Another September 11th
Our lives begin to end the day we become silent about the things that matter.
–Dr. Martin Luther King, Jr.
September 11, 2001 – 8.30 a.m.
I arrived home from a night float service at Montefiore Hospital in the North Bronx and looked out onto Manhattan from my balcony. Smoke filled the skyline as it usually does. But this time it was a thick heavy smoke. Soon, neighbors were knocking at my door telling me of the recent news. The television reported that US airplanes were used as missles to attack the World Trade Center. We looked out again — the first tower had fallen.
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With three other physicians from the Social Medicine Program, I went to the hospital, took some first-aid supplies from the Emergency Room and drove down. The Bronx streets were eerie. I could see the smoke clouds over Manhattan. Children and adults filled the streets. As we drove towards Yankee Stadium, the radio newscaster reported that the second tower had fallen and that people were running frantically. Thousands were believed to be injured. We learned of the attack on the Pentagon and that other planes in the air were possible terrorist threats. There was even talk of a plane hitting a target in Chicago. The major highways were closed off, and the National Guard and ROTC had been called. A police escort took us from Yankee Stadium down the clsoed Deegan Highway and into the FDR on Manhattan’s East Side. We were the only car on the road, except for emergency vehicles darting back and forth.
At the entrance to the FDR, thousands of people, fearing other attacks, filled the highway to cross over from Manhattan into the Bronx. The same was true of the Queensborough, the Triborough — of all the bridges leading from Manhattan into Queens and Brooklyn. They were completely packed with thousands of people walking out of Manhattan. It was a scene from an apocalyptic D-Day film, a mass exodus of people running from the imminent fear.
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We got off at Canal Street. The dust was thick in the air. With masks on, we went against the dust-covered throngs attempting to leave the site. Marcelo, you’re crazy, I told myself. You should have stayed at home, anything can happen — a building can collapse, more attacks can occur. We went on, dressed in scrubs, looking for a place to set up. We helped at a pier close to Canal Street. There were very few people, and most of the injuries were minimal. We moved on closer to “Ground Zero,” meeting a team of surgeons also looking to provide services. By now the fourth plane had crash-landed in Pennsylvania. We finally went to the Javitz Center where physicians from NYU and St. Vincent’s hosptial had set up a MASH unit to triage people. We were divided into medical and surgical teams.
But we saw only a small amount of people — mostly for smoke inhalation, minor cuts and scrapes, and eyes with debris and irritation. Many were rescue workers, paramedics, firefighters and policemen. They left and went right back to help. Others came in a state of shock due to teh trauma they had just lived through. Some were dust-covered office-workers who had managed to run from the smoke cloud after the towers collapsed. Some could not find their fmaily members and were downright frantic. Some sat in a half stupor, others cried, others yelled in anger and retaliation. I sewed up some small lacerations, irrigated eyes, and helped place IV solutions while we all waited for the many injured we expected. They never came. They never would come.
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I stayed at the Jacob Javitz Center a good couple of hours and then accompanied a friend to Stuyvesant High School, which had been set up as a triage center. The ame scenario was repeated, only with slightly more people. Either they walked out of teh towers alive or were buried in the rubble. NYU, Cabrini Hospital, and St. Vincent’s Hospital saw no more than 200 patients combined. I saw some more people until I was exhausted. I returned home for a couple of hours of sleep before going in for the next night float.
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Some friends set up a MASH unit right at the perimeter of Ground Zero, but they too saw only a few people. Another friend, Denise, volunteered to help identify body pieces from the site. She described hundreds of remnants. She suffered a nervous attack the next day. Hospitals throughout New York had sent most patients home, clearing the beds to receive the thousands of injured people expected to be found. Even in the North Bronx, our hospital hallways were filled with stretchers, our emergency room also ready for the worst. The injured never came.
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Consulates were filled, and family identification centers were crowded with family and friends looking for their loved ones. The lucky ones were found in the hospitals, but the overwhelming majority were never to be found. Those who were buried in the rubble, who had succumbed to the fumes, who were trapped on the floors, who had been taken by the flames, would become the missing. Their pictures would cover the walls outside of NYU hosptial, Union Square, Central Station, West Side Piers, and become memorials for the disappeared.
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Afterwards
I watch as cluster bombs fall down on Afghanistan, its collateral damage the Afghani men, women, and children, of as much value in human life as the men and women who died on September 11th.
And then, I ask myself. Can I, as a physician whose job it is to heal and sustain life, approve of more innocent lives lost in the name of avenging the lives already lost by innocent people? Can I buy the media portrayal of a benighn war of hunting down Osama in the desert caves, when in reality war affects real people, men, women and children who have no responsibility for what happened in New York? Can I explain the normalcy with which cluster bombs, bombs guided by global positioning systems, thickened armor tanks, F-14s, Delta commando units are being described when I knew that their sole purpose is the destruction of life?
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I attended a patient in Jacobi hospital writhing in bed from alcohol and heroin withdrawal, loaded with methadone. I could not but help think of Afghanistan. Heroin laboratories were set up all over Afghanistan, with the help of the CIA and the Pakistani intelligence services. And then it became Afghanistan’s top export, with annual profits of $200 billion. Afghanistan and Pakistan became teh single biggest source of heroin in US streets.
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In the South Bronx, where we have our clinic, people face even greater daily stress than your average American. At the clinic I heard countless tales of anxiety caused by September 11th. Adults jumping at everything, a woman embarassed because she yelled bomb on a crowded subway train. People who lost friends, family. A patient who was left behind, alone with her children, without any aid. Her husband was a cook at Windows on the World. Of course she was undocumented. In the Emergency Room, everyone thought they had anthrax. Rashes, cold symptoms and sore throats. A woman came in crying — the guy who rents her videos was Pakistani, and the videos had water droplets on them. She believed she had inhaled something. “It all the fault of those Arabs.” I remained quiet.
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Thousands in New York have been laid off. If you think about it in terms of health, losing a job means losing health insurance. It maybe even means losing apartments, clothing, a way of life. It also means an increased risk of clinical depression.
An article in the November 15, 2001 issue of the New England Journal of Medicine described a study that showed that after the September 11th terrorist attacks, forty-four percent of Americans reported one or more substantial symptoms of stress. The conclusion: “Even clinicians who practice in regions that are far fro the recent attacks should be prepared to assist people with trauma related symptoms of stress.”
I thought of what the results would be if the study were in Afghanistan. Thousands of lives have been lost. Thousands more will be lost due to the effects of war.
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September 11, 1973
I was still in my mother’s womb, as airplanes attacked the Chilean presidential palace in a bloody plot organized by the CIA — more than 20 million dollars was given in US aid. My father spent three years in various concentration camps throughout Chile, tortured and dehumanized. My mother lived clandestinely and was finally able to leave after seeking asylum in Colombia. Then, our whole family was exiled for supporting the democratically elected government of Salvador Allende. Suffering took the form of faces on placards carried or pasted on walls by family members. The World Trade Center “Missing.” Desparecidos, they were called in Chile. The majority of the friends of my parents from college were desparecidos.
Thanks to destiny or some other power my parents never disappeared. The tremendous pain and intolerable losses — whether September 11, 2001 or September 11, 1973 — will never be easily overcome.