9-11's Long Shadow: A personal remembrance

At 9 that morning I was on the Neuro ICU at the University of Virginia, working as an occupational therapist with a young man who was beginning to emerge from a car crash-induced coma.  He was sitting up in a bedside chair for the first time, and I was hand-over-hand guiding him in toothbrushing, trying to engage sleepy synapses, to awaken procedural memory through overlearned tasks. 

A television high on the wall was on, but I’d turned off the sound to reduce environmental stimuli.   It seemed to be tuned to a movie channel, playing a disaster movie with explosions and smoke.  As I kneeled beside the young man, it dawned on me that there were nurses gathering in the room.  I turned and saw that they were all looking at the tv, hands over their mouths.

I completed the activity, transferred the young man back to bed to recover from his exertions, and found an empty patient’s room, where I turned on the tv and for the next half hour watched the tragedy unfold.  It took the first tower falling for me to understand that something enormous was happening.  My wife Chris, also an OT, was working downstairs on the medical unit.  I found her and we hugged hard.  Should we pick up our toddler sons at day care?  Should we call our families?  Was this a World War? What should we do?  Like everyone else at the hospital that day, we just went back to work. There had been another crash at the Pentagon, and we were all on alert for an expected surge of patients that never came.

That’s our story.  I’m sure you remember yours just as clearly.  But what I really wanted to mention is how September 11^th has changed my life, and Chris’, over time.  For us rehabilitation professionals, there was work to do.  For seven years, I met with Iraq and Afghanistan war veterans who have PTSD, conducting research aimed at using mobile technologies to help them sleep better, manage their everyday stresses, cope.  I sat with them as they fretted and sobbed, set up my sleep monitors at living room sofas for men banished from the bedroom, heard harrowing stories about things that had happened to them and things they had done, about the many ways combat lived on in their struggles back home.  And again and again, I was touched by the choices they made.  So many of the 200 or so men I worked with found ways to serve in peacetime, as coaches, school teachers, police officers, firemen, mentors to the newbies coming home.  They helped me by urging their buddies to join my studies.   Always, they said, “If it may help somebody, I’m in.”

The wars changed Chris’ life too.  For the past fifteen years, she has worked at a free-standing polytrauma transitional living center on the Central Virginia (formerly McGuire) VA Hospital campus that didn’t exist before 9/11.  It was designed specifically to care for OIF/OEF veterans, men and women who had suffered the new types of injuries these wars caused.  So many of her patients live on in her heart, stay in touch, drop by.  Fortunately, there are fewer of them now, with the wars officially over.  Their rooms at the hospital are occupied by stroke patients, car crash victims, the wounded from America’s unofficial conflicts (not yet any from the Iran War).  Like me, Chris has been moved by the stoicism, comradeship and will to serve these veterans carry with them from their military service. 

As a professor at Virginia Commonwealth University, I began to teach the OT role in treatment for blast concussion and PTSD.  I took my class to the new amputee center at Walter Reed Hospital in Wahington, DC, where we all stood in awe as a young quadruple amputee, guided by his OT and PT, donned prosthetic limbs and took his first steps on a walking track. It was a busy gym, but when he stood everything stopped, all eyes on that cyborgian event. Some of our students had been deployed and willingly shared their stories.  I recall the hyper-vigilant Army captain in her brand new Prius, who – distracted by a car parked on the side of the road – ran smack into the back of another car.  And the medic who sat stoically in the back of the classroom. When I asked him about it, he said, “You don’t understand.  I never let anyone sit behind me.” Chris brought some of her patients to school for hands-on brain injury and PTSD labs in one of my classes. When asked where he'd fought, one Special Forces captain said, "The Middle East, of course, but everywhere else, too, especially Africa. The wars we don't talk about."

What does all this add up to?  I’m not sure I can say.  I do know that I’ve changed, that I have a better appreciation of war’s cost, its complications and its long shadow.  I recognize that the work we do in medical rehabilitation can make a difference for the wounded and their loved ones, and that this work must track a long arc of recovery.  A truism of these wars with their all-volunteer forces is that Americans hardly paid attention, that no one really cared.  But on this anniversary of the 9-11 attack, it can be helpful to reflect across the past twenty-five years, when actually so much has changed for all of us, in our private hearts, in our work, and beyond.