Editor`s Opinion: Before and After

  Our October issue went to press just before September 11. How the world has changed. Before September 11, most conversations and correspondence began with "How are you?" followed by the standard reply, "Fine, how about yourself?"

After September 11, most conversations began by asking your conversational partner if he or she was personally affected by the tragic events of that day. Before September 11, the terms survivors guilt and post traumatic stress syndrome were the stuff of professional healthcare jargon. Now, they are part of our everyday vocabulary because countless numbers of people are experiencing these conditions. Some people were directly affected by the attacks: the families and friends of the deceased and missing, the search and rescue workers, the people who were supposed to be in the targeted buildings or hijacked airplanes but had a change in plans. Most of us managed to escape the immediate terror, but not the residual emotions. Thousands of healthcare professionals stood ready to assist but didn't have victims to help. Others continue to care for the victims with resources that already were spread too thin.

  Technology gave ready access to the horror, unnerving us with vivid, brutal images. We weren?t immobilized by falling debris; we are immobilized by our sentiments. I continue to find myself overwhelmed by a sense of loss, an inability to focus on the mundane tasks at hand. Others share similar feelings. Patients who were always prompt forget their appointments. The person whose diabetes had been perfectly controlled for years indicates that he has "given up" trying to maintain optimal glucose levels.

  Ever impatient to heal wounds, it is frustrating to realize that familiar protocols do not work. They cannot because the condition of our world has not stabilized. You cannot treat an unstable patient. Yet there is this yearning to do something, anything, and the best you can do is to conduct what our leaders are calling "business as usual"... all-the-while trying to assure yourself that is the best thing to do. No one is pretending that it will be business as usual ever again. However, I believe that we, as clinicians, must focus on the seemingly fragile stability of providing care as usual: to treat what can be treated, to prevent what can be prevented. It may not allow us to make sense of the events before, during, and after September 11, but it has the potential to restore our sense of purpose.

  We - the editors, Editorial Review Board, and Ad-Hoc Panel members of Ostomy/Wound Management - perpetuate the editorial process because we keep telling ourselves that we are providing necessary information that at some point may be useful in the preservation of at least one body or mind. The physical and psychological effects of this most dreadful day and its aftermath will last for a very, very long time. By the time you read this issue, chances are that the number of persons whose lives changed as a result of September 11 will have increased, as will our joint determination to help them. My thoughts and prayers are for all of us.