By Lila Dominus, CNN
New York (CNN) — Bridget Gormley suspects her father was “well aware” he might one day get sick. She imagines him feeling a dark cloud following him around, “waiting to come when it wanted to.”
But the terrorist attacks on September 11, 2001, and the potential sicknesses that loomed over everyone who worked at Ground Zero, were “never discussed” in Gormley’s household, she told CNN — even after her father, Billy Gormley, got sick. It was likely a mix of “PTSD and guilt,” she said.
Only after her father, a New York City firefighter who spent months working at the World Trade Center site, died of bladder in cancer in 2017 did she start to understand the connection to his 9/11 recovery efforts — and the magnitude of 9/11-related illnesses. That Billy Gormley is one of thousands whose death is directly linked to exposure shocked her.
On Tuesday, New York City released more than 170,000 pages of previously undisclosed records showing city officials at the time misled the public about air quality around Ground Zero. The release not only underscores how dangerous the conditions were, but it is also an important moment for responders and survivors who have long fought for help and recognition.
A moment of silence for another group of victims
Until this year, the annual September 11 commemoration ceremony at Ground Zero has included six moments of silence — one for each of the key fatal moments of that day. As the names of the nearly 3,000 victims are read aloud, a bell rings at the exact minute each of the four planes crashed and when each of the twin towers fell. Silence follows each time, and the reading of the names continues.
But what will follow this year acknowledges another growing toll.
Many survivors and first responders who spent that day and the following weeks toiling away amid the World Trade Center’s ash and rubble have died from diseases linked to their exposure to carcinogens and toxic chemicals. Thousands of others are still struggling with some of those same diseases.
The World Trade Center Health Program, established in 2011 after years of advocacy for compensation for survivors, provides medical monitoring for first responders and survivors, and free treatment for 9/11-related conditions.
As of June, more than 57,000 responders and survivors enrolled in the World Trade Center Health Program have been diagnosed with cancer. As of March 2024, nearly 7,000 people enrolled in the program had died.
A new seventh moment of silence is intended to honor those among that growing count, and their families, whose anguish over their health battles can be traced to that day.
After the traditional six bells have rung at the ceremony open to family members of people who died on 9/11, the seventh bell will ring. The victims who are still alive and the families of those who died years later will join the ceremony at 11:00 as names of victims continue to be read. The newly added bell, followed by the additional moment of silence, will then ring at approximately 12:30, according to a spokesperson for the 9/11 Memorial & Museum.
“It means having my dad’s story along with all the other stories acknowledged as a part of the entire 9/11 story, as well,” said Leah Betso, whose father, Officer James Betso of the New York City Police Department, died from brain cancer in 2015 after spending months in recovery operations at Ground Zero after the attacks.
“For a long time, I think that a lot of the focus is on the people who lost their lives on that horrific day. But for families like me, the loss came many years later, and this moment is recognizing that.”
The path to recognition
This moment of silence is, for many first responders and survivors, a validation they’ve long fought for.
By now the lingering health impacts of 9/11 are better understood, with cancer, respiratory diseases and post-traumatic stress disorder among the most commonly diagnosed conditions. First responders and survivors can be treated for injuries and illnesses that arise from their exposure to the dust and debris through the World Trade Center Health Program — which, despite its name, also covers those who were at the Pentagon and responded to the field in Shanksville, Pennsylvania, where the third and fourth planes crashed.
But the road to help was fraught.
Some responders felt an awareness from the beginning their exposure would catch up to them.
After her father died, Bridget Gormley started speaking to many of his friends while making a film about the health effects of 9/11. One of the men recalled that in the early days at Ground Zero, he had said to a friend, “This is going to kill us all one day.”
“They said it like in jest and joking, but, like, they knew,” Gormley said.
But others hadn’t been aware.
Michael O’Connell was 25 on 9/11 and had just joined the New York City Fire Department as a probationary firefighter four months earlier. “I was a kid,” said O’Connell.
“I don’t think anybody else ever really thought that, ‘Oh, this is going to be bad in the future, you know, what we’re breathing in,’” he said, even though he was aware of the asthma and lung issues firefighters often face. Years later, that started to change.
“I started seeing firemen develop cancers, and then in 2007, I wound up getting sick with sarcoidosis,” O’Connell said. “That’s when it really became apparent that most people aren’t escaping this.” Sarcoidosis is a disease in which nodules form, most commonly, in the lymph nodes, lungs, bones and skin. The WTC Health Program has certified Connell’s condition, he said.
The documents released Tuesday showed city officials at the time knew conditions at the long-smoldering pit made the air there unsafe to breathe, despite repeatedly assuring New Yorkers the opposite.
New York Mayor Zohran Mamdani announced the release alongside 9/11 families and comedian Jon Stewart, a longtime 9/11 first responder advocate.
“People got sick because the leaders they trusted lied and told them they were safe to breathe in toxic air,” Mamdani said.
O’Connell is one of the many first responders who spent years advocating and testifying in Congress for better health coverage for first responders.
While there were various programs to help survivors and responders, they were short-term and left many responders still in need of care and financial support. The federal September 11th Victim Compensation Fund launched in 2001 but initially ran only until 2003.
In 2011, after a near-decade of advocacy on the part of first responders, President Barack Obama signed the James Zadroga 9/11 Health and Compensation Act of 2010, which established the WTC Health Program and reopened the compensation fund. The law was named for an NYPD officer whose death was linked to the toxic plume at Ground Zero.
But even after the fund was reopened, responders continued to advocate for long-term care. It wasn’t until 2019, after emotional pleas in Congress — including an angry speech by Stewart — that the health program funding was extended for another seven decades, through 2090.
These responders are still feeling 9/11’s physical toll
Survivors and first responders are still being newly diagnosed with 9/11-related illnesses: More than 7,000 first responders had been certified with a health condition by the WTC Health Program within the 12 months ending June 30, according to data released last month by the Centers for Disease Control and Prevention. Others have been reckoning with 9/11’s physical toll for years.
Ivonne Sanchez, who worked in emergency medical services recovering and identifying bodies, was injured twice — both at Ground Zero and decades later.
Sanchez fell sometime in the winter after September 11 while working recovery, she recalled. She was “startled” after she looked down and noticed remains, then fell backward onto a piece of rebar, which left her needing stitches.
She remembered the triage doctors giving her a pain reliever and offering to send her home or to the hospital. But she chose to stay. She attributed the pain that persisted in her back to the hours they were working; in the beginning, she remembered working 20- and even 25-hour shifts.
She said she continued to work until May 2002, determined to find more victims, though the pain persisted. Sanchez wanted to find her friend and fellow firefighter Hector Luis Tirado Jr., and that motivation kept her working even as the pain grew. She and Hector had just posed for the FDNY calendar; he was Mr. July. They were supposed to do a signing on the 9th, but she had had another commitment, and she promised him she’d be at the next one.
That she never found him still haunts her. “Every time I go down on 9/11 during the ceremony, I always, when I go into a museum, I feel, like, this heaviness. Like their ghosts are saying, ‘You didn’t find us. You didn’t find us.’ And in my head, I’m going, ‘I’m sorry. I’m sorry. I’m sorry. We tried.’”
It is what has stayed with her most, even as her own health has been turbulent.
When she finally saw an orthopedist after the recovery efforts were over, Sanchez said, she was told she had so much nerve damage she would never work again, and she was taken out of the line of duty. Today, she also has a spinal cord stimulator in her back to help with drop foot in her left leg.
In 2014, Sanchez was diagnosed with breast cancer, which she says has been certified through the WTC Health Program.
Many 9/11 first responders alive today feel as Sanchez does, more preoccupied with their survivor’s guilt than their own ailments.
“My heart goes to the families that lost (loved) ones that day, and you know, to the people that perished of 9/11 illnesses since then,” said retired New York Police Sgt. Thomas Wilson. “All my ailments happened afterwards. I’ve been able to live my life, though it’s painful.”
Through the WTC Health Program, Wilson has been, by his own account, certified with tongue cancer, skin cancer, PTSD, anxiety, asthma, sinus conditions and gastrointestinal conditions.
Wilson estimated he served 300 hours at Ground Zero, where he worked recovery and security, and Fresh Kills Landfill on Staten Island, which became a dumping ground and forensic site for Ground Zero debris.
At Fresh Kills, Wilson worked as a sifter, combing through debris with a metal rake. “You hope to find, like, a wedding ring or something to bring closure,” said Wilson. His last time at Fresh Kills was in April 2002. “I never found anything.”
The family members left behind
While tens of thousands still suffer and recover from their diagnoses, thousands have died because of their 9/11 exposure. Their families still mourn them and reckon with the pain of knowing their loss is tied to that day.
Evelyn Betso still vividly remembers the morning of 9/11. The day had started wonderfully. She had just dropped her daughter Leah off for her first day of kindergarten.
“The sun was shining. It was a beautiful morning, and they were all there in their little Catholic uniforms,” Evelyn said, recalling the students out in the play yard.
Evelyn “was all bright-eyed and bushy-tailed” when she got to her office. “I walked into work and everybody in the office were just looking at me. And I thought, ‘God, what’s going on?’”
Her husband, James, was in the NYPD, and her brother Paul was a flight attendant. Her mother and mother-in-law started calling her. Where were their sons?
Paul and James were both safe that day, Paul on a flight to Miami and James already working at Ground Zero.
Years later, in April 2010, while taking his daughter Jade to the movies, James saw a blood drive and went to donate, Evelyn said. His hemoglobin, a protein in blood, was so low he was sent to the hospital. There, she said, he was diagnosed with two blood cancers, non-Hodgkin lymphoma and myelodysplastic syndrome.
For two years, James was “very sick,” Evelyn said. He couldn’t walk or even go from the bed to the couch without getting out of breath. “All the treatments really took a toll on him.”
After nearly two years, James finally went into remission. “We thought, ‘Oh God, this is great! It’s all done. It’s, you know, it’s behind us,’” Evelyn said. “He was getting on with his life.”
Then, in 2013, James returned from getting bagels on a Sunday morning. “I don’t feel good,” he told Evelyn. “There’s something going on.” When Evelyn tried to take him to the emergency room, he insisted he was fine. Minutes later he fell to the ground in their backyard, his hands on his head, and started to seize.
Jade, 12 at the time, “came running out in her bare feet, and she was screaming,” Evelyn said.
He had a grand mal seizure — now known as a tonic-clonic seizure, among the most severe kinds. He would ultimately be diagnosed with glioblastoma, the cancer he would die from two years later; James’ cancers, Evelyn said, were certified by the WTC Health Program.
In the final years of James’ life, it was very hard on their daughters, Evelyn said, and they both struggled to watch their father deteriorate.
The last year of his life “he couldn’t express himself,” Evelyn said. “He couldn’t talk. He was on a cane. He couldn’t button his shirt.” One morning he was making himself coffee in the kitchen, she remembered, and the whole jar of coffee fell to the floor.
Evelyn remembered James as a very tall, strong and independent man. “It broke his heart to know that his daughters could see him like this.”
Marcy Borders was known to the world as the “Dust Lady.” In what became an iconic image from that day, 28-year-old Marcy – dressed for work in a skirt suit and pearls – reaches out her hands, looking almost like a statue, coated in a thick layer of dust in the lobby of the World Trade Center’s North Tower.
When her daughter Noelle Borders first saw the image, she was frightened. “It was a reflection of what my mom felt when she saw it,” said Noelle, who was only 8 at the time.
Marcy struggled with depression and addiction for years in the aftermath, but eventually grew to embrace the powerful image and “what it meant, not only to herself but to the world.”
In 2015, Marcy died of stomach cancer at age 42, a diagnosis that initially shocked her family as she’d “never had any health issues,” said Noelle. “She’s always been 100% healthy.” Noelle said she believes her mother’s cancer had been certified by the WTC Health Program.
The Borders family had seen how others were getting sick; it wasn’t difficult to “connect the dots.”
“You feel like, OK, we got through this one tragic event, and now in a way, it’s still affecting your life,” said Noelle. “Even though you felt like you overcame it.”
Health program continues to try to reach those suffering
The WTC Health Program continues to reach and treat people. As of June, there were more than 154,000 people enrolled — though one does not have to be sick to be enrolled in the program.
Michael Crane is the medical director of the WTC Health Program Clinical Center of Excellence at Mount Sinai in New York, and he encourages as many people as possible who were living in the city at and around the time of 9/11 to get involved with World Trade Center health programs.
More than 95,000 first responders are enrolled in the WTC Health Program, which Crane estimates is close to the true number of first responders. But the percentage is much smaller for other survivors: As of June, there were fewer than 60,000 of them enrolled in the program, which concerns Crane, who said around 400,000 people who lived and worked around the towers qualify as survivors.
“Environmental exposure is proven to have impact on everybody: adults, children, babies,” said Crane. “Particularly exposure like this.” Crane recalled the dust — the exposure — being everywhere. He doesn’t think the dust was truly out of the subways until Superstorm Sandy in 2012, when “the place flooded and got rid, finally, of large amounts of lingering dust.”
While most first responders who get sick later in life may quickly draw a connection to their work at the site of the World Trade Center, survivors who developed illnesses decades later, Crane fears, may not.
He said he hopes the 25th anniversary and the new moment of silence is a renewed opportunity to spread the word. “You have this program out there for you folks who live down there, and for your children, so take advantage of it. And you know, it can’t hurt. It can’t hurt to go and get evaluated.”
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