physical ailments from 9/11 and its aftermath. Breathing in the toxic dust, smoke and fumes at Ground Zero puts them at higher risk of severe illness if they get COVID-19.

    But they say that the threat of isolation during the pandemic was just as debilitating as the threat of the virus itself.

  • John Episcopo:

    The interaction is key to the mental health of the responder. That's what has helped me deal with and live through the aftermath of September.

  • John Yang:

    And as much as the last 18 months have stressed health care workers, Dr. Antonio Dajer says he's now seen another mass trauma event bring out the best in doctors, nurses and paramedics, and the city.

  • Dr. Antonio Dajer:

    There's a community spirit that mimicked 9/11 to some extent, that this really was everybody in it together. There was that sense of shared experience that I think probably sustained many people through it.

  • John Yang:

    As they struggle through a different kind of calamity, one whose memorials are yet to be built.

    For the "PBS NewsHour," I'm John Yang in New York.

Listen to this Segment