We are 10 years out from the September 11th that changed so much, and remembrance of it prevails throughout the land, as well it should. With so much reflection devoted to the topic, it is tempting to devote this column to something else. But frankly, September 11th is what's on my mind.
And there is, I think, a unique contribution to our collective reflections on this seminal calamity from the realm of preventive medicine, and holistic care. In holistic care, we always consider both mind and body, and how the two relate. In preventive medicine, we focus on vulnerability- and the risks that lie ahead.
The particular contribution has to do with mind, body, time, and distance -- and the way these factors relate to the effects of toxicity and trauma.
There is a well known expression that "time heals all wounds." Partly that's wishful thinking. Partly, it is a truism when enough time is involved, but if so, 10 years is certainly not enough. We are not "healed" of 9/11, and I suspect most of us not only know we never will be -- but don't even want to be. It is something of a sacred burden we all share to hold on to the pain of that day. We will -- as we all pledge -- never forget.
But we can confess that we carry with us only some of the pain of that day, and the days that followed immediately. Time does attenuate mental and psychological trauma, and treat if not fully heal those wounds. Most of us are, I suspect, in relative shallows now -- 10 years later -- compared to the depths of anger, sadness and fear we felt in 2001.
So for wounds of the mind, time is indeed somewhat therapeutic. In contrast, distance provides little defense. Of course, those directly caught up in the events of 9/11 experienced trauma- both physical and psychological -- the rest of us can only begin to understand. But for all the rest of us, it didn't really matter whether we were 10 miles away, or 100, or 1000. Distance provides no real protection against tragedy, terror and dread.
But while time is therapeutic and distance somewhat irrelevant for wounds of the mind and spirit, the opposite is true for wounds of the body.
For most physical traumas related to toxins, distance is a powerful defense. The density of airborne toxins will drop off with distance from the source. While even a tiny exposure to a carcinogen can cause cancer, it is far less likely to than a larger exposure under most circumstances.
For some dangerous exposures, such as radiation and electromagnetic energy, distance is, literally, of exponential importance. The strength of an energy field is inversely related to the square of the distance from its source. In plainer English: Every time you move Z distance away from the source of an energy field, your exposure falls by Z x Z. A little bit of distance between you and such a field can mean a whole lot of defense against its harmful effects. Consequently, first responders at Ground Zero were subject to toxic effects that those living nearby in lower Manhattan were largely spared.
But time, in contrast, does not offer protection here. Time certainly can heal large and superficial wounds. But it is the smallest and deepest of wounds -- wounds at the cellular and sub-cellular level -- that are most apt to ensue from toxic exposures. Exposure to radiation, other energy fields, and some chemicals does its most important damage to our chromosomes and genes. Aberrations here can translate into overt medical maladies, such as cancer, very slowly, as the genetic abnormality leads to an abnormal cell, then an abnormal cluster of cells, and only eventually, a mass of abnormal cells. For some cancers, this process plays out over decades.
This means, alas, that we have yet to see the full toll of 9/11 among first responders, even 10 years out. All relevant resources should be made available to address the burden of illness shouldered by these brave souls who rushed toward the very thing most of us with just average courage would flee.
An anniversary is generally a time for looking back. But this anniversary warrants consideration of traumas to spirit, and cell alike- and requires that we also look ahead. The full medical toll of that infamous day has, regrettably, yet to be tallied.
Follow David Katz, M.D. on Twitter: www.twitter.com/DrDavidKatz