September 11, 2001

Advances in Skin & Wound Care,  Nov/Dec 2001  by Salcido, Richard

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Editorial

Part of our overall evaluation of older patients is determining their level of cognitive function, including long- and short-- term memory. We screen long-term memory by asking specific questions that should be crystallized intelligence, such as, "What were you doing when Pearl Harbor was bombed?"

Most people, even those with impaired memory, remember. They also remember where they were and what they were doing the day John F. Kennedy was assassinated.

Sadly, we now have another horrific event that we will eventually use to quiz our patients: the tragic and painful attack on the mind, heart, and soul of our nation on September 11, 2001.

A Time for Action

Like most Americans, I moved from denial to anger to action in rapid order in the aftermath of the attack. Reaching the action stage, many of us did what we could: donated blood or money (or both), volunteered our services, prayed, and prepared for war.

During the Vietnam War, I served as a Green Beret, and later, after the war, as a Special Forces medic. Repeatedly watching the images of the planes being piloted into the Twin Towers filled me with an overwhelming need to do something, to put all of my training to use. By Friday evening, I could no longer sit and do nothing.

Andrea Cheville, a faculty member in my rehabilitation medicine department, and two of my resident physicians, Jeff Rowe and Anthony Lee, had volunteered at ground zero within days of the attacks on the World Trade Center. Inspired by their actions, I headed there on Saturday, September 14, in the company of Rowe and Vietnam veteran Steve Ockenden. Even if we could help only a few of the 3,000 rescue workers risking life and limb at the disaster site, I would know that we would be making a valuable contribution.

As we went through the various checkpoints to get closer to our destination, the gravity of the situation began to sink in. We walked past city hall, the financial district, and Wall Street, the quality of the air changing to a thick, choking cloud of pulverized concrete. The air was also tinged with a distinct stench from the smoldering inferno that a few days earlier had represented one of the nation's busiest office buildings and had held thousands of lives. Buildings close to the epicenter were windowless and covered with a sheet of gray dust.

Making our way toward the rescue site, we approached a fire station adjacent to what remained of the towers. Hundreds of rescue and salvage workers were forming long lines of bucket brigades, hoisting rubble and sifting the contents of the full buckets on a truck for further analysis and disposal. Giant cranes were lifting large, mangled steel beams and depositing them onto 18-- wheelers.

I was unprepared for the emotional jolt when we finally reached ground zero. This was no longer the surreal, eerie image I had watched on television; this was shockingly and devastatingly real.

Setting Up Triage

A team of medical volunteers met us at the fire station, which was serving as a triage area. They told us that they needed to shut down soon because the fire station was going to be reoccupied by fire fighters. They instructed us to quickly set up a new triage area within a hundred meters of the rescue site. The designated site was O'Hara's Restaurant & Pub on Cedar Street.

Inside the pub, we began sweeping and cleaning dust from the bar and tables. Working alongside our group from Penn was a police officer and a nurse from a plastic surgery practice on Long Island. Within an hour, loads of supplies miraculously appeared, including wound care dressings, antibiotics, medications, intravenous fluids, heavy gloves, and high-energy foods.

By the end of the day, we had tallied only a few customers, mostly rescue workers and national guardsmen who needed to have their eyes irrigated of debris and their minor wounds dressed. We felt a huge sense of accomplishment, though. We knew that the triage site we had set up could remain functional as long as necessary.

Lasting Impressions

As we trekked back through the barriers toward home, we encountered a frantic young woman in tears. She stopped us and asked how she could get to the site where she had lost her father. We felt helpless to assist her, except for directing her to the barriers and to the police manning them. We continued on, toward New York University and the last barrier. Two college students approached and offered us water; it was their contribution to the rescue effort. I imagine they felt as helpless as we did in trying to contribute to righting a terrible wrong.

A few days after returning home to Philadelphia, I learned that one of my closest friends, Richard (Dik) Brackett, a physician assistant, former Green Beret, and Vietnam veteran, had been in New York at the same time as I was, also volunteering his services. He had left his clinic in Boothbay Harbor, ME, to work at Chelsea Piers. I was not surprised by his devotion to duty; I had witnessed it most of my adult life. In fact, the devotion of everyone involved-the families and friends who had lost loved ones, the rescue workers, and the medical volunteers-made a lasting impression on me.