Tuesday, January 25, 2011

Heroes and Tigers and Saints Oh My!

“Well I won’t back down, no I won’t back down
You can stand me up at the gates of hell
But I won’t back down…

…Well I know what’s right, I got just one life,
In a world that keeps on pushin’ me around-
I’ll stand my ground and I won’t back down”
--Tom Petty

Thanks to the recent snowstorm here in Atlanta I was homebound for several days.  What’s worse is that the same 4 inches of ice which made it too treacherous for driving was also bad for running.  Normally I will journey out in all sorts of weather because I enjoy the adventure of running a few miles while everyone else may be huddled indoors.  I’m a firm believer in the theory that there’s no such thing as bad weather, just inappropriate clothing.  However this time, the risk of injury from the ice outweighed any potential adventure.  After a day or so of watching the never-ending news feed of road and school closings on TV I got more than a bit restless.  I had to do something or I was going to go crazy.   Finally, I put my bike up on the trainer and grabbed the iPod.  Normally I am not much of a headphone wearer.  I do not run with them out in the world because I like to be aware and part of my surroundings, rather than isolated from them.  In this case though, a little upbeat music provided a good rhythm for motivation and distraction.  On DVD I also have 7 years’ worth of Tour De France highlights from 1999-2005; the years that Lance Armstrong won them.  I popped in the one from 2000.  Now, watching the cyclists on the screen gave me something to look at and also helped to keep me moving.  I used to dread sitting on an exercise bike but this was turning out to be rather fun.
As I watched and peddled, I recalled where I had been in July of 2000 (The TdF is always in July).  I was in the middle of chemo treatments and feeling pretty crappy.  I had returned to working full time which did restore a bit of normalcy back in my life.

 One weekend in September I made a most memorable 3 day business trip to Austin.

A now famous Austinite, Lance Armstrong had just released his book, It’s Not About the Bike which turned out to be a huge morale booster for me.  Finally, I had found a cancer survivor who had encountered similar challenges and issues I faced.  I was a triathlete; I swam, biked and ran for fun.  I ate healthy, did all the right things. Sure, I wasn’t a professional, but it was a very important aspect of my life.  Like Lance, I was pretty much the poster child for being healthy.  But unlike Lance I found myself surrounded by a medical community that was unconcerned about returning me to racing.  Obviously, I didn’t fit neatly into any of the preconceived categories the medical illuminati had designated for the “typical” breast cancer patient.  I had to constantly battle my treatment team to make them aware that I was not the average patient.  I don’t think many of my doctors had ever encountered a patient like me before. I asked questions like; how much would I be able to run or swim during chemo?   What type of, if any, permanent damage to my swimming motion would the lymph node dissection impose?  I was more concerned with whether or not I was going to be able to participate in an ironman triathlon in the future and no one around me seemed to get it.   
Preserving my vanity seemed to trump saving my life.  
Everyone seemed more concerned with how I might look than how I might function after I recovered from cancer, IF I even recovered. Uncomfortable looks and shoulder shrugs were the only answers I got.  I wanted to fight like hell to get my normal life back and all I had been offered were ways to cover up and conceal my illness.  Makeup, wigs, breast implants and cutesy pink ribbons are not the tools of conquest against cancer.  In fact, they are worse than useless and irrelevant items for someone who cared more about thriving than facades. 

They were so busy telling me what I wasn’t going to be able to do anymore no one could tell me what I could do.  

One thing I was given was a list of “lymphedema prevention guidelines” which read like a litany of insanely overprotective nonsense.

Here is what I was told:

1. Avoid all types of trauma; cuts, scrapes, bruises, burns, including sun burns, sports injuries, insect bites, all animal bites and scratches and forceful impact.
2. Avoid pushing, pulling or lifting with the affected limb; Do not lift anything over 15 pounds, less if you are out of shape or the weather is hot and humid.
3. Protect the affected limb from weather extremes;
a. In hot weather seek air conditioning and keep the limb cool.
b. In cold weather seek central heating.
 If you must go out, have
the at risk limb well bundled, but not sweaty.
4. Avoid any repetitive movements, especially those against

Here is what I heard:
1.    Do nothing.
2.    Do nothing.
3.    Stay inside
4.    Do nothing

I don’t know what idiot wrote these contradictory guidelines, but apparently once diagnosed with breast cancer the only activities deemed suitable might include watching television while eating pink bon bons.  Apparently, having cancer meant that now I was to wrap myself in cotton and live in a bubble in order to avoid sweating or risking any chance that I might get bumped, scratched or in any way exposed to the great outdoors.

Faithfully following these guidelines meant giving up living.  

There was nothing else for me to do but ignore them.

 I finally found some answers in Lance’s book and from some of the people involved in his foundation.  After spending a long, queasy night in the bathroom reading the book in between bouts of puking, my first order of business for the next morning was to call the Lance Armstrong Foundation. (Now Livestrong.org)
I just knew that someone there would have some information about the types of things I wanted to know.  Who was doing research about exercise during treatment, through recovery and beyond?  What was LAF doing to help promote this? How could I participate?  Sure enough, I was put in touch with a wonderful volunteer named Laura.  I started asking my questions and right away I could tell that she shared my enthusiasm for the concerns I had and offered to meet with me when I visited Austin.

I flew to Austin on Continental Airlines which means that no matter where your flight originates, you will mostly likely change planes via their hub in Houston.  Once onboard I noticed that the flight attendants were particularly attentive.  Not a single one passed my seat without pausing to ask me if I needed anything.

Flight attendant: “Would you like a blanket”?
Me: “No, but thank you.”
Five minutes later;
Different flight attendant: “How about a pillow”?
Me: I’m fine, thanks for asking though”.
Ten minutes later;
Third flight attendant: “Would you like some water”? 
Me: (not wanting to seem ungrateful for all the attention) “Sure, some water would be nice”.
Flight Attendant: “Would you like some lemon in that”?
Me: “Uh, sure, that would be great. Thanks”.
Ten more minutes;
Original flight attendant: “Are you warm enough? Can I get you anything else”?   
Are you sure you don’t want a blanket”?
Me: I’m doing great, thank you so much”.

On and on it went for the duration of the flight.  They must have refilled my water every time they passed my seat so finally I had to get up to use the bathroom.  I unbuckled my seatbelt and was on my way to the back of the plane when I felt someone touch my shoulder. 
The flight attendant was handing me a hot washrag, the ones they sometimes give out in the first class cabins before meals.  As she handed it to me she said, “Here, this is for your face, in case you need it, when you are done”. 
There was a very pronounced, split second of brain lag between pondering why it was that my face would need to be washed after peeing until the eureka moment hit me-She thinks I got up to puke!

Here I was, bald and on a plane to Houston-home of the world famous M.D. Anderson Cancer Center.
It further occurred to me that since Continental hubs there that all of their crews are probably accustomed to seeing cancer patients traveling there for treatment.  Not sure if it is official company policy but they obviously were working very hard to make sure my needs were attended to.  I wanted to tell them that Houston was not my final destination and that, bald head aside, I was feeling just fine, this week.  I decided against that strategy because being ill had taught me to be gracious about accepting assistance even when I didn’t need it.  I had discovered that when you are sick, it makes others feel good if you allow them to help you.
I played along all the way to Houston. 

I made my way to Austin and attended business meetings on Friday evening and part of Saturday morning.  Saturday afternoon, as arranged, Laura picked me up from my hotel room to take me out for lunch.  Laura was an energetic, crazy ex-pat New Orleans Cajun living in Austin.   She had promised to show me some real Austin lifestyle and took me to the Shoal Creek Saloon.  Apparently there are a great number of ex-pat crazy Cajun’s in Austin because this place not only catered to their palettes, but also ensured that LSU and New Orleans Saint’s football team programming took priority.  This last discovery was not incidental.  As we entered the saloon, all eyes turned to the opened door as we stepped in.  I had grown accustomed to people staring at my bald head in public and mistakenly believed it was just another one of those moments.  Once we were seated however, I looked up at the big screen T.V. and noticed that the LSU game was starting and that they  were playing against Auburn University.   Although not much of a football fan, I just happened to be wearing an Auburn University sweatshirt I had been given as a gift.  No wonder they were staring!
Lunch was about to get interesting!  We chowed down on mudbugs, jambalaya and beer.  Our chat about research and programs that Lance’s foundation was funding was periodically punctuated by loud, boisterous cheering anytime LSU made progress.   Suddenly I found myself duty bound by my sweatshirt to cheer on Auburn for their gains.  I stood up and cheered wildly for an Auburn touchdown and that’s when the trash talk started. Back and forth, on and on…Laura, and the whole restaurant engaged me, but not in a mean or vicious way.  It was fun.   One guy seated to my left, seemed to really enjoy playfully needling me about Auburn as I played the role of the dedicated fan.  He smiled warmly throughout the first half even while he had been giving me a hard time and when half time rolled around and it quieted down he bought me a beer.   I thanked him and it became obvious he wanted to talk.  He gestured to my head and said, “I see you got something going on there”.  He went on, “My mom went around bald while she was treated for cancer and when I was a little kid it used to embarrass me.  When I got older though, I learned to really admire her for what she went through and how she handled it”.  His eyes were beginning to water when he said, “She was my hero”.  
I gave him a hug and thanked him for sharing his story, and for reinforcing my decision to never hide my illness.

I thought about how I would have missed out on so many spontaneous acts of love, support and encouragement, from so many people if I had hidden things by wearing a wig.  Being honest and open about cancer created opportunities for people to share very personal and intimate moments with me.   More importantly, I hoped that by rejecting the frivolous expectations the medical community put upon female cancer survivors, it might lead to a better focus on what really mattered.  Not sure what it will take frankly.  Perhaps I should bring my bicycle to a dramatic, skidding stop at the front doors of M. D. Anderson and all of the other comprehensive cancer centers and sling mud in every direction.

Maybe someone will notice. 

Being healthy and fully engaged in living is what counts.  For me, being alive meant being active.  Cancer and the medical community had conspired against me in that regard and it infuriated me.  My solution was to stubbornly dig in and prove to the world that having cancer was not going turn me into a victim.  The urge to defy their expectations of failure drove me to become even more, not less than I was before.  
Survival may mean different things to different people but at the end of the day, what really matters is how you spent that day.

Survival from the sidelines was not in my playbook.  

As it turned out, Auburn won the game that day.  The entire restaurant had been rooting against my team but it hadn’t mattered.  I was used to those kinds of odds.

Monday, January 10, 2011

Metastatic Pink

"Every great cause begins as a movement, becomes a business, and eventually degenerates into a racket".
--Eric Hoffer

I walked into a running store a few months ago to buy some shoes and shorts; men's gear on one side, women's gear on the other.  This makes sense given the different sizes and cuts of shoes and clothing needed. What became immediately apparent and painful to me though, was not just that the smaller sized stuff was on the right side of the store.  As I approached the racks I realized I was drifting dangerously closer to what more closely resembled a Barbie Playhouse nightmare.  Much of the running apparel and shoes were pink, glittery or some trendy shade of something ubër girly.  

In other words, nothing I could take seriously.

 I refuse to buy into the stereotype that all it takes to market an item to women is to "shrink it and pink it”. 

The simple formula is this: Pink=Girl.  Later on it becomes Pink=Women.   Who decided this? Who said so? Many women will claim that they just love pink and all things glittery and superficially girly. Maybe some do, but I believe that most of them learn to like what they think they are supposed to like because it’s expected of them.  It sends the right message. 
Women, everyone really, has been programmed by Madison avenue to think that if it's pink it’s feminine, regardless of the quality.

The sad truth is, there is nothing biologically innate that links pink to women.  It’s purely a cultural brainwash of the past 40 years.  Prior to WWII , pink was actually more closely associated with young boys or men.  The Great Gatsby himself wore a pink suit.  Many catalogues of the times showed pink children’s clothing for boys. In fact, pink was considered a stronger, more passionate color, softened from the warrior’s red, whereas blue was regarded as a dainty color, more suitable for girls.

No one thought Elvis the least bit effeminate for owning numerous pink cadillacs, and to this day, almost any mid century modern home sports at least one pink bathroom, originally intended for both genders to use.

I have a theory about what may have triggered the “pink is not for men” mentality.
I suspect the aversion had its subtle beginnings when our G.I.’s liberated the concentration camps and saw pink triangles assigned to the gay men in the camps.

It took quite some time though, before it became a mainstream notion.  I attribute a rapid shift in attitudes more recently, to the miracle of sonography.  Now that we may know the gender of the baby ahead of time, there’s money to be made in the  customization of products and pink imprinting now starts early. Prior to sonography, people bought “neutral” colors like green or yellow because no one knew what gender the baby was going to be.

Now baby showers may be properly color coordinated and parents tediously plan out the perfect shade of pink to paint their nursery well in advance of the new arrival.  The day a girl arrives at the hospital some sort of pink label and identifier is slapped on her as well.   Need more proof? Perhaps head on down to your nearest toy store and experience the Barbie Playhouse nightmare for yourself.  Certain aisles will blind you with the dazzling array of pink dolls, accessories and toys intended for GIRLS that emanate from the shelves.  

Why does the pink marketing bother me so much? 

I think, particularly with regard to sports equipment, there is a subtle, unspoken message.  Years ago, women were discouraged from participating in sports.  It wasn’t until as recently as 1972 that women were even allowed to participate in the Boston marathon.  Sports, it was said, masculinized women; it built up muscles and women weren’t supposed to have big muscles-not to mention beautiful, healthy bodies.  Even in medical circles at one time, it was argued that vigorous activity was harmful to women.

Sweating wasn't considered a feminine activity.  An athletic woman was presumed to be a lesbian. Fear of this stigma threatened and discouraged many women from participating in sports for decades.  Lesbians, according to some, were not really women, but women trying to be men.  This served the prevailing attitude of the time that sports participation somehow diminished femininity.

Those attitudes have mostly evaporated but we still have slightly more than vestigial remains. 
Women today get to have it all...They can bring home the bacon and fry it up in the pan….

Well almost…

Watch a broadcast of any women's sporting event lately?
The Olympics, perhaps?  Ever notice how they always manage to do a feature segment about how one athlete in particular can be a wife, terrific mother and….a super athlete! There is always that subtle attempt to disprove the stereotype that being a female athlete does not automatically make you a lesbian.

No kidding?

I guess it’s not quite such a miracle when a male athlete can father a child or two or three.  Some of them may even be with his wife, if he’s married.

Another angle to consider…

I'm sure athletic wear companies know they are getting many new female runners and walkers entering the sport for the first time via the Komen 5K and 3 Day gatherings.  I’m certain that the pink overlap between Komen’s "Race for the Cure" and the increasing amount of pink running gear being sold by race sponsors is no accident.  

Women’s bodies are different and we do have different needs.  Companies that market a smart, well thought out product that fits my 4’11’’ frame, will earn my dollar and my loyalty.   But don’t dare give me a dumbed down, low grade version of something.   I want a real product with the same features and colors available to men without the pandering and condescending attitude that pseudo-feminizing the technology conveys.

Once again there’s that unspoken bugaboo that’s being addressed.  The message is, you can run and sweat and still be a “real woman” if you wear these pink shoes/shorts/shirts/hats.  No one would dare suspect you are a lesbian if you drape yourself in pink gear because it has magical powers and serves as a counterweight to ward off the perceived masculinity of any sport.

The same pink paintbrush is often swept over other items like tools, guns and electronic technology-items that are not traditionally considered women’s products.  Or so the marketing people think.

Pinking” an item becomes an apology, an acknowledgment that yes, this isn't normally something a woman would buy but coloring it pink makes it not only appealing but permissible.

I don’t need anyone’s permission for anything.

It also carries over somehow into the Komen Foundation’s annual October onslaught of pink ribbon adorned products, some of which are actually unhealthy, all designed to get us to “think pink” regarding breast cancer awareness.
Is this really necessary?

Do I want people to be aware of breast cancer and the steps they need to take to help prevent/diagnose or treat the disease?

Of course I do.


Must we dress it up cute as a puppy to raise awareness or dumb it down by pinking it up?

Putting something as dark and insidious as breast cancer on the shiny, pink marketing wagon is more than surreal. 

It’s ridiculous.

More than ridiculous-it’s insulting.  

No one mentions that MEN also die of breast cancer-but that is quietly pushed aside.  I really feel some pain for the men that are struck by a disease that is so hyper feminized.  What kind of effect does this have on their mental state?  How do they hold on to their masculinity on their journey through the world of pink super saturation?  From diagnosis to treatment there is a constant assault on their Y chromosome.  When a man discovers a lump, they generally have to go to the "women's health or women’s imaging center" within the hospital to get their mammogram. I know of at least one company that has gone so far as to market a breast specific MRI scanner that has pink trim. 


I have seen men snuck in through back hallways of a hospital because someone thought they might make women uncomfortable if were they to sit in the regular waiting area with them.

Even when allowed in the waiting area, they must sit in a pinked out room, plastered with pink ribbons and women’s magazines reminding them everywhere that breast cancer=pink, which if we recall from our original formula, pink=woman, so where does that leave men with breast cancer?  

What I find particularly egregious is that many breast cancer support groups explicitly ban men outright.  This is so that women may engage in “girl talk”, or other some such nonsense is how it’s been explained to me.     

If they understand nothing else, Komen knows marketing, (many members of their board of directors came from the fast food industry) and they know that women have been conditioned to respond to pink when it comes to making purchasing decisions.  

Yes, it raises money for a cause that affects many women, and they have done some good, but they have unbalanced the equation. 

Let’s see if you can solve for pink:

Given that Pink=Women and Pink=Breast Cancer, does that make pink the square root of women with breast cancer?

What peculiar calculus allows for pink to hold more than one value?

Is there a standard deviation? 

It’s not adding up to me.

What I have personally witnessed over and over is this…

Certainly not all, but so many women spend their entire lives so wrapped up in their families that they have no other interests.
They have nothing that THEY do, as an individual that brings them personal satisfaction, be it a hobby, a sport, a craft, anything.  Their entire lives revolve around being involved with what is going on with other people, their spouses, their children.

They are completely subsumed as human beings and do not exist except as an adjunct to others.  Is it any wonder they are drawn into soap operas, fantasy literature and 50 Shades of Grey?

When women like this get breast cancer, as devastating as a diagnosis is, it’s the first time in their lives that attention is focused on them.  For this one moment in time, for the first time ever, something is all about them and they revel in it.  Not that any of them will admit or understand this, but I have seen it.  

Sadly, for many women, cancer is the most significant event of their lives. It’s all they have that makes them special and they hang on for dear life.

Suddenly, they are the center of the universe and their lives now revolve around the culture of breast cancer. 

This is very normal at first, for anyone with any type of a cancer diagnosis.  It is very useful to have support from a community, be able to ask questions, in order to gain an understanding of what they are going through medically.

Years later however, many women who have survived, never seem to move on, all the while nurturing open ended pity parties.  

Being a SURVIVOR, is the first thing you discover about them,
because, thanks to Komen Foundation events, and a million other online message forums, these women are given a new identity.  They belong to a cool new sorority. And of course, this sorority has a special uniform- any pink adorned product that screams I AM A SURVIVOR.  No need for a secret handshake because whether it’s the ribbon on their car, the license plate, their T-shirt, their hand bag, or their hat, they now have a visible way to identify their “bosom buddies”.

They buy into it and it owns them.

There are gatherings, and walks and all sorts of fun things to do with their new “sisters” and instead of learning to move on from a breast cancer diagnosis, they become mired in it and it becomes the crux of their existence.  Being a victim becomes full time occupation for them.

What I find pitiful is that Komen understands this and uses it.  They promote the wallowing, because it keeps them, shall I say, “well endowed"?  

 Don't get me wrong, I do believe that surviving cancer is something to be proud of, but I refuse to tattoo it to my forehead in order to draw attention to myself.  Whenever I come across someone needing medical advice or support I always gladly offer it, but moment to moment, cancer is no longer part of my life.

 It shouldn’t be.

There will never be a pink ribbon on my vehicle or my clothing. 

Displays of triathlon or marathon triumphs, cute sayings about my dog’s intelligence, politics or my favorite microbrew, rate much higher than pink ribbons for me. Ask me how many pull ups I can do, how much I can deadlift. Ask me about my work or let me show you the latest, crazy cat video I have made.

 I want a first impression to be about who I am, and what I do, not what happened to me. I would never hide it, but it's not first and foremost.  It's certainly not paramount.  It shouldn't be. 

I am greater than the sum of my treatments; 

I am not less than the remainder of my parts!

I am and have always been, much more than a diagnosis.

Wednesday, January 5, 2011

In Memoriam

In the summer of 2002 I flew to New York for a vacation.  It would be my first time back in the city since I’d moved away.  The landing approach to Newark Airport was where I caught my first glimpse of the World Trade Center site.   Even though it had been months since the bombings, a small, thin, column of rising smoke and dust, could still be seen.  Gazing out of the window, I recalled the endlessly replayed scenes of collapsing concrete and smothering dust that had shrouded everything in its path.

I closed my eyes.

The day I visited ground zero, was a disturbing one. Tourists were everywhere, scurrying around the protective fence line looking for gaps so they could take pictures of the damage.  As a New Yorker, all I could think about, all I could sense was what wasn’t there.  My anger escalated the longer I stood there.  It was projected in multiple directions at once; at the terrorists and also now at the tourists that were gawking at the concrete crater.   Somehow, I felt it was completely disrespectful for people to stand there casually eating hot dogs and having their pictures taken.  At least ten street vendors were selling all kinds of clever T-shirts.  


What happened here was no accident, nor random tragedy.  Deliberate, sinister intent flew those airplanes into the buildings and now this spot was turning into damned Disney world.  I felt that this place deserved the same solemnity reserved for war memorials and concentration camps. Suddenly, I felt off balance.  I was disoriented for a moment and then it slowly dawned on me why. Everyone around me was looking down at the wreckage; I had been looking up at the empty space. 

The buildings were gone.  

Bright sunlight poured down on Broadway where it hadn’t shone for many years. 

The twin towers (as most New Yorkers referred to them) had not been mere landmarks but served as tremendous anchor points for the entire island of Manhattan; for all of New York City.  You could never be lost in New York when you could see the towers.  Without them the entire island of Manhattan was now free floating and somehow set adrift.  I knew exactly where I was standing but I was still lost.

I decided to change my perspective and walk around the block.  When I came to Trinity Church’s St. Paul’s Chapel I stopped.  Covering the walls and makeshift fences was an amazing collection of signs, photographs, flags and personal items from all over the world. It was as sad as it was fascinating.  The entire area had been transformed into a spontaneous memorial site.

 Once again, my mind drifted from presence to absence.  What about all the people that weren't there that day. Where were their shadows? I tried to think about everyone that didn't punch their alarm clock that morning, sip coffee, kiss someone good bye and go to work.  So many names were on those signs and photographs it boggled my mind.  I closed my eyes and tried to imagine who those people were, what they felt when the insanity struck.  I imagined the ones killed instantly to be the lucky ones, compared to those that were burned alive in elevators, or sat, hopelessly waiting for help in the floors above the impact zones. What about the ones that were able to call their loved ones and tell them goodbye? Such gruesome, modern theater thanks to technology.  I looked back to the sky and tried to imagine what horror there must have been inside the burning towers, the kind of horror that drove people to voluntarily jump to their deaths hundreds of feet below.   I thought about the sights and sounds of bodies thudding on the pavement and I could almost see their shadows rapidly approaching the ground.  I shivered just a little.  I wanted to empathize, not just sympathize. I wanted to feel everything that happened there so it would burn an impression in my psyche.  I stood in sunlight but it should have been in the shade of their shadows.  Where were the people…the buildings... the dust, all that dust...?  I knew I couldn't change what happened, but I wanted to walk away from there doing their memories justice, in my own small way.  I tried to mourn each one by acknowledging the pain of their sufferings in my heart.  

I read something a long time ago that was written by a rabbi that had been an army chaplain during the liberation of the concentration camps.  He had entered the death camps with his unit and came across stacks and stacks of bags marked "DÜNGER" (Fertilizer).  When he opened one he realized that they were filled with the dust and ashes of the crematoria. He plunged his arm deeply into the bag, up to his elbow to feel it, grab as much as he could so that he would never ever forget what he’d witnessed.  Perhaps that is what I was trying to do, as I stood there staring at the sky, I’m not exactly sure. For me, the dust somehow connects the tragedies. 

If you visit the area now, I am sure things are much cleaner.  I have heard there are even organized tours.  I will not make political commentary about memorials in Manhattan but I will say this:
With any tragedy, particularly those that underscore the human capacity for cruelty, we must find a way to honor the legacies of those who died.  
We must incorporate those who died into our hearts and souls, and to let them lead us to act in ways that will honor them. We must allow them to inspire us to fully embrace life to the extent that they were denied and to work to prevent the endless repetition of history.

Note: According to Trinity Church’s website, “Opened in 1766, St. Paul's Chapel is Manhattan's oldest public building in continuous use - a place where George Washington worshiped and 9/11 recovery workers received round-the-clock care”.