Legacy in the Dust

The last time 9/11 was known as the day after 9/10, Larry Zacarese was sleeping in. “I’d been working plainclothes in Jamaica (NY),” the 35-year-old police officer and paramedic remembers, “and was supposed to start my vacation that morning. Instead, I got a call from my mother about planes crashing into buildings.”

Larry drove very fast to his precinct, the 113^th, then continued toward the nearest bridge linking the Isle of Long to the target-rich environment known as Manhattan. His trek was interrupted by an unrelated shooting. The victim, who needed a priest more than a cop or a medic, would be Larry’s only patient that day.

Zacarese reached Ground Zero mid-afternoon, joined by like-minded responders whose lifesaving skills were limited to scenarios not involving ballistic airliners. He spent the next three days doing 12-hour shifts—for 14–15 hours. “I told my dad, ‘I’m not coming home until I find somebody,’” Zacarese says. “I was convinced we’d pull people out. I just wanted to get one person out.”

Days became weeks, then months. By December, Larry’s tour of duty at the country’s biggest crime scene had tapered to one or two days a week. It was time to return to Jamaica, but not for long. In March, Zacarese achieved a long-term goal by joining NYPD’s elite Emergency Services Unit (ESU). There he met Capt. Barry Galfano, who would become his mentor and friend. Like Larry, Capt. Galfano had worked at Ground Zero almost every day until December. With no one to rescue, Galfano had dedicated himself to supporting the living: “[As a Captain] I had the ability to go up to people and say, ‘I know you’re hurting. We’re all hurting. We have to pull through.’ That became one of my biggest functions down there.”

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Larry was almost through ESU’s four-month training when he was diagnosed with reactive airway disease and a site-specific malady known as World Trade Center (WTC) cough. Unable to achieve a peak flow suitable for ESU’s scuba mission, the third-generation NYPD veteran knew he’d have to choose a different assignment. Galfano, who had commanded a K-9 unit earlier in his career, convinced his protégé to follow that route. It wasn’t easy, but Zacarese got through it in 16 weeks. “K-9 was the toughest training I did,” Larry confides. “By then I was using an inhaler to help me catch my breath.”

Zacarese is one of approximately 6,000 adults exposed to WTC debris who suffered new-onset asthma. Some estimates put that number twice as high. Workers who arrived at Ground Zero on 9/11 and spent at least three months on the pile have shown the highest rate of respiratory illness. Forced expiratory volume, a measure of lung function, remains well below normal limits for more than 10% of the firefighters, cops and EMS workers who were part of the recovery effort.

Those folks had more than a casual knowledge of hazmat. Weren’t they worried about ongoing exposure to vaporized skyscrapers?

For Galfano, an environmental science background helped make the consequences of his duty pretty clear: “I knew I was breathing smoke and chemicals, and I’m saying to myself, ‘Twenty years from now you’re going to end up with lung cancer,’ but we still had a job to do. We still had to recover bodies, recover all our people.”

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By 2004 Zacarese was feeling more winded. He developed a persistent rash, and added GERD and sleep apnea to his job-related illnesses. His list of medications started to resemble a formulary for COPDers twice his age. “I was tired all the time. It became a quality-of-life issue.”

In June of ’09, two years after being promoted to sergeant, Larry left NYPD to become assistant chief of police and director of emergency management at Stony Brook University. He also attends law school and works as a paramedic in Suffolk County. He knows he’s lucky to be as healthy as a 60-year-old two-pack-a-day smoker. “A lot of guys are much worse off,” he concedes.

Galfano, whom many subordinates credit with helping them through the horrors of 9/11, underwent surgery in 2008 for a malignant tumor in his small intestine. Within two years, cancer had spread to his legs, lungs, liver and brain. He died while I was writing this.

Barry Galfano and Larry Zacarese represent thousands of emergency services workers for whom rescue and leadership—not scene safety and backup—were the first priorities on 9/11. Our textbooks were right: You can get hurt that way. What the textbooks don’t teach is that no one should be left behind. I’m glad I know people who get that.

Mike Rubin, BS, NREMT-P, is a paramedic in Nashville, TN, and a member of EMS World’s editorial advisory board. Contact him at mgr22@prodigy.net.