Inside the FBI: First Responders and 9/11-Related Illnesses, Part 3 | The Growing Numbers


April 18, 2019

As losses attributed to the September 11 attacks increase, listen to an FBI employee suffering from 9/11-related illnesses share her story, and learn why 9/11 responders should register for federal benefits despite concerns over the fact that one program is running out of money.


Audio Transcript

Mollie Halpern: The FBI mourns the loss of a beloved member of its family, William “Homer” Lewis, who took his dying breath on April 3.

Homer was an electronics technician whose line-of-duty death is a direct result of his work at the Pentagon following the deadliest terror attack in U.S. history on September 11, 2001, when nearly 3,000 people were killed. 

Homer worked on the night shift at the Pentagon for weeks, setting up and maintaining radio communications. He was instrumental in the FBI’s recovery efforts, keeping team members safe inside the Pentagon and at surrounding evidence review locations. 

Homer began his FBI career in 1990, and those who worked with him say he was someone they could always depend on.

Homer is the first professional staff employee whose death is recognized by the FBI as 9/11-related. But Homer’s death is not an isolated case, as the lingering effects of the terrorist attacks becomes more palpable every day.

Dawnele Holbrook is a current FBI professional staff employee who, like Homer, responded to the Pentagon. 

Her cancers have been directly linked to her exposure to the dozens of different types of carcinogens in the smoke and dust during the performance of her duties on that dreadful day and in the aftermath.

A growing number of members of the FBI family are sick for the same reason.

In addition to Homer, 15 FBI special agents have died so far from 9/11-related cancers—some of whom Dawnele worked alongside at the Pentagon.

The health ramifications of 9/11 extend to the FBI’s law enforcement partners, emergency personnel, and volunteers who helped at all three crash sites and the Staten Island landfill, as well as those who worked, lived, or attended school in the New York City disaster zone on the day of the attacks and the months that followed.

FBI Deputy Director David Bowdich says 9/11 responders were focused on carrying out their duty of helping others—not concerned for themselves.

David Bowdich: The number of responders who have died from 9/11 illnesses will soon eclipse the number of people who died that day. Think about that. That is a staggering number.

Halpern: 9/11 first responders and survivors live in every single state across the country.

For Dawnele, thinking of each impacted life is overwhelming.

Dawnele Holbrook: We not only lost so many people on 9/11 from the act itself, but we continue to lose responders. It was hard then, and it continues to get harder with the fact that we're still losing people. Every time we lose somebody, it brings it all back, and that's been a lot of years to have to relive something that's that tragic.

Halpern: I’m Mollie Halpern of the Bureau. Coming up on this episode of Inside the FBI:

Hear an oncologist’s medical opinions about staying healthy and the scope of 9/11-related illnesses and death cases.

Dr. Menachery: Are we going to continue to see more and more? I think the answer is yes.

Halpern: Learn why 9/11 responders should register for federal benefits despite concerns over the fact that one program is running out of money.

Rupa Bhattacharyya: The VCF remains very strongly committed to serving the needs of the 9/11 community, which we know to be strong and resilient. So we're hopeful that despite the difficult situation that we find ourselves in, the work that we continue to do provides at least some measure of needed relief to those who sacrificed so much and suffered for so long.

Halpern: And discover how efforts underway will help prevent the September 11 terror attacks and its victims from slipping from America’s consciousness. 

Anthony Gardner: 9/11 is not a static historic event. It's one that continues to shape our world. And in the context of 9/11 health impacts, there are people that are sick and who are dying as a result of their exposure on the day or in the aftermath, as a result of what they came to do to help other people.

Halpern: But first, back to Dawnele’s story.

The calm tinkling of the wind chime and the view of the woods beyond it provided a tranquil distraction for Dawnele while she received nine-hour-long intravenous chemotherapy treatments.

From a rocking chair she would sit—sometimes with her feet propped up—on the back porch of a Virginia cancer clinic, where she had been diagnosed with not only one type of cancer but two.

On this day, I’m sitting with Dawnele in that very spot as she relives and shares her personal and professional experiences with me.

Dawnele has served in the FBI for more than 30 years, and in the early 2000s her main duty was as a senior intelligence analyst on the international terrorism squad at the Washington, D.C., Field Office.

Her ancillary duty assignment was with the Evidence Response Team, or ERT, whose members are trained to respond to complex crime scenes, where they provide services such as proper evidence packaging, recovery of human remains, conducting sophisticated search techniques, and documentation.

In addition, Dawnele was a peer counselor for the Employee Assistance Program, which among its many services provides support to FBI employees coping with work-related stress. 

On September 11, 2001, Dawnele was in the squad room when five al Qaeda hijackers crashed American Flight 11 directly into the north tower of the World Trade Center in New York City at 8:46 a.m. The 76 passengers and 11 crew members on board and hundreds inside the building died instantly.

At approximately 9:03, United Airlines Flight 175 struck the south tower of the World Trade Center. Fifty-one passengers and nine crew members perished—as did an unknown number of people inside the building.

At 9:37, five hijackers crashed American Flight 77 into the Pentagon, killing all 53 passengers and six crew members. On the ground, 125 military and civilians lost their lives in the ensuing explosion of fire.

Less than three miles away, across the Potomac River, Dawnele and her squad had started scrambling.

Holbrook: …knowing that we needed to get agents on-scene, and we needed to get a command post up and running in the building itself and getting ERG out at the Pentagon.

Halpern: While the commotion unfolded on the ground, in the sky, passengers aboard United Flight 93 stormed the cockpit where hijackers were piloting the plane. At 10:03, the aircraft crashed in a field near Shanksville, Pennsylvania; 33 passengers and seven crew members died.

That evening, after a full shift at the office, Dawnele reported to the Pentagon to collect evidence and provide counseling for other on-site responders, as needed.

When she arrived, the fires were out of control—and as each day passed, the flames appeared to be unquenchable as they continued to smolder and reignite for about another week.

Dawnele performed her duties on an almost daily basis, working more than 12 hours a day for about two months.

As a representative for the Employee Assistance Program, she shared the same experience as those she counseled, but she tells me she relied on her critical incident stress management training to help herself through it.

Holbrook: In a crisis situation like that, put everything to the side. You do what you need to do, whether it was talking to other people that needed someone just to talk with about what they did see or what they did recover within the Pentagon, as well as people within the office that were dealing with the same crisis but in a different manner. They were dealing with the investigative process and who the hijackers were, and listening to the tapes coming in from the airlines. There was a lot that was going on in every aspect of the investigation.

Halpern: In Dawnele’s evidence recovery duties, FBI case records show she recovered the identification cards of two of the hijackers.

On many occasions, she was assigned to a storage facility in Northeast D.C., where she sorted through contaminated evidence.

Memories of her work during PENTBOMB—the FBI’s code name for the 9/11 investigation—haunt her even more than 17 years later.

Holbrook: The sights and the smells from within the Pentagon itself—those you can't push away. Those will be there. When you're walking through looking for evidence within the Pentagon, and you're picking up parts of bodies. Or, for instance, you just see remnants of what was in the building. Like I recovered a little girl's jacket that had the princesses on the front. Or somebody's to-do list from within their wallet that had been on the airplane. Or, I went into a conference area where there was obviously a meeting being held at the time of impact, and you can see the conference table and where everybody was sitting, and them being thrown back. So there's a lot that will always be there. The smell, the noises from alarms, will always be there, but just, you don't want to think about it. It's part of what happened. So as much as you want to push it away, it's not easy to do.

Halpern: Pushing it away is exactly what Dawnele did when her role in the case was complete. She dedicated herself to other work at the FBI.

Outside of work, the single mother of two was busy caring for her daughters.

Running helped her relieve stress from both work and home. She ran up to 10 miles a day, five times a week, and completed many half-marathons and the Marine Corps Marathon.

Then one day back in 2013 …

Holbrook: I was out running. I was having tightness of breath, or shortness of breath, and tight chest, and wasn't able to run like I had previously.

Halpern: Eventually, Dawnele was forced to put away the running shoes and quit competing because of the uncomfortable way running made her feel.

Little did she know, the worst pain was yet to come.

In 2016, she noticed a lump on the right side of her neck. Her primary doctor sent her for a biopsy.

When the results returned, Dawnele was told that in her right supraclavicular lymph node, she had follicular lymphoma—a type of non-Hodgkin lymphoma that develops when the body makes abnormal B-cells, which are the white blood cells that fight infection.

Holbrook: When you hear that you have cancer in your lymph nodes, you think the worst. You always hear that once it travels to your lymph nodes, it's bad.

Halpern: Dawnele was ready to fight it and started treatment immediately.

Holbrook: My youngest was going into second grade. So my biggest concern at that time was not letting whatever was going on with my body affect my kids. One was very young, and I didn't want it to scare her, and the other one had her senior year and college ahead of her, and I didn't want it to affect what was going on in her life, as well. So I let them know, we talked about it, and we kept it open, so they could ask whatever they needed to, and what was going on daily.

Halpern: After months of chemotherapy, a CT scan was administered to see if the cancer had shrunk or was gone. What it revealed, however, was an enormous amount of cancer was in another part of Dawnele’s body—her chest.

Dawnele shared a photo of that scan to my mobile phone. Her cancer-ridden body in black and white was in the palm of my hand, and it was difficult to look at. She explained that the invading black blobs were a second type of cancer called diffuse large B-cell lymphoma—another type of non-Hodgkin lymphoma which is aggressive and most often develops in older people.

With a second diagnosis, Dawnele returned here—her spot on the porch of the cancer clinic—for additional treatment under the care of oncologist Sudeep Menachery, who concurs with other medical doctors that Dawnele’s cancers are linked to her service during 9/11.

Dr. Menachery likens 9/11-related illnesses, including cancers, to what happened at Camp Lejeune, where members of the military exposed to contaminants in the water supply later developed cancer and other diseases.

He says often times there is a long latency period before illnesses emerge.

Dr. Sudeep Menachery: Whether it be asbestos, tobacco products, and when I think about Agent Orange from Vietnam, that takes a while for the exposure that one has had, to manifest itself, eventually as a cancer or some other sort of ailment.

Halpern: In late 2001, The Centers for Disease Control and Prevention, or CDC, including its National Institute for Occupational Safety and Health, partnered with public and private health organizations to conduct extensive research on the exposures of environmental pathogens, toxins, carcinogens, and hazardous chemicals from 9/11 on responders and others in the area. A registry was also established to track the symptoms and conditions of that population.

The James Zadroga 9/11 Health and Compensation Act of 2010, known simply as the Zadroga Act, established the World Trade Center Health Program, called WTCHP, to provide free medical screenings, monitoring, and treatment to responders and survivors with certified 9/11-related illnesses in New York City as well as the responders to the Pentagon and Shanksville-area crash sites. The WTCHP is authorized to provide these benefits through fiscal year 2090.

The Zadroga Act allows for additional health conditions to be covered under WTCHP. When cancer was added as a covered condition, the numbers of people enrolled in the program began growing. Enrollment statistics have increased overall.

According to the CDC, 94,501 individuals were enrolled in the WTCHP as of February 28, 2019.

As of that same period, 12,185 enrollees have been certifiably diagnosed with at least one 9/11-related cancer; 39,746 enrollees have been certifiably diagnosed for at least one aerodigestive disorder such as asthma, GERD, or COPD.

Many of the members have both a certified cancer and aerodigestive conditions.

And lastly, at least 15,340 enrollees experience at least one mental health condition, such as depression or anxiety.

Dr. Menachery expects those numbers to rise as more people are diagnosed with 9/11-related health conditions.

Menachery: It’s usually in that second to third decade of life where we start to see more ailments from people that are smoking. So the same thing with these various toxins from 9/11 exposures—I think that the remaining part of this decade and going into the next decade, I think we're going continue to see more and more.

Halpern: He goes on to say …

Menachery: As all of us get older—and by that, I say 40 and above—go see your doctor. Trust your body. If you think that something's wrong, you gotta get checked out. Especially if you're in a field or you're in a career where you have had some sort of significant exposure—whether it be 9/11, whether you're a firefighter—you need to be part of more aggressive screening, just like you would be if you had some sort of genetic predisposition to some ailment.

Halpern: The WTCHP has a health provider network across the country, in every single state, where responders and survivors can receive medical monitoring and treatment.

Jessica Bilics, the policy and governmental affairs coordinator for the World Trade Center Health Program, says to apply even if you aren’t sick.

Screenings can detect illnesses early.

Jessica Bilics: So we really encourage everybody to come to the program, get seen by doctors, do an assessment of their exposures, and either get a diagnosis of whether or not the symptoms they've been having over the last 17 years—or even the last couple years—are related to their 9/11 exposures and are eligible for treatment and annual monitoring benefits through the program.

Halpern: Outreach events designed to generate awareness about the program are held throughout the year—not just around the 9/11 anniversary.

Bilics: We do events throughout because we know that there's still a large universe of people who are likely exposed that are not in our program.

Halpern: Some of these events are held in partnership with the FBI and WTCHP’s sister program, the September 11th Victim Compensation Fund, or VCF, which provides monetary compensation specifically for those who suffer from physical ailments, or their beneficiaries.

The WTCHP and VCF have nuanced differences in their missions, requirements, and eligibility criteria but serve the same population—those who were at the crash sites with or without a badge. Like Dawnele, whose cancers are certified 9/11-related health conditions under both programs.

Holbrook: It's important to know that it doesn't matter what your title was at the time—that this can happen to anybody that was there, that was a responder. It can happen to anybody that was there. I was there. It happened. There were so many people that came to help; the Pentagon parking lot was full of people donating food, giving out massages, that were just willing to help anybody that was there responding. And they were breathing the same toxins. The toxins didn’t stop and stay on the inside walls of the Pentagon.

Halpern: The most recent VCF statistics show that as of March 23 of this year, 111 claimants have been found eligible for compensation—1,000 of them have died of causes related to a 9/11 condition.

Another 16,711 eligibility claims are under review.

A total of more than $5 billion in compensation has been awarded to VCF claimants.

The U.S. Department of Justice administers the VCF, which has a deadline for claims—December 18, 2020—although efforts to extend the deadline and the funding are underway.

The VCF is required to conduct an annual reassessment to ensure that the fund does not exceed the $7.3 billion it was appropriated by Congress.

Earlier this year, on February 15, based on data from an influx of submitted claims, the VCF special master determined that the funding is insufficient to pay all pending and projected claims at the same levels.

As a result, she made modifications—which is required under the law.

The VCF adopted a percentage reduction strategy.

It works like this: Any claim or amendment that was submitted on or before February 1 of 2019 is considered a pending claim and will be reduced by 50 percent.

Claims or amendments that come in on or after February 2, 2019 will be cut by 70 percent.

VCF Special Master Rupa Bhattacharyya …

Rupa Bhattacharyya: We are very aware that this is unfair but, unfortunately, the law requires us to take these actions.

Halpern: Bhattacharyya says there is a lot of work left to do but she and her team are committed to supporting those who are still suffering as a result of 9/11.

Bhattacharyya: I have, over the last couple of years, met many members of the 9/11 community—federal law enforcement officers, firefighters, police officers, everyday citizens who lived or worked or went to school in the affected areas—and they are extremely brave, and they deserve every bit of thanks for their service that can be given to them.

Halpern: What happens to the VCF is for the U.S. Congress to decide. In the meantime, Bhattacharyya encourages those affected to register.

Bhattacharyya: If you were down there, whatever you were doing, if you were down there, register with the VCF now. That's easy. It can be done on the phone. It can be done online. It preserves your right to file a claim.

Halpern: The FBI urges the entire 9/11 community—not just FBI employees—to register for federal benefits. And it has taken that message on the road—to reach 9/11 first responders across the country.

Together with the FBI Agents Association, members of the FBI Human Resources Division are visiting heavily affected field offices—such as New York City, Pittsburgh, Cleveland and Detroit—where seminars and briefings are held to spread the word. Partner agencies are welcome at the events.

Dawnele hopes by sharing her story, she will motivate fellow first responders to register.

Holbrook: I highly recommend to anybody that was on-site to have the paperwork started, get the process moving. Get yourself enrolled in the program and accepted, so you're comfortable with the fact that part has been done, and then you can get your annual check-ups. And then if, by chance, something does come up, now, later, or years from now, you don't have to start worrying about the process when you're also worrying about your health.

Halpern: Dawnele has battled cancer for the last six years—more than half of her youngest daughter’s life.

In March, she completed two and a half years of a chemotherapy maintenance treatment and is currently in remission. Dr. Menachery and a team of doctors will continue to monitor her health.

She is also suffering from other 9/11-related medical issues like GERD and neuropathy.

Dawnele tells me she has anxiety about whether the cancers will return but is trying to shift her attention to a popular fitness regimen for the social and health benefits.

She is also preparing to launch a program that would emphasize the importance of exercise and nutrition for other 9/11 responders. 

Holbrook: I’m trying my best to continue to live my life the best I can without too much of looking back and wondering, “Why?” I don’t think I ever really wondered, “Why me?” It happened, and I need to do what I can do to get through it for myself and for my girls.

Halpern: Dawnele’s colleagues who have lost their battle to 9/11-related illnesses are remembered in the hearts and minds of the FBI family and extended community.

Their names are forever on the FBI’s Wall of Honor in remembrance of their sacrifice.

Fifteen FBI agents have been approved for the Wall of Honor for line-of-duty deaths related to their 9/11 response.

Five of them will be added to the wall at an FBI fallen agents ceremony during National Police Week next month.

May is also when the National September 11 Memorial and Museum in New York City will unveil a new pathway dedicated to those who are suffering or have succumbed to 9/11-related illnesses.

Called the Memorial Glade, it will celebrate the selfless dedication of those who responded to the nine-month rescue and recovery efforts.

Anthony Gardner, senior vice president of government and community affairs at the 9/11 Memorial Museum, describes the historic pathway.

Anthony Gardner: There are six stone monoliths that break the surface of the memorial plaza. They rise skyward. These are stone monoliths, so the very nature of the material that's been selected is meant to symbolize the courage and the strength of the people who responded here.

Halpern: The pathway will include a space for reflection.

Hundreds of miles from what was Ground Zero more than 17 years ago, I ask Dawnele to reflect on whether she would change anything since that dark day.

Without hesitation, she told me, “No.”

Holbrook: I’ve worked some amazing cases, I’ve worked in some amazing programs, and the Bureau can do amazing things. And I’ve been blessed.

Halpern: On the next Inside the FBI: If you are of a certain age, then you likely have your own 9/11 story. As the Bureau’s current workforce ages out, learn how the FBI is ensuring the next generation of agents and intelligence analysts gain a deeper understanding of 9/11 and its continuing global significance.

Register and submit claims now for the WTCHP and the September 11th VCF. Additional information about the 9/11 health crisis is available on www.fbi.gov. There, and on iTunes, you can also listen to more FBI podcasts and public service announcements. Thanks for listening.

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