September 11, 2001:
Doctors answered the call

"I just wish I could have done more." That was the anguished regret of physicians who rushed to aid the victims who never came. Their patients became the rescuers who toiled too long in vain.

By Mark Crane
Senior Editor

Within minutes of the devastating terrorist attack on the World Trade Center, hundreds of physicians and other medical personnel raced to the scene and to nearby hospitals. Many more were turned away as it became tragically apparent that few survivors would emerge from the destroyed towers.

Why did so many physicians respond so quickly? Those we spoke with offered no lofty dissertations about the Hippocratic oath. Their instincts simply took over. The essence of being a physician is to comfort the afflicted. It never occurred to these doctors that they didn't have to be there, that others could handle the carnage.

The volunteers themselves faced life-and-death danger. At the time, no one knew what might still happen. Would the terrorists strike another building nearby? Might a gas leak cause an explosion? Indeed, two physicians we interviewed barely escaped with their lives when an adjacent 47-story building crashed to the ground that Tuesday evening.

It would be impossible to chronicle all the acts of heroism performed that dreadful week. But to bear some witness to them, we asked five physicians to help us—and you—see what they and their colleagues saw and felt at the scene of the disaster.

In doing so, they relived horrifying scenes no human should ever have to witness. They responded with raw emotion, tears, and a need to let others know what it was like. We salute for their valor all the doctors who went to help, and these doctors in particular for sharing such intensely personal feelings with us. They represent the finest tradition of medicine.

Raymond S. Basri, internist, Middletown, NY

"The pain is so fresh," said Basri, his voice breaking even nine days after the World Trade Center was leveled. "There was such destruction. Everything had a layer of soot and ash. It looked like nuclear winter."

A volunteer firefighter and triage physician for his local disaster team, the 46-year-old Basri knew he could help. "I did a quick assessment of my office patients. None needed immediate attention, so I explained why we'd have to reschedule.

"I got to lower Manhattan [about 70 miles away] right after the second tower collapsed. My sister works nearby, and I started worrying about her, too. I didn't find out she was safe until late afternoon."

As soon as he arrived, though, Basri learned that hundreds of firefighters—two of them his friends—had been killed when the first tower collapsed. "It was incredibly upsetting to everyone there, but they just kept working."

So did Basri. He treated rescuers who had difficulty breathing because of the smoke, dust, insulation, asbestos, and jet fuel. He treated lacerations and irrigated smoke- and debris-damaged eyes. "I got hit on the head with some falling debris. Luckily, I was wearing a safety helmet. Then I made sure other physicians had helmets."

When Basri wasn't providing medical aid, he helped the firefighters push hose and worked on the bucket line to remove debris. "I was too close to the Number 7 building when it collapsed. I started running for my life as this 47-story billowing cloud of dust, debris, and glass came flying at us. I climbed on the back of an ambulance that was pulling away. That's how I got out alive."

Basri reluctantly left around 11 pm, physically and emotionally drained. He had office hours on Wednesday. "Every patient wanted to talk about the disaster, and I just couldn't. I closed my door and cried through my lunch hour. I went back on Thursday and joined a bucket line."

A strange vision stands out in his memory. "I was walking the perimeter. I came across a large chunk of a jet engine, just sitting upright at the corner of Church and Murray streets. It looked like a city waste basket."

Pamela Hops, family medicine resident, New York City

This second-year resident was at home with her husband, anesthesiology resident Robert Worth, when the planes crashed into the towers. "We jumped in a cab and got as close as we could. Someone put us on a bus, then gave us triage tickets and instructions that were chilling: 'If you kick them and they don't move, give them a black tag. If they're critical, give them a red tag.' We expected there would be thousands of injured people.

"The scene was surreal, like no place I'd ever seen, dark and like a lunar landscape. The air had a horribly different quality to it. Seeing bodies at the morgue set up in a Brooks Brothers store will stay with me forever," says the 38-year-old resident.

Hops and other volunteers set up several triage centers at the scene, only to abandon them time and again when they heard that nearby buildings were about to collapse or that there was a gas leak. "We set up a high school as the main treatment center. We hung IV bags on the student lockers, because we didn't have any poles. We set up ORs. We were ready for anything, but few people were brought to us."

Like Basri, Hops was near building 7 when it collapsed. "It was oddly quiet, like it just fell into itself. People were running and yelling. It was mass chaos. I ran for my life and thought I was going to die. A fireman picked me up and threw me into the back of an ambulance. We barely outraced the debris cloud."

Few firefighters would leave Ground Zero to get their eyes irrigated. "They'd lost so many of their buddies and they wouldn't stop working even for food and water. They didn't want to be separated from their squads. Sometimes, we'd have to insist that they take a break to get some Gatorade or an IV. Then they went right back to work. We went to those who wouldn't come to us. One person held the IV bag high in the air while the other irrigated the eyes, right there on the rubble."

Daralyn Samuels, internist, New York City

"I didn't think about whether I should go or not. I just went," says Samuels, an attending at St. Vincent's Hospital and Medical Center, the primary hospital for the disaster. "The victims could have been any of us. There but for the grace of God go I."

The streets around the hospital were barricaded, so she didn't have to worry about missing office hours. No regular patient could get through. Samuels assisted families searching for loved ones who'd worked in the towers. "We had lists of people who'd been admitted or treated at the hospital. It was heartbreaking to talk to these families."

She also helped treat firefighters, police, and rescue workers at the scene, mainly by giving oxygen, washing eyes, or treating cuts and blisters. "I even gave eye washes to a couple of the dogs used in the rescue effort. The firemen were so unbelievable. They worked well past exhaustion in the slim hope that they could rescue someone, anyone.

"It's hard to talk about some of this—not only the devastation, but also the most wonderful things. Everyone was reaching out to each other. I felt privileged to be there, to do what I could."

Some scenes were particularly poignant. "I noticed on the ground someone's 'to do' list with the ordinary tasks we all remind ourselves of, like 'pay bills, call John back, get a gift for Mom's birthday.' Amid this destruction with thousands dead, thinking about how this one person will never get to do those things really got to me."

Noah Gilson, neurologist, West Long Branch, NJ

"I was seeing patients in my office when I heard the news," says Gilson, who's 45. "I got a fax from Riverview Medical Center in Red Bank asking physicians to help treat disaster victims who might be sent from New York, about 20 minutes away by ferry. I finished my office hours and got there around 11 am."

Seven hours passed before the first patients were brought in. One man's story chilled Gilson. "He worked for the PATH train line and was in the basement of the towers when the first plane hit. He ran into the street, but couldn't find his partner. He saw about 20 people jump out of the burning building to their deaths. He saw the second plane crash into the tower, creating a fireball that he felt at street level. Flaming debris barely missed him. The first building collapsed. He ran for a few blocks and then ducked into the first open door he found, a bar, to get away from the dust cloud.

"Later that afternoon, he was stumbling around the area, covered with dust, obviously inebriated, and horribly distraught. Police triaged him to our hospital. He had no physical injury, but the psychological trauma was intense. It was painful for him to describe what he saw. He felt guilty that he didn't save his partner.

"Our community has a lot of commuters. At one high school, 32 kids lost a parent. Four hospital employees lost close relatives. Discussions among physicians changed. It wasn't about this patient or that one, but about friends and neighbors who had died or escaped in time. The artificial distinction between doctor and patient became meaningless. It was about community, and a shared loss of unbelievable proportions."

Anthony K. Gordon, radiologist, Roswell, GA

When he heard the news, Gordon knew he had to get to New York even though rescue organizations told him they had enough doctors. He drove all night, about 870 miles, with a friend, a British medical tech.

Once in the city, the 42-year-old physician got on a bus with other doctors, nurses, and rescue workers heading for Ground Zero. "People would walk up to us, hand us water, or show pictures of their loved ones and ask us to help find them. They had big signs saying 'Thank you' and were blowing kisses. It was a spirit I'll never forget. People would do literally anything they could to help. If you had told someone to run 20 miles to get supplies, he would have welcomed the opportunity. No one wanted to stop to rest or eat."

Gordon did eye washes and tended to the lacerations of rescue workers. "The dust would turn to concrete in their eyes. We'd rinse them out with saline, force them to rest a bit, and then they'd go back out. Like everyone, I just wish I could have done more."

 

Mark Crane. September 11, 2001: Doctors answered the call. Medical Economics 2001;20:28.