New York's New “Normal”: Members Reflect on Their Lives and Practice Five Months After Sept. 11 For 30 years, Marc Kramer has worked with New York’s bravest. As the consulting audiologist for the New York City Fire Department (FDNY), he has spent more than half his life working with firefighters and caring for their hearing needs. Without a doubt, the past year has been the hardest. ... Features
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Features  |   March 01, 2002
New York's New “Normal”: Members Reflect on Their Lives and Practice Five Months After Sept. 11
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Speech, Voice & Prosodic Disorders / Hearing Disorders / School-Based Settings / Healthcare Settings / Professional Issues & Training / Features
Features   |   March 01, 2002
New York's New “Normal”: Members Reflect on Their Lives and Practice Five Months After Sept. 11
The ASHA Leader, March 2002, Vol. 7, 1-24. doi:10.1044/leader.FTR3.07042002.1
The ASHA Leader, March 2002, Vol. 7, 1-24. doi:10.1044/leader.FTR3.07042002.1
For 30 years, Marc Kramer has worked with New York’s bravest. As the consulting audiologist for the New York City Fire Department (FDNY), he has spent more than half his life working with firefighters and caring for their hearing needs. Without a doubt, the past year has been the hardest.
Late one afternoon in January, Kramer leafed through a program for a reception being held that evening. The event honored firefighters who were awarded medals last spring for their bravery the year before, and included photos of the department’s top officers.
“We lost him, and him, and him,” Kramer said, indicating the officer photos in the program, which was printed months before Sept. 11. In all, 343 city firefighters perished at the World Trade Center. He stopped at one photo, of First Deputy Fire Commissioner Bill Feehen. “He and I talked about designing a more efficient siren for fire trucks. We were going to get together to discuss it in early fall,” he recalled.
Kramer’s office on East 68th Street reflects both his long association with firefighters and his status as a bona fide fire buff. Rows of tiny fire trucks from around the world line two tall, glass display cabinets near his desk. On the wall, framed with crimson mats, are FDNY citations naming him as an honorary deputy fire chief and medical officer.
As a specialist in forensic audiology, Kramer has gone to the scene of more than a hundred fires, plane crashes, explosions, and train and subway collisions to observe conditions and establish his credibility as an expert witness for the FDNY. When the fire alarms sounded on Sept. 11, however, he was miles away—in Denver, presenting a course at the annual meeting of the American Academy of Otolaryngology–Head and Neck Surgery. With the Denver airport closed, Kramer had to use his credentials from the New York Police Department—another long-term client—to get a rental car and drove straight to Manhattan. He immediately reported to the FDNY’s Mobile Communication Center at Ground Zero.
Kramer worked at the site for two weeks, first distributing batteries for walkie-talkies to firefighters assigned to the smoking “piles,” and later compiling on a computer the lengthy daily reports from each of the four sectors of the 16-acre disaster site.
Then he returned to his normal job of testing the hearing of firefighters, many of whom had spent time at Ground Zero. Assessing the effects of noise exposure on firefighters’ hearing can be difficult, Kramer said, because of the reported synergistic effects of the ototoxins found in the byproducts of combustion. Because of the scale of destruction and the uncertainty of the compounds present, Ground Zero posed particular challenges.
The test results vary, he says, among the two dozen firefighters he has seen for hearing-related problems reportedly associated with the World Trade Center attacks. “People who were there that day were affected differently,” Kramer noted. “One guy got hit in the head and had circumferentia stitches and has had big-time vestibular problems. I have seen a couple of ear infections, which may have been secondary to a foreign body perforation of the tympanic membrane.”
“Most of the people who were in close proximity to the collapse and survived found that their nasal passages and their external auditory canals were literally plugged with particulates—total occlusion,” he said. “Many of them reported that they stood in hot showers until it loosened up. When you look into their ear canals now, the drums are OK, but you can still see particles of metal or glass imbedded in the walls of their external canals.”
Recovery Continues
After months of working around the clock, firefighters and other skilled workers have transformed the “The Pile” into “The Pit,” where victims continue to be recovered and returned to families. The site now appears vast and empty, with most workers doing their painstaking labor out of public view. On the perimeter, a few buildings appear pockmarked.
“They were hit by ‘torpedoes’—chunks of the twin towers that blew out during their collapse,” explained Jerry Cammarata, an SLP, member of the city’s central school board, and a commissioner of youth services in the mayor’s office. He recently took ASHA members presenting at a conference (see story on page 25) to a small viewing area near Ground Zero.
The platform, built shortly after the attacks under the direction of former Mayor Giuliani, has become a memorial to victims and is blanketed with offerings—flowers, banners, children’s drawings, photos, messages, fire and police patches, Popsicle-stick angels, and teddy bears.
Nearby, rescue workers find refuge at St. Paul’s Chapel. In 1789, George Washington gave thanks in the chapel for his inauguration. Now rescuers can eat hot meals, nap, or receive counseling in the sanctuary, which is draped with banners and other gifts of compassion.
As the months pass and the site is cleared, Cammarata says attention has shifted to less tangible but no less difficult problems—the nature of a memorial, for example, and the lingering question of long-term environmental effects.
“We have seen widespread upper-respiratory problems, but the tests are still underway and no conclusive determinations have been made,” he said.
The long-term psychological impact on children remains unclear. Thousands of students were temporarily relocated to other schools, away from the site of destruction.
“As long as trucks are hauling out debris, there will be negative reinforcement of the devastation on children,” Cammarata said.
“Kids are expressing themselves through art and three-dimensional designs. A lot of tools get to the same place,” he said, adding that ASHA “could look at portfolio assessment, and how to bring together these ideas so that no matter what communication modality exists, every child will be at their highest level of competency.”
Beyond Hatred
At “The New York Conference: Harmony and Healing” held on Jan. 11 (see story on page 25), two speech-language pathology supervisors working in the city’s public schools reflected upon their roles in the wake of Sept. 11, and the impact of the attacks on their professional and personal lives.
Jorge Gonzalez lives and works on the Lower East Side, where, until Sept. 11, the World Trade Center dominated the view. Phone lines were down for four months, and until a few weeks ago the staff relied on cell phones. Cheryl Glenn works in East Harlem, more than 100 blocks north of the World Trade Center site. A long-time resident of TriBeCa, she lived in the shadow of the twin towers for years before moving to Dingman’s Ferry, PA, where she has a private practice in addition to her school-based work.
On Sept. 11, Gonzalez was conducting a supervisory visit to a middle school when the attacks occurred. He recalled, “I was outside helping parents get into the school when the second plane hit. Students could see this from different classrooms, and we strongly reassured them that the school was the safest place to be. We went inside and immediately started covering the windows.”
When the buildings fell, he forced himself to stay calm and assisted clinicians as well as distraught students and parents. By 1 p.m., all 1,200 students had been dismissed. Gonzalez stayed late at the district office to escort other students home.
Parents were frantic as far north as East Harlem, Glenn recalled, where SLPs worked with guidance counselors and social workers, focusing on language issues related to the trauma. She believes SLPs had an important role.
“We are communication specialists,” Glenn said. “For children to express how they feel, they need the mode of communication to do it. If they don’t have that mode of communication, they have no way to get their feelings out.”
Children with communication disorders sometimes struggled with their overwhelming feelings. Three weeks after the attacks, Gonzalez said, “I went to observe an SLP, and the children were drawing pictures. They didn’t have strong communication skills, but the SLP recognized that they needed to express themselves in another way.”
Driving home to Dingman’s Ferry, PA, from her school in East Harlem after the harrowing events of Sept. 11, Glenn arrived home to learn that her day’s work was far from over. A community supervisor asked her to assist with children whose parents were lost in the towers, including one child who had lost both parents—a difficult task for which she didn’t feel prepared.
“We cooked dinner for them. I was the only adult there who worked in the city, and the children kept asking me, ‘Were you there? Did you see it? What happened?’”
Even now Glenn notices that fear creeps into the narratives of the children of Dingman’s Ferry.
“We’ll be talking about things and they’ll say, ‘Suppose a tank comes up the road and starts shooting into the school, what would we do?’ There is a fear that we will be infiltrated, we’re going to be attacked, we’re going to die.”
Admitting to vulnerability is hard for New Yorkers, Gonzalez said. “We’re tough. We thought we couldn’t be touched.” Adds Glenn, “Even when the World Trade Center was hit in 1993, it didn’t shake us. But this time, it was different.”
Looking to the future, Glenn hopes that people look more deeply at the roots of hatred.
“All of this happened because of hate,” she said. “Let’s not fool ourselves. There are a lot of problems in this country. Now I think we feel united because of our common enemy. But when the dust settles, that may change.
“We need to think about respect and brotherhood, the things we learned about in the 1960s. Whatever your religion or your race, you’re still an American.”
Gonzalez agreed. “We have a real opportunity now to look at tolerance and cultural differences, and not just on the surface. We need to teach character education.
“If Sept. 11 teaches us anything, it’s that we must make stronger connections, respect our differences, and act upon our common humanity.”
“We Knew Nothing About Anthrax”
Last fall in New York City, the weapons of terror were massive—and microscopic. A month after the twin towers collapsed, the invisible bacterium known as bacillus anthracis was converted into aerosol and secretly distributed by an unknown perpetrator.
Kathy Nguyen, a quiet, hardworking employee of Manhattan Eye, Ear, & Throat Hospital (MEETH), breathed the deadly spores into her lungs, where the disease is 90% fatal. She developed flu-like symptoms and died, becoming New York City’s first anthrax victim.
The hospital—and its speech-language pathology and audiology staff—faced this unprecedented crisis just one month after Sept. 11. Gayle Morris, the assistant director of speech-language pathology, first learned of Nguyen’s illness when Mayor Rudy Giuliani announced it and mentioned the hospital by name.
“We were concerned because no one in the city—really, no one in the world—seemed to know a lot about anthrax and how it was spread,” Morris said. Following an all-night inspection by a hazardous materials team, she said, “We were told to come to the hospital, where we waited in a holding area and made a list of everyone who had walked through our doors” in the previous two weeks.
“We informed patients that the Centers for Disease Control (CDC) recommended that they go on prophylactic antibiotics until further notice,” Morris said. Lenox Hill Hospital, which owns MEETH, quickly set up an evaluation and treatment site for anyone who might have been exposed. The site was staffed by local health officials, the CDC, and the FBI. Following extensive questionnaires and interviews, a 10-day course of antibiotics was dispensed to the staff and others.
“Every test came back clean,” Morris said, adding that the process eased her anxieties. “Going through this, we were able to put anthrax in a better perspective, to understand more about it than if we had only seen it on TV.”
After five days, the hospital reopened, and Mayor Guiliani declared it was “the safest place in New York,” she recalled.
“We felt safe and secure, and communicated that to our patients. The vast majority of them returned.”
With the ongoing concerns about air quality, Morris said she is “surprised” that she hasn’t seen an increase in breathing problems for laryngectomy patients. Those patients breathe through stomas, which closely link their airway and lungs.
The hospital’s staff has taken extra care to monitor how their clients have been affected by Sept. 11.
One patient, she recalled, delayed in pursuing voice treatment because of guilt that it was unimportant in light of the tragedy. “People think, ‘I was spared and I can breathe, and that’s enough,’” she said.
“But eventually you need to resume your life and take care of yourself. And that’s our job—to help people communicate so they can be part of this world.”
In New York, A Conference for “Harmony and Healing”
In the months since Sept. 11, people around the world have opened their hearts to New York City. On Jan. 11, exactly four months after the attacks, ASHA members in the city received a very special gift—a free day of professional development titled “The Conference for New York: Harmony and Healing.”
Three nationally known presenters—Wayne Secord, Elisabeth Wiig, and Judy Montgomery—presented the full-day conference at their own expense, as a gesture of condolence, support, and solidarity with the speech-language pathology and audiology community.
The event was sponsored by the Higher Education Opportunities for Speech Providers Committee of the New York City Board of Education (NYCBOE), and hosted by the Speech and Hearing Center at St. John’s University. Five corporate sponsors also provided generous support: The Psychological Corporation, American Guidance Service, Super Duper, Thinking Publications, and Phonic Ear.
“The idea for the conference began with a phone call between friends,” says Jane Coyle, the NYCBOE’s supervisor of speech services. Secord called her to ensure that her family was safe, and offered to come to the city and give a full-day presentation.
“Wayne was inspired by ‘The Concert for New York,’ and called the other presenters. Their response was, ‘How soon can we come?’” Coyle recalled.
The conference was more than an ordinary day of learning. Nearly 400 clinicians, faculty, and graduate students braved a cold, blustery day to attend the conference, which opened with a color guard ceremony.
In opening remarks, Donna Geffner, director of the Speech and Hearing Center at St. John’s and former ASHA president, and other speakers extended deep condolences to the speech-language pathologists, audiologists, and others in the ASHA community who lost immediate family on Sept. 11. Jerry Cammarata, a former school-based SLP who now serves as Commissioner for the Mayor’s Office of Youth and Community Development and as a member of the city’s central board of education, brought greetings from Mayor Bloomberg.
The guest speakers, for their part, demonstrated a high degree of passion and creativity in their presentations. Secord, an ASHA Fellow and the director of the National Center for Speech-Language Pathology in the Schools, presented “Becoming an Effective Classroom Interventionist: A Few things Done Extremely Well!” In addition to examining classroom intervention, his slide show of expressive dogs and a cell phone that rang in his shirt pocket brought laughter from the audience.
Wiig, an ASHA Fellow, professor emeritus of Boston University, and recipient of the Kleffner Award, spoke on “Effective Assessment of Language and Communication: Using Multiple Methods for Analysis, Synthesis, and Application.” She discussed language assessment as a multi-dimensional process designed to provide more than a disjointed collection of observations and test results.
Montgomery, an ASHA Fellow and former ASHA president, is a tenured associate professor of special education at Chapman University in Orange, CA. She discussed ways that the SLP can support reading and writing skills at the primary and secondary levels.
For more information about the presentations, contact Jane Coyle at jcoyle@nycboe.net or Donna Geffner at geffnerd@stjohns.edu. The program was recorded for future use. It is anticipated that proceeds from the sale of a product will go into a Sept. 11 fund to help support the families of members who lost loved ones.
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March 2002
Volume 7, Issue 4