Free A Decade of Hope by Dennis Smith Page B

historic telephone company fire on Thirteenth Street and Second Avenue in the 1970s. Every firefighter who was there had large PCB [polychlorinated biphenyl] exposure, and all over the world firefighters believe that those who worked at that fire died of cancer. We don’t know whether that’s true or not. We did not provide medical services; we did not study it. We did not prevent people from thinking that 100 percent of those firefighters died from cancer. If we had been there, do you really think we would have found 100 percent dying of cancer? Even if we found conclusively 90 percent dying of cancer, it would have been better than believing it wrongly.... Von Essen agreed instantly. And we then began to fight a battle, which continues today, with the federal government to get the funding necessary to do this right—from a medical perspective and from a science perspective.
    FEMA had money for rebuilding New York after the terrorist attack. I think they had $20 billion in emergency funding, and we successfully received a grant of $4.8 million for the first two years. That allowed us to demonstrate to the federal government what I’ve always believed, which is that you cannot provide a short-term or a long-term medical monitoring or treatment program after a disaster if you’re not able to partner with credible local people. And then we had to convince people that our program was state of the art.
    We started our 9/11 program before any other 9/11 program in New York City, a year before Mount Sinai started theirs. We have consistently provided top-notch, state-of-the-art medical care and monitoring, and we have provided services that no one else can match, because our dollars go further. We don’t have indirect overhead costs that many institutions have for federal funding, and we don’t have to advertise to find people. We don’t have to search them out, since we know every one of our firefighters and EMS workers. We maintain the retirees in the group, and we keep in touch with them so that we don’t have longitudinal dropout, which screws up any long-term medical monitoring and treatment program. It is bad for science and creates barriers for providing medical care to those most in need. The sick people are lost to follow-up, and there is the false impression that everyone is well. The primary goal was clinical service. But again, just like the unions and management know, just like I know, and now just like our patients know: If you’re not able to show credibly that there’s a need for a program, just asking for it is not enough. This program exists here, and at Mount Sinai for non-FDNY workers, because our scientific studies are credible.
    Â 
    We wanted a sustainable medical program. And so we do clinical service, and we study that service, because in studying it we get to be better by learning what’s working and what’s not, keeping the program at its freshest level for our firefighters. For example, we did some blood and urine heavy-metal studies right from the beginning, with the first three hundred people, and then, to a lesser extent, with the first ten thousand people we saw. Those studies, showing that heavy metals like lead and mercury were not elevated, indirectly kept the World Trade Center site open when people wanted to close it due to a [misplaced] concern about high mercury levels [and the potential of ongoing exposure to it]. We were able not only to keep the site open but to redirect our dollars into much more useful things, like pulmonary function tests and CAT scans, mental health therapy, things that the group really needed rather than chelation therapy for mercury. So this is a fundamental value of our World Trade Center Medical Monitoring and Treatment Program.
    Â 
    We then made certain decisions that were very helpful. The key decision that we made was advocating right from that day for a monitoring and treatment program. We were capable of