2001/09/12 – A Day of Terror: Hospitals

The New York Times

September 12, 2001

Day Of Terror: Hospitals By DAN BARRY

As emergency vehicles careered through smoky chaos and triage centers and morgues sprouted wherever space allowed, it became sorrowfully clear that the hundreds of people bloodied and burned by yesterday’s destruction of the trade center towers may have been the lucky ones.

Throughout the day, the city struggled to quantify the wholesale carnage visited upon it on a beautiful late-summer’s morning. But by evening, there was only the sense that hundreds — probably thousands — of people were dead, their bodies buried beneath the still-smoldering rubble of what once had been a soaring symbol of the city.

No one knew how many; no one knew what to say.

»I don’t think we really want to speculate about that,» Mayor Rudolph W. Giuliani said at one point yesterday afternoon. »The number of casualties will be more than any of us can bear ultimately, and I don’t think we want to speculate on the number of casualties.»

Last night, the visibly shaken mayor said, »That will be in the thousands, but there is no way of knowing at this point.» Later, he expressed hope that many had been able to evacuate.

At hospitals throughout Lower Manhattan, hundreds of doctors and nurses worked as though all part of one big MASH unit, tending to the wounded at the front lines of a war. Meanwhile, many of those who had not been injured — at least physically — by the worst terrorist attack in American history donated the only thing they could think of, their blood.

Then there were the patients, their clothes and hair covered with debris and blood and shards of glass. Some had burns covering their entire bodies; others were more dazed than wounded; a few died while being tended to. One police officer, brought into the emergency room at Bellevue Hospital Center complaining of chest pains, tried to explain to doctors what was wrong. »Doc, the things I’ve seen today,» the officer said, before bursting into tears.

By late afternoon, the emergency rooms at several hospitals were teeming with the wounded, sometimes in less-than-ideal circumstances; New York University Downtown Hospital, for example, had lost power and was relying on a backup generator. But most of the area’s hospitals — throughout the rest of Manhattan, as well as in the outer boroughs and in New Jersey — remained mostly on standby, a status that became more unnerving by the hour.

A television studio lot at Chelsea Piers was quickly transformed into an emergency trauma unit after the first plane struck the first tower at the World Trade Center, shortly before 9 a.m. There were rows of gurneys and IV racks, stacks of gauze and white cloths, all beneath makeshift signs reading »Trauma» and »Critical» in neon orange paint. Doctors and nurses in surgery gowns and masks stood at the ready, including some out-of-town doctors who had left a medical conference in Midtown to help out.

But as rescue workers frantically searched through the smoky rubble of the twin-tiered buildings that once defined the Lower Manhattan skyline, there was nothing for these doctors and nurses to do except wait and hope that they would be called upon.

»It’s extraordinarily unsettling,» said George G. Neuman, the chief anesthesiologist at St. Vincent’s Manhattan Hospital. »We want to take care of these people. They are down there, walking-distance away, but we can’t get to them.

»There have to be thousands of people there,» he added. »And we have seen only a few hundred.»

There were other sobering signs of preparedness far surpassing need.

A doctor working at Jacobi Medical Center in the Bronx said the first call that hospital received was for body bags. Psychiatrists at Bellevue Hospital Center were preparing for the days to come, when they expected to see people seeking treatment for psychological trauma. And Dr. Robert L. Jones, the president of the New York Blood Center, said at midafternoon that health officials were no longer »worried about having an insufficient supply» of blood, as they had been earlier in the day.

Mr. Giuliani estimated that, as of late yesterday afternoon, 600 people were being treated at local hospitals, including about 150 who had been critically injured.

There were also those whom the mayor called the walking wounded: dozens, if not hundreds, of people who were injured in the terrorist attack, but chose to return to their communities in New Jersey and on Long Island to be treated.

But »ground zero,» as it was being called by hospital workers and police officers, was Lower Manhattan — as reflected in the ashen face of Luis R. Marcos, the president of the city’s Health and Hospitals Corporation, as he drove up to Bellevue Hospital in a car whose windows had been shattered in one of the explosions.

»One of the most shocking things I’ve ever seen in my life,» he said, his body shaking. »People jumping and dropping from the tops of those buildings.»

After the first tower collapsed, about 10 a.m., many people ran and groped their way through the blizzardlike dust, making their way to N.Y.U. Downtown Hospital, near City Hall. Soon the hallways and lobbies were thick with the soot brought in by people, some of them hysterical. Hospital workers alternated between handing out water and directing people to remove their dust- and glass-covered clothing.

Just as some of the uninjured were being led away from the doors of the emergency room, there came a shout — and a new wave of people came in, following the collapse of the second tower. There came a call to make room for children, which caused nurses to cry.

Contributing to that sense of controlled chaos were the stories of the wounded in the emergency room. Christine Sasser, 29, was on the 78th floor of Tower 2 when the second plane struck. While recovering at N.Y.U. Downtown with minor injuries, she recalled scurrying down the stairwell with a bleeding friend. »We kept saying 50 more to go, 30 more to go, 16 more to go.»

With the afternoon bringing no end to accounts like those of Ms. Sasser — accounts punctuated by the mushrooms of smoke billowing from ground zero — those medical workers not immersed in emergency-room work prepared to treat victims who never came.

Triage centers were being set up, including one in the shadows of the court buildings in Foley Square, staffed by hundreds of medics. By late afternoon, only one person — a firefighter — had been treated, but that did not mean that the volunteers had been spared.

Michael Weisblatt, a volunteer with the Hatzolah ambulance service, said that he and his colleagues had been sent down to the scene to relieve other workers, only to be buried under debris with others when a walkway collapsed. »We’re still missing one member,» he said.

Meanwhile, on the west side of Lower Manhattan, an emergency medical technician, covered from head to toe in gray dust, said that he and several other medical personnel were in the midst of setting up a triage center a couple of blocks from the trade center when the first tower collapsed. »Afterwards we had no equipment, no vehicles,» he said, wiping his watering eyes with a rag. »Ten minutes straight of blackness. I thought I was in hell.» Most of the victims to first flood the emergency rooms were suffering from smoke inhalation and glass cuts, but there were many with more serious injuries as well. Dr. Steven Stern, an anesthesiologist at St. Vincent’s Manhattan Hospital, said there were dozens of victims with severe burns. But after that initial wave, the expected deluge never came. At the trauma center set up at Chelsea Piers, it seemed that every detail had been attended to in preparation. There were color-coded tags: green for stable, red for life-threatening conditions, black for the dead.

»You go to them, you check their airway,» Dr. Michael Guttenberg, deputy medical director of the city’s Emergency Medical Service, told volunteers. »If they don’t start to breathe spontaneously with an open airway, they get a black tag.»

But neither the dying nor the injured came. About 3:30 p.m., the ham-and-cheese sandwiches arrived. But 4 came and went, and then so did 5. Doctors rested on tables and sat on the floor, some of them trading stories now seared in their memories.

»I just hope there are people to see,» said Howard Katz, a surgeon who had hitched a ride to the scene. Then he said what all his colleagues feared: »We might not have anyone to work on.»

Then, shortly after 8:30 p.m., an emergency services official at Stuyvesant High School, where a makeshift hospital had been set up, made an announcement over a bullhorn. Trauma surgeons were being urged to go to the scene; there might be survivors in the rubble.

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