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Hospitals Plunge Into Recovery Efforts Following Terrorist Attacks
In the days following the September 11 terrorist attacks on the World Trade Center and the Pentagon, orthopedic surgeon David S. Feldman, MD, and residents from the Hospital for Joint Diseases in New York volunteered to saw body parts from corpses trapped under massive steel I-beams amidst the rubble and carnage of the fallen trade towers.
Two weeks later, his voice still reflected the shock and disbelief that began at 9:03 that Tuesday morning when he witnessed, from the window of his hospital's conference room, the second plane smash into the south tower. Among the many frustrations of the episode is the inadequacy of words, even from those at the front lines of emergency patient care, to fully convey the experience. "You can't really describe it, how horrible this thing is," Dr. Feldman says.
Among the first people to realize the magnitude of the tragedies in New York and Washington were the emergency personnel in the hospitals near the disaster areas. Outpatient Surgery interviewed several health care workers to get a sense of what they experienced that day. Here are their stories.
First to receive the injured from the New York attacks were the emergency personnel at NYU Downtown Hospital, four blocks from ground zero. The 200-bed community hospital received more than 350 patients during the first two hours after the attack. Some 40 blocks uptown, the 600-bed St. Vincent's Hospital took in about 575 patients. Well-rehearsed disaster plans at both institutions went into effect immediately as the doctors and nurses triaged the patients to receive appropriate care.
The earliest injuries were mostly burns and blunt trauma. Three patients were essentially dead-on-arrival at NYU Downtown Hospital, and two more died in subsequent days. Four patients died after arriving at St. Vincent's Hospital, three from massive crush injuries and one from respiratory burns.
"A lot of severe head injuries, soft-tissue injuries, crush injuries to the chest and pelvis" arrived in the first wave at NYU Downtown Hospital, says Howard Beaton, MD, chief of surgery and emergency services. "But we also had hundreds and hundreds of people who just had lacerations, sprains, and various minor fractures. There was an awful lot of dust and smoke inhalation."
St. Vincent's Hospital chief of trauma service Jesse Blumenthal, MD, thought it might be an unannounced code-3 disaster drill when his beeper sounded shortly before 9 AM on the 11th. He looked out to see a gaping, smoking hole in the north tower of the World Trade Center. "Within 10 minutes we were totally mobilized," says Dr. Blumenthal. All elective procedures were cancelled, all available space converted to the triage and care of a tremendous influx of victims.
Meanwhile, the doctors and nurses at NYU Downtown Hospital were dealing not only with a deluge of the injured but also with the heavy smoke and debris that blanketed the entire area after the towers collapsed. Rather than seal the building to keep out the dust cloud, they opened their doors to provide a safe haven for hundreds of people running from the fallen towers. Soon the corridors and offices of the hospital were swarming with those seeking shelter. By early afternoon the hospital lost power and phone service. Emergency generators kicked on immediately. Cell phones, however, proved unreliable after antennae went down with the twin towers. Dr. Beaton e-mailed his wife in Boston to let her know he was all right.
Not until later in the day did the staff realize the magnitude of the disaster. Only then could they give license to their own grief. "But when those patients come through, you're focused on them," says Donna Pritchard, RN, the director of nursing for perioperative services at NYU Downtown Hospital. "You focus on, how can we help this patient? What's going to be the plan of care?" One patient underwent three surgeries at once, for an open leg fracture, a GI procedure and facial reconstruction.
After the morning wave of injuries, personnel at NYU Downtown Hospital, St. Vincent's Hospital and other city health care facilities braced for a second wave that never came. The collapse of the towers buried the remaining victims.
Sixteen burn victims arrived within the first hour of the attack at the emergency room of the New York Presbyterian Hospital-Weill Cornell Medical Center in midtown Manhattan. The city's premier burn center was prepared for many more. "The physicians and nurses, the personnel, the hospital workers, everybody was there, the resources were there," says Neal Flomenbaum, MD, emergency physician-in-chief. "The only thing missing were the patients."
Meanwhile, few of the injured survived the Pentagon attack, either. Twelve patients arrived at the 907-bed Washington Hospital Center in northwest Washington, DC, between 10 AM and noon on the 11th. Mostly these were burns. "There was concern that we would receive a lot more victims given the magnitude of the incident," says Sandra B. Marshall, RN, vice president of nursing at the hospital. "The staff responded well, and we rapidly triaged those patients to the appropriate area."
Three blocks from the White House, police evacuated all personnel from the Center for Ambulatory Surgery, amidst reports of explosions at nearby government buildings. Those reports turned out to be unfounded, but the hospital's proximity to the White House put it potentially in harm's way while a fourth hijacked plane remained aloft. "Everybody was really terrified," says Kathleen Owens, president of the surgical center. "We knew it was heading here." That plane, of course, crashed in western Pennsylvania.
In the aftermath of the attack in New York, personnel at NYU Downtown Hospital turned their attention to the elderly and disabled of lower Manhattan, delivering food and medicine to those unable or unwilling to venture out into what had become a ghost town. Dr. Blumenthal of St. Vincent's, meanwhile, witnessed the nascent stirrings of the patriotism that was soon to sweep the nation. "I came back from ground zero in a Jeep, a National Guard vehicle, and people were yelling and cheering," says Dr. Blumenthal. "I was over in Vietnam, and I remember when I came back, if a National Guard truck went down the street, people would boo and throw things. [Now it was a] totally different attitude, a very supportive attitude."
All Americans struggled to return to some sense of normalcy in the days and weeks that followed the attacks. Nowhere was that struggle more acute than in New York, where, as of September 28, more than 5,960 people were officially missing in the rubble at the World Trade Center, with 305 confirmed deaths. One-hundred eighty-eight perished at the Pentagon.
"People are trying to act as if everything is okay and nothing more is going to happen," says Dr. Flomenbaum of New York Presbyterian Hospital. "But sooner or later, usually sooner, you just see it in their faces. They are thinking about it."
In the days following the September 11 terrorist attacks on the World Trade Center and the Pentagon, orthopedic surgeon David S. Feldman, MD, and residents from the Hospital for Joint Diseases in New York volunteered to saw body parts from corpses trapped under massive steel I-beams amidst the rubble and carnage of the fallen trade towers.Two weeks later, his voice still reflected the shock and disbelief that began at 9:03 that Tuesday morning when he witnessed, from the window of his hospital's conference room, the second plane smash into the south tower. Among the many frustrations of the episode is the inadequacy of words, even from those at the front lines of emergency patient care, to fully convey the experience. "You can't really describe it, how horrible this thing is," Dr. Feldman says.
Among the first people to realize the magnitude of the tragedies in New York and Washington were the emergency personnel in the hospitals near the disaster areas. Outpatient Surgery interviewed several health care workers to get a sense of what they experienced that day. Here are their stories.
First to receive the injured from the New York attacks were the emergency personnel at NYU Downtown Hospital, four blocks from ground zero. The 200-bed community hospital received more than 350 patients during the first two hours after the attack. Some 40 blocks uptown, the 600-bed St. Vincent's Hospital took in about 575 patients. Well-rehearsed disaster plans at both institutions went into effect immediately as the doctors and nurses triaged the patients to receive appropriate care.
The earliest injuries were mostly burns and blunt trauma. Three patients were essentially dead-on-arrival at NYU Downtown Hospital, and two more died in subsequent days. Four patients died after arriving at St. Vincent's Hospital, three from massive crush injuries and one from respiratory burns.
"A lot of severe head injuries, soft-tissue injuries, crush injuries to the chest and pelvis" arrived in the first wave at NYU Downtown Hospital, says Howard Beaton, MD, chief of surgery and emergency services. "But we also had hundreds and hundreds of people who just had lacerations, sprains, and various minor fractures. There was an awful lot of dust and smoke inhalation."
St. Vincent's Hospital chief of trauma service Jesse Blumenthal, MD, thought it might be an unannounced code-3 disaster drill when his beeper sounded shortly before 9 AM on the 11th. He looked out to see a gaping, smoking hole in the north tower of the World Trade Center. "Within 10 minutes we were totally mobilized," says Dr. Blumenthal. All elective procedures were cancelled, all available space converted to the triage and care of a tremendous influx of victims.
Meanwhile, the doctors and nurses at NYU Downtown Hospital were dealing not only with a deluge of the injured but also with the heavy smoke and debris that blanketed the entire area after the towers collapsed. Rather than seal the building to keep out the dust cloud, they opened their doors to provide a safe haven for hundreds of people running from the fallen towers. Soon the corridors and offices of the hospital were swarming with those seeking shelter. By early afternoon the hospital lost power and phone service. Emergency generators kicked on immediately. Cell phones, however, proved unreliable after antennae went down with the twin towers. Dr. Beaton e-mailed his wife in Boston to let her know he was all right.
Not until later in the day did the staff realize the magnitude of the disaster. Only then could they give license to their own grief. "But when those patients come through, you're focused on them," says Donna Pritchard, RN, the director of nursing for perioperative services at NYU Downtown Hospital. "You focus on, how can we help this patient? What's going to be the plan of care?" One patient underwent three surgeries at once, for an open leg fracture, a GI procedure and facial reconstruction.
After the morning wave of injuries, personnel at NYU Downtown Hospital, St. Vincent's Hospital and other city health care facilities braced for a second wave that never came. The collapse of the towers buried the remaining victims.
Sixteen burn victims arrived within the first hour of the attack at the emergency room of the New York Presbyterian Hospital-Weill Cornell Medical Center in midtown Manhattan. The city's premier burn center was prepared for many more. "The physicians and nurses, the personnel, the hospital workers, everybody was there, the resources were there," says Neal Flomenbaum, MD, emergency physician-in-chief. "The only thing missing were the patients."
Meanwhile, few of the injured survived the Pentagon attack, either. Twelve patients arrived at the 907-bed Washington Hospital Center in northwest Washington, DC, between 10 AM and noon on the 11th. Mostly these were burns. "There was concern that we would receive a lot more victims given the magnitude of the incident," says Sandra B. Marshall, RN, vice president of nursing at the hospital. "The staff responded well, and we rapidly triaged those patients to the appropriate area."
Three blocks from the White House, police evacuated all personnel from the Center for Ambulatory Surgery, amidst reports of explosions at nearby government buildings. Those reports turned out to be unfounded, but the hospital's proximity to the White House put it potentially in harm's way while a fourth hijacked plane remained aloft. "Everybody was really terrified," says Kathleen Owens, president of the surgical center. "We knew it was heading here." That plane, of course, crashed in western Pennsylvania.
In the aftermath of the attack in New York, personnel at NYU Downtown Hospital turned their attention to the elderly and disabled of lower Manhattan, delivering food and medicine to those unable or unwilling to venture out into what had become a ghost town. Dr. Blumenthal of St. Vincent's, meanwhile, witnessed the nascent stirrings of the patriotism that was soon to sweep the nation. "I came back from ground zero in a Jeep, a National Guard vehicle, and people were yelling and cheering," says Dr. Blumenthal. "I was over in Vietnam, and I remember when I came back, if a National Guard truck went down the street, people would boo and throw things. [Now it was a] totally different attitude, a very supportive attitude."
All Americans struggled to return to some sense of normalcy in the days and weeks that followed the attacks. Nowhere was that struggle more acute than in New York, where, as of September 28, more than 5,960 people were officially missing in the rubble at the World Trade Center, with 305 confirmed deaths. One-hundred eighty-eight perished at the Pentagon.
"People are trying to act as if everything is okay and nothing more is going to happen," says Dr. Flomenbaum of New York Presbyterian Hospital. "But sooner or later, usually sooner, you just see it in their faces. They are thinking about it."
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