Recollection

At the hospitals where I did my residency in New York City, the pediatrics department had its Grand Rounds every Tuesday morning.  One of my favorite attending physicians was delivering a talk on hematopoietic stem cells on the morning of September 11, 2001, so in contrast to my usual habit of sleeping quietly in the back during the often dry, abstruse presentations I was actually awake and paying attention.  On my way out of the conference room I stopped to check the sign-in sheet to make sure I’d get credit for attending the presentation, and I bumped into one of my fellow senior residents on her way in.  She asked if I’d heard that a plane had struck one of the towers of the World Trade Center.  I hadn’t.

It seems almost obligatory when describing that day to note that the weather was gorgeous.  The sun was shining and the air was fine and clear as I walked from the building at the medical school where the talk had been held back to the hospital where I was the senior resident on the inpatient pediatric service that month.  I told the junior resident and the interns to go up to the pediatric ward and start getting ready for rounds.  That hospital has a pediatric emergency department, and I thought I would just swing by to see if they needed any extra help for what I assumed would be a relatively small problem.  When my friend told me about the plane, I had pictured a small private aircraft of some kind hitting the building through pilot error.  I didn’t imagine that there would be much going on in the emergency department or anything for me to do, but it seemed like a good idea to check.

I stepped through the doors of the pediatric ED to find a place going absolutely apeshit.  Rather than a couple of attending physicians and a handful of residents and fellows, the rooms were swarming with just about every doctor in the department.  Everyone was wearing plastic trauma gowns, and running all over the place.  Somewhere in the chaos I found someone in relative charge to ask what was going on.  It wasn’t a small personal aircraft that had hit one of the towers.  It was a four-engine airliner.  Yes, they would need me.  Yes, I should stay.

I called up to the pediatric floor and told the junior resident that every patient who was even close to being discharge-ready should be sent home.  We would need the room.

I pulled on a plastic trauma gown and went to one of the trauma bays to help check equipment.  Though the hospital was in midtown, it was a major trauma center and we knew we were about to get very, very busy.  It was during this time, while I was checking laryngoscopes and IV bags and vials of medication, that we heard that another plane had struck the other tower and yet another had hit the Pentagon.  An unknown number of planes were still in the air and unaccounted-for. I remember a feeling of nauseated vertigo that seemed to permeate the atmosphere as the news and its implications settled it.  As people struggled to prepare and stay focused on the hard and grisly work that was sure to start at any minute, they would freeze for a moment as they were seized by thoughts of people they knew who worked at the World Trade Center, or who took the subway under the buildings, or who for some reason might possibly have been affected.  I was lucky in this way, having no such connections myself.

The phone lines were, of course, completely jammed.  I tried to call my parents in my hometown in the Midwest to let them know I was OK, but it was impossible to get through.  Despite knowing that I neither lived nor worked anywhere near the World Trade Center, I knew that my mother would construct implausible scenarios wherein I happened to have been in one of the towers until she heard otherwise.  I was finally able to get through to my best friend, who eventually was able to reach my parents to reassure them that yes, I was fine but very busy.

At some point that morning, someone came into the pediatric ED to ask for volunteers to go to our other hospital.  Unlike the one where I was assigned that month, it had neither a dedicated pediatric emergency department nor pediatric emergency medicine specialists.  Assuming a massive number of casualties, many of whom were sure to be children, it seemed likely that the one hospital would be overwhelmed and both would be needed.  Along with another couple of residents in my class I volunteered to run over.

The next moment is one of those experiences that I hope stays with me forever, to remind me of why I still believe in the basic decency of most people.  The hospital I was leaving is the flagship medical center of New York City’s public hospital system, and a sort of emergency command center had been set up near the EDs.  As we raced through the back hallways we came across a huge crowd of reporters completely obstructing our path as they shouted questions at some random public official.  I yelled “We need to go that way,” and pointed through the knot of people.  This hardened gaggle of reporters, desperate for any news during one of the most unfathomably awful moments in the NYC’s history, took one look at our small group of young, frantic doctors in plastic trauma gowns and without another word or hint of protest parted like the Red Sea and let us pass right through.  In retelling the story now, it seems small and unimpressive and obvious, but for me it will always serve as a reminder that people can put aside their own interests and do the right thing when they know that it’s truly important, even in the very worst of circumstances.

After running the few blocks between hospitals, we arrived breathless at the other ED.  We immediately began the same kind of equipment check and set-up we had done at the other hospital.  We braced ourselves for the worst, and waited for the first patients to arrive.

And waited.  And waited.

It was sometime around then that I heard that one of the towers had collapsed.

Every so often some update would reach us.  Traffic had been cleared.  Ambulances had gotten into the area, and had begun to head back out.  With each new piece of news, we expected the patients to start showing up.  And still we waited.

Finally it became apparent that we were just taking up space in the ED, and there was no need for us to be there.  I told someone to call up to the pediatric floor if any children came in, and headed up to wait.  I sat with my friends by windows overlooking the FDR Drive, devoid of traffic except for the occasional black official vehicle screaming downtown with blazing lights.  I remember talking about who might be responsible, and one of my close friends starting to cry when I said “of course this means there will be a war.”  Her husband was in the Navy Reserve, though in the end I think he wasn’t called to serve.

Eventually I headed back the pediatric ED over at the first hospital, as there was clearly nothing for me to do where I was.  When I arrived I saw stacks and stacks of order forms for lab tests, which people had obviously filled out in advance to shave every second off the wait for results.  There were dozens of bags of hanging IV fluids, spiked and ready to go.  All for patients who never came.

I lived all the way across town on the Upper West Side at that time, and so I volunteered to spend the night in the ED in case there was a need for extra hands.  The one patient I saw all night was a firefighter from Long Island who needed to have his eyes flushed free of grit and debris.  He smelled more acrid than anything I’d ever smelled before.  Another thing I will never forget is how overjoyed and relieved his buddies were when they discovered him in our department, where he’d been sent because they were full of the same over on the adult side.  It makes my throat close and my eyes sting when I remember how glad they were to have found him, hidden beneath a lot of jokes at his expense about not being man enough to deserve the regular ER.

I had an otherwise quiet night.  By and large, people escaped with minor injuries or they didn’t escape at all.

The fliers began to appear over the coming days.  Pictures of missing people, captured in a happy moment, smiled out over lists of identifying features and contact numbers for desperate loved ones.  I remember one man whose picture I kept seeing had a scar on his leg.  He looked like a nice guy.  Eventually the walls of the buildings starting two blocks away, the fences, the pillars in the hospital entryway were papered from floor to eye level with these pleas for information.

A few days later, we had a meeting to talk about how we all were doing.  All of us talked about how profoundly, inescapably useless we felt.  How much we wanted to do something, anything to help.  How crushing it was that there was nothing to be done.  The only cold comfort came from my friends in the emergency medicine residency, who told me they had the same feelings of frustration and futility when they went to Ground Zero to find and treat any survivors, the only difference being that they felt useless while working inside damaged and collapsing buildings.

I remember the smell of burned plastic that wafted up to my neighborhood in the days after the attack.  I remember how quiet and respectful everyone was on the subway.  I remember all the messages of support that appeared in the Times, and crying when I saw the one from the people in Oklahoma City.  I remember the tent city that arose around my workplace as the medical examiner’s office started processing truck after truck after truck of remains.  I remember thinking that my parents liked to stay near the World Trade Center when they visited, despite my living at the opposite end of Manhattan, and that the terrorists would happily have murdered anyone and everyone I knew.

In the end, I have no special claim to the day.  No more than any other American, and certainly no more than any other New Yorker at the time.  Standing in the emergency department of a massive midtown hospital, I was no more able to help anyone than if I’d been in Des Moines.  All I have are memories and impressions, feelings of impotence and incredible sadness.  However, what I always remember most of all is how full New York City was, in the days and weeks after the attacks, of decency and compassion and sacrifice.  Which is why I will always consider it in some way my home, no matter where I live.  Why I will always love it more than any other place on earth.

(Cross-posted at Blinded Trials.)