Captain John Gage was assisting with the removal of a collapsed roof off a trapped firefighter when he first noticed it. Despite being in good physical shape, he was finding it difficult to catch his breath. He put it down to a problem with his SCBA and continued working, but soon he had to signal another firefighter to take his place.
He went outside the burning building and pulled his mask off. Leaning over, his hands on his knees, he began coughing uncontrollably.
“Cap, you okay?” Firefighter Stu Evans asked.
“Yeah, just couldn’t get my breath. Probably a problem with the tank. I’ll go back in after I get a new one.”
“Cap, we’ve got enough guys. Stay out here. You really don’t sound so good.”
“Evans, the day I can’t do my job…” Gage said threateningly, the twinkle in his eyes giving him away.
“Yeah, ol’ man, I’ve got it,” Stu replied with a grin. That grin faded as he watched his captain begin coughing again, seemingly struggling for breath. “Cap?”
Johnny contented himself with waving his hand at the younger man. He fought to control his breath, concerned by the difficulty in doing so. Was there something toxic in the building he had just left, he wondered. But no one else seemed to be having problems. He continued coughing, spitting up dark bits of what appeared to be dust. Black spots began to appear in his vision as he fought on.
“Cap, sit down. Johnny Gage, sit down now!”
Johnny stumbled to walk to the engine to sit on the bumper, but couldn’t see to find it. He felt an arm reach around his back, helping him stay upright. He tried to say thank you only to feel the world tilt and found himself sliding off.
*** *** ***
Roy and Joanne DeSoto hurried into the emergency room, searching for a familiar face. As the years had passed, Rampart had become busier and busier, adding more personnel and completely revamping the once small and simple emergency facility. In the past, the waiting area was in the same section as the treatment rooms, making it easy to see the doctors and nurses working on a particular loved one. Now there was pneumatic doors that separated the entrance from the actual treatment area.
“Chief! Chief, over here!”
Roy saw Johnny’s crew standing against the far wall of the waiting room and escorted his wife to join them. “What’s going on? You said Johnny couldn’t catch his breath?”
“Yes, sir, Chief. He was talking and coughing and turning blue. Scared the crap out of us.” Marty Wilson nodded at Evans. “Stu caught him just ‘fore he collapsed.”
“What was it? A chemical fire?” Roy asked, trying to understand.
“No, sir. It was just an ordinary fire.” Stu shook his head. “Cap thought his SCBA might be fouled, but Gil checked it out and it was fine.”
Joanne frowned. “Roy? Could this have something to do with that cough he’s had for last year?”
“I don’t know.” The retired Battalion Chief shrugged. “I told him to have it checked out. Johnny claimed he did, but that the doctors weren’t that concerned. Said it might be all the gunk we breathe in as firefighters.”
“Roy? What are you doing here?”
The group looked up to see a distinguished looking black doctor with a smattering of grey hair in his short cut afro. “Hi, Mike. I’ll give you one guess.”
“Gage is here? Damn, I thought he was past all that accident-prone foolishness.”
“Doc, we’ve been waiting here for over an hour. Can someone check on him?” Stu Evans asked.
Morton nodded. “I’ll see what I can find out. Wait here.”
“Jo, why don’t you sit down here?” Roy pointed to the nearest chair, helping settle his wife on the uncomfortable plastic seat. “You’d think they could’ve gotten better chairs when they remodeled.”
“Don’t be silly, they don’t want to encourage people to stay.”
With the men standing nearby and Roy leaning against the wall, Johnny’s friends waited semi-patiently for word on the hapless ex-paramedic and station captain.
*** *** ***
“How long have you been coughing up all this debris, John?” Morton asked as he helped Gage sit up on the gurney.
“Since New York.”
The other doctor in the room who was viewing x-rays of the man’s chest turned at that. “What do you mean, since New York?”
“I was there, helping at the site on September 11th.”
“You were at Ground Zero?”
Johnny shrugged. “Yeah, although we weren’t there when the Towers fell, we got there shortly after.”
“How long did you stay?”
Johnny had to think about that. “I don’t really know. Six, maybe eight hours. There was a convention in town and most of the firefighters and paramedics attending were working there until we were ordered back to our home departments.”
“What do you think it is, Julie?” Morton asked as he checked the x-rays out for himself.
“There’s something that some hospital personnel are calling World Trade Center cough. It hasn’t been officially recognized as yet, although there’s a movement to do more research.” Pushing her auburn hair back from her face, Dr. Julie Manning walked to where Johnny sat hunched over, a oxygen mask pressed to his face. “Did you have a cough before you worked at the Towers?”
Johnny shook his head, removing the mask to answer. “Not really. Just when I’ve been on a fire that was pretty heavy on smoke. Even the SCBAs can’t keep it all out.”
“Before 9/11, how long did the cough last?”
“Couple of hours, maybe a day or two if it was really bad.”
“I cough almost all the time. Usually it’s not this bad, but it never really goes away. I’ve quit noticing it, frankly.”
“I noticed you were spitting up something that looks like cement dust. How long has that been going on?”
Johnny shrugged. “Since 9/11. It was a lot worse for the first year or so after I came home. It used to be chunks of debris.”
“Weren’t you wearing protective gear at the site?” Julie asked, puzzled. “You had to realize that it could be dangerous. I mean, those two towers simply collapsed into a large rubble field.”
“Well, yeah, doc, we knew it might be dangerous, but there wasn’t enough gear for everyone. Plus, I doubt it would’ve helped. The only real way to have been safe would have been to don a hazmat suit, but that wasn’t an option then. We were trying to rescue people. It wasn’t until later than it was recovery rather than rescue, and by then I was headed home.”
“So what do we do?” Morton asked.
“What? What do you mean, nothing!”
“We don’t know enough about it to know what to do. It’s only been three years since the collapse. I can only tell you what I see.” Julie smiled sympathetically at Johnny.
“Which is?” the man in question asked.
“Your lung capacity has been severely decreased. Based on your extensive medical records here at Rampart, I have a good view of what your lung capacity was before 2001 and since then. I would say that you have declined in lung capacity equal to 10 years of normal age related time. You literally breathed in the very fiber of that building, the pulverized building material and the combustion products. You’re looking at upper and lower airway inflammation as well as bronchial hyperactivity.”
“Is this gonna be a problem for me on my job?” Johnny swallowed, trying to control his fear.
“Yes. But…I would say that right now you can continue working. Frankly, Mr. Gage, we don’t know enough about this to know what to do. The effects are more than likely not reversible, but as to whether we can stop it from getting worse? There just isn’t enough information yet to make a guess.”
“What does he need to do in the meantime?”
“I would recommend treating it just as we do asthma and other bronchial problems. I want you to get pneumonia and flu shots first off. Then we’ll try an inhaler, possibly a combination of inhaler and spray that will widen your passages. Frequent checkups are mandatory. I know the fire department does a yearly check up, but I want you in every three months. Understand?”
“Now, let’s do some respiratory therapy and get you breathing better before I release you back to work.”
“I can go back on duty?” Johnny asked, amazed.
“Certainly. I’ll also provide you with some material to read. Until I can better understand the problem and the solution, I’ll treat this the same as asthma and allergies.” She pulled a pad out of her white jacket pocket. “I need to contact someone in New York City, see what’s being done about this. Everyone who was there with you, can you name them?”
“Well…not all of them, but I know where we can get a list of attendees at the convention. As far as I know, everyone who was still in town went there. We were on the last day, so some had already started home the night before.”
“Good, good. Get that list to me and I’ll contact their departments for followup.” The female doctor looked up at Morton and Johnny with a smile. “I will do what I can to get this under control, keep you working as long as you want to continue as a firefighter. You have to promise me something as well.”
“Name it, doc.” Johnny flashed a lop-sided grin at the woman.
“No smoking. Keep away from others who smoke as best you can. Wear your SCBA whenever you’re near smoke, no matter how mild a fire it might be. If you do any cleaning with chemicals such as ammonia or bleach, wear a mask. When there are smog alerts, do as little as possible outside unless you’re on duty. That’s for a start. I’ll give you a list of other dos and don’ts when I bring your medication.”
“No problem. Whatever it takes, I’ll do it.”
“That’s a switch, Gage,” Morton commented with a wry grin.
“Hey, with age comes wisdom, Mike,” replied Johnny.
“You’ve got a lot of scared firefighters and friends outside in the waiting room. I think I’ll go reassure them that you’ll live.”
“Is Roy here?” Johnny asked, almost positive about the answer.
“Of course. He and Joanne are both here.”
“Can he come in here? I think I’d like him and Doctor Manning to meet, let her tell him what’s what. He won’t believe it from me.”
“Wonder why? Couldn’t have anything to do with a history of saying ‘I’m fine’ when you’re about to collapse now, would it?”
Johnny’s grin was in full force behind the mask. “I’m not saying!”
Morton grinned in reply as he left the treatment room.
*** *** ***
“Roy? What are you reading?” Joanne leaned over her husband’s shoulder, trying to read the computer screen.
“Just reading up on World Trade Center cough. I just don’t get it, Jo.”
“What do you mean?”
“Why has it taken so long to realize that the collapse of an entire building, pulverized into dust, could be a health hazard to the men and women who were trying to conduct a rescue operation? You’re talking about metal, concrete, wood, plastic, glass…”
“And people,” Joanne said softly.
“Yeah, and people. Not to mention the fuels used in the air conditioning and heating, the fibers in the filters. What’s worse, some of the people who should’ve known better have accused the rescue people of fabricating illnesses in order to retire on disability!”
“What’s going to happen with Johnny? Roy, what does he have to look forward to?”
“I don’t really know. Dr. Manning is hoping that the research being done will come up with a treatment that will stop the deterioration. If it doesn’t, chances are that Johnny will have more and more problems with his lungs.”
“All this because he wanted to help?”
“Yeah. But you know something?”
“If he knew what might happen, Johnny would still have gone to help.”
Joanne wrapped her arms tightly around her husband, somewhat ashamed to admit, even to herself, that she was glad Roy was already retired from the fire department. Otherwise, he would’ve been with Johnny in New York City in 2001 and would’ve joined his partner in their futile search and rescue mission.
“Guess what they say is true,” Roy murmured.
“What’s that, honey?”
“No good deed goes unpunished.”