The lives of two family members were lost almost two decades after the attacks
Credit: Courtesy Raymond Alexander Jr.

Robert Alexander, a 43-year-old 9/11 first responder, died on August 14 from a brain tumor doctors say was related to his work at Ground Zero. His death came just nine months after his firefighter father, Raymond Alexander, Sr., passed away after a 13-year fight with multiple cancers also believed to be linked to the attacks.

More than 3,700 first responders have been diagnosed with a collection of cancers tied to exposure to the carcinogens—such as jet fuel, mercury and 400 tons of asbestos—that were released into New York City’s air during the collapse of the towers. The Uniformed Firefighters Association said Robert and Raymond Sr.’s deaths mark the first time since the fateful day that two generations of a single family have died with the attacks being a direct cause.

“Watching my dad and brother deteriorate was painful,” Robert’s brother, Raymond Jr., 46, tells PEOPLE.

On September 11, 2001, Raymond Sr., a seasoned member of the FDNY, and Robert, then a police officer before later becoming a firefighter, bravely rushed into the toxic ash and dust that would eventually wreak havoc on their bodies. The poisonous air would affect many firefighters, police officers, volunteers, construction workers, clergy and health professionals who arrived at the scene.

Credit: Courtesy Raymond Alexander Jr.

Raymond Sr.’s health worsened about a year after the attacks, and he was diagnosed with hairy cell leukemia, skin cancers such as squamous cell carcinoma, lung cancer and eventually a painful tumor on the bottom of his spine.

The brothers watched as their father underwent radiation, chemotherapy, operations to remove the cancerous skin from his face and invasive leukemia treatments. Over 13 years, trips to the doctor three to four times a week became the new normal for the family that had no previous history with cancer.

“I always thought at some point that it would all calm down and he would be able to do what a retired person should be able to do,” Raymond Jr. says. “He earned his retirement and he never got to enjoy it.”

Robert, who trained as an EMT and went “all in” with everything he engaged in, shared much of the responsibility of caring for his father with his mother. Raymond Jr. says his brother and father always had a close relationship and serving others only strengthened their bond. “They just had the job in their blood,” he says.

Credit: Courtesy Raymond Alexander Jr.

Raymond Sr. died in November 2016 after a second bout with lung cancer at the age of 76.

In November 2014, two years to the month before the passing of his father, Robert was diagnosed with an inoperable brain tumor after he noticed he had issues with his balance. Robert retired from FDNY in 2016, and in mid-2017, he moved in with Raymond Jr. in Middletown, Connecticut, after he experienced a fall in his backyard that left him with two black eyes.

Raymond Jr. cared for his younger brother as the tumor on his brain stem ruined his speech, hearing and vision—radically transforming him from the Robert he remembered.

“My brother was always incredibly mechanical and capable, there was not a whole lot of stuff that was beyond his expertise,” Raymond Jr. says. “He was not an easily intimidated person.”

While Raymond Jr. admits that caretaking was difficult, the two did enjoy each other’s company in between the many frustrating moments, such as when they watched Dunkirk together at a local movie theater.

On August 14, Robert succumbed to his brain tumor while at Sloan-Kettering Hospital. Raymond Jr. had expected it to be a routine visit.

“I cried a lot, he was always the first guy I texted or the first guy I called when something important happened,” he says of his brother. “My house is filled with Rob’s stuff. I’m going to go home and stare at it and not know what to do.”

In the final years of his life, Robert was an outspoken activist for his fellow first responders and campaigned to help push for federal legislation to help them receive medical and financial assistance. In 2015, Congress passed legislation that extended the James Zadroga 9/11 Health and Compensation Act—a law providing health monitoring and financial aid to the first responders, volunteers and survivors of the attacks— for another 75 years.

Robert and Raymond Sr. had assistance from the World Trade Center Health Program for their medical bills. But Raymond Jr. says his brother wanted to remind people there are firefighters and police officers who were not involved on September 11 who are in need of assistance all around the country.

Credit: Courtesy Raymond Alexander Jr.

“This is the type of stuff that can easily bankrupt the average family,” he explains. “These people need unrestricted and unencumbered access to all the health care they need.”

If you would like to help families of September 11 victims and first-responders such as Robert and Raymond Sr., you can donate to charities such as Tuesday’s Children, Families of Freedom Scholarship Fund, New York City Police Foundation and the FDNY Foundation. You can also give to the National Law Enforcement Officers Memorial Fund and the National Fallen Firefighters Foundation.

“People who have chosen to become firemen, policemen, and soldiers, they’re likely to get hurt,” Raymond Jr. says. “They deserve us to do everything we can do to make them whole again once something bad happens to them.”