Acknowledging the Ripple Effects: Recognizing the Continued Suffering of 9/11 Responder and Survivor Families
On September 11, 2001, Jean Pasternak’s husband, Michael, worked at his office at Goldman Sachs, just a five-minute walk from the World Trade Center. After the planes struck the Twin Towers — an event that killed nearly 3,000 — Mr. Pasternak evacuated along with the other employees amid a scene of panic, smoke, and chaos. Despite the abundance of debris and toxic particles still heavy in the air and the distress of that day fresh in his mind, he was sent back to work a few weeks later and stayed at the firm until he was laid off in 2002.
Mr. Pasternak’s PTSD began that year as well, followed by an illness that went unidentified and untreated until 2017, when he was officially diagnosed with stage four bladder cancer related to 9/11.
Every member of the Pasternak family sought therapy to cope with the ordeal of witnessing a loved one suffer. “Everyone was thriving, and our life came to a halt that day,” added Mrs. Pasternak. “It’s not just him,” she continued, referring to her husband. “The entire family…was impacted.” No one wanted to repeatedly relive through the effects of her husband’s PTSD, she added. “They want to stay away from it.”
Watching the transformation of the family patriarch into a seemingly different person who was a shell of his former self fractured the family. “It is the ripple effect,” Mrs. Pasternak explained. “One person gets torn apart mentally and physically, and the entire family structure gets destroyed.” For Mrs. Pasternak in particular, it was a double loss. “As a mom,” she lamented, “I not only lost the husband that I had, but I also lost my children too, because they don’t want to be around this either.” Although the family may be gathered in their home, physically present with one another, Mrs. Pasternak said they are far from together.
The dominant narrative of 9/11 focuses on the stories of the almost 3,000 victims and their families, leaving over a hundred thousand families of responders and survivors in the peripheral shadows — neglected and overlooked despite their continued struggle with the tragedy over the last two decades. As a large number of responders and survivors struggle with physical and psychological harms arising from 9/11, their families suffer from the enduring ripple effects of their loved one’s trauma. The failure to recognize the plight of these families, even during anniversaries of the tragedy, leaves families like the Pasternaks feeling abandoned. “You feel invisible,” said Mrs. Pasternak. Acknowledging and appreciating the stories of these families not only inserts them back into a narrative they have largely been excluded from, but also reveals how the effects of September 11, 2001 extend beyond those who experienced it directly and stretches to the present day.
Since 9/11, media coverage, the public’s attention, and government and nonprofit resources have centered primarily on those directly affected by the tragic day. This focus has led to the memorialization of those who died on September 11, 2001, lionized the first responders who sacrificed their lives, and honored survivors. For these groups at least, the common slogan “Never Forget” rings true even two decades later.
Those who have been impacted by the tragedy in different but equally treacherous ways, however, but don’t belong to one of these hallowed groups are seldom acknowledged by the public, receive little media attention, and rarely benefit from the medical and monetary resources developed to help people adversely affected by 9/11. Mary Fetchet, co-founder and director of VOICES Center for Resilience — a nonprofit organization formerly known as the Voices of September 11th that provides long-term support of 9/11 survivors, victims’ families, and responders — said that “across the board with the families of responders and survivors, is the sense that over time their support system gets smaller.” Fetchet emphasized that many cannot understand why people are still struggling two decades later, especially those not directly impacted (meaning losing a loved one or being a survivor or responder). For these reasons, Fetchet works to make VOICES a resource for this overlooked population and hopes to serve as a continued support system.
Many families feel that the lack of acknowledgement and support will only continue, however. “It’s penny-wise and pound-foolish not to grab this thing by the horns and deal with it,” said Mrs. Pasternak about increased attention and resources for her husband and families like hers.
Her family’s experience is not unique. Ali Hochbrueckner, whose father was a paramedic at Ground Zero diagnosed with both esophageal and prostate cancer, said that the “events of that day are slowly becoming a historic memory in textbooks and more of a narrative that’s pre-written. But to some of us,” she added, “it’s a daily thought and heartache that we have to relive over and over.” Ms. Hochbrueckner was frustrated and disappointed by the lack of acknowledgment of her family’s plight: “It’s a heart-sinking feeling where you don’t want to be selfish,” she said, “but you kind of think, what about my dad, my family?”
Mrs. Pasternak and Ms. Hochbrueckner are not alone. Over 112,000 responders and survivors are registered with the World Trade Center Health Program, with the likelihood that this number is much higher as many may not know their illnesses are related to 9/11. This means that at least 112,000 families are possibly suffering from the destructive ripple effects of a loved one’s 9/11-related physical or mental ailments.
Despite this large number of potentially afflicted families, there is little to no research on their experience with a loved one suffering from a physical or mental illness arising from 9/11. The closest proximity to this experience is that of families of war veterans. According to a 2018 study by the Uniformed Services University of the Health Sciences Center for the Study of Traumatic Stress on bereavement in military families, civilians experiencing a sudden or violent loss of a loved one share similar outcomes to military families faced with the same circumstances. Experiences of families living with a veteran are also similar to those of people living with a loved one who survived sudden and violent events.
When veterans return to their families after experiencing the trauma of war, they often come back with physical and mental health disabilities that can overwhelm a family. Physical injuries often require long, costly, and stressful rounds of treatment. Plus, the struggle of adapting to life with a disability has “profound and long-lasting” impacts on service members and their families, according to research by the Uniformed Services University of the Health Sciences Center for the Study of Traumatic Stress. In addition to contending with physical ailments, “invisible injuries” like PTSD and psychological trauma can cause dramatic behavioral changes and warp a veteran’s personality in ways that can damage familial relationships. Experts call this “injury duality,” where a loved one has the same appearance, but has a completely different personality — a condition that can tear apart a family.
Families of 9/11 responders and survivors may struggle in the same ways as those of veterans. Throughout the last two decades, for example, Mr. Pasternak’s psychological trauma and physical suffering detrimentally impacted not only himself, but his wife and four children. “You just disintegrated as a person,” said Mrs. Pasternak about her husband’s experience after surviving 9/11. “Then, you disintegrate as a family.”
Connie Palmer, a grief counselor and clinical social worker at Imagine, A Center for Coping with Loss, explained that the “experience of the vulnerability of that event, coupled with the trauma, coupled with the grief, has a long-lasting impact on a family and on the individuals.” In situations where a loved one suffers long term health effects after experiencing trauma, Palmer says “it’s not so much about overcoming, but thinking ‘how do I live with the reality of this event that happened to me and the feelings about it forever?’”
Trying to live with the reality of the transformation undergone by their loved ones can be exasperating. Mrs. Pasternak said families like hers “don’t understand why their loved one changed so dramatically. There’s no explanation. They lose their jobs. They’ve stopped loving their spouse. They stopped caring for their children.”
Similar to veterans, the impact of injury duality can emerge within a 9/11 family as well. Grief specialist Palmer said that families often “actually lost that person,” in terms of who they were before the tragedy, and “lost what the family and marriage was like prior to 9/11.” Mrs. Pasternak can attest to this. Her husband, once a man she said loved to work, cook, take care of household duties, and take pride in being a family man, completely changed following 9/11. “I couldn’t understand at all how my loving, adorable husband turned into this monster,” she said. “What the hell happened? All of a sudden, it’s like, who is this man?”
Ms. Hochbrueckner also said that her family was “given back a version of our dad who completely changed from that event,” something that the family struggled to cope with. Her hardly-ever-still, hardworking, blue collar father who could often be found mowing the lawn, helping the neighbors assemble furniture, and fixing anything, was gone according to his daughter. One recent summer afternoon, Ms. Hochbrueckner called her dad to help install an air conditioner in her apartment, a typically easy task for her handy father. “As soon as I finished the sentence, I realized my dad wasn’t capable of doing that anymore,” she said. “It was really, really hard to accept the fact that this big, strong man that always did everything was not really interested anymore.”
For these families, reminders of 9/11, which are intended to honor the tragedy’s victims, often have the opposite effect, provoking a reemergence of the feelings experienced that day. “It’s like a re-exposure, a repeat of triggers,” said Palmer. When a family lives in a situation where they experience the effects of the tragedy daily, “the acuteness of it is as if somebody is turning up the dial.”
Families like the Pasternaks, however, don’t need annual reminders of the tragedy. “For them every day is 9/11,” added Dr. Heidi Horsley, a trauma expert and psychologist who worked with families of firefighters who died from the terrorist attacks for over 10 years. Dr. Horsley said that this is likely the case not only for those who lost their loved ones, but those whose loved ones now suffer as a result of that tragedy.
9/11 may have taken place two decades ago but for the Pasternaks, its impact over their lives has never waned. “It ruined everything that we had dreamed up,” Mrs. Pasternak said about the tragedy. “The kind of family that we set out to raise… and the financial future that we both fully expected and should have has just crumbled,” she continued through a cracking voice and tears. “We’re not the loving family that we should have been.”
