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A Paramedic Reflects on 9/11 USAR Operations


On the morning of Sept. 11, 2001, I was working as an EMS supervisor in the Bronx. I was the station supervisor who was busy getting units in service, completing the log book and ordering supplies when the signal 10-40 was announced over the Bronx radio. “Signal 10-40 has been announced at 7 World Trade Center [WTC]; I am dispatcher 5678 and the time is 9:02 hours.” I remember thinking, “That must not be real. How could a pilot not see the tower on such a clear day? Maybe it was a small touring plane that hit the tower.” I went back to work and paid attention to station operations.

EMT Keith McGregor came in the office and turned the TV on. “Boss we are under attack,” he said to me. I didn’t understand and asked him to repeat himself. “We are under attack, boss. There is a plane into the World Trade Center and another one crashed into the Pentagon in Washington.” I looked at the TV in disbelief. For the first time, I saw the imprint of the plane on the side of the World Trade Center. It was huge: This was no tour plane; this was a jetliner, and smoke was rising out of the building through the plane’s footprint. The group of EMTs who had gathered in my office started to go wild in disbelief. We watched the TV in amazement. I looked the dispatch screen and saw some 60 ambulances were assigned.

“Wow, this is bad,” I thought to myself.

When the first tower collapsed, I could not believe it was gone. I thought, ‘We just lost 30 EMTs and medics down there.” I wondered what it would be like with only one tower. Little did I imagine that there would be hundreds of rescuers killed by the days’ end. Many of those killed or severely injured were co-workers, firefighters we had done EMS jobs with and urban search and rescue team (USAR) members I had trained with at the fire academy.

One unit from my station was heading to Ground Zero. I helped them load their equipment in the ambulance; we loaded extra weapons of mass destruction (WMD) kits and oxygen bottles, and closed the back door. I knocked on the side and gave the thumbs up in the rearview mirror to the crew. They acknowledged me with a wave and drove out the apparatus floor bay. I heard on the citywide radio a medic calling for help. The dispatcher advised him to go to the triage center. He replied, “I cannot see, I cannot breathe. I need help.” I wondered if they were using weapons of mass destruction. Sun filled the empty apparatus bay as my BLS unit pulled away. I wondered if I would ever see those EMTs again. They were going into a war zone.

Search & Rescue
I responded to Ground Zero with the USAR team. When I arrived, I found my way to the USAR team staging area and saw personnel waiting. I walked up and asked, “What are we waiting for?”

“Direction,” I was told. “We are waiting for word to come down about the plan, the operation.”

“What about Chief Downey?” I asked.

“He is gone,” a voice said.

“The rescue guys from USAR?” I asked.

“Steve, we lost all five rescue companies, the hazmat truck and all squads,” another voice said.

The enormity of the collapse was hitting me. There was no radio communication because the radio towers were on top of the WTC. There was no plan, no forward motion. The collapse had left the city decimated, and a vacuum in command existed. I had never been to any type of disaster where there was no forward motion. Not the Happy Land Fire, not the 1993 bombing of the WTC.

A voice spoke out, “We should get to the pile.”

A different, clear voice said, “Our brothers are digging on their hands and knees; they will last for another 10 or 12 hours, and we have to set up for a long-term operation. We are here until the end.”

Yet another voice shouted, “Run, number seven is going!” We turned and looked up and began moving backward.

A salient voice boomed, “Do not run; we are far enough away. We do not run; we are the FDNY.”
Seven WTC fell in about three seconds. At the time, I thought it was a seven story building. I later found out the building was 47-floor building. To see that building fall in three seconds was Earth-shattering.

The collapse of 7 WTC was like a pacing spike to an asystolic heart. The salient voice I had heard before directed us, “Unload the cache. Let’s get to work. Unload the Anvil boxes. Everybody wears gloves; don’t need any more injuries.” We set up the tents and a new pattern arose out of the dust as we all started performing our jobs and checking equipment. We were fortunate to be issued masks with filters as we unloaded the cache of equipment. The masks fit nicely because we had been test fitted as part of our training.

Our Country’s Worst Nightmare
When we finally suited up and began rotating down to the pile, we were awestruck with the devastation and number of fire department vehicles destroyed. The collapse of the Twin Towers had left a disorganized pile of four-ton “I” beams that stood hundreds of feet high. We were chasing the shadows of hope as we searched the pile, hoping we would find pockets where rescuers had been trapped alive. As we climbed and searched we asked, “Where is everybody?” We had team members who had found people in Oklahoma City; surely we would find people here. Day after day, hope grew into frustration and exhaustion. Determined to find our lost brothers and sisters, we searched buildings and tunnels for access beneath the pile. As the “pile” turned into the “pit,” hope dissipated and the reality set in.

Little details were poignant. I can remember looking up and seeing the American Flag on a fire truck that had been uncovered from the debris. Firefighters had started using the engine as a tool storage and rehab area. The bright colors of red, white and blue were a stark comparison to the grey and black, dust-filled background. I thought to myself, “In all the jobs I have been to, I have never seen the American flag flying.” I then realized we were no longer working for New York City, but rather for our country.

Dario Gonzalez, MD, had trained us to take care of trapped patients, care for team members and stay safe. He once told us, “The worst case scenario the planners think of is a small nuclear bomb being placed next to the World Trade Center and both towers coming down over Manhattan. They estimate there would be 50,000 people trapped and all the USAR teams in the country would not be enough.” When he said that I scoffed and thought, “That will never happen.” As I looked round the pile I saw USAR teams from Florida, Massachusetts, Puerto Rico and Texas; they were all here except Virginia—who were busy at the Pentagon. Our country’s worst nightmare had come true.

My Three Best Friends
There were distinct times during this rescue effort at Ground Zero where hazards posed a threat to my well-being. I’m grateful for the training I had, which kept me safe at Ground Zero. I teach students that my three best friends are time, distance and shielding. By minimizing our time exposed to a hazard, maximizing your distance from a hazard and using the right personal protective equipment (PPE), we were able to work safely at Ground Zero. I’m grateful for the training I had and the outstanding teammates I worked with.
In a response of this scale, it’s not the required training alone that gets you through the moment. The collective abilities and unique talents we each bring to the scene is what helps us establish a new system and recover from an incident of this scale.

The Greatest Lesson
Day in and day out in EMS the pressures of our job often causes EMS providers to argue over trivial issues and alienate each other. During events like 9/11 we’re all drawn closer by the pressures of the day. I think it’s important to see the big picture and respect your coworkers knowing they’re a dedicated breed who are also vulnerable. Why wait for a tragedy to honor and respect our co-workers. During the rescue efforts it was amazing to see fire, police and Port Authority working hand-in-hand to achieve a common goal. The pressures of these disasters bring us all closer and to meet the challenge. It’s important to keep things in perspective during the relative safety of day to day work.

Dealing with the Loss
Looking back at the co-workers we have lost and continue to lose due to exposure it is difficult to find any good or lesson learned from Sept. 11, 2001. After reliving the sights, sounds, smells of Ground Zero, I realize that we’re only left with the humanity and caring our fellow EMTs and paramedics exhibited there in Sept.11, 2001.

As we honor the 10th anniversary of Sept.11, 2001, it’s important to remember those we lost. Equally important is for us to share the lesson learned with the new generation of EMTs and paramedics who will face the challenges of the future. Whether the next Big One will be terrorism, earthquake or a hurricane we don’t know. But the increasing lethality of terrorism is great reason to prepare and hand down the experience of 9/11.

How to Move Forward after 9/11?
Occasionally a medic or EMT would come into my office complaining about the job, their partner or the stresses of life. I often remind them. “Hey, I know 343 guys that would trade places with you in a heartbeat” as I look at the poster of the fire department personnel who died on 9/11. “You’re right, boss. Every day you wake up is a great day, and this is a great job.”

How do we move forward from Sept. 11, 2001? We move forward by honoring our co-workers who we lost on 9/11, by appreciating those we work with each day and sharing the lessons we learn in EMS to the next generation of EMS providers. I would ask you to reflect on each anniversary of Sept. 11, 2001 and ask yourself, “Have I delivered patient care with the same caring EMTs and paramedics demonstrated at Ground Zero? Am I living life to the fullest by improving and learning?”

We cannot forget Sept. 11, 2001, Hurricane Katrina or any other disaster that weighs on our minds. However we can take solace in the fact that during the worst moments of our country, we aren’t a collection of cities but one country united, working together.


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