In her novel Ask Me No Questions [1] Marina Budhos tells a 9/11 story that is very different from the one most Americans would recognize. Her narrator, Nadira Hossain, is the younger of two teen-aged sisters in a Bangladeshi immigrant family living in New York but, like many in that community, without legal residence status. After 9/11, when immigrants from Muslim countries become the object of public fear and suspicion and greatly increased government scrutiny, their father is sent into detention as an illegal alien. The family’s life is upended — and with it, Nadira’s and her sister’s sense of who they are and where they belong. This story, Budhos told the ACIA conference, represents the “invisible” narrative of 9/11: the experience of Muslim teenagers, particularly Muslim girls, in the post-9/11 United States.

Ask Me No Questions  was named one of the year’s Best Books for Young Adults by the Young Adult Library Services Association, and also won the first James Cook Teen Book Award. Budhos’s other books include Tell Us We’re Home, The Professor of Light, House of Waiting, and Remix: Conversations with Immigrant Teenagers. Budhos is also associate professor of English and Asian Studies at William Paterson University.

Budhos set the stage for her talk by reading a passage from the book’s opening chapter.

What I would like to talk about is how I came to write this novel. First I will read a bit from the very beginning because I think it gets to the heart of what I was trying to explore:

“I remember when we first arrived at the airport in New York, how tight my mother’s hand felt in mine. How her mouth became stiff when the uniformed man split open the packing tape around our suitcase and plunged his hands into her underwear and saris, making us feel dirty inside. Abba’s leg was jiggling a little, which is what it does when he’s nervous. Even then we were afraid because we knew we were going to stay past the date on the little blue stamp of the tourist visa in our passports. Everyone does it. You buy a fake social security number for a few hundred dollars and then you can work. A lot of the Bangladeshis here are illegal, they say. Some get lucky and win the Diversity Lottery so they can stay.

“Once we got here, Abba worked all kinds of jobs. He sold candied nuts from a cart on the streets of Manhattan. He worked on a construction crew until he smashed his kneecap. He swabbed down lunch counters, mopped a factory floor, bussed dishes in restaurants, delivered hot pizzas in thick silver nylon bags. Then Abba began working as a waiter in a restaurant on East Sixth Street in Manhattan. Sixth Street is lined with Indian restaurants, each a narrow basement room painted in bright colors and strung with lights with some guy playing sitar in the window. They’re run by Bangladeshis, but they serve all the same Indian food, chicken tandoori and biryani, that the Americans like. Every night Abba brought home wads of dollars that Ma collected in a silk bag she bought in Chinatown.

“The thing is, we’ve always lived this way–floating, not sure where we belong. In the beginning we lived so that we could pack up any day, fold up all our belongings into the same nylon suitcases. Then, over time, Abba relaxed. We bought things. A fold-out sofa where Ma and Abba could sleep. A TV and a VCR. A table and a rice cooker. Yellow ruffle curtains and clay pots for the chili peppers. A pine bookcase for Aisha’s math and chemistry books. Soon it was like we were living in a dream of a home. Year after year we went on, not thinking about Abba’s expired passport in the dresser drawer, or how the heat and the phone bills were in a second cousin’s name. You forget. You forget you don’t really exist here, that this really isn’t your home. One day, we said, we’d get the paperwork right. In the meantime we kept going. It happens. All the time.

“Even after September 11th, we carried on. We heard about how bad it had gotten. Friends of my parents had lost their jobs or couldn’t make money, and they were thinking of going back, though, like my father, they’d sold their houses in Bangladesh and had nothing to go back to. We heard about a man who had one side of his face bashed in, and another who was run off the road in his taxi and called bad names. Still people kept coming for pooris and alu gobi on Sixth Street; still Abba emptied his pockets every night into Ma’s silk bag. Abba used to say, ‘In a bad economy, people want cheap food. Especially cheap food with chili peppers that warms their bellies.’

“But things got worse. We began to feel as if the air had frozen around us, trapping us between two jagged ice floes. Each bit of news was like a piece of hail flung at us, stinging our skins. Homeland Security. Patriot Act. Code Orange. Special Registration. Names, so many names of Muslims called up on the rosters. Abba had a friend who disappeared to a prison cell in New Jersey. We heard of hundreds of deported Iranians from California and others from Brooklyn, Texas, upstate New York. We watched the news of the war and saw ourselves as others saw us: dark, flitting shadows, grenades blooming in our fists. Dangerous.”

This gets to the heart of what the book is about, an undocumented Bangladeshi family, a Muslim family, in New York at that time.

I’ll fill in a little bit on how I came to this story and what and what compelled me to write it.  A number of years before, I had written a nonfiction book called Remix: Conversations with Immigrant Teenagers. [2]  I interviewed teenagers from all different backgrounds, curious about their journey here.  Those interviews took place around 1996 and 1997, and I began to notice that there were certain teenagers who were talking about the Gulf War, Muslim teenagers.  And I realized that I had stumbled onto this invisible story or narrative, this invisible group that nobody is really talking about, particularly Muslim girls. We have all these ideas that those girls have to wear a hijab, or their parents are really strict, or they are not into education, and I was finding it far more nuanced and complicated.

Move on a few years.  9/11 happens and my interest again is in immigrant teenagers and their stories, what’s happening to them. I thought about many of the teenagers I had interviewed, Bangladeshi teenagers, Pakistani teenagers. I thought okay, I am just going to go out and find out.  So I started hanging around with teens, talking to people who were dealing with these communities, thinking I was actually going to write a journalist’s piece about this.  I wanted to do a profile of an undocumented teenager who was coping with the pressures of 9/11.  This was about a year after 9/11. The Special Registration program was in effect, requiring that male non-citizens 16 and over from 24 predominantly Muslim countries had to go register with the government. [3]  And what started to happen is these men would go down to register and when the immigration authorities found some kind of violation or some reason that they could detain them, hordes of men were being detained.

I would say at least 50 percent of the Bangladeshis in New York were undocumented. They are working in the kind of jobs that my character’s father had. Their children are trying to gain some foothold and their status is very ambiguous. During this period when Special Registration starts to happen and these communities are being impacted, they don’t know what to do.  Do they register and get caught, do they expose themselve, or do they go further underground and become more invisible? The amount of terror and fear that is rippling through these communities is very great, and they just don’t know what to do.

During this time Coney Island Boulevard in Brooklyn had a lot of Pakistani shops. Within months they are shuttered up , they are gone, people have disappeared, people are gone. The invisible became more invisible. And I began thinking, what about a young person who has been here six, seven, eight years and this has happened to her family. I thought about those girls I had interviewed five or six years before who thought their future was here, even though they knew there was ambiguity to their status, and suddenly the ground was pulled out from under them.

The other thing I thought about was that most of us were thinking about 9/11 as Americans.  I teach young people in New Jersey, and some of them have relatives or neighbors who were impacted.  And that’s their narrative about 9/11. But I was really interested in this other narrative that began about a year later when the crackdown started to happen in Muslim communities.  The federal government started to do raids on houses, knock on doors, and that’s when lot of deportations started to happen.  There is a scene in the book where they come knocking on the door in the middle of the night, immigration officers are there to take the girls’ uncle in for questioning. When I was working on the book with my editor, she said, oh, come on, you know it is getting a little too dramatic, this is not really happening. And I said, no, it really is happening.

I don’t think it was known to most Americans, the degree to which these kinds of tactics, banging down doors, men put into detention centers and if they do not have documentation, they don’t have the same civil liberties as Americans.  So you could have families not knowing for months on end where their father is or what the charges are against him in this kind of secret shadow world. That was the context that interested me, and trying to think about what it felt like from the perspective of a young immigrant — two girls who are also just dealing with being sisters, just dealing with the pressures of being teenage girls, thinking that their whole life was in front of them, and the rug gets pulled out from under them.

I want to talk a little bit about how the novel has been received by teenagers. When I gave a talk at a high school in the Bronx, a  Bangladeshi girl came up to me. She’s a star student, she is undocumented, her status is really unclear. She said, “you told my story, I can’t believe somebody would tell the story.” Again, it is the degree to which they feel invisible. I can’t say enough about how profound that is. And then the book has been brought into the classroom for American teenagers who might not ever have thought about that side of the story, because the narrative in their minds is the event of 9/11 — the actual event, the trauma, seeing the news over and over again or knowing a family of somebody who died. I remember one of my students talking about being on the Weehawken waterfront and seeing the smoke and so forth. Their response to the book is oh my god, I didn’t know, I didn’t know.  There is this other dimension, that there might be teenagers living among them whose immigration status is unclear, and they don’t know the signals. The teachers might not even know. I had letters from teenagers saying I was fairly well rounded, you know, knowledgeable kids, and they were surprised.

Educators have been looking for ways to teach 9/11, from kindergarten to grade 12. One new K-12 curriculum was just announced in New Jersey, called Learning from the Challenges of Our Times: Global Security, Terrorism and 9/11. [4] So that’s one way the book has been integrated into the American classroom, in teaching about 9/11. The other place it’s been taught is either in a teaching tolerance unit or in a middle grade social studies curriculum where it is paired with another moment in history, the Japanese internment in World War II. By now most good courses try to cover the Japanese internment. They teach the book Farewell to Manzanar, [5] and what I like about that way of approaching it is that it’s not only a historical perspective, it also helps look at differences: Pearl Harbor versus 9/11; who were the outsiders then in America when there was a kind of long-standing hostility toward the Japanese, especially on the West Coast, whereas the status of Muslims 60 years later was far more ambiguous — they were invisible, nobody really quite knew about them, and then suddenly their lives were turned upside down and this harsh glare was put on their landscape.

If you look globally, our immigration stories in America make a far more successful and happy story compared to what’s happened in Europe, what has happened in England. So I think one of the tragedies of 9/11 is that it set us back or set the tone in a different way. Muslim immigrant teenagers since 9/11 have been faced with having to defend  themselves. Are they patriotic enough, do they have the proper allegiances, do they belong in the United States, should they be here? This all goes back to 9/11.  It was not in the discourse before then. That’s what I was interested in, what is it like to be a young person thinking you are a part of this country, thinking that you are entering the mainstream, as invisible as you are, and suddenly your allegiances, your sense of belonging are called into question. That is what Muslim teenagers are thinking about now.

That leads me to a final point: there is a need for nuance with respect to Islam and Muslims. A lot of Americans tend to have one definition of what it is to be a Muslim. But really there are strains and different strands within those countries, and young people are impacted by these strains, whether within Bangladeshi society or Afghan society or Pakistani society. That’s very, very important. In the educational context, there would be no difficulty explaining that to children if we were talking about Christianity. We understand that there are different strands and different approaches, so I think there is no reason why they can’t see those nuances among Muslims.

Part of what I wanted to do is write a novel where being a Muslim is not the issue for the main characters. The issue is the pressures that are coming to bear upon teenagers who could be like any teenager to some degree. I am of South Asian background, though not Bangladeshi or Muslim, but I made my characters Bangladeshi. Why Bangladeshi? First of all there is a long tradition of support for girls’ education in Bangladesh. There are two sisters in the novel; the older sister wants to go to Harvard medical school. There’s a very very ambitious father who doesn’t care when people talk about whether she is going to get a good marriage partner. The idea of girls’  education and being an observant Muslim, that is not a conflict here. There has been a little bit more fundamentalism that has crept into Bangladesh  recently, but that’s not the tenor of the world my characters came from.

From the get-go I wanted to portray a family where that kind of conflict is not an issue — strict parents who want to keep their girls behind the veil or whatever, I did not want that to be the story of my characters because I did not think it was true with New York city kids. There’s a short scene in the book where one of the sisters was wearing a head scarf at school when they first came, and kids were making fun of her. She went home crying and her mother said, you know, take it off, it’s ok, we are here, we are just going to  have to deal. So the parents can be flexible. They are actually a love match, the parents,  which they aren’t in some of those stereotypes. We’re trying to work against some of those stereotypes.  So the choices I made in writing the novel were meant to broaden the discussion, to describe different flavors and textures in the way people experience being Muslims in this country.

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[1]

Atheneum Books for Younger Readers (Simon & Schuster), 2006.

[2]

Henry Holt & Co, 1999

[3]

The Special Registration program was in effect between November 2002 and April 2003. It applied to non-U.S. citizens from 25 countries, 24 of them predominantly Muslim (the one exception was North Korea). Males 16 and over from those countries were required to report to immigration offices to be questioned, photographed and fingerprinted. Of the more than 80,000 men who complied with the order, about 13,000 were put into deportation proceedings, most for overstaying their visas or other immigration violations.

[4]

The curriculum can be found at http://www.state.nj.us/education/holocaust/911/k12curr.pdf

[5]

Farewell to Manzanar: A True Story of Japanese American Experience During and After the World War II Internment. Houghton Mifflin 1973.

Dr. Cynthia Pfeffer is professor of psychiatry and program director of the Childhood Bereavement Program at Weill Cornell Medical College.  Her clinical work, research, and teaching center on child development, anxiety, depression, suicidal behavior, and bereavement. At ACIA’s conference, she spoke about a major empirical study on children who lost a parent on 9/11.

I got swept into 9/11 practically the moment after the disaster happened.  I had started a Childhood Bereavement Program the year before, which developed primarily as a result of my research with children who lost a very close relative, a brother, sister or parent, to suicide. I had decided to develop a treatment program in a group format for children from the ages of 6 to about 14.  Of course whatever is going on with the child is affected by what is happening with the parents, and the parents of these children obviously were grieving also. This was a traumatic loss for all of them.  So our work focused on group intervention based on grief, loss, and trauma.  We wrote a manual and tested it with some families and then launched an empirical study.

The program was a 16 week intervention. There was a parent group and a child group that met simultaneously every week. We found that that approach did decrease children’s depression and anxiety and to some degree decreased the trauma factor too, but not entirely.  So that was really yet an area left as an open problem. We follow these children.  They seem to have done much better, those who were able to be in the group.

Around 2000 a donor donated money to us to develop a bereavement program. I decided to write a grant for work with children who were bereaved, not from a loss from suicide but children who lost a parent primarily as the result of illness. The medical center was willing to help. They would not have done it just for a research project but because we were helping the families.  The grant was due October 1, and I was ready to send it in and suddenly 9/11 occurred.  I was at the Westchester division of New York Presbyterian Hospital and one of my research assistants came running into my office. She had just driven from New York City and as she was driving she heard that an airplane hit one of the World Trade Center towers. We turned the TV on and I watched and I was in shock as I saw both towers burning and then suddenly I saw them both coming down and my first reaction was what about all the people.

I wondered if there was a way that I could help, since I had this bereavement program. I contacted some people and people started to contact me because of the program. The first step was in helping the companies that had lost many people. They set up sites at hotels and the families of people who worked for that particular company came there and were given help.  One of the first types of help was “debriefing.” It was discussed as a panacea to help these people. We have learned subsequently that that is not necessarily the best approach, but that was what was discussed.

9/11 was not an event that had much research. Most of the companies were not willing to help out a researcher but they were more than willing to help out people who were offering an intervention.  So I was well suited because I had the bereavement program.

I met one little girl whose parent died at Cantor Fitzgerald.  She was in this room, lot of people were milling around.  She was 5 years old.  I walked past and I said hello to her and I figured she lost someone. When I said hello she said to me, “my daddy died, my daddy just died.”  At the age of 5. She just blew me over, I almost did not know what to say to her because she was so small and this was such a horrendous situation and that was her first comment to me.  I knelt down and talked to her a little bit and then her mother came over. The mother was very busy trying to get assistance from the company, there were lots of lines. This child had an older sister who was about 7. Later on this family did come into our study program and so we followed that family for little bit. I changed my grant around, because NIH developed a rapid process for funding studies on 9/11. I was awarded a grant but the grant did not come through until four months after 9/11 occurred.  But we had started preparing and I had my program so I was able to start meeting with people.

And now ten years after 9/11 the question is what have we learned and what can we offer at this point and what else have we learned subsequently in many other major disasters, the tsunamis, what is happening in Japan, Katrina and many others that may have been on a smaller scale. There is a lot of discussion and literature on bereavement, lots of books by people who were either therapists or people who had lost someone, but not a lot of empirical research to know what really helps, what doesn’t help and what the outcomes are. The study  that I proposed to do focused on children who lost someone on 9/11.  It was more or less a naturalistic study, in which you follow whatever is happening to people without necessarily offering an intervention as part of the research. But we could offer help, we were willing to help them also. If they needed help and intervention, we felt it would be unethical not to help them. And we felt that having them come and talk and react was also a way of helping.

In the study we had children who lost their parents or a very close relative and were getting interventions that were offered in the community, and we had a control group of children who were not bereaved but were living in the same community as the children we were studying.  That’s an interesting control group because one would wonder how they were affected by 9/11.  But it’s an adequate control group because our aim was to find out what is the difference in outcomes between the children who lost someone and other children who were living in the community. So if they were all somewhat traumatized that’s still part of the naturalistic study.

It was to be a longitudinal study. We hoped to follow the families as long as we could or as long as our funding held out, but the actual plan was for a two-year followup, with a reassessment of the children and the surviving parents every six months. We took every child in the family, not just one child, and the main focus of our research was on stress responses. We were interested in two main features relating to stress: what type of psychological or psychiatric symptoms did the children have, and did they have physiological responses as well.

When we met with the children, we had lots of materials to play with and to draw, and we made it very comfortable.  We had a lot to ask but we did it in a very comfortable way for them.  I had several research assistants so if someone came with several children, one research assistant was with one child, the next was with another and another one was with the parent.  We also had volunteers who were helping us.  We established five sites, in New York City, Westchester County, and in New Jersey.

On the psychological aspect, we were looking for psychiatric symptoms, and whether these people had a disorder.  We used standard measures. For the children we used the K-SADS* and for the adults we used the SCID.**  We also used self reports on depression, anxiety, PTSD as well as an interview for PTSD.  We also got family histories. We had measures on social adjustment for the parents and a variety of other measures.  It was a massive study.  The biggest task was to get people to come because different companies had all kinds of mixed issues about the whole thing, but we did publicize our study and we got people.

I think the biggest thing that they found helpful was to be able to talk.  The mothers would come and they would talk about what happened, how their husbands died. We had some fathers who lost their wives also, and I think the fathers were more affected than the mothers.  Some of the fathers were from foreign countries.  I remember one man whose family is from India.  He and his wife worked with one of the companies but he wasn’t at the world trade center that day. The wife died.  He had a little boy and the father did not know what to do about raising his child because in his culture the women raise the children, not the men, and he was tremendously grieving and he was also depressed.  So we worked with him and the child, that was just one example.

There was another family where the father was from Israel. He was a technology person; he did not work at the World Trade Center but he was going to the World Trade Center that day for a conference. He died. There were two children and the mother came into the study with the children and she stayed with us for about a year and then she moved back to Israel with the children. The father of the man who died was a general in the Israeli army and this grandfather in Israel developed memorials in many of the cities of Israel to 9/11 victim families.  This is how intense the effects of 9/11 were.

What we found was that among the children as well as the parents, the majority developed symptoms of PTSD.  One can say how can that be, they weren’t there at the site, a lot of the parents rightly did not allow their children to watch TV.  But the children heard about things in school, they heard about 9/11, they knew their parent died. The majority of the bereaved children had PTSD. Of the children in our control group, there were only two who developed PTSD, and most of them did not have any major disorders.  There were some children in the bereaved group who also had developed symptoms of depression and some with major depression.

Since we had a followup time, we were interested in knowing also whether over time, did these symptoms disappear? What we found is that the PTSD seemed to stay high in terms of symptomatology.  For at least two years PTSD symptoms remained, over two years.  The depression diminished, gradually but we could definitely see there was a significant decrease in depression symptoms.

A majority of the parents had PTSD and many of them had depression and anxiety.  Anxiety was a big issue, more so than depression — anxiety disorder and other types of anxiety, generalized anxiety which some of the children had also.

On the physiological aspect, we worked with cortisol, which is one of nature’s stress hormones. We  got samples of salivary cortisol three times a day, in the morning, around noon, and in the evening. They collected the cortisol at home. We had the mothers make sure that the children were doing it; we had the parents do it also and we evaluated the parents as well as the children. We gave them tubes, everything was labeled. We gave instructions. A research assistant was assigned to call every single family every day.  “How is it going, remember to do it.”

We had them do it for three days in a row, and on the third night they took a pill called dexamethasone. Dexamethasone is a synthetic cortisol-like compound. It inhibits the adrenal gland’s secretions of cortisol because the brain thinks it has enough cortisol in the system and shuts off the secretion of cortisol in the adrenal gland. There is other research showing that when dexamethasone is working that way in the normal population it suppresses the level of cortisol in the body and that is what we were measuring, the level of cortisol in the saliva. If people had a suppression that would be a normal reaction; if they didn’t suppress, other research has shown that may be associated with disorders such as depression.

So on the fourth day, they again collected the saliva to measure cortisol after the dexamethasone. We were looking for the effect, if there was suppression or not.  That was the model for studying the physiological effects.

The results were very interesting. The children and the parents had higher baseline cortisol levels, that is in the first three days without the dexamethasone, than the control group.  That’s a typical stress response. With stress there’s more cortisol produced by the adrenal gland as a result of feedback from the brain.

There were also differences in the post-dexamethasone levels. The study group seemed to have suppression of cortisol that was greater than the suppression among the non-bereaved children in the control group. They not only suppressed; they over-suppressed. In the literature you’ll find that this over-suppression is often associated with PTSD. We had the same findings for parents too, the over-suppression and the higher rate of cortisol before dexamethasone.

Among the bereaved children there were subgroups. There were some children who had really no other pathology. They were grieving, they had lost a parent, but didn’t show any psychopathology.  When we analyzed our cortisol data, we found that the ones who suppressed most had only PTSD, the ones who suppressed next most were those who had PTSD and depression, and the ones who suppressed least in the bereaved group were the ones who were just grieving without psychopathology. And then there were the control children who were within normal range of cortisol levels and post-dexamethasone suppression.

So what does this mean?  I think the children who had PTSD looked very much like the literature shows, very much suppression of cortisol.  The children who had PTSD and depression had less suppression and that goes along with what’s in the literature too. And those who had no pathology but were just grieving had some suppression but not as much as the other two groups. They were primarily within the normal range.  The children who were grieving had baseline high levels of cortisol. All the bereaved children had high levels. They were reacting to stress.  But post-dexamethasone we saw there were different levels of suppression.  So that made me realize that grief is not just grief and trauma is not just trauma, one has to look at comorbidity and one has to look at not only psychiatric disorders and symptoms but underlying hidden issues like physiological concerns.

In all categories, the cortisol abnormalities persisted over the two years. Unfortunately we were not able to follow the children up until now or even five years ago, because there was no more funding left. And also, the children wanted to blend into the community.  Some of them didn’t want to come any more for research, they didn’t want to be different.  Children think being different is not good.

And I want to add something: I’ve focused today on children who lost a parent. That’s a small group, but the remaining population of children in the United States were affected also by 9/11. There are studies of that, some of them are epidemiological, some are smaller studies that point out that there was  an increase of anxiety in children.  You can live in Oregon and they were affected, you can live in Boston and they were affected, and we can’t lose sight of that. When you talk about educators and storytellers and others who work with the children in different capacities, we can’t forget those children too.

* Schedule for Affective Disorders and Schizophrenia for School-Aged Children, a diagnostic interview instrument often called Kiddie SADS

** Structured Clinical Interview for DSM-IV Axis I Disorders