Stony Brook course analyzes 9/11 health care issue

Jeremy Brownstein, a second-year medical student at Stony Brook University, wasn't surprised to learn that the men and women who worked at Ground Zero after the Sept. 11, 2001, terrorist attacks got sick -- some horribly so.

What astonished him, he said, is the difficulty many of those people have had getting medical treatment.

"I would say it's pretty disappointing," he said. "It's upsetting to see that."

Brownstein, 26 and from Shoreham, is one of a dozen students enrolled in a Stony Brook class called "9/11: The Anatomy of a Health Care Disaster."

Participants in the five-session course, now in its third year, study the environmental, medical, psychological, legal and political elements of the catastrophe, not just the science of treatment.

The course's very existence is a testament to how the events of Sept. 11 -- unprecedented and on a massive scale -- merit study.

Guest speakers include the medical director of the World Trade Center Health Registry, a psychiatrist, representatives from the Long Island World Trade Center Medical Monitoring and Treatment Program, attorneys representing first responders and other advocates.

The attorneys who spoke to the class last week talked about the barriers to compensation for first responders, volunteers and other workers.

Attorney Victor Fusco of Woodbury told the students that many responders missed deadlines for filing for benefits in part because their ailments had not yet surfaced. Even as those deadlines were extended, he said, the paperwork was so complicated that many simply didn't file.

In addition, the burden of proof was particularly high for volunteers, Fusco said.

"They had to show badges, pictures, letters from an agency," he said. "Many were contested."

Students spent the next hour asking how the response could have been handled better, which was exactly how Benjamin Luft, the doctor who created the course, hoped the class would go.

He wants his students to learn the health ramifications of 9/11 from every angle and to understand the full complexity of disease. Effective treatment, he said, can't be reduced to symptoms and science.

Luft is the head of Stony Brook's WTC monitoring and treatment program, which serves more than 5,000 patients in offices in Nassau and Suffolk counties.

The monitoring program started immediately after 9/11 when Luft thought he would be treating mostly survivors. But because the attack killed so many that day in the Twin Towers and surrounding area, the program's patients largely are people who searched for victims' remains and cleaned up the site.

Luft said he hopes his students will be equally flexible when they enter the field.

He said he makes the most of his time with them and has limited the class to just 12. Students have had to be turned away from the highly sought-after elective.

Luft lures his students to class an hour early by supplying lunch.

His plan has worked, maybe too well. One participant told him he should ax the lunch hour so he could extend discussion time.

"I don't think I've ever heard a student say that before," said Luft, an affable and approachable doctor who starts each class with videotaped statements from first responders who have become ill.

Heather Lander, 23, from upstate Narrowsburg, was 13 on Sept. 11, 2001. She was in school when jetliners hijacked by terrorists slammed into the World Trade Center, the Pentagon in Washington, D.C., and a field outside Shanksville, Pa.

School officials shut off all of the television sets in the building. Lander said she had to wait until she got home to learn more about the tragedy.

Now, nearly a decade later, as she prepares for a career in medicine, she said she's interested in how responders' health problems have unfolded and evolved since then. Of particular interest to her are the psychological ramifications.

She said classes like this will help her become a better doctor. The more exposure she has to these issues now, she said, the better she ultimately will be able to relate to her patients, considering their physical and emotional health.

"It's easy to heal bones," Lander said. "Bones heal, but the psychological effects . . . can last for a long, long time. Oftentimes, physicians don't have the time to get down to these difficult issues, and they are really important."