by Kristen Lombardi
November 28, 2006
It was October 6, 2004, three years after Ernie Vallebuona's
three-month stint as a rescue and recovery worker at ground
zero in the wake of the 9-11 terrorist attacks, and he was
hunched over and trembling, racked by a pain like nothing he
had experienced in his 40 years of sound health. He had just
returned to his Rockland County home after finishing the midnight-to-8
a.m. shift in the NYPD vice unit, where he'd reported to work
for the last six years. Vallebuona had bought some fish from
a street vendor near his office, on the Lower East Side. And
as he drove the 35 miles from Manhattan to New City, he chalked
up a searing stomachache to food poisoning. Maybe the vendor
had filleted that fish with a dirty machete?
By the time he pulled into his driveway, the pain had grown
excruciating, too horrible for him to even lie in bed that
day. The chills swept over his body; so did the shakes. He
called his doctor, who suggested ulcer medication. His mother
advised him to forget that diagnosis and consult a specialist
instead, but like a lot of young, healthy men, he didn't listen
right away.
Vallebuona isn't much for complaining; what ailing cop is?
But for six months, he had noticed his body betraying him.
His toes had reddened; his joints had stiffened. They throbbed
in prickly pangs, as if glass shards were wedged underneath
his skin. When his own heartbeat began to hurt, he had visited
the family doctor, who diagnosed him with gout. He was told
to drink cherry juice and take anti-inflammatory medicine.
Neither worked.
Now as his stomach convulsed, Vallebuona listened to his mother
at last. Later that day, he found himself at a gastroenterologist's
office in Pomona, lying on a table, watching a nurse poke at
his abdomen. She felt a lump and ordered tests. It would take
a month to reach a definitive diagnosis of non-Hodgkin's lymphoma,
a cancer of the lymphoid tissue. Evidently, Vallebuona had
developed a golf-ball-sized mass in his abdomen that had grown
so fast and so quick that pieces of it were dying and depositing
into his blood, causing gout-like symptoms.
One week after that, he was at a Manhattan hospital, meeting
his oncologist, hearing about the heavy-duty chemotherapy he
would have to undergo over the next four months. At the visit,
a nurse explained he had an aggressive cancer—a rare
stage-three—and asked a battery of questions.
Did he ever do modeling with glue?
Did he ever handle insecticides?
Did he ever work with chemicals like benzene?
Vallebuona answered no to all the questions. He had led a
clean life; before becoming a cop, he'd worked in a bank.
Sitting in the examining room with him, Vallebuona's wife,
Amy, finally spoke up.
"What about 9-11?" she asked. "What about all
that smoke and dust?"
Only then did Ernie Vallebuona first consider the possibility
that the events of September 11 could be the cause of his cancer.
--------------------------------------------------------------------------------
This is not the story of rescue and recovery workers at ground
zero getting sick with respiratory illnesses from their exposure;
you have read those stories, and you have heard those cases.
This is the story of 9-11 and cancer.
To date, 75 recovery workers on or around what is now known
as "the Pile"—the rubble that remained after
the World Trade Center towers collapsed on the morning of September
11, 2001—have been diagnosed with blood cell cancers
that a half-dozen top doctors and epidemiologists have confirmed
as having been likely caused by that exposure.
Those 75 cases have come to light in joint-action lawsuits
filed against New York City on behalf of at least 8,500 recovery
workers who suffer from various forms of lung illnesses and
respiratory diseases—and suggest a pattern too distinct
to ignore. While some cancers take years, if not decades, to
develop, the blood cancers in otherwise healthy and young individuals
represent a pattern that experts believe will likely prove
to be more than circumstantial. The suits seek to prove that
these 8,500 workers—approximately 20 percent of the total
estimated recovery force that cleared the rubble from ground
zero—all suffer from the debilitating effects of those
events.
The basis for the suits stems from the plaintiffs' argument
that the government—in a desperate attempt to revive
downtown in the wake of the catastrophic events on 9-11—failed
to protect workers from cancer-causing benzene, dioxin, and
other hazardous chemicals that permeated the air for months.
Officials made these failures worse by falsely reassuring New
Yorkers that they faced no long-term dangers from exposure
to the air lingering over ground zero.
"We are very encouraged that the results from our monitoring
of air-quality and drinking-water conditions in both New York
and near the Pentagon show that the public in these areas is
not being exposed to excessive levels of asbestos or other
harmful substances," Christine Todd Whitman, the then
administrator of the EPA, told the citizens of New York City
in a press release on September 18—only seven days after
the attacks. "Given the scope of the tragedy from last
week, I am glad to reassure the people of New York . . . that
their air is safe to breathe and the water is safe to drink."
Those statements were not only false and misleading, but may
even play into the basis for the city's liability for millions
of dollars in the recovery workers' lawsuits. Last February,
U.S. District Judge Deborah Batts cited Whitman's false statements
as the basis for allowing a different class-action lawsuit
to proceed—this one, against the EPA and Whitman, is
on behalf of residents, office workers, and students from Lower
Manhattan and Brooklyn, many of whom suffer from respiratory
illnesses as a result of 9-11.
"No reasonable person would have thought that telling
thousands of people that it was safe to return to Lower Manhattan,
while knowing that such return could pose long-term health
risks and other dire consequences, was conduct sanctioned by
our laws," Batts wrote in her February 2 ruling. "Whitman's
deliberate and misleading statements made to the press, where
she reassured the public that the air was safe to breathe around
Lower Manhattan and Brooklyn, and that there would be no health
risk presented to those returning to the areas, shocks the
conscience."
And that was before anyone knew of the apparent cancer link,
first reported in the New York news media in the spring of
2004. Even more shocking is the incidence of cancer and other
life-threatening illnesses that have developed among those
participating in the recovery workers' lawsuits. Given the
fact that some cancers are slower to develop than others, it
seems likely to several doctors and epidemiologists that many
more reports of cancer and serious lung illnesses will surface
in the months and years to come. The fact that 8,500 recovery
workers have already banded together to sue, only five years
later—with 400 total cancer patients among their number—leads
many experts to predict that these figures are likely to grow,
meaning a possible death toll in the thousands.
In many ways, these illnesses suggest the slow but deteriorating
health issues that faced the atomic-bomb survivors of Hiroshima
and Nagasaki, where thousands died in the years and decades
that followed the United States' use of nuclear weapons. And
that similarity has not been lost on David Worby, the 53-year-old
attorney leading the joint-action suits on behalf of those
workers who are already sick, and even dying.
"In the end," Worby declares, "our officials
might be responsible for more deaths than Osama bin Laden on
9-11."
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In the five years since the attacks, much of the focus on
the 9-11 health crisis has missed a broader question, the one
that every ground zero worker fears most and the one that Ernie
Vallebuona has already had to ponder: What about cancer? What
if all that pulverized concrete and ground glass and caustic
mist that Vallebuona inhaled while on the Pile didn't attack
his lungs but instead went straight for his lymph nodes? Could
this noxious mix have caused his lymphoma?
No one has done a comprehensive study of the health consequences
on the estimated 40,000 rescue and recovery workers who raced
to ground zero after the attacks. A study by Mount Sinai Medical
Center—one that received widespread media attention two
months ago—released statistics on the five-year anniversary
of 9-11 that focused almost exclusively on respiratory problems
and bypassed any mention of cancer today.
But David Worby has tracked the cancer patients among his
growing client base for the last two years. Here are the latest
tallies: Of the 8,500 people now suing the city, 400, or about
5 percent, have cancer. The biggest group by far consists of
people like Vallebuona, who have blood cell cancers. Seventy-five
clients suffer from lymphoma, leukemia, multiple myeloma, and
other blood cell cancers; most are men, aged 30 to 60, who
appeared in perfect health just five years ago.
The field of cancer research is not known for consensus. But
six prominent specialists on cancer and the link to toxins—on
the faculty of the nation's top medical schools and public
health institutions—all come to the same conclusions
when told these statistics. They are Richard Clapp and David
Ozonoff, professors of environmental health at Boston University
School of Public Health; Michael Thun, director of epidemiological
research at the American Cancer Society; Francine Laden, assistant
professor of environmental epidemiology at Harvard School of
Public Health; Jonathan Samet, chairman of the epidemiology
department at Johns Hopkins Bloomberg School of Public Health;
and Charles Hesdorffer, associate professor of oncology at
Johns Hopkins School of Medicine. These doctors and epidemiologists
agree that the incidence of cancer among this subset of workers
sounds shockingly high, that they cannot and should not be
dismissed as coincidence, and that the toxic dust cloud that
hung over downtown Manhattan, and particularly the Pile, likely
caused or promoted the diseases. Some even went so far as to
say that the blood cancer cases, especially, indicate what
could become a wave of cancer cases stemming from 9-11 over
the next decades.
"Those numbers seem quite outrageous," is how Hesdorffer
puts it. Now at Johns Hopkins, Hesdorffer directed until last
year the tumor immunotherapy program at Columbia University
Medical Center, where he treated two recovery workers who got
cancer post–9-11. He notes that the average healthy adult
person has a 20 percent risk of having cancer over a lifetime.
Calculate that risk over five years—the time frame from
the events of 9-11 until today—and it drops to about
1 percent. Yet 5 percent of the suits' workers—1 percent
of the overall worker population—have already been diagnosed
with malignancies. And these patients don't include the thousands
whose illnesses have yet to be recorded because they aren't
participating in the lawsuits or in the World Trade Center
medical-monitoring programs.
What the experts find most telling are the types of cancer
now emerging. They say the blood cancer cases seem too disproportionate
to be random. Two percent of these workers have been diagnosed
with what amounts to related diseases, none of which fall into
the "high-frequency" category, which includes prostate
cancer. One out of 9,000 people nationwide gets lymphoma a
year; for myeloma, it's one out of 30,000. By contrast, the
75 blood cancer patients translate into several dozen new cases
a year.
"That's not just a fluke," says Ozonoff, who studies
cancer clusters and toxic waste sites.
Samet, a worldwide expert on smoking and cancer, notes that
when so many cases of related cancers emerge, it can signal
a forming cluster. "It sounds like an impressive cluster
of cancer cases, and I would want to study it," he says.
To be sure, the experts advise caution until more evidence
is collected. They acknowledge that the data needed to draw
a definite link between 9-11 and cancer don't exist. None of
the cancers emerging now are the kinds that come only from
toxic exposures—like, say, asbestosis, which is caused
by asbestos and can take two decades to grow. This sentinel
cancer would go a long way toward proving a 9-11 connection.
Absent that, scientists would want to determine whether a higher
proportion of cancer patients exists among the workers than
in the general public. But because there are no independent
data on the 40,000-strong group, they can't make this calculation
yet. Meanwhile, the latency periods for most cancers from the
time of a full-blown carcinogenic exposure to a full-blown
malignancy can take years, if not decades. Says Thun, of the
American Cancer Society: "It is the exception rather than
the rule to have cancers develop this quickly."
--------------------------------------------------------------------------------
Despite the lack of definitive data, we may still be in the
midst of a cancer epidemic. Indeed, according to these experts,
traditional data don't help much here because 9-11 represents
such a singular exposure. No one can deny that the workers
were exposed to a blend of pulverized and aerosolized toxins
that had never existed in any occupational setting before.
And this mix of toxins alone is enough to cause more aggressive
cancers.
"It's also enough to throw out prescriptions on timing," Hesdorffer
adds.
Back in May 2004, before most doctors even contemplated a
9-11 link to cancer, Hesdorffer provided testimony to the federal
government's September 11 Victim Compensation Fund on behalf
of one police officer who had developed pancreatic cancer within
a year after his recovery stint. Hesdorffer finds it odd that
two of his patients had been diagnosed with the rare cancer
after working on the Pile. "It's strange to have two people
who were subjected to the same exposure," he says, "developing
the same cancer in the same time frame." Now that he has
learned of Worby's statistics, he is convinced that "there
is definitely more than a likely link between the 9-11 exposures
and cancer."
Francine Laden, who specializes in air pollution and cancer,
agrees. Because so many of Worby's clients have blood cancers—which
have faster incubation periods than tumor cancers, forming
in as little as five years—Laden confirms that it's not
a stretch to attribute their diseases to the dust cloud. "Blood
cancers are different," she says, noting the tie between
benzene and leukemia, as well as dioxin and lymphoma. "It's
not beyond the realm of feasibility that these chemicals caused
these cancers."
Ozonoff puts it more firmly: "For an acute episode like
this, it's definitely possible these blood cancers were caused
by 9-11."
Ozonoff echoes all five of his colleagues when he draws parallels
between the aftermath of 9-11 and that of another massive exposure:
the atomic-bombs dropped on Japan. Bomb survivors experienced
excessive spikes in leukemia rates within the first five years,
a surprising discovery for epidemiologists in the mid 20th
century. While this outbreak resulted from radiation, both
it and 9-11 involved a sudden and intense blast of carcinogens.
For bomb survivors, leukemia appeared first, followed by breast
and lung cancer. "That could happen with 9-11," says
Samet, the Johns Hopkins epidemiology department chair. "It
might be what we're seeing today."
It's also possible that the carcinogens in the Trade Center
dust accelerated cancers already dormant or developing in the
recovery workers, epidemiologists say. According to Richard
Clapp, who directed the Massachusetts Cancer Registry from
1980 to 1989, toxins can not only instigate the genes that
cause cancerous cells to divide, but also hasten their dividing.
That means that a person with an undetected cancer will develop
it faster and in a more virulent manner. He calls this the "promotional
effect" and says some toxins associated with 9-11 have
been known to speed up lymphomas and leukemias. "The promotional
effect could have happened already," he says.
Either way, Clapp adds, "It's hard not to attribute these
cancers to 9-11." His gut, he says, is telling him one
thing: "We'll be seeing a cancer explosion from 9-11,
and we're starting to see it today."
At 8:30 on the morning of the terrorist attacks, Ernie Vallebuona
was driving with his three-year-old son, also named Ernie,
to a nearby Home Depot in search of the perfect paint color
for the family bathroom. Vallebuona always listens to 1010
WINS in the car, so he turned on the radio. He soon heard the
incredible news that a plane had crashed into one of the twin
towers. Instantly, he got the call to respond.
"We're all mobilizing," his NYPD supervisor told
him via cell phone. "Get to work as fast as you can."
Over in Pomona, some 36 miles away from Manhattan, 37-year-old
NYPD detective John Walcott was at his suburban home, killing
time before a midnight tour on the narcotics unit, where he'd
worked for a dozen years. He was relaxing on the couch when
a friend from St. Louis called.
"What the hell is going on in New York?" the friend
asked, incredulously. Walcott had no idea what his friend meant.
He flipped on the TV, only to see flames raging from the twin
towers. Minutes later, he was behind the wheel of his minivan,
speeding down the highway toward the World Trade Center.
Some 200 miles southeast of the Trade Center site, 49-year-old
Gary Acker was working in a bomb shelter dubbed the "earth
station," an undisclosed location where AT&T keeps
its large satellite dishes. At the time, Acker was managing
the company's disaster recovery team, which restores critical
communications after catastrophes. He had long viewed the post
as the crowning achievement in his 31-year career, one that
suited his desire to make a difference.
When the first plane hit the north tower, he was sitting in
an equipment room, four floors below ground, running emergency
drills. No one had turned on the TV, so he remained oblivious
to the events unfolding in Manhattan. His wife, Alison, called
him.
"Look at the TV," she said, just as the second plane
hit the south tower. Acker knew that New York City officials
would be calling AT&T for help. "Pack up your equipment," he
heard his wife say, "and get ready to ride."
Back in Manhattan, Jessy McCarthy was not about to roll anywhere.
The Verizon field technician was sitting in his office on East
91st Street, listening to the news on the radio, when he heard
about the planes hitting the towers. He froze in place, unable
to pull himself away from the broadcast for hours that day.
Only that afternoon did he manage to go to a nearby work site
to repair phone lines. Sitting in his truck, he stared in disbelief
at all the people doused in gray dust walking up Third Avenue
from downtown. His eyes locked on the caravan of people who'd
been caught in that cloud.
By the time McCarthy was taking in this ghostly scene, Vallebuona
and Walcott had joined thousands of first responders at the
World Trade Center. Both arrived at the site shortly after
the 110-story twin towers came crashing down, and they spent
the next 15 hours sifting through the wreckage. Racing to the
scene from the Seventh Precinct, on Pitt Street, Vallebuona
encountered a giant cloud of dust and smoke so hazy and dense,
he couldn't see his hand in front of his face. He circled the
periphery of what he thought was the scene, following the blaring
sirens and running past pumper trucks and police cruisers twisted
up like discarded tin cans. The dust caked his eyes and coated
his lips. It filled his nostrils with a horrible smell, like
burned plastic and flesh. Vallebuona happened to have a bandanna
in his pants pocket, which he wrapped across his face. It did
little to ward off the rancid odor.
Walcott was also experiencing the noxious effects of the chemical
brew. While the massive cloud had dissipated, the crystalline
particles hung in the air like speckles in a snow globe. He
waded though mounds of pulverized dust, knee-deep, tasting
it on his lips, spitting it out of his mouth. Without a mask,
he was coughing immediately. First came the black mucus and
ashen chunks, then the dry heaves and blood. For hours, he
wiped away dark gunk dripping from his eyes. He couldn't help
but think that something was wrong. But he focused on the mission
at hand, on the faint hope of discovering survivors. That day,
he stepped over the only human body that he would find intact—a
female, burned beyond recognition, a charred bra over her face.
Acker arrived on the scene 24 hours later, after driving with
11 team members up the East Coast in a company trailer equipped
with satellite transmission consoles and multiplex cables.
He would spend the next 33 days in and around ground zero—first
setting up a satellite at 1 Police Plaza, then manning phone
lines across the street from what came to be known as the Pile.
The plume enveloped the area from the moment he set foot there
until he left. Many nights, he'd oversee the satellite atop
1 Police Plaza, just east of ground zero, and watch as the
prevailing winds subsided and the bright-blue smoke settled
in. It hung so heavily on the city that he couldn't see the
guards stationed across the street.
In these early days, Acker, Vallebuona, and Walcott all struggled
to protect themselves from the toxic dust. The foul odor clogged
the air for the three months that Vallebuona ended up working
at the site—first on the Pile, hauling rubble with buckets,
then around the perimeter, providing security and escorting
residents to their dust-laden homes. When he and Walcott searched
the rubble as part of the initial bucket brigade, they wore
nothing over their faces but surgical masks. Respirator masks
came weeks into their months-long recovery work; sometimes
they came with the wrong filters.
Because Walcott was a detective, he ended up spending his
five-month stint not just at ground zero, but also at Fresh
Kills. As much as he choked on the Lower Manhattan air, he
dreaded the Staten Island landfill. Walcott knew everything
in the towers had fallen—desks, lights, computers. But
apart from the occasional steel beam, the detritus that he
sifted through there consisted of tiny grains of dust—no
furniture pieces, no light fixtures, not even a computer mouse.
At times, the detectives would take shelter in wooden sheds,
in an attempt to get away from what Walcott likes to call "all
that freaking bad air." One day, he was sitting in the
shed with his colleagues, eating candy bars and drinking sodas,
when some FBI agents entered. They were dressed in full haz-mat
suits, complete with head masks, which they had sealed shut
with duct tape to ward off the fumes. As Walcott took in the
scene, contrasting the well-protected FBI agents with the New
York cops wearing respirator masks, one thought entered his
mind: What is wrong with this picture?
The same thought would cross Acker's mind only fleetingly,
and only after weeks of working near ground zero, while he
was hacking so hard he vomited something akin to chewed-up
licorice. During his first days at the site, he wore the painter's
mask that an NYPD lieutenant had given him, but it soon became
too filthy from debris. By October, he was spitting up so much
gunk that he called his doctor for an antibiotics prescription.
But he wouldn't leave the site; when the fumes got bad, he'd
sit in the company trailer and flip on the air conditioner.
That had a filter, at least. AT&T had stocked its disaster
trailers with almost everything—rubber boots, hard hats,
rope, a first aid kit. Funny, Acker thought, staring at the
shelves. All this stuff, yet no one had ever considered respirators.
Around this time, McCarthy was just beginning to report for
recovery duty. When Verizon asked for volunteers to restore
phone lines near ground zero, he didn't hesitate. He arrived
for his first assignment in early October and wound up staying
downtown for the next 13 months, going from basement to basement,
moving from Wall Street skyscrapers to Chinatown walk-ups.
The first thing he saw in the company terminals was the Trade
Center dust, piled on top of consoles, crammed into corners.
He had to wipe down the equipment with his bare hands to see
the wires. The dust had an orange hue; at times, it twinkled.
And it always stunk, an unforgettable smell he struggled to
get past every time. Invariably, he'd find it in his hair,
on his eyelashes, in his tool belt, even under his fingernails.
Sometimes, he'd gaze at the ceiling and get the sense of standing
in the middle of a meadow thick with pollen. He could see the
soot and dust floating in the air.
--------------------------------------------------------------------------------
When it occurred to these responders that they might be sacrificing
their health for the sake of the cleanup—as it did to
anyone who came in contact with the foul-smelling smoke and
dust—they took comfort in the official word at the time.
In the immediate aftermath of 9-11, the EPA issued multiple
statements on the air quality downtown. All were reassuring
in nature. On September 18, the day after the New York Stock
Exchange reopened for business, the EPA's Whitman said the
air was safe to breathe.
It has turned out those words were, in fact, false. In August
2003, the EPA inspector general issued a scathing 155-page
report concluding that the agency hadn't had the data to make
such blanket declarations at that time. By then, more than
a quarter of EPA samples showed unsafe levels of asbestos,
and the agency had yet to complete tests for mercury, cadmium,
lead, dioxin, and PCBs. The inspector general's report went
on to disclose another disconcerting fact—that the White
House had pressured the EPA to sanitize its warnings about
ground zero. The inspector general revealed that the White
House Council on Environmental Quality had taken a red pen
to the agency's press releases, adding reassuring statements
and deleting cautionary ones, creating the overly rosy picture
that the air was clean.
In reality, the 9-11 fallout was like nothing anyone had been
exposed to before. Everything in the towers had been ground
into dust—concrete, steel, glass, insulation, plastic,
and computers. Dust analyses would detect glass shards, cement
particles, cellulose fibers, asbestos, and a mixture of harmful
components, including lead, titanium, barium, and gypsum. In
all, the dust contained more than 100 different compounds,
some of which have never been identified. And then there were
the fires that smoldered for three months. They gave off not
only the putrid plume, but also a blast of carcinogens—asbestos,
dioxin, and polycyclic aromatic hydrocarbons, or PAHs. They
also emitted benzene.
In one disturbing analysis done by the U.S. Geological Survey,
the dust had such high alkalinity levels it rivaled liquid
Drano.
Thomas Cahill, a physicist who sent a team to analyze the
plume from a rooftop a mile away from ground zero, says he
got worried once he noticed the color of the smoke had turned
a fluorescent blue. That's a sure sign that ultra-fine particles
(which can go deep into the lungs and enter the bloodstream)
were coming off the Pile and permeating the air. When his team
tested the plume, the scientists found higher levels of sulfuric
acid, heavy metals, and other insoluble materials than anywhere
else in the world, even in the Kuwaiti oil fields. "Not
nice stuff," says Cahill, a professor emeritus of physics
at the University of California at Davis, who has published
three papers on the 9-11 plume, "and it was all being
liberated by that smoldering pile, so those people got the
full force of it."
Today, Cahill is trying to identify what exactly the recovery
workers were inhaling, but the data are incomplete. He does
know one thing for certain: "You'd have to stand by a
busy highway for eight years to get what these people on the
site got in just four weeks." He then adds, "These
poor people are part of an enormous experiment, I think."
--------------------------------------------------------------------------------
In May 2003, John Walcott was 39 years old. He had just become
a first-time father—of his daughter, Colleen—and
had proudly coached a Bedford high school hockey team to the
state regionals. That spring, he had noticed his energy fade.
But he figured his 16-hour days juggling the narcotics beat,
hockey practice, and parenthood were finally catching up to
him. Still, the fatigue would consume him for weeks. He'd fall
asleep at his desk or behind the wheel. Often he'd nod off
in the middle of a conversation.
Then he got the diagnosis: acute myelogenous leukemia, a white-blood-cell
cancer. He was ordered straight to the hospital, where he underwent
chemotherapy for the next 28 days.
Eventually, a nurse would ask Walcott questions similar to
those put to Valle-buona, the ones meant to pinpoint the possible
causes for his cancer. Like Vallebuona, Walcott answered no
to all the questions. And like Vallebuona, he didn't connect
the dots between his time at ground zero and the cancer growing
in his body.
Visiting him in the hospital later, his sister, Debbie, did.
"John," she said, "what the hell do you think
you were around at ground zero?"
It was a question that Gary Acker would also have to confront
that summer, in a visit to his own doctor's office. The AT&T
manager had never shaken that World Trade Center cough, struggling
with sore throats and lung infections for 18 months after completing
his recovery work, suffering through all kinds of inhalers
and antibiotic regimens. At one point, his doctor diagnosed
him with sleep apnea and ordered him to wear a pilot-like mask
strapped over his face at night, so as to reduce his roaring
snores. It didn't work.
A perennial optimist, Acker ignored any hint that his health
problems were 9-11 related. In September 2002, he got the first
warning that his health was deteriorating from exposure to
the dust cloud when he underwent a pulmonary test for the company.
He was stunned by the doctor's response.
"How many packs of cigarettes do you smoke a day?" the
doctor asked Acker.
"I don't smoke. I never have in my life."
"Well, you have a real breathing problem," the doctor
informed him.
His second warning came in the summer of 2003, as Walcott
was getting chemotherapy. In August, Acker was landscaping
the backyard at his home, in Columbus, New Jersey, carrying
two 50-pound buckets of stones, when his body buckled under
a jolt of pain. It felt as if somebody had jabbed a fishhook
into his rib cage and was slowly gutting him. He allowed for
the possibility of a kidney stone and paid a trip to the doctor.
Days later, he got a diagnosis that would stop his heart cold:
multiple myeloma, a plasma cell cancer. Already, the super-
advanced cancer had eaten its way through the bone marrow in
his ribs, as well as many other bones in his body.
For a fleeting moment, Acker thought about that thick and
foul plume hanging over the Pile; could it have caused his
cancer? But his optimism flooded back and he focused on his
treatment instead—on the chemotherapy pills that he would
take twice a day for the next 28 days. Only days later, after
his oncologist confirmed that his myeloma likely formed in
the last two years, did he finally make the tie-in to 9-11.
By the spring of 2004, Acker and Walcott had endured not only
months of chemotherapy, but also stem cell transplants. They
experienced a series of life-threatening infections and trips
in and out of the hospital before beating their cancers into
remission.
Meanwhile, Vallebuona had just begun noticing gout-like symptoms.
They started in his big toes, which doubled in size and became
hot to the touch, and then moved to his knees, joints, and
chest. For six months, he went back and forth to the doctor,
getting more medicine, seeking more remedies. He wouldn't doubt
that diagnosis until October 2004, when the searing stomachache
tipped him off to what had really been causing pain in his
abdomen.
When he got the cancer diagnosis, Valle-buona was relieved
about one thing. His doctor had been wrong about the gout.
If nothing else, at least he wouldn't have to live with that
excruciating pain for the rest of his life.
As Vallebuona was coming to grips with his cancer in the fall
of 2004, Jessy McCarthy was still feeling healthy. The Verizon
technician had managed to evade the kinds of respiratory problems
that have afflicted so many ground zero workers—the cough,
the sinusitis, the asthma—in the two years since his
recovery assignment had ended. He would experience nothing
to suggest the grave disease that would sneak up on him.
At least not until one day in October 2004, while taking a
shower, when he saw a swelling around the glands under his
arm, about the size of a marble. He thought: This is not right.
But McCarthy didn't feel sick; there were no dizzy spells
or nausea. A trip to the family doctor to ask about the lump
yielded little information, just something questionable about
his blood. So McCarthy plodded on with his life, holding down
his full-time job, taking care of his teenage son.
Suddenly, within weeks, he noticed the lump had grown, and
more had developed. His lymph nodes swelled all over his body,
underneath his arms, in his groin, around his neck and chest.
The lumps just seemed to sprout; they grew so big that they
looked like mini-baseballs. Suddenly, McCarthy found himself
undergoing a battery of medical exams—CAT scans, PET
scans, blood tests, and anything else that would help narrow
down the possibilities. It took six months to rule out every
type of lymphatic infection. In March 2005, after a biopsy
of one of his lymph nodes, McCarthy finally was given the definitive
diagnosis of non-Hodgkin's lymphoma.
By then, the recovery workers' lawsuits had been more than
a year in the making. Back in the winter of 2004, Walcott had
just survived the worst of his hospital stays, a 17-day stretch
of 106-degree fevers, and was confined to his home. Months
had passed since he learned that his leukemia likely resulted
from his exposure to benzene while on the Pile, but he went
in search of legal advice. He started with a lawyer friend,
who encouraged him to keep looking. One attorney offered to
take Walcott's case, as long as he put up his modest house
to cover the fees. "Forget it," he said.
Eventually, parents of the kids on his high school hockey
team heard about his plight. During a visit, Walcott told some
parents about his fruitless search. They had an idea. They
could contact a trial lawyer whose son went to the same high
school; his name was David Worby.
--------------------------------------------------------------------------------
"I took the case as a favor," the lead attorney
in the recovery workers' lawsuits says, sitting in his spacious
penthouse office in White Plains. A trim man whose brown hair
is graying at the temples, David Worby exudes confidence as
he reclines in his chair and recalls the early days of what
has become his greatest legal crusade. Long before the 9-11
suits, he had built a reputation as a gladiator lawyer on personal-injury
cases; in 1989, he set a Westchester record by winning $18
million for a construction worker run down by a car. Fifteen
years later, he was settling into early retirement when one
of the Bedford parents told him about the ailing Walcott.
"What was I supposed to do?" Worby asks.
What started out as a case for one sick recovery worker quickly
snowballed. Today, a team of 20 attorneys at his firm of Worby
Groner Edelman Napoli & Bern is handling the suits, filed
in U.S. District Court in Manhattan, for the thousands of workers
associated with the Trade Center cleanup—police officers,
firefighters, sanitation workers, iron workers, and Latino
day workers. Last month, Federal District Judge Alvin Hellerstein
rejected the city's claim for immunity in the Worby lawsuits
and recently capped its liability at $1 billion. The judge
is expected to appoint a special master to settle the workers'
claims.
Worby's client list continues to grow. It now includes Vallebuona,
Acker, and McCarthy, all of whom came to him after he filed
the first suits in September 2004. They found out about him
as most of his clients do—by word of mouth, one sick
recovery worker to another, one worried spouse to another.
Others have called him after hearing about the cases on TV
or the radio or in the papers. Most of the clients have grown
ill from respiratory problems like asthma, sinusitis, and bronchitis.
But some have kidney failure, and 400 people have developed
cancer. So far, 83 clients have died.
The number of cancer patients has multiplied at a rate that
Worby says he never anticipated. Back in 2004, he represented
only 20 workers who had cancer. But by last March, he had watched
that number soar to 200, and within six months after that,
it had doubled. Now he gets at least several calls a week from
clients who have just been diagnosed with some cancer. Or from
new clients who have had the cancer for weeks or months.
Like many trial lawyers, Worby has a penchant for talking
in fervent, breathless tones, as though his words were writ
large, in bright, blinking letters. Convinced that the 9-11
fallout has made for a cancer explosion, he doesn't hesitate
to say so. "There is going to be a cancer catastrophe
the likes of which we've never seen in this country," he
says. "The numbers are going to be staggering."
Perhaps it'd be easy to dismiss him as another hot-aired plaintiffs'
attorney were it not for his own command of numbers. He has
become something of a gumshoe epidemiologist, compiling the
data on his cancer patients that are lacking in the larger
worker population, tracking their diseases, ages, diagnosis
dates, and their 9-11 exposures. "Look at the cancers
my clients have," he says, flipping through a dozen pages
of a document entitled "Seriously Ill Clients." It's
updated every month; this one is dated September 13, 2006.
The document outlines what he calls his "cancer clusters" and
lists rare cancers often associated with the 9-11 toxins, such
as thyroid (30 people), tongue and throat (25), testicular
(16), and brain (10). He keeps a separate document on the 75
people with blood cancers. Two dozen of them have various forms
of leukemia; the remaining four dozen have various forms of
lymphoma, multiple myeloma, and other blood cell cancers.
"If I had two blood cancers, it'd be a strong coincidence," Worby
argues. "But 70? That defies coincidence. The word coincidence
should not be in anyone's vocabulary."
Worby contends that it wasn't just the unprecedented amount
of toxins in the air that caused his clients to develop cancer;
it was that the toxins worked together. Worby calls it a "synergistic
effect," and cancer specialists say there is such a thing
as toxic synergy, which occurs when chemicals combine. They
can enhance the damage that the other ones would cause. Think
of it this way: The benzene at ground zero may have caused
Walcott's acute leukemia; the dioxin probably sped up its development.
"This amount of toxicological exposure is going to speed
up normal latency periods," Worby argues. He makes this
assertion with the same zeal that he exhibits in the courtroom,
citing medical studies on animals, rattling off the findings
as if they were second nature. Why would the doctors monitoring
the effects of 9-11 on people's health not understand this
connection, he wonders. "Why would people not make this
link?"
--------------------------------------------------------------------------------
Five years after September 11, there's no doubt that the toxic
dust cloud has devastated the lungs of those who participated
in the Trade Center cleanup. In September, the Mount Sinai
Medical Center released data from its WTC Worker and Volunteer
Medical Screening Program, which has tested 17,500 recovery
workers to date. In that analysis, doctors found that nearly
70 percent of the 9,500 subjects they surveyed experienced
new or worsened respiratory symptoms at ground zero; close
to 60 percent saw those symptoms persist for years. Doctors
have seen chronic sinusitis, laryngitis, asthma, gastroesophageal
reflux disorder, and disabling musculoskeletal conditions.
Even the famous World Trade Center cough has lasted much longer
than anticipated.
"All of us have been badly surprised by the persistence
and the chronicity of the World Trade Center diseases," says
Robin Herbert, the director of the screening program.
But at the Mount Sinai program (and at the WTC program of
the FDNY, which declined to comment for this article), the
link between the dust cloud and cancer is discussed more as
a possibility than a reality. It's not that doctors aren't
extremely concerned about the connection, Herbert says, given
the cancer-causing agents and other toxins in the mix. While
individual cancer cases may be attributed to 9-11 toxins, she
says, the doctors, so far, lack full epidemiological proof
linking the two.
"We don't know if we're seeing a spike in cancer rates," Herbert
says, as they have in the rates of respiratory illnesses. Herbert
confirms that the Mount Sinai doctors have seen some workers
with cancer, including unusual cancers, but says they'd expect
some workers to develop malignancies over the last five years
anyway. Is there more incidence of cancer among Pile workers
than among those who didn't toil on the Pile? "That's
the key question," she says. The Mount Sinai epidemiologists
have just begun to try to answer that by launching an initiative
to update medical records, document new diagnoses, and track
less-com mon diseases like cancer. It's a slow process, with
no timeline. Still, she says, "We are now aggressively
investigating every case of cancer that has been reported to
us."
But the WTC programs—funded by the federal government—have
their share of critics, who wonder how interested the doctors
are in the 9-11 and cancer issue. Al O'Leary, the spokesperson
for the Patrolmen's Benevolent Association, says that many
of its members feel as if the doctors are ignoring the signs
of a growing cancer cluster. "It was our impression that
no one in the medical-monitoring programs believed the cancers
could be happening this early," he explains.
Over the past year, the police union has fielded a steady
increase in calls from members who have developed cancer since
working at ground zero. Last July, the PBA started its own
World Trade Center health registry for its members, listing
seven cancer cases at the time. Today, there are 20 cases;
they include the 35-year-old who worked on the Pile and at
Fresh Kills and now has multiple myeloma, the 45-year-old who
surveyed the Trade Center site for two years and now has leukemia,
and the 41-year-old who manned the landfill morgue for three
weeks and now has myeloma.
"Now, don't you think this is all very suspicious?" O'Leary
asks. "The medical community needs to be more open-minded
about what diseases can be caused by 9-11."
Some cancer specialists agree. Hesdorffer, of Johns Hopkins,
still remembers the reaction to his testimony before the Victim
Compensation Fund, back in 2004. He was called back about a
half-dozen times to explain why he would attribute the pancreatic
cancer in his two patients to the dust cloud so soon after
9-11. It was as if no one wanted to make the connection; one
patient lost his claim despite the doctor's opinion.
"We're in this period where no one wants to accept the
link," Hesdorffer observes. Maybe the official denial
stems from economics, from a desire to limit the amount of
money owed to the thousands who have lost their health. Or
maybe it has to do with politics. Admitting a link, as he points
out, "would mean that the fallout from 9-11 was a lot
bigger than we'd thought."
What it would mean is that people got cancer from government
decisions. From the decision of Whitman to lie about the air
quality in Lower Manhattan, which gave the recovery workers
and many other New Yorkers a false sense of security. From
the decision of the White House to put Wall Street ahead of
public health, which the EPA inspector general found had influenced
all those rosy statements. And from the decision to let workers
toil without proper respirators for weeks, or without any respirators
at all.
--------------------------------------------------------------------------------
For Gary Acker, now 54 and still undergoing monthly chemical
drips to heal his bones, gone are the annual trips hunting
for caribou in Canada and fishing for trout in the Adirondacks.
Those years in the late '90s when he threw the javelin and
shot put in the New York version of the Olympics seem like
an adolescent memory. No longer working at AT&T, he devotes
his time to trying to relax, watching mindless sitcoms on TV,
anything to make himself laugh. "If I'm laughing, I'm
not stressed," he says. His doctors tell him that no stress
means less chance of a cancer relapse.
Last year, Jessy McCarthy, now 48, had to work through his
chemotherapy treatment, juggling the 72-hour drips with his
job and his son for six months. He didn't have much choice;
otherwise he'd lose his medical benefits. He could never afford
the medical bills on his $65,000 salary; some of his medications
cost $5,000 a dose. Now in remission, he continues to fix phone
lines, though he knows the day will come when he can't anymore.
Already, he has had to call for help on assignments he used
to do alone. He also knows, in the back of his mind, that his
cancer is the kind that will likely return, and possibly kill
him.
Walcott and Vallebuona, both retired from the force because
of their cancer, continue to live with the side effects of
their treatments—the lost feeling in their hands and
feet and the extreme fatigue. While Vallebuona has undergone
chemotherapy, radiation, and a stem cell transplant, he still
hasn't been able to beat his lymphoma into remission. They
also grapple with what they both like to call "chemo brain." The
drugs left Walcott, now 42, too incoherent to witness or recall
the first time his daughter learned to walk or talk. For Vallebuona,
now 41, the littler things seem to escape him, like the weekend
plans his wife mentioned earlier in the day. But even their
foggy minds have not erased the memories of two planes hitting
the World Trade Center on that sunny September morning, when
they had woken up healthy and happy to be alive.
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