Living with Depression

            There is no cure for clinical depression. It may surprise you to hear me, a clinical psychologist, say this. But I’m not saying this now as a psychologist. I’m saying it as someone who has lived, and struggled, with clinical depression for two decades. Depression doesn’t just “go away.” It waxes and wanes endlessly. It requires constant vigilance. When you’re lucky, depression can wane for months or even years. But when something challenging happens, like being laid off from a job you love for example, it can rear its ugly head again, reminding you that you still have it, still have to struggle against it, still have to manage it. Putting my shrink hat back on for a moment, I need to say that this does NOT mean that depression is not treatable. I know both as a psychologist and as a psychology patient that it is very treatable. It’s just not curable. Not when you have the recurrent (more than one episode) type as I and most people living with depression do. No, depression is not like syphilis, cured with a single shot of penicillin; it’s more like diabetes, something you will carry for the rest of your life, something you’ll have to manage or it will manage you. If you take your insulin, eat a proper diet, and exercise, you may go on for a long time with no ill effects from your diabetes. But if you ignore that you have it, eating whatever you like while lying on the couch all day, diabetes will eventually catch up with you and cause you great pain and even death. Depression is like that. On days like today, I need to remember to take my medicine (both literal and figurative), get some exercise, find something that gives me joy, and try to be productive. Because I know if I don’t, the depression will catch up to me and finally overtake me. There is no cure for clinical depression. But I thank God (and my therapist and the makers of Welbutrin) that I am learning to live with it and thriving in spite of it.

One Day in September: A Memoir of 9/11

Prologue

 

I was born and raised in Long Island, New York. At the age of 13, my family moved to a suburb of Atlanta, Georgia, and I’d been plotting my move back to New York ever since. In 1997, after graduating from Morehouse College and a year working at the Centers for Disease Control, I finally moved back to New York and into a room in my Aunt’s house in St. Albans, Queens. A few months later, I moved into my own studio apartment in the Fort Greene section of Brooklyn. I began my graduate training in psychology and began hanging out with a bunch of other Morehouse alumni. As any New Yorker knows, learning the subways is one of the most difficult and most essential steps to navigating the city. Another essential skill is finding a way to quickly orient yourself when you finally emerge from the bowels of the underground transit system. We quickly learned that the easiest way to do this was to search the skyline for the Twin Towers of the World Trade Center, visible from most of the island of Manhattan (as well as large portions of Queens, Brooklyn, and New Jersey). Unless you were already in lower Manhattan, the towers were downtown (south). Turning your back to the towers was uptown (north). East and west could then be easily determined as well. This trick also proved useful when stumbling drunk out of a lounge or nightclub.

 

In the spring of 2000, I got engaged to my girlfriend who was completing medical school at the University of Miami. She got into a pediatric residency program at NYU Medical Center/Bellevue Hospital and I was admitted into a Ph.D. program in clinical psychology at Rutgers University. We temporarily moved into my Brooklyn studio apartment, but decided to get an apartment in Jersey City, a city in New Jersey just across the Hudson River from Manhattan and a good midpoint between our respective training sites. After finding a suitable place, we went to rent a U-Haul for the move. Oddly, the U-Haul in Jersey City required a fingerprint in addition to the usual credit card and driver’s license. It quickly occurred to me that we were at the same U-Haul where Ramzi Yousef and crew had rented a truck for use in the 1993 World Trade Center Bombing. Over the course of our yearlong engagement, my fiancée asked me repeatedly to take her to visit the World Trade Center. We were busy planning a wedding and starting our respective training programs. In a move that I have yet to live down, I kept putting her off. On at least one occasion, I said “We have time baby, the Towers aren’t going anywhere!”

 

Al Gore was running for President against a man who promised to “restore honor” to the White House. W. was referring of course to the long drawn out Monica Lewinsky scandal – the blow jobs in the oval office, the semen-stained blue dress, and unspeakable things done by the President with a cigar. Despite a booming economy and a budget surplus, the Gore team made the decision not to campaign with Bill Clinton, nor to run on the Clinton record. As we all know, he lost. Well, not lost really, but he certainly didn’t win with enough of a margin to prevent the W. camp from stealing the election. Everyone expected the Bush presidency to be dogged by an air of illegitimacy, and the likelihood that he would be vulnerable to defeat in 2004. Years later it would occur to me that, given the possible alternative history (Gore might have taken the warnings of counter-terrorism advisor Richard Clarke more seriously for example); Lewinsky may have given the most costly blowjob in history.

 

My wife and I were married in June of 2001 in her hometown of Daytona Beach, Florida. The following September, the death of a close family friend brought us back to Daytona for the funeral. After the funeral, I returned to New Jersey alone leaving my wife home with her family for a few extra days. I boarded a flight bound for Newark on the evening of September 10, 2001. The flight was unremarkable, except for a strange sensation I had during the flight. I’ve been a flyer since infancy and I’m generally not afraid to fly. However, on this flight I felt a fear that I recall thinking was unusual. I took deep breaths to calm myself as I got the strange premonition that the plane was going to crash. The flight landed without incident and I was of course unaware that the next morning a flight would leave from that same airport bound for a deadly mission.

 

Tuesday, September 11, 2001

 

I was on my way to campus, driving south through Newark on route 1/9 and listening to Morning Edition on NPR. The Manhattan skyline had probably just receded from my rearview, when the news came that a “small commuter plane” had crashed into one of the twin towers. Had I taken a glance over my left shoulder as I’d entered the Pulaski skyway (an elevated roadway connecting Jersey City and Newark), I no doubt would have seen the smoke billowing from the North Tower. About 15 minutes later came the news that a second plane had crashed into the South Tower and with it the horrible realization that this was no accident. It was also announced that this was a large passenger jet as it was now know the first had been. I remembered that my brother (a music journalist) was scheduled to fly to Atlanta that day to interview the Dungeon Family (a Hip Hop crew consisting of Outkast, The Goodie MoB, and others) about their upcoming album. I called him to find that he was sitting on the tarmac at La Guardia airport. After hearing his complaint that he’d been sitting on the tarmac for quite some time, I told him what was going on and let him know that he wouldn’t be going anywhere.

 

For the rest of the hour drive to New Brunswick the NPR broadcast was sheer horror. They had reporters on the scene describing the raging fires and worst of all the heart wrenching reports that people could be seen jumping to their deaths from the upper floors of the towers. And then, at 9:03 am, the South Tower collapsed. The NPR reporter struggled to remain composed, but to no avail. The usually hypnotic NPR voices changed to multiple reports that “the whole friggin’ building collapsed!” I recall shouting “holy shit!” and calling my brother back with the news. “You mean there’s only one tower left?” He asked in disbelief. “Yeah man, a whole fucking tower just collapsed!” I shouted into the phone. By now he was off the plane and going to retrieve his luggage from the baggage claim. “I’m getting the fuck out of here!” he said. At some point I spoke to my parents in Atlanta, who were frantic knowing that both of their sons lived in the New York City area. The broadcast continued with the news that an as yet unknown number of people had died in the first collapse. Despite the grave danger, police and fireman from New York and many surrounding areas rushed toward the remaining tower, trying to save who they could.

 

I decided I needed to get to campus. To get out of the car and see what was happening. I was having trouble imagining what the skyline looked like with only one tower. I got to the psychology building and ran into the main office. The secretaries were all there looking stunned as I was. In what I would later realize was an eerie premonition of things to come, one of them said “We should have killed Saddam Hussein when we had the chance!” I recall thinking that this was an odd statement, given that no one knew who the attackers were at this point. I walked down the hall to the psychological clinic where a television had been set up in the patient waiting area. A group of faculty and students were crowded around it watching in horror. It was here that I learned that a third airliner had crashed into the Pentagon at 9:37 am. And then, at 10:03am, I watched in disbelief as the North Tower collapses. At first, I wasn’t sure it was real. I thought it might be a replay of the first collapse. All of lower Manhattan was engulfed in a billowing cloud of smoke and debris, and I thought maybe there had just been an explosion, that when the smoke cleared the North Tower would still be there. It didn’t take long to realize that there was nothing left. It took a bit longer to register that both of the Twin Towers were now a memory. Everyone knew that the death toll would be in the thousands and that hundreds of police, fire and other rescue workers had just given their lives trying to save others.

 

I don’t remember when I left that television in the clinic. Classes were cancelled and I drove aimlessly around campus listening to the further developments on NPR. I remember hearing the news that a fourth plane had crashed in rural Pennsylvania, and I remember thinking that it had probably had to be shot down. I remember learning that all air traffic had ceased for the first time in American history. The story was now put together. Hijackers had taken control of four commercial airliners and used them as guided missiles. They had attacked the centers of American economic and military power. The first American war of the 21^st century had begun.

 

Later that afternoon, I met my classmates and clinical supervisor back at the psychological clinic for our regularly scheduled group supervision. We talked about what we had just witnessed, the fear of what was to come, the soldiers who would soon be sent to war, the possibility of further attacks, the students and faculty who had just lost loved ones, and our own tremendous shock and grief. At some point in the meeting I mentioned that we should also give some thought to how this was going to affect the Muslim and Arab students on campus, as a backlash was surely to come. My chosen vocation as a psychologist, a healer of the heart and mind, suddenly took on a new and more urgent meaning. I wanted to do something. But what?

 

All of the roads leading toward New York City were closed, so I spent the night of September 11, 2001 on the couch of one of my classmates. I fell asleep watching Tom Brokaw in what must have been his 14^thstraight hour of reporting.

 

September 12, 2001

 

I woke on the morning of September 12, 2001 still in central New Jersey. I rinsed my mouth out with mouthwash and started the drive back to my apartment in Jersey City. It seemed like my cell phone range every 5 or 10 minutes from friends and family members asking if I was okay, and asking what I had seen. I told them that, like them, I’d witnessed the horrific events on television (and radio). Then, still about 45 minutes away from Jersey City, a huge plume of black smoke appeared from the horizon. I drove on until the New York City skyline came into view. The Twin Towers had been the most prominent part of the skyline to greet me as I returned home every evening for the previous year. Now there was the plume of black smoke where the towers had been. Seeing the events unfold on television had been terrible, but had somehow remained surreal. Now, seeing the devastation live before my eyes shocked me in a way I hadn’t anticipated. Tears had been streaming down my face most of the way home, and now the emotion became too much to bear. I pulled the car to the side of the road and wept.

 

As I got closer to Jersey City and entered the Pulaski Skyway, traffic slowed to a crawl. I was on the elevated roadway now with a panoramic view of the New York skyline, and that horrific black plume of smoke which stretched up into the clouds. Tears were still streaming down my face as I pondered the tremendous violence of it all; the thousands dead, the bravery and self-sacrifice of the “first responders” (this word hadn’t entered my vocabulary yet), and the sheer gall and cold-blooded dedication of the 19 hijackers who’d deliberately and meticulously planned such an apocalyptic act. I glanced at the other cars around me. There were stunned looks on everyone’s faces, and many others were weeping openly as I was.

 

I don’t know what time it was when I finally got to my apartment. The first thing I noticed as I got out of my car was the smell. An acrid smell of smoke and dust filled the air, carried across the Hudson River by the winds. At some point, the macabre thought occurred to me all of us who lived in the area were inhaling the vaporized remains of the dead. They would become a part of us, to the very core of our being. I took a glimpse up the street before going inside and already American flags had been hung from the fronts of homes or placed in windows. For some reason, the sight made me uneasy. I wondered what our new-found nationalism mixed with pain and anger would bring. Even then, I feared more blood of the innocent would be shed as America unleashed its righteous anger. Finally I looked up to see a crystal blue sky, as the day before had been, and there was an eerie silence. You never really notice how often planes fly overhead until there are none. But soon after the silence was broken by a sound; the high pitched whoosh of a jet engine and my first sight of an F-16 fighter flying air cover over an American city. “So this is what war feels like”, I thought.

 

I checked on my wife in Daytona Beach and began packing a bag. I didn’t want to be alone and for some reason I wanted to be closer to the city. I had to be in New York. I left for my brother’s apartment in Brooklyn across the street from Prospect Park. Traffic was at a crawl at the Holland Tunnel as police pulled over trucks and checked their contents. Bomb sniffing dogs patrolled the lanes of traffic. I drove across Manhattan on Canal Street towards the Manhattan Bridge, leading into Brooklyn. To my right all of the streets leading into lower Manhattan were blocked by barricades and National Guard troops holding M-16 machine guns.

 

That night, my brother and I took the subway to Brooklyn Heights, where the Brooklyn Promenade overlooked the East River and faced lower Manhattan. The area was packed with stunned New Yorkers. We looked each other in the eye, possibly for the first time in the history of the city, silently sharing our grief. People spoke in unusually hushed tones and sadness hung heavy in the air. Many were crying openly and unashamed. And there too was the acrid smell of the smoke still rising from the smoldering wreckage of “The Pile” at “Ground Zero.” My brother and I reached the Promenade. There, along the railing overlooking the East River, were hundreds of candles, flowers, and pictures of the “missing.” We stood there for a long time. Just looking across the river at the plume of black smoke where the Towers had once stood.

 

Aftermath

 

My wife finally was able to fly home from Florida about a week later and life began settling into the “new normal.” All New Yorkers (and most Americans) were still skittish as no one knew if more attacks would follow or how soon. New Yorkers suddenly realized how vulnerable the 23-square-mile island of Manhattan was. The center of New York City, and the center of the much of the nation’s financial and cultural infrastructure, was crowded onto a tiny island solely accessible by bridges and tunnels. Subway and utility tunnels stretched for miles underground, and on any given business day the population of Manhattan swelled to over 10 million.

 

New sights and sounds now. The wreckage of the World Trade Center smoldered for weeks afterward. The plume of black smoke gradually turned grey then white, a constant reminder of what had occurred, before finally disappearing from the skyline. The PATH train linking Jersey City to Manhattan still had “World Trade Center” listed on its map as one of two final destinations in the city. Heavily armed police and National Guard soldiers were positioned at bridges, tunnels and other strategic positions all over the city. Fire Stations were draped in black cloth, with candles and flowers left as offerings to the fallen. The usually stoic New Yorkers seemed kinder to each other. And no one was surprised when the sound of a car crash or boom from a construction site caused people to startle and look around wildly for the source of the sound. For me (and many others) the most haunting images of the days and weeks that followed September 11^th were the hastily constructed “missing” posters, bearing the names and faces of loved ones who had not returned home. Within a few short days after September 11^th, the walls of every Subway, PATH, Long Island Railroad, and Metro North train station were plastered with these posters. Bits of autobiography accompanied the photographs, identifying the lost as fathers, mothers, sons, and daughters. They came from all walks of life. They were stockbrokers, firemen, policemen, cooks, janitors, doctors, nurses, and many others. They seemed to come from every nationality, every ethnic group, every social class, and every religion on Earth. By the end of the second day, we all knew that the vast majority of these people would never be coming home, and the walls became memorials. People began leaving lighted candles, flowers, and written prayers at the base of these walls as offerings to the dead. They were everywhere and the city itself seemed to become a graveyard, the remains of the dead and the dust of the Towers carried to all parts of the city by the wind. Those pictures are what have stayed with me the most. Even now, the mere sight of them replayed on television makes me sick to my stomach and tears well up in my eyes.

 

My wife returned to her pediatric residency program at Bellevue Hospital where a makeshift morgue had been constructed on the outside of the hospital in an attempt to identify the remains of the dead. This was done mostly through DNA analysis, as the tremendous violence of the Towers collapse had left little other than small bits of human remains, shredded clothing, or a bit of ID from a recovered purse or wallet. My wife drove by this grim reminder of the attack every day. I saw it myself on the numerous occasions that I drove her to work, or met her for lunch. I don’t recall how long that morgue stayed there, at least a year after the attack, maybe more. In the years since, she has shared with me that this memory that haunts her just as much as the posters of the “missing.”

 

In 2003, my wife and I moved back to Brooklyn. We found a garden apartment in Prospect Heights (Bed Stuy really) were she continued in a pediatric fellowship and I continued in my doctoral program at Rutgers. Lower Manhattan had been reopened and we got used to the police and National Guard presence at bridges, tunnels, subway stations, and other parts of the city. Now on the days I went to campus, I took the New Jersey Transit train from Penn Station to New Brunswick. The NYPD in Penn Station now wore bullet-proof vests and carried automatic rifles. There was a permanent National Guard station there as well. As I navigated the massive transit hub of Penn Station on my way to the New Jersey Transit trains, I was careful to give the National Guard station wide berth. I reasoned that the National Guard station would be a logical target for a suicide bomber, and who could really stop one amidst the huge crowds of Penn Station at rush hour? I tried to imagine how much C-4 plastic explosive I could stuff into my own backpack and how easy it would be to cause mass casualties were I so inclined. On occasions when I drove over the Brooklyn or Manhattan bridges, I began to notice that the police no longer stopped every truck or U-Haul going over the bridge. How much sodium nitrate fertilizer would it take to blow up one of those bridges, I wondered? I tried to banish such thoughts from my mind when travelling through the Holland or Lincoln Tunnels. The thought of the waters of the Hudson River flooding a packed tunnel was too frightening to entertain. Finally, sometime in the summer of 2004, I was in my backyard fighting our ever-present weed problem when the now familiar sound of a high pitched whoosh filled the air and I looked up to see an F-16 Fighter Jet flying overhead. My heart began to pound as I raced inside and turned on the television. Nothing was happening. Channel after channel of regularly scheduled programming. I don’t know what the F-16 was doing over Brooklyn that day, but I had had enough. It was time to leave New York.

 

Epilogue – September 11, 2011

 

I can’t believe it’s been 10 years. As I write this now, I’m sitting in my apartment in Tuscaloosa, Alabama. It feels like New York City is light years away. After leaving New York in 2005, I began to realize that those in other parts of the country experienced 9/11 differently from those of us who were there. I hesitate to say this because it sounds like a sort of disaster elitism, but those who simply watched the events on television don’t really know what it was like to be there. I know all Americans were shocked, saddened, and outraged by the attacks, but after the television was turned off they were able to return to their normal lives in the days that followed (relatively). This is what I realized instinctively during the drive home from Rutgers on September 12, 2001 and finally saw the destruction for myself, up close and personal. Television can give you an idea of the thing, but it’s not the real thing. We New Yorkers lived with the reminders for days, weeks, and even years afterwards. Those of us who didn’t lose someone we knew personally usually knew at least one other person who did. I have friends who were working in lower Manhattan then and who have their own stories of what it was really like on that day.

 

Still, there is something familiar about the place I’m in now. On April 27, 2011, about three months prior to my arrival, Tuscaloosa was hit by a massive, 1.5 mile wide EF4 tornado. Forty seven people lost their lives and over 1000 were injured. Whole neighborhoods were wiped off the map. In the immediate aftermath of the tornado thousands of rescue workers dug through the wreckage looking for survivors and recovering bodies. The VA Medical Center, where I now work, was transformed into a shelter for the displaced and a makeshift morgue for the dead. When my wife and I came here in May to look for apartments, we were shocked by the sight of the utter destruction. There were still piles of rubble where homes and businesses had once stood. Tree trunks reached for the sky, stripped of their leave and most of their branches. Although the tornado was a natural disaster and the loss of life far less severe than New York on September 11, I feel a certain understanding and kinship with the people of this small city of 90,000. I recognize the look in people’s eyes when they describe what it was really like to witness such a horrific event and to live with the aftermath of destruction.

 

There’s so much more I could say and want to say about the past decade. We have lost so much as a nation. So many more lives have been lost. So much more innocent blood has been shed around the world by Al Qaeda and by us in our nation’s “War on Terror.” Many of us suffered an additional trauma as the attack on our beloved city was cynically used for political gain; to win an election against a genuine war hero and to start a reckless and senseless war of choice. As I feared on that day, the righteous anger of America has been let loose upon innocent Muslims at home and abroad. Even now, we hear the of protests against the “Ground Zero Mosque”, the Islamic Center in Murfreesboro, Tennessee, and hysteria over Sharia Law. I’ll save these thoughts for another day.

 

For now, I take solace in remembering the courage and selflessness of that day in September. When police and firemen rushed into the burning towers, when buildings that usually held 30,000 were largely evacuated in time to save countless lives, when a city and a nation mourned together, and we were truly One Nation…if only for a day.