WE COUNSELED 55 OR 60 PEOPLE at our center within the first two weeks after the World Trade Center catastrophe. We saw many people who had escaped the building and survived, and we saw others who had narrowly escaped being caught in the rubble. We saw numerous eyewitnesses. We also had a number of people come in almost as a family—say, community members who had smelled the smoke or had seen the news or had known people affected.

People's reactions depended in part on the dose of trauma they had experienced. They generally experienced increased emotionality. They would think they had their feelings under control, then burst out crying. We saw many people who were having insomnia or panic symptoms. We saw individuals who were dazed and somewhat disoriented. We saw adults who didn’t want to be alone, who wanted to sleep together in the same room.

We also counseled some rescue workers. Some had narrowly escaped being trapped in the rubble. One had been temporarily trapped, but had been able to dig himself out when the buildings came down. Although the workers showed varied emotional responses to the extreme stresses they were experiencing, on the whole they coped amazingly well and had every intention of returning to work at the catastrophe site.

Being a doctor in Manhattan, I was part of the disaster community itself, of course. On the one hand, I sometimes felt intense despair and helplessness. On the other hand, I believed that my efforts to help people counted—that every little piece counted. And that kept me intact.

    —Molly Poag, M.D., assistant director of education and training in the department of psychiatry at Lenox Hill Hospital in New York City