For the past year, more than 140 New York City firefighters, some ailing from their work in the ruins of the World Trade Center, have walked into a seventh-floor medical clinic just two blocks from the former disaster site. Once inside, some have abandoned the medical care and emotional counseling provided to them by their own department's doctors, and all have taken up a treatment regimen devised by L. Ron Hubbard, the late science fiction writer and founder of the Church of Scientology.
The firefighters take saunas, engage in physical workouts and swallow pills — all of which together constitute what for years has been known, amid considerable dispute, as Mr. Hubbard's detoxification program, one meant to wash the body of poisons or toxins. The firefighters are not charged for their trips to the clinic, called Downtown Medical.
Of the more than 140 firefighters and 15 emergency medical workers who have undergone the program, some have told colleagues of its virtues. Others have said they were simply following the regimen in order to enjoy free saunas.
But one retired firefighter is a paid member of the clinic's advisory board, and the city's main fire union has pledged its "full support" to the clinic as it seeks government grants and other forms of financing.
"The statements I have heard from firefighters who have completed the program are truly remarkable," Stephen J. Cassidy, the president of the Uniformed Firefighters Association, wrote in a letter that is posted on the clinic's Web site. The letter adds, "The work you are doing in this regard is unique in the city, and is very welcome."
But the existence of the clinic has upset city Fire Department officials, who, among other concerns, are alarmed that the medical treatment prescribed by its doctors is being discarded by some firefighters who enroll at Downtown Medical. They say the clinic's detoxification program requires firefighters to stop using inhalers meant to help with their breathing and any medications they may be taking, like antidepressants or blood pressure pills.
The department officials, including its physicians, said they had no way of vouching for the program's practices. The exact makeup of the pills taken as part of the program, for instance, is not widely known, although they are believed to contain niacin. One clinic board member wrote a report published in a firefighting magazine that firefighters produced blue beads of sweat during the program. One city firefighter said that the man next to him in the sauna once appeared to sweat a quarter-size black substance — evidence, he said, that toxins were being drained out of his body.
"While we are aware some members of the department have availed themselves of the program, we in no way endorse it," said Deputy Commissioner Francis X. Gribbon. Dr. David Prezant, deputy chief medical officer for the department, added, "It's risky for anybody to stop any type of medication without guidance and a plan from their own treating physician."
Officials with the clinic, while acknowledging some of them are Scientologists, said the clinic is not formally affiliated with the Church of Scientology. An official at the church's office in Los Angeles said they were aware of the clinic, but described it as a secular enterprise employing Mr. Hubbard's methods.
The official in Los Angeles, Linda Simmons Hight, said many Scientologists had donated to the clinic, but "as far as it being part of the church, it isn't." Joseph Higgins, a retired firefighter who is now a paid member of the clinic's advisory board, said Tom Cruise, the actor, had paid for "quite a bit" of the treatments for rescue workers, estimated by Mr. Higgins to cost $5,000 to $6,000 apiece.
People inside and outside the department said they regarded the use of the clinic to be yet more evidence of the degree of the distress experienced by members of the force, which lost 343 men on Sept. 11.
"People are desperate to feel better," said one fire lieutenant. "As far as I can tell, they'll try anything, even off the beaten track." Another officer, who said he planned to sign up for the regimen in hope of clearing up lung congestion, said: "Right now, I'm at the point I would try a voodoo doctor."
Clinic officials, after briefly addressing issues involving the clinic, said they would not comment further about the program. But Mr. Higgins, the former firefighter, said, "It's actually a pretty awesome program."
The use of the New York clinic is not the first instance of firefighters' being persuaded to use Mr. Hubbard's methods.
In 1987, after a fire in a transformer room at the Louisiana State University School of Medicine, in Shreveport, dozens of firefighters became alarmed that they had been exposed to high levels of polychlorinated biphenyls, or PCB's.
After repeated complaints of headaches, dizziness and rashes, the city of Shreveport contracted with a private outfit that advocated Mr. Hubbard's detoxification methods. But after the city's insurance carriers questioned the legitimacy of the treatments and their escalating cost, the city hired an independent medical doctor to investigate the regimen.
In a blistering 1988 report, Dr. Ronald E. Gots, a toxicology expert from Bethesda, Md., called the regimen "quackery," and noted that "no recognized body of toxicologists, no department of occupational medicine, nor any governmental agencies endorse or recommend such treatment." The report ended Shreveport's dealings with the program.
In an interview yesterday, Dr. Gots said of the program, "It's an unproven, scientifically bereft notion."
Keith Miller, a Downtown Medical board member, said yesterday in regard to Dr. Gots's 1988 Shreveport report that Dr. Gots was not a reputable source.
In the days after the Sept. 11 attack, Scientologists were among the representatives of many religions and religious groups moving among the rescue workers and the traumatized residents. They were even allowed to remain along with the American Red Cross after many other groups had been ordered to leave.
The Church of Scientology was founded in the 1950's by Mr. Hubbard, a science fiction writer who died in 1986. Its adherents, who number in the millions and include many Hollywood celebrities, believe that Scientology's self-help techniques and counseling sessions, known as auditing, can help people live more productive and satisfying lives. But the cost of the auditing sessions, which can run into thousands of dollars an hour, has drawn criticism, as have the church's aggressive tactics toward its critics.
The Internal Revenue Service granted the church tax-exempt status in 1993.
Officials at the Manhattan clinic said that shortly after the terrorist attack, an official with the firefighters' union contacted the Foundation for Advancements in Science and Education, a group that promotes the detoxification program developed by Mr. Hubbard, to request the regimen for New York firefighters.
In September 2002, the Downtown Medical clinic opened on the seventh floor of 139 Fulton Street, in a building full of homeopathic clinics. The building's lobby directory, however, does not list a clinic in that name.
In addition to Mr. Higgins, a well-known fire academy drill instructor who estimates he has trained over half the city's firefighters, another department figure, Israel Miranda, the president of the union that represents emergency medical workers, is also on the clinic's board. Mr. Miranda is also an instructor at the emergency medical workers' academy.
Stacks of of pamphlets about the program have appeared at Fort Totten, the department's training center. Department officials have tried to distance themselves from any impression that they endorse the regimen, but they say that it has been difficult.
"This is a very hard battle to win," said Dr. Prezant, who noted that firefighters do the regimen on their own time and do not have to report to the department that they are undergoing it. "It's not our job to say you can't go. All we can do is say there's no proven evidence it works."
Mr. Cassidy, of the main fire union, did not return a phone call yesterday.
A lieutenant named Rob, who refused to give his last name, stopped outside the clinic's building Thursday evening to talk about the regimen. He said that a visit included a weigh-in, a checkup with a clinic doctor and a four- or five-hour stretch in the sauna interspersed with intervals on a treadmill or stationary bike. In addition, he said, patients are given a packet of vitamins with gradually increasing doses of niacin.
The lieutenant said he had no serious medical trouble, but looked at the regimen as a way to give up drinking, and possibly sweat out any toxins he thought he might have. "The only reason I'm doing it is because I have a sinking feeling about what I took in on Sept. 11," he said.