Tom Hansen was trying to walk home to Brooklyn, just minutes after the World Trade Center towers fell, when a stranger grabbed him. He was standing next to a hastily assembled triage center at the Manhattan entrance to the Brooklyn Bridge, and the man wanted to know: "Do you have medical experience?"
He did, from his time in the Coast Guard. And so the 31-year-old Internet entrepreneur suddenly became part of Burn Unit B1. He was among eight to 10 volunteers grabbing the injured as they emerged from the blinding dust. "I saw burnt people. I saw a lot of eye injuries from the dust, fiberglass. Their eyes were bleeding. We didn't have any good scissors, and you'd have a plasma bag but no tubing for it. We were just not prepared."
It's the nightmare of every doctor, medic, and hospital administrator—disaster strikes, and the medical system can't cope. But after the first chaotic moments, when nobody knew what they had on their hands, thousands of medical workers mobilized throughout the Northeast to care for the victims of the World Trade Center and Pentagon attacks. For many, the tragedy was not that they weren't able to help, but that there was nobody who needed help. "We could have handled a lot more casualties, and we just didn't get them," says Glen Brooks, director of anesthesia at Cabrini Medical Center, who worked at triage centers at Stuyvesant High School and a shattered American Express building near ground zero. "Either they're walking wounded, or they're dead."
The tale repeated itself in Virginia, where doctors from Walter Reed Army Medical Center arrived to find the Pentagon's medical staff had pulled people from the rubble, with more than 40 patients on the lawn. "The physicians on scene did a heroic job of getting to the people who ultimately survived," says Lt. Col. Edward Lucci, chief of emergency medicine at Walter Reed, who arrived in one of the first ambulances on the scene. Lucci sent the four most critical patients away in ambulances. Some passersby handed over their cars so that soldiers could drive seriously injured people to the hospital. Other cars were commandeered. With those patients moved, Lucci's staff set up a triage center in the courtyard of the Pentagon.
But only about 80 people were treated at area hospitals, according to Walter Reed officials. At Virginia Hospital Center in nearby Arlington, over 100 nurses and 50 doctors were called in—16 times the normal emergency staffing. They treated 44 victims in the first 24 hours, more than any other hospital in the region. But it was a mere trickle compared with what they expected. Inova Alexandria Hospital treated just 22 victims, 16 of whom were released Tuesday. Six patients were helicoptered from the Pentagon to Washington Hospital Center. "We got the first wave," says Marion Jordan, director of the hospital's renowned burn unit. "After that, nothing." In the end, his trauma teams treated about as many people as they would from a large house fire.
Waiting for survivors. Navy Lt. Charles McGill, 26, who had worked at the Pentagon for just four weeks, joined a group of people who calmly evacuated the massive building, then made his way around the perimeter to where dark, heavy smoke poured out. He lined up to be a stretcher-bearer. He and his fellow volunteers, four to a board, were told that during these first hours only survivors would be moved. "In three hours, no one came out."
There were many more victims in New York, with an estimated 2,000 people treated by Wednesday morning, according to the Greater New York Hospital Association. Hundreds made their way to ferry docks in lower Manhattan and arrived in New Jersey, dazed and white with concrete dust. Firefighters at the Hoboken bus station hosed people down; volunteers toweled them off. "When you get close to ground zero, the ground itself is just coated with several inches of paper and gray dust," says Brooks. "It's blowing around and creating a lot of eye injuries."
Manhattan's St. Vincent's Hospital, among the closest to the scene, treated 320 people by 9 p.m. Tuesday. But by 10 at night, there were so many volunteer medical personnel, and so few new patients, that the idled staff sat outside, chatting, eating Salvation Army sandwiches, staring silently. A TV producer was heard yelling, "Why are there no people here? Where are the victims?"
Medical associations throughout the nation started fielding calls soon after the attacks, with hundreds of doctors volunteering to go to New York. Health and Human Services Secretary Tommy Thompson sent more than 300 emergency medical and mortuary personnel, and authorized the Centers for Disease Control and Prevention to ship emergency supplies. Lines stretched around the block at blood donation centers in New York, Washington, and cities across the country. Many centers ended up turning away donors because they ran out of supplies.
Great response. "I've never seen a response mobilized so well, so fast," says John Brennan, director of pediatric emergency medicine at St. Barnabas Medical Center in Livingston, N.J. "We had so many volunteers, physicians, nurses, people coming in offering to do laundry, a sub shop and pizza parlor sending in food." But the hospital got only 32 patients, mostly with minor problems—smoke inhalation, stress. By Tuesday night, hospital staff was dismantling the elaborate triage unit built in the parking lot.
At the Pentagon, two trauma teams remain on the scene in two triage tents, with the workers replaced every eight hours. Lt. Col. James Goff, assistant chief of surgery at Walter Reed, says that no survivors have been removed from the building since the early hours Tuesday. "We're standing by, and our prayer is they are going to find people alive," Goff says. "But we are in a dangerous position because of the structural instability of the building."
Michael Kurtz is experiencing a measure of relief. His wife, Louise, an accountant at the Pentagon, was helicoptered to Washington Hospital Center. She suffered first- and second-degree burns over 70 percent of her body and was so wrapped in bandages her husband couldn't recognize her. But when he asked her the next morning to wiggle her toes, the toes moved. "I was ecstatic," Michael Kurtz says.
Julie Boryczewski hopes she'll be as lucky. On Wednesday morning, she stood in the bright sun outside New York University Medical Center with her mother, Krystyna, clutching a photo of her brother and sobbing. Martin Boryczewski, 29, worked on the 104th floor of the World Trade Center as a trader. No one had heard from him since the blast. The family has been calling hospital hotlines looking for news. They found one of Martin's coworkers, but not him. "Today we're going to comb the city, going to all the different hospitals," said Julie, 38. "He's a tough son of a bitch. We're very hopeful."
With Nell Boyce in New Jersey; Jeff Howe, Rachel K. Sobel, and Stacey Schultz in New York City; Mary Brophy Marcus, Katy Kelly, Joseph P. Shapiro, and Marianne Szegedy-Maszak in Washington, D.C.
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