Reflections on 9/11 and the Suffering of Our Helpers
By Siddharth Ashvin Shah, M.D., M.P.H. Founder and CEO

9/11 Post-Traumatic Stress

Although it’s been two weeks since the anniversary and remembrances of 9/11, I find myself still reflecting on how it changed the lives of so many, including my own. The horrors of that day occurred only two months after I started my residency at Mount Sinai Hospital in NYC. For me, once I was able to see through my own fog of insecurity and grief, the major thing that helped relieve the pent-up pain was effective action with other helpers like myself.

As a community outreach kind of guy since my childhood, I found ways to connect with several different helper “tribes”: other physicians, community leaders, government servants, firefighters and police, mental health counselors, and pastors. Their own trauma, fear, grief, and pain – and the resulting physical symptoms – were magnified as they helped the city and citizens through the aftermath. It was natural for me to be at the center of these soul-searching discussions. To me, it is wrong that helpers who head towards suffering should get an outsized dose of suffering themselves.

The 9/11 wound was so public and unmistakable that it opened up people’s hearts.  Like never before, American society was now advocating for the emotional support needed around insecurities, fear, chronic stress, burnout, and trauma. I noticed that 9/11 tragically mainstreamed those shadowy emotions out of their silos. We now broke through layers of stigma and shame that stopped many crisis responders, healthcare workers, law enforcement, humanitarian aid workers, and other helpers from sharing their personal traumas. In fact, as a physician specializing in integrative and preventive medicine at the time, it felt like a quantum leap to me and showed me our society’s eagerness to counteract trauma.  

With all of the great pain that 9/11 brought, there is also what many psychologists call post-traumatic growth. Mainstream awareness of undetected and unresolved trauma has grown over the last two decades, leading some government, healthcare, and private sector organizations operating in highly demanding environments to take positive strategic actions to protect and support their helpers. Indeed, we at Greenleaf have been able to guide forward-thinking organizations in the design and implementation of science-based wellbeing assessments and solutions.

But, here’s the thing: The progress made since 9/11 isn’t enough – not by a long shot. In fact, that September morning 17 years ago ushered a new layer of anxiety and unsettledness into the lives of most Americans. It sensitized us to what is felt more privately by millions of traumatized people in our society and around the world. Such overwhelming stress, the kind that keeps aching even though the “cause” is gone, is an unmistakable cause of altered brain function and behavior. That stress also biologically hurts our physical health, our personal relationships, and professional activities. Stress has long been this nation’s #1 workforce health issue.

Yet, among the thousands of organizations with employees operating in highly demanding and stressful conditions, very few are making far-reaching improvements. Many still view these complex workplace issues and the related risks only through the lens of encouraging employees to use the 1-800 number for the EAP and to learn more self-care techniques. Unfortunately, against the tsunami of stress waves felt in the post 9-11 era, the old tips-and-tricks stress management trainings don’t work anymore.

In the meantime, the chronic stress and burnout as well as direct and vicarious trauma in many of these organizations are only getting worse. All indications show that the preventable suffering of many physicians, nurses, humanitarian aid workers, and other helpers is growing. Let that sink in a moment.

We as a country know better. We now have scientific knowledge and resilience-building strategies that lead people to thrive in our demanding environments. Being told to “suck it up” or “this is just the way it is” no longer holds water. In the era of social media posts and widely available information on occupational stress, it seems that many are just hoping the problem resolves itself. I prefer the alternate reality where organizations cultivate workplaces in which stress and fear are examined with eyes wide open and reduced at their root causes. Where people are protected from unnecessary suffering and preventable breakdowns. And where everyone in the enterprise feels safe in acknowledging the personal toll of getting the job done.


Siddharth Ashvin Shah, M.D., is founder and CEO of Greenleaf Integrative, a unique consulting firm that enables clients operating in highly demanding environments to protect the wellbeing of their employees and resiliency of their organizations. Greenleaf’s tailored solutions mitigate the causes of and improve the responses to chronic stress, burnout, and trauma.

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