September 11, 2002 | On a flight from San Francisco to New York City on September 10, 2001, Jim Campbell read a book he would remember later as extraordinarily prophetic. One Day in September, the story about the massacre of Israeli athletes by Palestinian extremists during the 1972 Olympics in Munich, was a perfect example of how a normal day can turn into "the nightmare of nightmares."

When the first plane hit Tower One, Campbell was in a meeting on the 64th floor of Tower Two. For a few moments he was mesmerized by the burning holes in the tower next door and the thousands of pieces of white paper that filled the air. Then one of the women in the conference room yelled, "Everybody out now!" and Campbell -- along with thousands of others -- began a long descent down the stairs. It felt surreal, more like a fire drill than a holocaust in the making. By the time his group got down to the 25th floor, the second plane slammed into Tower Two -- one floor above where Campbell had stood staring out the window. The building swayed, and many in the stairwell fell down from the force, then got up and kept going.

Campbell was in a state of shock. Outside, the stench of smoke was overpowering and it seemed like it was snowing. Among the debris he saw shoes, paper, and something that once may have been a person. Police and Port Authority officers guided his stunned group to safety. "I continued to walk north, stopping every 50 feet and watching," the 46-year-old CEO would write in his personal account of that day. "Then there was a jumper and the crowd moaned. I had enough. I stopped being a voyeur and made my way north."

Campbell was so anxious to get home that he drove straight across the country, and was reunited with his wife and three young children in San Francisco 80 hours later. In his mind he began to replay the horrific things he had seen and wonder why he had survived when thousands of others had not. That's when he found himself crying every day.

"It was uncontrollable. I'd wake up, get in the shower, and cry," says Campbell. "There was so much there, too much for me to think about. And I kept asking myself, 'What happened? Why did I make it out when other people didn't? Why me?'"

The president and CEO of a business software company at the time, Campbell typed up a blow-by-blow description of what he'd lived through on September 11, and sent it to friends and coworkers.

As the essay circulated around the Internet, Campbell began receiving dozens of calls and emails from people he'd never even met, all wanting to hear his story and offer their support. That, says Campbell, turned out to be his saving grace. "It gave me the opportunity to tell my story over and over again. I probably told it 10 times a day when I first got back, and that helped me process everything," he says. Being one of the few people on the West Coast who had experienced the disaster firsthand and lived to tell about it, Campbell was besieged with questions about the attacks. "It was very different from, say, a Vietnam vet or even someone in New York City where everybody has a story," he says.

As it turned out, Campbell's feelings of guilt, depression, and uncontrollable weeping were classic symptoms of post-traumatic stress disorder, an anxiety disorder that can develop after exposure to a terrifying event. Other symptoms include frightening memories and flashbacks, hallucinations, nightmares, sleep disturbances, anxiety, irritability, and sudden outbursts of anger. PTSD is common among people who have lived through violent assaults, natural disasters, and military combat, according to the National Institutes of Health.

On the anniversary of the September 11 attacks, millions of us see the footage of the crumbling towers and feel vulnerable all over again. Others will relive a narrow escape, like Campbell's, or experience a resurgence of grief over the death of a loved one. But you don't necessarily need to have experienced the terror firsthand to suffer from PTSD. Repeatedly watching the planes slam into the twin towers on television, and living with the fear of future physical or biological attacks have already proved to be enough to cause post-traumatic stress symptoms in a large percentage of Americans who don't live in New York City.

A study published in the Journal of the American Medical Association on the one-year anniversary of the attack found that 17 percent of the US population outside of New York City reported symptoms of post-traumatic stress two months after the terrorist attacks. By six months after the attacks, the figure was down to 5.8 percent

If anything positive has come out of the national trauma, it's that the federal government and scientific community have begun to place more emphasis on mental health. Writing in the August 2001 issue of Scientific American, public health experts Ezra Susser, Daniel Herman, and Barbara Aaron point out that the US government, universities, and health insurance systems have long paid little attention to mental health issues.

The authors write that the Centers for Disease Control and Prevention has "traditionally paid scant attention to public mental health, despite World Health Organization findings that depression is the fourth leading cause of disease and disability worldwide." They conclude, however, that the attacks of September 11 revealed once and for all the importance of mental health to the nation's well-being. After all, one of the primary goals of terrorism is to inflict psychological damage that extends far beyond any physical casualties. Both the plane hijackings and the anthrax letters that followed caused widespread fear and anxiety.

The article's authors also take heart in two government actions in 2002 that suggest increasing support for mental health programs. First, the Federal Emergency Management Agency announced a $132 million grant to fund a New York state program offering free counseling to those affected by the air attacks. And a task force of the federal Department of Health and Human Services Agency recommended that primary care physicians routinely screen adult patients for depression by asking them a series of simple questions.

For Jim Campbell, being at the World Trade Center that day had a profound impact on him besides the terrors and memories -- it turned his life and priorities around.

"I made some important decisions on that long drive home," says Campbell. He quit his 70-hour-a-week job, sold his house in San Francisco, and moved with his family to Arizona -- all within 90 days of his escape from Tower Two. September 11, he says, was a wake-up call to make the changes he and his family had been longing to do, but had always put off. On September 10, he says, "I would have never thought I had the capability or the funds to do what I did; but I did, and here I am."

Campbell took several months off to spend time with his family, plant a garden, and enjoy the Arizona outdoors. He is only now beginning to look for work again, and this time around he's determined not to work more than 40 hours a week. "I want balance," he says.

For the September 11 anniversary, Campbell says he may take a jeep ride, stop by the local firehouse to chat with the firefighters, and otherwise spend a normal day with his family. "I just want to pick up the kids from school and do normal stuff -- reaffirm life," he says. "Maybe eat some Mexican food."

-- Paige Bierma is a health and medical writer who has contributed to Hippocrates, Safety + Health magazine, and Vibe.

References

First published September 11, 2002
Last updated March 11, 2008
Copyright © 2002 Consumer Health Interactive