On 9/11, in the early morning, I sat in my office with a patient. I began work a 6:15 a.m. Seeing people continuously, as is my practice, I wouldn't get to the news of the day until my lunch break. A patient came in saying that the Twin Towers in New York had been attacked and were down.

Patients tell me many things. Some factual. Some distortions. Some complete fantasies. I listened to her tell me her perspective of what happened as I would listen to any experience any patient told me. I suspended disbelief. I believed she was telling me what she believed to be true. I listened for her emotional experience behind her words. I thought of her history, where we were in her therapy and how this story would fit into the psychological constellation she was dealing with today.

After the session I turned on the news and saw the video of the plane and then the second plane piercing the buildings with relentless grace and precision. I knew I was in an altered state of consciousness and needed to watch the repeat videos many times as the reality gradually seeped into my denying mind. I needed repetition and details. I needed to see the buildings fall, the smoke cloud, a cummulous of ash, roll through the streets, thousands of people screaming and running.

It was war, here, finally and inevitably. I've studied war. I've deeply studied World War II. I've read, slowly and with great concentration, Winston Churchill's memoirs of World War II. I've watched a hundred documentary films that show actual footage of
the war in Europe and Japan. I had a British friend who was a boy in the war and yet dropped bombs on Dresden. He told me agonizing stories.

And now I saw it here.

I kept hearing the story. Two people who were living in New York at the time, fled to California and sought therapy. They still suffer the aftermath of that day. One woman I knew at the time was dealing with a bereaved five year old. Her classmate was with her family visiting her grandmother in New York when the planes hit the Towers. The child and her mother died. The woman's daughter didn't understand why she would never see her friend again. A friend had a business with a branch in the towers. All his associates at work that day died. The shock and grief seemed endless.

I went to an art show in Venice, a grouping of children's art depicting the the disaster. One stands out in my mind still today.

The two towers stood side by side in a childish drawing with sad faces and tears. They were holding hands.

The memory of that picture still brings up tears of suffering and loss.

And the repetition of the event continues. So many heroes rushing into the towers to rescue people died in the attempt. Many died later from toxic exposure. Many suffer from cancer and other horrible illnesses that are directly attributable to what they experienced going into the disaster to help.

The disaster continues as these people have to fight for the finances they need to bear the personal health costs they paid that day.

I'm struck with the terrible irony of the medical aspects of 9/11. The emergency rooms of all the New York City  hospitals were open and at the ready. Emergency medical staff were called in and standing by. No patients came. People weren't wounded. They were dead. And yet, later, patients did come, are still coming. And relief is stalled. It seems that the doors that were open on the day closed when patients needed access.

The enemy didn't come as we expected. The enemy needed no special armaments. They simply turned planes into bullets. Patients didn't come as we expected. They didn't come, bleeding and broken from the disaster site. They came later, the policemen and firemen, suffering from toxic fumes.

The invisble wounded, those with psychological and emotional damage from the experience, are still with us, quietly living their lives as they pull the remnants of their torn psyches together.

Where was I on the day? Here. I'm still here.

Where were you?   Where are you now?

The reverberations of 9/11 still emanate out and affect us all. I still have to sometimes suspend disbelief so I can be present for the reality of that continuous day. That cloud of toxic ash rolls on.