Lost in the Dust of 9/11

There is no voice left in Manuel Checo’s voice. He speaks in a granular rasp that fades, occasionally, to whispery puffs of air. Sometimes, for periods as long as two days, he is unable to speak at all.

When that happens, Checo carries a pad of paper with him so he can scribble down notes if he needs something. But for the most part, he will simply disappear into his rented room, ignoring his cellphone when it rings.

Checo, a janitor, spent six months cleaning dust from office buildings around ground zero after the World Trade Center attack. Five years later, the lining of his lungs is pocked with scars and densities that do not belong there -- possibly a sign of a disease that can cause lung tissue to become so stiff that it can no longer carry oxygen, wrote a radiologist who examined a scan of his lungs last year.

The son of a general in the Dominican Republic, Checo, 54, irons his shirts with military precision. When he meets a woman on the street, he kisses her hand. But the truth is that when he discovered that he was too weak to work again, his life veered terribly off course. He was evicted from his apartment and slept in his car for six months. Acquaintances didn’t understand his racking cough and thought he had tuberculosis or AIDS.

Whoever he was before Sept. 12, 2001 -- when a supervisor from his company called to tell him there was work near ground zero -- he is a different man now. Sometimes he is overwhelmed by the feeling that he has lost his way.

“I get up, I get dressed,” he said, in Spanish, through a translator. “And then I say to myself, ‘Where am I going?’ ”

The dust around ground zero, we now know, contained caustic, finely pulverized concrete, trillions of microscopic fibers of glass, and particles of lead, mercury and arsenic, as well as carcinogens like asbestos and dioxin. Five years out, the “World Trade Center cough” has started to look like a persistent -- and in some cases disabling -- respiratory condition.

An ever-growing number of New Yorkers is coming forward to describe symptoms: the first responders who plunged into the tangled wreckage to find survivors; the volunteers who hauled diesel fuel and doled out cigarettes; the students at Stuyvesant High School who returned to classes while acrid fires burned nearby.

Less visible is the army of cleaning workers who were sent to the area to clean office buildings. Those were the cases that were shocking to Scottie Hill, a social worker, when the Mount Sinai Medical Center opened its WTC health clinic in 2002. The cleaners, mostly Polish and Latino immigrants, were already living close to the edge when the job began; by the following year, many were in crisis because of lost wages and poor health.

Three out of four lacked health insurance. Forget workers’ compensation -- many of them could not even contact their employers by phone. Hill frequently saw clients who were facing eviction or had lost their homes. Some couldn’t afford the $4 it cost to ride the subway to the clinic and back.

A few of the immigrant workers, too sick to support themselves in the U.S. anymore, have returned to their home countries. But that decision is fraught, too, because relatives back home -- or doctors, for that matter -- may not know what is wrong with them. Jaime Carcamo, a psychologist who treats 50 Latino workers who cleaned around ground zero, said some of them, finding that they were unable to work, simply withdrew from society.

“They just remain like nomads,” he said. “Some of these people just fell into the cracks. People don’t know about them, but they’re out there still.”

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It is ironic, then, that Checo remembers the job so fondly. He had been a U.S. citizen for almost a decade by then, and working around ground zero gave him “so much sense of brotherhood,” as if he were descending into the pit every day with police and firefighters. It was an environment stripped of class, of racism. What he says about the experience is this: “Something so bad created something so beautiful.”

He worked a night shift as part of a two-man team with Alex Sanchez, a fellow Dominican 15 years his junior. Using a handsaw, they would cut two holes, each large enough for a man’s torso, in a building’s air vents. Peering into the dark passageway with a flashlight, all they could see was dust, glittering in the dark. Then one of them would hold up a hand vacuum, and the other would switch on an air hose, and both would disappear in a cloud of dust.

Tons of material had settled in the buildings. When terrorists crashed two planes into the World Trade Center on Sept. 11, its two towers collapsed with such force that dust and debris poured in and upward through the ventilation systems of the buildings around them. It was up to landlords to decide who would clear the buildings, and many chose cheaper labor: men and women who days before had been emptying trash cans and dusting computers.

The city’s Department of Environmental Protection generally oversees the removal of debris containing asbestos, but that system was informally abandoned after Sept. 11, according to David Newman, an industrial hygienist with the New York Committee for Occupational Safety and Health, a coalition of union leaders and safety activists. Landlords got no guidance from state or federal agencies, leaving them “free, if you will, to do whatever they wanted, or to do nothing,” Newman said. “It was kind of a Wild West.”

Checo and Sanchez wore paper masks that covered their noses and mouths when they were available -- about 30% of the time, Sanchez said. But the dust permeated everything; a T-shirt that was white at the beginning of a shift would be mousy-gray by its end. Anyway, health was the last thing on their minds. They were making $18 an hour, plus time and a half for overtime, instead of the $12.75 an hour they earned cleaning university buildings. It was good money. It was a good cause.

What was painful, oddly, was leaving at the end of a shift; that’s when the hopeless, leaden feeling sank in. Sanchez, 39, who was born in the U.S. and wears hip, Woody Allen-ish glasses, recalls making a conscious effort to tune out at the end of the day. Back in his apartment in Washington Heights, he would watch silly, diverting television shows. Then he would collapse in bed. He had no idea whether the air was safe to breathe because he didn’t ask.

“If we all used common sense, we would say, ‘This is not a healthy environment,’ ” Sanchez said. “But the whole 9/11 situation itself kept you from thinking.”

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Sanchez figured he deserved to be exhausted at the end of the job. But this exhaustion was depthless, unfathomable. In May, when he tried to return to his ordinary job -- buffing floors at New York University -- he got dizzy and his chest closed up. He lasted six days, then went back to bed. He, his mother and his son had moved in with an aunt to save money, and both women were pressuring him, angrily, to go back to work. At one point, the fighting grew so stormy that his mother called the police.

Sanchez’s world revolved around his symptoms: fatigue, joint pain, pressure in his chest, a sore throat that would not go away. Only one person seemed to believe him, and that was his work partner, Checo. The sickness drove them closer to each other, and farther from everyone else. “Me and him, we’re a team,” said Sanchez.

Checo had his own set of problems. Because of a bureaucratic mix-up at the company where he worked, ABM Industries, he was unable to receive unemployment benefits, and he ran through his savings so quickly that in the summer of 2002, he took a few of his possessions and moved into his car. He began to tell Sanchez that there were shadowy figures following him. Asked how Sept. 11 had altered him, he rasped out this answer:

“Every man -- every great man, every evil man -- has feelings,” he said. “No matter how rough you are outside, you have a weak spot. 9/11 hit me in my weak spot.”

Soon after the first anniversary of Sept. 11, Checo called Sanchez with exciting news: He had been watching a news show when Sen. Hillary Rodham Clinton appeared, urging ground zero workers to go for screening at the Mount Sinai Medical Center’s new clinic. “Boom. I put one and one together,” Sanchez said. “It’s like, ‘This is why this is happening.’ ”

The day they went in for appointments, everything changed. Checo was diagnosed with rhinitis, sinusitis, asthma, chronic post-traumatic stress disorder, major depression, delusional disorder, and schizophrenia, paranoid type. Sanchez was diagnosed with asthma, sinusitis, gastroesophageal reflux, various musculoskeletal injuries and post-traumatic stress disorder. Each now takes fistfuls of medications.

The two men don’t see their old circle of Dominican friends as much these days, Sanchez said. New friends have replaced them: doctors, therapists, environmental activists. In 2004, Sanchez and Checo traveled to Washington to testify before an Environmental Protection Agency panel.

Both now receive regular workers’ compensation payments -- Sanchez receives $243 a week, Checo about $350 -- and free healthcare at Mount Sinai. They are among 75 plaintiffs who have filed a $30-million lawsuit against the owners of dozens of office towers in Lower Manhattan. But that case is not likely to go to trial for at least two years, said their attorney, Robert Grochow.

In the meantime, Sanchez and Checo shuttle from appointment to appointment. Each man carries a sheaf of medical records and hospital bills around with him -- artillery in an ongoing battle to get care. The future is something they do not focus on. But this is not unusual, said Carcamo, the psychologist.

“We don’t know what is ahead of them,’ ” he said. “They often ask me, ‘What am I going to do?’ To be honest about it, I am not sure.”

Sanchez is jerked back to ordinary life by the demands of his son, Jack, who started kindergarten this fall. But Checo still seems a bit lost as he walks slowly down Broadway, stopping every now and then to catch his breath. What undoes him, as he waits for the next round of doctor’s appointments, are the trappings of ordinary life that have slipped away from him: for instance, the collection of jazz recordings that he gave away when he was evicted.

In the black vinyl folder that he carries around with him -- it contains, among other things, the program from his father’s funeral -- is a photograph of himself kneeling in front of a softball team, the J-Boys, for whom he played center field until he got sick. In the picture, he is dark-haired, vigorous. It was taken a few weeks before the World Trade Center attack. He looks at it, occasionally, to remind himself who he was.

ellen.barry@latimes.com