This is the case of a 44-year-old captain in the New York City Fire Department who had not been feeling well since the events of September 11, 2001. Immediately afterwards, his sleep was very restless. As the months wore on, he became increasingly irritable, depressed, and fatigued. Previously, he had been a man of extraordinarily high energy, always on the go, with a sunny disposition. His low energy and ennui were significant changes. He came to see me on March 12, 2002.
A firefighter’s story
“I get a deep feeling that something bad happened and I think about families left behind and guys I knew,” this NYFD captain told me. “It comes with the territory. I feel desperate for the people I know and the people left behind. There’s so much to do, to help the families. I feel responsible to help. I feel guilty that I should be doing more but I’m trying to hold down my end.
“My spirit is wounded. Part of me died. The optimistic part that said ‘I can do anything.’ I’m just tired, man.”
“My best moments are when I’m at work, when I’m occupied, with the guys. When you are removed from that, there’s loneliness, a detachment, you drift, your mind swirls. I have a sense of the total despair of what went on. 343 guys are dead. 50 of them I knew. Maybe another 10–12 attached to each guy that I knew. Now it’s about 500. We all lost them and their families. You mourn for now about 1,000 people. It’s an open wound. And all these people that weren’t NYFDâ€”they have no one to care and they’re in trouble.
“At work, we do what we do and it’s alright. There’s a loneliness. The lossâ€”how devastating it is. I know what the families are going through. The wives, brothers, sisters, children. I have a sense of despair. I can feel the pain. I wish I was doing more. There’s plenty to do. Visit the families, etc.”
“I have a certain level of anger but now it’s more with my wife. She’s not understanding me.”
“I feel like my stamina is down. I don’t have the will to get up and go. I’m happy doing absolutely nothing. I’m down, physically tired; my energy level is down.”
“My focus/attention is down a couple of notches. I miss a couple of things here and there at the officeâ€”payroll, schedules, vacations, leaves. I used to have a bead on everything; now it’s harder to keep a bead on it all.”
“My military training helped me cope. You learned how to keep the unit under control, deal with the reality of it. I was a commissioned officer.”
I asked, “Do you feel like your heart is broken?” He said, “Absolutely. I told you that. That’s what I’ve been saying.”
A wife’s story
A pattern that I’ve noticed among firefighters dealing with the trauma of September 11 is that the wives are the ones who notice the changes; they tell me about it or talk among themselves. This patient’s wife told me, “He feels obligated to a dead firefighter because he got him the job. He feels guilty. He takes care of this man’s mother and girlfriend.”
Commenting on his irritability, she said: “Nothing is good enough. He says I don’t respect him after everything he’s given me, the house, etc. He thinks I’m manipulating, pathetic.
“His moods alternate. At the funeral home he called me his rock and at dinner he called me a bitch. He’ll tell me, ‘You’re stupid, you’re not doing it right.’ He’s always right. He’s never wrong. He never apologizes. ”
“He’ll sit in front of the fireplace and stare into it. He thinks I’m barging in on him, on his reveries.”
I chose the following symptoms/repertory rubrics for this case from Murphy’s Homeopathic Medical Repertory (unless otherwise noted):
Mind: Despair, about others
Mind: Guilt, feelings
Mind: Responsibility, over responsible
Mind: Weary, of life
Mind: Concentration, difficult
Mind: Company, desire for
Mind: Work, ameliorated from work or diversion
Generalities: Worse, winter months
Generalities: Nighttime aggravation
Mind: Weakness of memory, inability to reflect, prostration of soul and body (Hering)
Mind: Weary of life (Hering)
Mind: Feeling as if lost (Kent)
Prescription: Aurum metallicum 200C, one dose.
This man is a firefighter, a soldier as it were, who is in a position of command. He is a man who keeps his personal feelings to himself and tends not to speak about the negatives. He loves his job and the camaraderie of his men in the firehouse. He is the type of person who would always be there to help a person out.
Catherine R. Coulter in her Portraits of Homeopathic Medicines, Volume 3, describes the remedy Aurum metallicum (gold) in an apt way for this case. “Gold is the simillimum for the individual placed in a position of honor or trust who, through some misfortune, finds his reputation or promising career on the brink of ruin. In fact, it is due to the type’s intrinsic high-mindedness and delicate scruples of conscience that one encounters, at times, a dramatic quality to his crisis of ego, as if a mighty oak were struck down with a single blow.” This is a wonderful analogy to the falling of the World Trade Center and the patient’s reaction to that event.
Edward C. Whitmont, MD, in his book, Psyche and Substance, says, “Gold is the earthly representation of the Sunâ€”thus, the human imagination has associated gold with light and warmth, vitality and good cheer. The pathology of Gold fits personalities with serious, over responsible and depressive character. Usually, they are active and intrinsically strong people who feel they bear heavy responsibilities often experienced as overwhelming. Their pathology expresses the tension between their sense of responsibility, their will and felt call to control people and circumstances, as over the existential limitations they encounter.”
J.T. Kent says about Aurum: “Such horrible depression of spirits that there is an absolute loss of enjoyment in everything. You take away a man’s hope and he has nothing to live for, he wants to die. Such is the state of this medicine.”
C.M. Boger says the following about Aurum: “Midway between a merely pessimistic attitude and sinking into absolute despair lies a ‘brooding melancholy.’ … So fault finding with girlfriends, he sabotaged every relationship. Nobody and nothing was good enough for him.”
Later that day after this NYFD captain took Aurum metallicum, he phoned me. “What was that stuff you gave me? About a half-hour after I took it, I felt immediate relief in the right temporal lobe. Relief, like a tranquilizer, relaxed. My whole body. This is pretty powerful stuff.”
3/18/02: “It cleared my head. The despair lifted. It was pretty amazing. I felt physically relaxed, like a Valium. Can I buy a bottle of that stuff?”
Plan: Wait. The remedy is acting.
His wife told me: “I see a major improvement.
He’s so loving and sweet. We went out last night and he was so open and expressed himself. We had a wonderful time.” She said he was more calm, not depressed. He told her that he had some ambition again. He told her that he loved her.
A few days later he yelled at her, but soon apologized for it. “He has never said he was sorry in our whole marriage!” she told me.
3/21/02: “I have good energy,” the firefighter reported. “I went swimming.” I asked him about his “wounded spirit.” “It’s just got to run its course,” he replied. “After the job is done at the World Trade Center, they’ll hang plaques and then it will be ‘moving on’ time. There’s an order to things.”
Plan: Wait. The remedy appears to be acting.
4/2/02: “I haven’t felt this good in years,” he reported. “I feel so relieved and have energy and inspiration to do things again.”
4/5/02: “People say, ‘you’re glowing, man.’ For a long time, I was missing something. This whole thing was rejuvenating. I can’t remember feeling this way. It’s been a long time. I feel like I’m at cruising altitude again!”
7/9/02: Three months later, the captain’s condition had changed. “I’m short fused,” he reported. “I’m not in the zone where I was. I’m gritting my teeth at night. I’m not sleeping well. I can’t remember my dreams, but they’re not good. I notice planes flying overhead more. I used to look at the World Trade Center from here, and now I have an empty, hollow feeling. I’m anxious. On July 4th, I was uncharacteristically angry and got involved with neighbors fighting over a parking ticket. I’ve never done something like that in all the years I’ve lived here. Things that didn’t used to bother me, do now. It’s hard for me to focus. I have decreased optimism. I’m overwhelmed. I have too much responsibility. Too much on my plate. My wounded spirit is back. My senses are dulled a little bit. I felt more in touch, alert before. I’m getting dulled out by the pain: the pain of what happened across the boardâ€”the whole tragedy of it. The senseless, mindlessness. You know what’s weird? I think of those people on the plane. Did they have their window shades open? Can you imagine? What a horrific ending.”
Plan: The remedy appears to have stopped acting. Rx: Aurum metallicum 200C, one dose.
7/11/02: His wife reported: “About 12 hours after you gave him his remedy he came upstairs and said, ‘I’m sorry.’ I’m married for 12 years and the only two times that he has ever said he is sorry is right after you give him this remedy. It’s amazing! He turns into a whole new person.”
7/22/02: The patient reports: “It took a while longer to kick in this time but I’m feeling, you know, more centered. Back on track.”
Plan: Wait. The remedy appears to be acting.
Nancy Gahles, DC, CCH, RSHom(NA), NCH President, practices homeopathy and chiropractic in New York City and Belle Harbor, NY. She operates Health and Harmony Wellness Education which offers consultations and symposia on Complementary and Alternative Medicine and Integrative Medicine. She also serves as a CAM expert on the panel of Mothering Magazine.