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Web Exclusives: Bonus Stories October
9 , 2002: Sooty
horror "Let us go then, you and I . . . " "The horror, the horror"' Mr. Kurtz exclaims during his familiar epiphany. I am a surgeon, skilled in trauma and critical care, but as the horror of the World Trade Center catastrophe unfolded, I felt stranded and helpless in our safe haven of the hospital, prepared for the worst of disasters. My trek began at 9:30 that night after I had returned home frustrated. Only a few minor injury victims had presented to our ER. Between the harrowing repetitions of the newsreels, there appeared in small print on the TV screen: "Doctors go to the Chelsea Piers staging area." I telephoned my close friend and fellow surgeon-who had just been married one week ago-and we set out in her car. From the Upper East Side, we attempted to travel west through Central Park, until we reached the first of many police barricades. No problem. A single flash of a "Police Surgeon" PBA card was enough. All the way down the West Side Highway to 23'd street the NYPD waved us through. We entered the large gym-now-trauma-center, and were directed by the triage staff to the first two of some 55 makeshift stretchers, where we met a myriad of similarly helpless-feeling healthcare providers who desired to make a difference. After spending an hour there, treating only one patient who had sustained smoke inhalation injuries, I discovered that several other surgeons and anesthesiologists were hitching a ride down to the front-line triage area at the epicenter of destruction, One Liberty Plaza. We had heard reports that there might be chest, abdominal, and extremity trauma, that we might help to extricate the living from the rubble. This news — or rather, rumor — seemed encouraging. So the seven of us — three surgeons, one anesthesiologist, and two fearless medical students — piled into an ambulance replete with life-saving supplies: chest tubes for pneumothoraces; saws and scissors for potential amputations during extrication; IV catheters stuffed in our scrub pockets. The mere odor of soot in this van that already had performed multiple trips downtown was both sobering and ominous, as each person's countenance revealed. We all had treated countless serious bum victims in our training, but this was not some "one alarm" tire. As we approached "ground zero," there was the usual chit-chat and gallows humor for which doctors — especially surgeons — are infamous, since so often we must distract ourselves from bitter realities, lest unbridled emotion cloud our thought processes and meticulous technique. The anesthesiologist said he was worried that his new job next year in Upstate New York would be in jeopardy if someone discovered that he had forgotten to sign out the specific quantity of morphine for his drug bag. Sympathetically, I told him I was sure that there would be plenty of jobs upstate at Attica. At that moment, as we peered out the window and saw the billowing clouds of smoke and flying debris along with the multitude of personnel in masks, the conversation turned serious. Had the World Trade Center been constructed with asbestos? Had the hijackers carried on board the aircraft anthrax or other chemical/bacteriologic weapons? The ambulance could go no farther: The random plies of debris and the plethora of tire trucks had created insurmountable blockades for most vehicles. As we exited the van, we hardly could believe what we saw as our escort guided us closer to the heart of the action. The double high-filtration mask was suffocating, but breathing seemed easier when I thought of the thousands who already had suffocated to death. Police and civilian cars — some heaped on top of one another — had been reduced to scrap metal: bare axles, contorted hoods and door frames, glassless remnants of carcasses. After only a few minutes of trudging through the deep ash and mud, my old tennis shoes were filthy and soggy; my curly brown hair, so laden with ashes and dust that my friend said I looked 40 years older. I certainly felt that way. Suddenly on my left appeared the Chambers Street subway station entrance, but the adjacent sidewalk was in no condition for us to progress: the only way in was to shimmy sideways along the iron fence above the sidewalk, not unlike an army obstacle course. Finally, we found a route on the ground over fallen aluminum and steel beams, and we forged ahead. Then I saw it — first from the comer of my right eye and subsequently with a full frontal view. What once had towered over a hundred stories into the heavens had been reduced to a 60-foot mound of twisted metal and jagged concrete pieces. Dazed, I walked on until I saw One Liberty Plaza, with the dust-laden, haunting acronym NASDAQ on the steps ascending to the rotating door entrance: We had arrived. Gazing upon the ruins, thinking about the laws of physics, I realized that for any mortal to survive would be nothing less that a miracle. That was my first depressing thought, after which ensued blood-curdling, hypertension-inducing rage. What evil monster could have perpetrated such a nefarious deed? In time, we became one with our surroundings — enveloped by the whirlwind of ashes, the noise, debris, and mayhem. There were a few injured personnel with minor trauma and smoke inhalation, but as the night progressed, our worst fears became apparent. My surgical skills would be of no use: I desperately longed for a single victim to treat, and then perhaps one more, and then another. But our tour of duty concluded without that satisfaction, and tightly strapped to the jump-seat of the FDNY Command vehicle — a maneuverable modified golf cart — I departed the scene. As ground zero began to vanish behind us and the massive clouds of dust dissipated, I finally could see "the evening spread out against the sky," and we sped along the half empty streets of NYC. Never have I encountered a New York so deserted, populated only by scattered groups of NYPD, FDNY, and news crews. The tears on my crusted cheeks were painful sequelae of both ash and sorrow. We approached the Chelsea Piers parking lot, and I thanked the fire captain for his help, although so many words and thoughts passed through our minds unspoken, unspeakable. Is this what Pompeii and Herculaneum looked like in 79 A.D.? Is this a microcosm of the nuclear ablation of Hiroshima or Nagasaki? Is this what Pearl Harbor felt like? While these analogies seem fitting, I cannot answer such questions, since I am familiar with these disasters only vicariously.. As dawn ensued, my first elective surgery of the day, a laparoscopic hernia repair, was almost ready to start — a simple job of repairing a common defect in the human body. Yet, emblazoned on my mind remained the images of utter destruction and chaos. Forced to suppress these negative thoughts, I tended to my patient's needs and concerns. Surely it was better that he not know where I had been all night, what I had seen, felt. Focus. Concentrate. Just as she had done for Orpheus, for Dante, for T.S. Eliot, my
muse reveals my epiphany: that I have been to hell and back and
have envisioned the wasteland; that I have been privileged to observe
and to assist, to experience for myself the shock, the anger, and
the despair; and that I must sing my tale to induce catharsis. Even
if I close my eyes now, I still can detect the faint odor of soot.
The memory lingers: I will never forget. The horror.
You can reach the writer at avine@laparoscopicsurgeons.com
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