Wisdom
A Surprise Gift of Being a 9/11 First Responder
In the wake of calamity, self-reflection can spark the light of transformation.
Updated August 4, 2024 Reviewed by Margaret Foley
Key points
- Healing is not linear and grief cannot be scheduled, but with time and treatment, healing is possible.
- Self-reflection brings better understanding and helps develop empathy.
- By learning how to nurture and love myself, breast cancer allowed me to heal the relationship with my mother.
![Source: Chartchai Sansaneeyashewin/Getty Images Source: Chartchai Sansaneeyashewin/Getty Images](https://cdn2.psychologytoday.com/assets/styles/article_inline_half_caption/public/field_blog_entry_images/2024-08/Nina%20PT%20Blog%20Pic%20Flower.png.jpg?itok=cdck96Em)
The old adage can be somewhat true: Time heals all wounds. From personal and professional experience as a psychiatrist, I say that healing is not linear, grief cannot be scheduled, and that with time, desire, and professional treatment, one can see new perspectives that spark the light of transformation. Self-reflection helps us get there.
For many, September marks back-to-school, High Holidays, and the beginning of crisper weather. For me, 23 years later, I’m transported to memories of my time as a first responder at 9/11, reflecting on the woman I was, changed forever by the repercussions of my trauma, with its own unique personal and cultural overtones.1 Sifting through the aftermath of my profound sense of loss and sorrow in reflection was not easy. Those days and months were hard enough. But I decided long ago that I wouldn’t remain a victim to the many lamentable keepsakes of that time. Doing the work to alchemize wounds into gifts may not happen overnight, but it’s a worthwhile endeavor that can lift the fog of despair. Here's one such story:
In 2001, Christine Todd Whitman, the administrator of the Environmental Protection Agency at that time, continually falsely reassured me and my fellow first responders and those who lived near Ground Zero that the air was repeatedly tested and found to be not harmful. On NBC news, despite Whitman’s overconfident and inaccurate report that the air was tested and not dangerous, I expressed my firsthand experience at being at Ground Zero, that the air continued to smell of burnt bodies and remained highly caustic to our skin, eyes, and lungs.
Sadly, much later, my concerns were confirmed. We learned that the air was “wildly toxic,” according to air pollution expert and University of California, Davis Professor Emeritus Thomas Cahill, and consisted of pulverized concrete, glass, asbestos, and detectable amounts of lead and mercury.2 There were also unprecedented levels of dioxins and polycyclic aromatic hydrocarbons (PAHs) from the fires, which burned for three months.3 Many of the dispersed substances (asbestos, crystalline silica, lead, cadmium, polycyclic aromatic hydrocarbons) are carcinogenic; other substances can trigger kidney, heart, liver, and nervous system deterioration. This toxic blanket that had descended and covered Ground Zero was well known by the EPA at the time of collapse.4
Sixteen years later, on a routine mammogram and ultrasound, the radiologist bluntly blurted out, “You have breast cancer,” which felt like an astonishing gut punch. Because I had no family history of breast cancer, I found it necessary to repeat over and over to my partner that I had been given a breast cancer diagnosis for the news to sink in. Although I did not give much thought at that time to the risk of developing cancer from my exposure to the noxious air at Ground Zero, my breast surgeon later stated that the origins of my breast cancer could be consistent with being exposed to toxins, as she “had never seen cancer with such high resolution and detail on ultrasound results.”
Since 2017, I have been on the World Health Trade Center Insurance, as my breast cancer was assessed to have resulted from my exposure to toxins at Ground Zero. Even if I had prior knowledge that going down to Ground Zero would result in my developing breast cancer, I would like to think that I would have still chosen to volunteer to help others.5,6 Despite the stress of having an 11-hour surgery consisting of a right mastectomy with reconstructive surgery, somehow my loss was compensated and diminished by the satisfaction of bringing some modicum of help to really traumatized people.
Although it may seem a reductive narrative, I have found that whether I was caring for women diagnosed with breast cancer as a Consultation/Liaison Fellow at Memorial Sloan Kettering Cancer Hospital, attending physician at New York University/Bellevue, or psychoanalyst in private practice, the majority of my patients felt that their illness was a metaphor for a lack of maternal nurturance.7 Both for myself and these women, our breast cancer diagnosis became an opportunity to learn how to provide ourselves with the love that we lacked growing up.
During my psychiatry residency, which consisted of mostly male physicians, I suffered fantasies of cutting off my breasts in a desire to gain a sense of belonging, as I was raised in a misogynistic environment where women were second-class citizens. Maybe the benefit of anesthesia, maybe just an uncanny spiritual experience, but upon waking from anesthesia, I had the dream-like experience of being transported to another world that was embraced in light, where something was released from me. And suddenly I awoke with crystalline clarity; I felt an immense sense of compassion for my mother. Both my mother and I suffered from the sagacious words of Jill Johnston, cultural critic of The Village Voice, paraphrased here: There are daughters and daughters and daughters and every few generations a mother is born.8 By helping me learn how to nurture myself and self-soothe, breast cancer allowed me to heal the relationship with my mother and gradually begin to relinquish grasping for maternal love, which simply wasn’t available. It didn’t happen overnight, but it did happen. My illness provided a pathway to maternal love. And that’s a gift worth grasping for and holding onto.
Self-reflection helps us better understand and handle feelings, ultimately helping us to develop greater empathy and understanding for others. In sharing one poignant 9/11-related reflection, it is my sincere hope that I help others to courageously mine deeply to alchemize any wounds to discover their own gifts.
References
1. Cerfolio, N. (2023). Psychoanalytic and spiritual perspectives on terrorism: Desire for destruction. Routledge.
2. Armour, S. (2006, June 25). 9/11 health troubles? USA Today.
3. Pleil, J. D., Funk, W. E., & Rappaport, S. M. (2006). Residual indoor contamination from World Trade Center rubble fires as indicated by polycyclic aromatic hydrocarbon profiles. Environmental Science & Technology, 40(4), 1172–1177. https://doi.org/10.1021/es0517015
4. Gates, A. (2006, September 11). Buildings rise from rubble while health crumbles. The New York Times. https://www.nytimes.com/2006/09/11/arts/television/buildings-rise-from-rubble-while-health-crumbles.html
5. Cerfolio, N. (2019, June 20–23). Terrorism as a failure of imagination: A lack of individual and societal empathy [Paper presentation]. The 17th Annual International Association for Relational Psychoanalysis and Psychotherapy International Conference, Tel Aviv-Jaffa, Israel.
6. Cerfolio, N. (2019, May 23). Trauma two times over: Developing breast cancer as a result of being a first responder during 9/11. Terror House Magazine. https://terrorhousemag.com/trauma/
7. Sontag, S. (1977). Illness as metaphor and AIDS and its metaphors. Picador.
8. Johnston, J. (1973). Lesbian nation: A feminist solution. Simon & Schuster.