Hospitals in the New York City area and nearby New Jersey and Connecticut treated almost 6000 patients in the wake of the September 11, 2001, World Trade Center tragedy. Almost all the patients were those who could escape the two 110-story towers before the towers collapsed or were rescuers injured while trying to find survivors. An estimated 5000 people died in the World Trade Center tragedy, including the passengers on the 2 passenger jets used as flying bombs to destroy the buildings. In Washington, DC, where another hijacked plane ploughed into the Pentagon, it is thought that >180 people died, including those on the aircraft.
In each instance, the outpouring of concern and volunteers to help in the search, rescue, and treatment of patients was overwhelming. Edward Bessman, MD, chairman of emergency medicine at Johns Hopkins Bayview Medical Center, was part of an urban search and rescue task force that was assembled on the scene at the Pentagon at 3 pm on Tuesday, September 11. “Our role is to enter the collapsed structure, identify victims, and extricate them,” said Dr Bessman.
However, “It became apparent early on that if an individual was not able to get out of the building, he or she succumbed to the fire and smoke,” said Dr Bessman. Although the structural damage to the building was confined and in some ways seemed to be less than that to the federal building in Oklahoma City (which was destroyed by a bomb set by domestic terrorists), “the situation was made far worse by the fire. Jet fuel spread out and caused an enormous fire.” The fire was put out several times only to spring forth anew when the turning of debris would reveal hotspots that renewed the flames.
The medical component of a task force such as his has three components, noted Dr Bessman. One is to keep the task force itself healthy. A second is to take care of the group’s canine members, and the third is to care for patients found in the rubble. “But really, mission number one is finding people.”
Joseph Ornato, MD, a cardiologist and emergency physician, was chairing a meeting for the National Heart, Lung, and Blood Institute’s public access defibrillation study in Brooklyn when a loudspeaker came on at his hotel telling them to evacuate because a plane had hit the World Trade Center. Outside, they could see a large plume of smoke coming from lower Manhattan. At that time, there was a desperate need for doctors, nurses, and medics. His group volunteered and found itself on a commandeered city bus headed for the rubble of the two buildings. They set up a triage area there and eventually had the equivalent of a 40-bed hospital.
“That was the saddest part,” he said. “We only treated 19 patients over the next 12 hours.” All of the critically ill patients who were rescued or escaped before the buildings collapsed ended up in local hospitals quickly. After that, there were only injured rescuers, policeman, firemen, and emergency medical personnel.
“I never thought I’d live to see thousands of people die right before my very eyes,” he said. Dr Ornato is the chairman of emergency medicine at the Virginia Commonwealth University/Medical College of Virginia.