I waited one year to the day after September 11th before returning to New York to visit my family. In many ways New York looked like it always has with the exception of an entirely different vista where the Twin Towers once stood. Now there is a gigantic opening bringing out smaller buildings into relief. My eyes were drawn to the gothic spiral of the old Woolworth Building which had been almost invisible while the Towers were standing. The Battery of lower Manhattan has a fresh look about it – there is a tranquil garden walk along the Hudson River on the west side facing New Jersey, which must be an oasis for office workers looking for a picnic during lunch hour. Away from downtown, New York was as vibrant as I ever remembered it, and Long Island may have been any suburb of a large metropolitan area. Yes, there is Ground Zero and the federal and police buildings are all barricaded and required briefcase X-rays, but New Yorkers seem to be back to being NEW YORKERS.

                A few individuals involved in last year's rescue efforts are beginning to suffer significant respiratory problems due to their inhalation of the particulate debris from the explosion and fires. The inhaled dust containing concrete, silicon, steel, asbestos and many other materials has begun forming pulmonary fibrosis in many involved firemen and police workers who wore minimal respiratory protection. Most of these individuals are receiving medical attention for cough, bronchial congestion, dyspnea, phlegm and other related chest and allergy symptoms. Their work efforts are now beginning to show disability. Like other victims of inhalant disability such as coal miners, asbestos workers, feather and fabric workers, this respiratory impairment has little effective medical treatment available. Occupationally one of the most surprising fields where workers are developing some form of respiratory fibrosis, is among the workers manufacturing the special butter for instant popcorn which has caused respiratory distress in some workers after only a minimal exposure. While particulate inhalation has been the most obvious toxicity reported by examining medical specialists, other forms of toxicity have assuredly occurred during the September 11 debacle. The jet fuel combustion allowed for inhalation of petrochemical byproducts as well as other organic chemicals. Heavy metals used in the building materials including lead, arsenic, cadmium, mercury, nickel, tin, and possibly radioactive elements were undoubtedly atomized in the heat exceeding 2000°F and were inhaled during rescue operations. These elements would not have been only retained within the lung alveoli but were absorbed within the blood and circulated to bone, fatty tissue, brain, and internal organs.

                 Although clinical medicine has not generally broadly examined patients for absorption of organic chemicals and toxic elements, such examination has been pursued by alternative medical practices. It is a fact that has been largely belittled by medical authorities that the general public has been accumulating these toxic substances gradually over the years not just in manufacturing occupations, but in general work duties at the office and at home. Perhaps the most outrageous and underreported toxic element accumulation has been the element mercury. Still the Public Health authorities made headlines this year with their new guidelines to pregnant woman who were recommended to avoid eating tuna fish as well as swordfish (why not salmon as well?) because of mercury content in the fish. It is perhaps the height of hypocrisy to advise avoidance of tuna fish but to make no comment about dentists drilling cavities and filling teeth with amalgams containing 50% mercury. Infant vaccinations containing mercury preservative would appear to be dangerous to a toddler's nervous system, but vaccines are administered regardless according to pediatric schedules.

                 Given the widespread problem of toxic element and organic chemical bioabsorption, it would seem that medicine would be interested in directing some public health efforts at detoxification. Regrettably detoxification is limited to acute and chronic poisoning only, not to accumulation which has been deemed to be lower than an arbitrary safe limit. The limits of safety are generally right up to the level determined to be poisoning. Hence, a level of toxin accumulation at 50% of the poisoning level would be deemed to be within acceptable limits and would require no treatment. With such a cavalier disregard for partial accumulation of toxins, medicine essentially ignores toxic element and organic chemical lab examinations and treatments. While the primary family doctor will gladly check for cancer, heart disease, anemia, diabetes, no tests will generally be made for mercury, arsenic, or lead, much less PVC's, pesticides or petrochemical residues. Part of the reason for this is that medicine has developed no basic, means for detoxification.

                 Proponents of natural and alternative medicine have largely taken over this role of assessing and treating toxicity. Detoxification procedures play a major role in the naturopathic physician's approach to patient health. The scope of detoxification procedures ranges from the folk remedy approaches of fasting on water and juices to more sophisticated strategies involving selective use of herbals, amino acids, vitamins, minerals, protein powders, as well as cleansing techniques generally focused on the bowel. Toxic metals are highly attracted to chelating agents which vary from foods such as garlic and cilantro to amino acids including EDTA which is generally administered intravenously.

                 Politically because most MDs avoid detoxification treatment strategies while most natural and alternative practitioners focus on detoxification and chelation, the MDs and natural practitioners are often at odds in their care of patients. The MD tends to judge the detoxification process to be unnecessary and ineffective and potentially harmful; the alternative practitioner insists that detoxification is key to a return to vibrant health and healing. How the patient is able to balance treatments administered by the MD and the natural healer often makes the difference between cooperative and antagonistic health providers. Unfortunately, a bad detoxification experience and poor patient outcome is frequently the starting point for disciplinary action and malpractice claims. The natural practitioner must always maintain a vigilant stance during the process of detoxification and chelation to ensure patient safety and to redirect the patient to standard medical treatment when symptoms and signs indicate the likelihood of a poor outcome. (This may be the time when a little less physician arrogance and a little more humility may be due.)

                 In this issue of the TLDP, we examine detoxification and chelation from many vantage points. It is very clear that the methods of detoxification are widely varying; it is equally clear that chelation proponents argue for many different methodologies. We welcome reports from you on your detoxification techniques and strategies.

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