Professional Responses to September 11, 2001
HFA invited a number of grief and bereavement professionals to answer the following questions:
- Were there elements of past public tragedies that have been intensified by the events of September 11?
- Will your experiences in the aftermath of 9/11, either personally or professionally, affect your response to future tragic events?
We appreciate their thoughtful and honest responses, and are pleased to share their opinions and insights below. Click on their name to the right to read their full response.
Barbara L. Bouton - September 11 seemed to reconnect us with past public tragedies we have all experienced in our lives.
Bonnie Carroll - Unlike past public tragedies that occurred in an isolated area and affected a select few, the events of last September left no one untouched.
Charles A. Corr - I think it is likely that every major event in our lives, whether it is a happy event or a sad one, will influence how we live our lives in the future and will have been shaped at least in part by events in our past.
Joyce Davidson - It is with trepidation and ambivalence that I even consider the question. I witnessed the attack not on television but from my 48th-floor Manhattan apartment.
Rabbi Earl Grollman - I was there at Ground Zero and beheld the shredded metal and pulverized concrete of sixteen acres of rubble where smoke was rising from the depths, where thousands of people could not escape.
Patricia Loder - The magnitude of the events of September 11 made this very public event felt in a very personal way by the American public.
Janice Harris Lord - Family members of the dead have been teaching me for 20 years.
Nadine Reimer Penner - The events of September 11 resulted in a paradigm shift for disaster response.
Ashley Davis Prend - I think that now more than ever I understand how powerfully public tragedies impact each of us as individuals.
Phyllis R. Silverman - I heard about the 9/11 tragedy while in Manchester, England.
Margarita Suarez - In answering questions about September 11 I would like to bring some balance in looking at the overall tragedies we all face.
Barbara L. Bouton, MA, is Director of Bridges Center, a hospice bereavement and community grief and loss program of the Alliance of Community Hospices in Louisville, Kentucky. Ms. Bouton serves on the Board of Directors of the National Hospice and Palliative Care Organization, is the Vice-Chair of the National Council of Hospice and Palliative Professionals and has served six years as its Bereavement Professional Section Leader.
September 11 seemed to reconnect us with past public tragedies we have all experienced in our lives. From the assassinations of President Kennedy, Dr. Martin Luther King and Mr. Robert Kennedy in the 1960's to the enormous losses of Pearl Harbor and Hiroshima in the 1940's, people seemed to relive and remember those defining moments of their respective generations.
More than anything, people seemed to need to retell those stories from past public tragedies; i.e., where they were when they learned of the tragedy, the details that were important to them at the time, the way we, as a people, collectively mourned these losses, how they and their families coped. Those who have the benefit of years and wisdom seemed to be able to provide comfort and perspective for younger generations, telling them that we have endured enormous tragedy and loss in the past and that, ultimately, "everything will be all right."
Undoubtedly, my experiences in the aftermath of 9-11 will affect my response to future events! One of the profound lessons for our bereavement program was that our own reactions -- our personal trauma and devastation -- prevented us from being as immediately responsive as we like to be in other situations. This experience has led us to create an initiative that will guarantee we are prepared for such tragedies in the future. We are very good at responding to community and regional tragedies and many of our staff are involved in the Kentucky Community Crisis Response Board, (a state agency that coordinates crisis response), but we really were not prepared to respond to an event (even on a local level) of this magnitude. Our staff has discussed the personal impact that 9-11 took on each of us, the differences in what each of us needed to do to cope with the tragedy, and the necessary steps we need to take to ensure an immediate response to tragedy while also attending to our own grief. It is a delicate balancing act. We will be prepared and ready to act immediately in the future, all the while ensuring that we are attending to our own needs.
Personally, I learned what I needed in order to cope often went "against the grain" of what was recommended. Limiting exposure to media reports and taking "breaks" from the trauma are generally not coping strategies that work for me. I seem to need to take it all in - the more information the better. I believe that this is my psyche's way of trying to understand and integrate the unimaginable; to make sense of the senseless. This was really no different for me than it was when, as a child, I needed as much information and "exposure", if you will, as possible. It is an important reminder that we each have our own ways of coping and that we should honor them.
Bonnie Carroll is the Founder and Chairman Emeritus of the Tragedy Assistance Program for Survivors, Inc., (TAPS); a Major in the United States Air Force Reserve where she has served as Chief, Casualty Operations; and a former White House staffer currently serving as Deputy White House Liaison for the Department of Veterans Affairs. Her husband, a Brigadier General in the Army, was killed in 1992 in a military plane crash in Alaska.
Unlike past public tragedies that occurred in an isolated area and affected a select few, the events of last September left no one untouched. For the families of those who lost loved ones in the bombings at Oklahoma City, Khobar Towers in Saudi Arabia, the USS Cole attack, or the bombing of the Marine barracks in Beirut, the events of 9/11 were eerily familiar. All terrorist attacks leaving devastating results.
What we are seeing now, as we approach the first anniversary, is evidence of our human response. We may believe it's a general malaise, the familiar end of summer doldrums, or just anticipation of a coming winter. But it may be that this depression is the classic effect of a horrible trauma - the very human response to trauma caregivers and counselors know so much about. An event occurs that in a moment changes us forever. Our body, mind and entire being capture every aspect of that intense moment so that we can, in a very primitive way, protect ourselves against similar circumstances. We imprint the crisp temperature outside, the bright color of the leaves, the drone of constant news broadcasts, the sights and sounds and smells of that moment in time when our lives were threatened. We do this so that in the most basic of ways, we can survive in the future.
Is the nation, or at least the East Coast, experiencing in a broad way the same anniversary grief that so many of the bereaved have come to know? This anticipation of September 11, 2002 is gentle and subconscious. For some, it's harder to wake up, go out to face the day, feel a sense of purpose, even laugh out loud. Whether we lost a loved one in the attack, found our office space disrupted, or just felt our sense of security being taken from us, our lives are different now.
Things are different, despite the fact that the area around Ground Zero has been raked and bulldozed and graded so thoroughly it has almost become a Zen garden of thoughtful reflection, or despite the appearance of the Pentagon being as it was, after workers spent a heroic year replacing walls and repairing damage until no sign of the destruction remains. Have we worked equally hard to put up the walls within ourselves, and repair the damage so that no one can see that inside us, we are still fearing, still remembering, still holding that learned survival response to an unconscious trigger?
My personal experience was entirely related to the events in Washington, DC. I had the chance, through the Tragedy Assistance Program for Survivors (TAPS), to work with the families and friends of those killed in the Pentagon, both in the building and aboard Flight 77. Many of those who I met during that response are now dear friends, and sometimes we even forget that it was a horrible event that brought us together. But now that we are coming up on the anniversary of the date, it feels as though we are sailors on a very small ship, battening down the hatches for a typhoon we feel in the air. It's very calm, the sun is shining, but like a seasoned sailor, there is some instinct we can't identify that is setting off alarm bells and telling us to "prepare".
TAPS works with all those affected by a death in the armed forces, and that often means death in a catastrophic mass casualty, or during combat, with many complicating factors. TAPS provides four standard services - peer support, grief counseling referral networks, casework assistance, and crisis intervention. During the Pentagon response, we learned that our program really does address a legitimate need and provide a unique service. We validated the scope of services while working side by side with the Departments of Defense and Veterans Affairs, the American Red Cross, and many other caregiving agencies. We saw that a joint response works well, that the Army Lieutenant General who provided daily briefings could effectively address the concerns of the Navy families. We learned that there is a need for a more consolidated base of information and casework assistance, as we watched the various services come together to share bits of information that had never been consolidated until this joint command center.
Our role at the Center evolved slowly, for in the first days, there was hope. Hope that loved ones would be found like the Pennsylvania minors in the shaft, miraculously alive in an air pocket. DNA collection was being done right outside the briefing room at the Pentagon Family Assistance Center at the Sheraton. For the first days, that was the focal point for the families to be doing something pro-active, to be helping in the search by bringing in bits of evidence to be tested against remains found.
But then the FBI left, having collected all the samples they could. And TAPS moved into their space, to quietly offer a presence of hope and healing and comfort. Manned entirely by survivors who had walked the journey of grieving a loved one and were ready with an ear or a shoulder, sitting around a table filled with materials on trauma and bereavement generously donated and available for the taking, the TAPS area became a haven in an uncertain place. Families have since told us that they could see in our faces their own pain, and yet also the promise of healing. That while they weren't ready to even admit their loss much less experience their grief, they knew by talking to us that they were not alone, and that they would have a safety net in the coming months.
The daily briefings were given to families in a frank yet compassionate manner and demonstrated the power of truthful information to be healing. Just knowing. Because what we in our minds can imagine is often much worse than the most horrific trauma. Lt. Gen. VanAlstyne, the Director of the Pentagon Family Assistance Center, did an amazing job of offering honesty, dignity, and care to all those who attended his daily briefings. He began each day with a key statement, that he was not a "public affairs officer" and not someone who would be providing "spin", but that he was an "infantry officer" who "dealt in facts". and to expect that "facts would follow". This rare candor was appreciated and embraced. When the briefing concluded, he would pause, remind the families to breath, and then take a moment to reflect before moving to the questions. During this pause, he would sometimes play soothing music, and on occasion would ask everyone to rise, and join with him in the National Anthem to "remind them that their loved ones were on duty for America at the moment of their death." The dignity and honor this offered was bonding and comforting.
During the question and answer section, he would give each question an honest answer, and if the person asking was too weak to stand, or too emotional to speak, he would leave the podium and go to them, kneeling down and holding their hands, until they could get the words out to form the question. He would then answer that question quietly, and with their permission, repeat both question and answer from the podium for all to hear. If the general questions from the audience weren't probing enough, he'd encourage the families to "take another breath" and "ask the tough ones" that were on everyone's mind. And sometimes those would come flooding out.
This extraordinary experience validated what we have known, that those who have suffered a trauma have a need for the information that fits pieces into the complex puzzle their minds are struggling to complete. It also teaches us that human beings have a wonderful capacity to understand and comprehend, when they are given honest information in a compassionate manner.
For those of us in TAPS who served at the Pentagon Family Assistance Center, the response efforts following September 11, 2001 validated the tremendous power of peer support. As we batten down our hatches for the coming anniversary storm, we feel a sense of safety knowing we have weathered worse. With our shipmates around us, we'll weather this too.
Charles A. Corr, Ph.D., is Professor emeritus, Southern Illinois University Edwardsville. A long-time educator and writer in the field of dying, death, and bereavement, Dr. Corr's most recent book is the fourth edition of Death and Dying, Life and Living (co-authored with Clyde M. Nabe and Donna M. Corr; Wadsworth, 2003).
I think it is likely that every major event in our lives, whether it is a happy event or a sad one, will influence how we live our lives in the future and will have been shaped at least in part by events in our past. Major events in the lives of individuals, like a birth, a marriage, or a death, will inevitably affect the futures of those individuals, just as those events themselves will be encountered and experienced in the context of the personal histories that preceded them. Much the same is true for public tragedies.
The events of September 11, 2001-some of which were truly horrific, while others were genuinely heroic-are very likely to stir up unfinished business from previous public or personal tragedies. Any events like this may also intensify some difficult aspects of those prior experiences. Nevertheless, those same events will also become part of the context within which we as individuals, as professionals, and as members of communities, experience and respond to future tragic events.
The American humorist Josh Billings (1818-1885) is reported to have observed that "life consists not in holding good cards but in playing those you do hold well." He meant that we must face the fact that we cannot control many of the events that we encounter in life and that we all live with limitations. Still, the real lesson is that we are most often able to determine how we will respond to whatever happens to us and we can decide what we will make of those events in our ongoing living. That may not be easy, but it is the sure path that can take us from being mere victims of events to being real survivors.
Joyce Davidson, MS, is a trauma counselor and palliative care counselor at University Hospital in Newark, NJ. She is also on the faculty of the New Jersey Medical School.
It is with trepidation and ambivalence that I even consider the question. I witnessed the attack not on television but from my 48th-floor Manhattan apartment. I can't get the sound of the first plane screaming by our building out of my mind, and when I hear airplane noise that approximates it my heart still races. From that moment on I watched the attack and collapse from our balcony. When the towers collapsed, it looked to me like the cloud of dust and debris was enveloping my son's downtown neighborhood; I couldn't reach him for hours. My husband couldn't get back home from work, and I have never felt more alone in my life. Phone service, even cell phone, was out, so we communicated by e-mail. Late on the night of September 12 we were evacuated from our apartment because of a bomb scare in the Empire State Building, which is only four blocks away. (What do you take with you when you have no time and don't know whether you'll see your home again -- birth certificates? pets? family photos?)
Our hometown was a surreal, frightening, sorrowful landscape. There was no way to avoid the ubiquitous posters of "missing" people -- smiling photographs of people on vacation, playing with children, at birthday parties, at their weddings. I can't get out of my mind the image of a doleful man wearing a sandwich board with his son's photograph and a plea for help in finding him. For weeks the acrid smell of the smoldering debris was overpowering, people wearing masks--even gas masks. And each day I walked by our neighborhood firehouse, its overhead doors open, the memorial to its lost comrades spilling onto the sidewalk, sad and sobbing passersby paying respects. And of course, there was palpable continuing fear, swarming military and police, horrendous traffic jams at tunnels due to vehicle checks. It felt like New York, and life, would never again be the same.
My immediate response to the attack, on the afternoon of 9/11, was to call the NYC crisis hotline to offer my services as a crisis and bereavement counselor. I was so eager to be of help. But two days later, as I prepared to return to work for the first time (a trip that involves traveling by train through a tunnel to New Jersey), I had an emotional meltdown that took weeks, perhaps months, to recover from.
On good days I just felt numb and worried that I might never again have the heart to be a crisis/bereavement counselor. I felt alienated from my New Jersey colleagues, who didn't really understand. I clung to the one fellow New Yorker at work like a life preserver. I felt (and feel) that I abandoned my private clients. I learned that being a crisis counselor did not inoculate me against crisis.
Over time it got better, of course, and now I can approach my work with enthusiasm and heart, but some things will never be the same. The approaching anniversary reminds us of the depth of our terror and sorrow in those first days, weeks, even months. I don't feel that I have any national or theoretical insights -- just the fragile sense of getting my life back on an even keel and my counseling legs back under me.
We have moved from the high rise; we lost the heart for living on the 48th floor and looking at the fractured skyline. Now we're in an apartment right on the water that is, ironically, only four blocks from ground zero but faces only the harbor, the Statue of Liberty, and the broad sky to the west. It is a peaceful place. We are so near the water that we can hear it lapping against the bulkhead, and at night we can hear the cicadas in the trees.
I am acutely aware of the dilemma of honoring the lives of the dead or forever reliving the personal apocalypse of the dying and the unbearable suffering of the survivors. New York Times writer Jack Hitt recently noted the importance of constructing memorials with "some connection to the best intentions of those who survive" and asked, "What will a pilgrimage to [Ground Zero] mean in the future? Shall we all stand before a tombstone, allowing our sorrows to tremble perpetually at the surface, or can we construct a story that leads us out of the valley of the shadow and back to New York City and the future? That is the difficult work all great memorials attempt, binding the meaning between two temporal realms--that they died and why we live." (August 18, 2002)
Rabbi Earl Grollman, DHL, DD, is a contributing editor to HFA's newsletter Journeys and author of many books about grief and bereavement, including Living When a Loved One Has Died.
I was there at Ground Zero and beheld the shredded metal and pulverized concrete of sixteen acres of rubble where smoke was rising from the depths, where thousands of people could not escape. Even as I consider the possible natural fear of another attack, I am spiritually reinvigorated with a renewed love of country. For me, God was present in the darkest hours, even as the fires raged. God was cleverly disguised as the men and women who formed human chains in the stairwells of the World Trade Center in their determined effort to save as many of their co-workers as possible. God masqueraded as the brave men and women of the Fire and Police Departments who plunged into the towering inferno to rescue whomever they could. And God also bore a striking resemblance to those I saw working around the clock in the smoldering rubble, oblivious to their own personal safety. Their memories will hopefully inspire me to make the world they remember better than the world they left.
Patricia Loder is the Executive Director of The Compassionate Friends, a self-help support organization for families that have experienced the death of a child. Pat is a twice-bereaved parent and a bereaved sibling. Her daughter and son were killed in a car accident in 1991 and her brother died from cancer in 1990.
The magnitude of the events of September 11 made this very public event felt in a very personal way by the American public. The country mourned, for the victims, the nation, and life as we had known it. In our organization, The Compassionate Friends, many of our chapters throughout the country reported seeing an increase in attendance at chapter meetings because people were feeling the renewed sting of their own personal grief while trying to deal with the public tragedy.
In the aftermath of September 11 The Compassionate Friends organization realized that there were unique aspects the victim's families were dealing with that are not normally dealt with when a tragedy is not a public event. To better equip our New York City area chapter leaders we are holding a September 11 orientation. We have invited professionals to speak who specialize in crisis incident trauma and post traumatic stress syndrome, a representative of the medical examiner's office, and a person who experienced the death of her son in the 1985 Rome airport terrorist attack. It is our hope by providing this orientation we will be assisting our chapters so they can, in turn, help the families in the best possible way.
Janice Harris Lord is a national consultant on crime victim issues and the author of No Time for Goodbyes: Coping with Sorrow, Anger, and Injustice After a Tragic Death. She was awarded the U.S. Presidential award for excellence in crime victim services in 1993.
Family members of the dead have been teaching me for 20 years. As 9/11 unfolds, I think about the families of 23 children who burned to death when a drunk driver hit their church bus in 1988. I remember the survivors of the Oklahoma City bombing and wonder how they might be reliving their terror. I think about the estimated 150 families whose loved ones are murdered, die from suicide, or are killed in a car crash every day. I know that for some, their personal grief will be disenfranchised because they will die on 9/11.
As the first anniversary of the terror attacks approaches, I anticipate a media orgy already in place. None of us will be allowed a silent day of reflection. Huge extravaganzas of fireworks, orchestras, the military, and politicians will attempt to whip us into patriotic frenzy. We will hear endless rhetoric regarding the events of September 11. We will be inundated with opportunities for "closure," the other C word besides cancer.
Many of the survivors and family members of September 11 still are haunted by nightmares, flashbacks and overwhelming sadness. Many wait for a day when their agony will end. But I've never met a survivor who wants "closure." They simply hope to get to a place in their life where they can remember their loved one with gentleness of spirit or a smile rather than searing pain. "Closure" is a word best suited for companies that go belly up. As a healing nation, it's time for us to put a moratorium on the word as it relates to people who have been suddenly, violently, and senselessly killed.
I'm also weary of the phrase "terrorist attack on the World Trade Center." This term, which has become national shorthand, is insensitive and disrespectful to all the family members of loved ones who died or were injured in Washington, D.C., and Pennsylvania on September 11. It's time for an accurate description, such as the "terrorist attacks on America" or a specific reference to Washington, New York, and Pennsylvania.
I bristle, also, at the overuse and inaccuracy of the term, "suicide bomber." Let's place the blame where it needs to be and make reference to "homicide bombers." The hijackers had a choice. Their victims were innocent. The focus should be on the innocent victims who were killed, not the killers.
Finally, can we stop for a minute to reflect on the misguided message of "God bless America?" How about "Blessed are the peacemakers?" We are a nation, indeed a world, of many faiths. Our spiritual leaders go by many names. I suggest we join with survivors of the Holocaust in proclaiming, "Never again!" We must search for a new vocabulary that honors the sanctity of life more than patriotic extremism, remembering that every human being contains a spark of divinity.
As homicide survivors continue to teach me, I'll be watching my language. Will you?
Nadine Reimer Penner, ACSW, LSCSW, is a clinical social worker and Director of Long-Term Care for Harry Hynes Memorial Hospice in Wichita, Kansas. Ms. Reimer Penner is an American Red Cross disaster mental health instructor and a member of the National Hospice Trauma and Bereavement Advisory Panel.
The events of September 11 resulted in a paradigm shift for disaster response. In the past disaster efforts were primarily focused on specific geographical sites. The Oklahoma City bombing and then more significantly the terrorism acts of September 11 created the need for services to be expanded to the entire country to deal with the universal anxiety and uncertainty.
I consciously tried to pay attention to my own anxiety. I refused to watch television replays and would turn the radio off when news reports and sad songs came on. As one who has experienced the traumatic death of a parent, hearing and seeing the events repeatedly was too painful. One of the ways I coped was by playing a favorite CD with an upbeat tempo. I believe it is critical professionals are aware of their own coping mechanisms as they try to help people. We need to own our fears. Many concerned professionals responded to the disaster efforts but more research is needed. We need to know the interventions that are helpful and the characteristics of professionals who are more likely to experience vicarious trauma so our efforts do not inflict added harm.
Ashley Davis Prend, ACSW is a grief counselor in private practice in Portsmouth, NH. She is the author of "Claim Your Inner Grown-up" and "Transcending Loss."
I think that now more than ever I understand how powerfully public tragedies impact each of us as individuals. Not only do we mourn the actual loss of life (whether it is a President, a celebrity, a hero, or thousands of lives in a war or terrorist attack), but each of us is personally challenged to cope with feelings of vulnerability, helplessness, and grief. Public losses stir our own private losses and thus our own private feelings of fear and pain.
In terms of coping with future public tragedies, I would most certainly advocate group gatherings for support, be it via churches, community groups, neighborhood vigils, etc. After a public loss, there is a strong need for people to join together in sorrow. Likewise, there is a tremendous healing power that generates from such communion. We truly are social beings and we need each other, as always, in the best of times and the worst of times."
Phyllis R. Silverman, Ph.D., is the author of Never Too Young to Know: Death in Children's Lives. Dr. Silverman is an Associate in Social Welfare, Department of Psychiatry Mass General Hospital, Harvard Medical School; and a Scholar in Residence, Brandeis University Women's Studies Research Center.
I heard about the 9/11 tragedy while in Manchester, England. I was speaking at the Manchester Bereavement Network Forum. Within a few minutes, watching coverage on a British Television Station, I heard a British academic say that this would not have happened if the U.S. had not supported Israel. I was amazed me. To me this was a case of blaming the victim. I asked myself how was it possible to in any way justify this kind of killing? I immediately thought of how long it took us, as professionals, to recognize that a wife is not to blame for her husband's abusive behavior. This approach of blaming the victim continues to this day as I read some of the reflections about what happened on 9/11. However, if we listen to the terrorists' message, nothing short of our committing suicide would make a difference. I find that an attitude that tries to take the terrorists' point of view has prevailed in this country to becoming an axiom, amongst some segments of the population, and we almost take it for granted, that we somehow brought this on ourselves. But would it make more sense if we said that this behavior was never acceptable regardless of the purported justification? By not recognizing it for what it is, and being clear about its unacceptability, we enable those who support and carry out the terror. I do not see how we can honor those who died on 9/11 without considering our responsibility as citizens to be involved in activities that could deter or stop this behavior. This may be beyond the role of any organization but nonetheless I cannot separate my role as citizen from my role as a professional in this instance. I think our American vision of the world is very limited, as is our political discourse. We worry about being critical of other governments or ideologies that, for example, teach hate as part of their curriculum. We don't insist that people take responsibility for their own actions - our own government included. Do I run the risk of being shouted down as politically incorrect if I want to encourage critical discourse, and if I don't think Israel or ourselves are to blame for the behavior of the 9/11 perpetrators? The 9/11 victims were violated, as were all of us, by men who felt entitled to destroy innocent people. I am outraged and frightened for our future. For me this means that we can not be free from facing the reality of what these bombers represent. It has become politically correct to see things as relative and make such different acts as self-defense, morally equivalent to the chaos and death caused by suicide bombers. Evil is not a relative concept, it is deliberate, and is centered on the terrorists' very egocentric view of the world. It has many faces and we need to be able to recognize and acknowledge them.
A more typical concern for those of us involved in end-of-life care relates to the way we responded to the needs of those personally affected by this disaster. I learned that Americans are very comfortable providing support and solace to those who were personally touched by this tragedy. To our credit, we have mobilized our resources to provide them with many services. One of the most valuable services was that provided by the New York Times in which the victims of 9/11 were featured in a short biographical piece accompanied by their picture. It brought the reality of what was lost home to all and in its way honored the lives of each of these people so that they were not simply a statistic. In contrast grief has been framed in a language that focuses on getting over it, finding closure, feeling better in as short a time as possible. Trauma that people experienced is described as a symptom or an indication of a syndrome. This could be seen as implying that something is wrong with them. Does it serve survivors well to give them this label? I would suggest that to feel traumatized would be an expected part of what people experienced and that, in fact, there is no getting over it, no closure. Lives are changed by the loss and in many ways - one by one- their experience is very similar to that of most bereaved people, regardless of the cause of death. Are we being too solicitous? Are we giving people enough room to use their own resources to get through this horror? Often the professionals who have assumed responsibility for caring for the bereaved try to protect them by speaking for them and not understanding the importance of help from many sources including that which comes from meeting people like themselves even though bereaved for other reasons. As the bereaved discover each other they find that they have a lot to learn from each other. The newly bereaved will learn that there is another step for them to take, as they cope with the changes in their lives. Mothers Against Drunk Driving, for example, changed the laws about driving under the influence, thus saving many lives. The hospice movement itself in many parts of the U.S. was founded by disgruntled relatives of people who had not received good end-of-life care and who wanted to improve what was available. What type of social action will give meaning to the lives of those who died on 9/11? What can be done is beyond the work of any one hospice organization but we can join together to develop initiatives, in other settings that might take us in a preventive direction.
Here my two responses to 9/11 come together. Some survivors of 9/11 are channeling their energies into social action that encourages new coalitions of Americans from diverse backgrounds learning about each other's perspectives; others are lobbying Congress to find out how this could have happened. These are a minority, but their numbers may be growing. I received a call from a reporter who was "worried" whether this kind of behavior was helpful to these bereaved people. These activities can only help as they honor their dead. However, as we do this we run the risk of making waves in the system. It is the bereaved who perhaps can lead the way and with help from their friends, and all the rest of us who were touched this terror. I think we all need to learn that without waves nothing will change. I am not sure how to call people to account. I am sure that what I know professionally is very limited and that while it may give comfort and solace to some individual mourners, unless I can find a way to act in the larger context it will do nothing to prevent a repetition of 9/11 and that's what I need to do. Perhaps my resolution for the Jewish New Year is to work harder at this.
Margarita Suarez, MA,RN, is a counselor whose professional emphasis is on diversity, grief therapy and self-care. She was born in Cuba and moved to the United States, and served as a US Army Nurse in Vietnam. She is one of the founding members of Avanta the Virginia Satir Network, and has been the Executive Director since 1993.
In answering questions about September 11 I would like to bring some balance in looking at the overall tragedies we all face. Without minimizing the pain that the events of September 11 have brought, I hope we can also see that other pains and tragedies continue to happen to children, families and individuals. I have found that for some who have come to this country, running away from the dangers of other countries, this event brought them face to face with a new reality- here too we can have events of great destruction.
I am not sure how I have been affected by September 11...I do feel that I, like others, have thought a lot about how I would behave in a similar event...would I try to do something? Would I use my cell phone to say goodbye? I then move to future events, and will try to continue to do what I have done so far...connect with those I love, and encourage others to do the same. In the words of a colleague, "I do not have all the answers. I am still thinking and searching.I would ask myself as an individual to think about the consequences of my thoughts and actions."
Even with the differences in how we have been affected, the changes are in the air we breathe...from the security system in our airports, to the language we now use. It is incredible how often one can hear the simple numbers "9/11" and know exactly what it is all about. One of the changes I see and that I like is how many of us are asking "why did it happen" and "what I can do."
