AMSA's 2015 Annual Convention
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February 26 - March 1, 2015 

Witness to Devastation

OFFERING ASSISTANCE AT GROUND ZERO.

The New Physician March 2001
Herald Ostovar, a fourth-year medical student specializing in emergency medicine, took time off during his Somerville, New Jersey, family practice rotation on the nights of Sept. 12 and 13 to help with rescue efforts at the World Trade Center. The following story contains edited excerpts of letters he wrote reflecting on these experiences.


WEDNESDAY, SEPT. 12


I clearly remember the acrid smell of ozone and burning plastic as I stepped off the subway at Fourth Street, about 30 blocks from the wreckage site. As I started walking south, I was immediately struck by the silence. The only sounds were the beeping of distant dump trucks and the occasional somber “hello” of a passerby. Once in a while an emergency vehicle rushed by me. A makeshift sign saying “I § NY” hung outside a residence.


A little after 8 p.m. I reached the main checkpoint, which was crowded with police, media and other people. I nervously approached and told them I was a member of the American College of Emergency Physicians. The next thing I knew, I was thrust into a world I will never forget. The ground was dusty, and it was dark—the streetlights were out. In the distance, I could see the dim glow of the rescue workers’ lights and smoke billowing out of the rubble where the World Trade Center towers once stood. It looked like the aftermath of a volcanic eruption. As I continued to approach the disaster area, the dust on the ground deepened to several inches. I walked past a quarter-mile line of waiting dump trucks and nodded to the policeman or military guard who stood on each block. As I neared Ground Zero, the acrid smell became stronger, and large amounts of dust and debris flew into my eyes and mouth. I stopped numerous times to clear my eyes and throat, and I kept looking up as if I might see the two buildings if I looked hard enough.


The next thing I saw was beyond words or comprehension. The 7 World Trade Center building had been reduced to twisted shards of steel, wire and glass, and the building next to it leaned to the right with all of its windows blown out. Cars were flattened to the ground, their rubber tires melted off. A UPS truck had a huge hole in its roof. A firetruck was covered in soot, its windows shattered and the passenger cab filled with pieces of cement and steel. A New York City police car was burned almost beyond recognition, and other demolished cars were piled upon each other as if in a junkyard.


I walked around the massive debris field and ventured into an even more disastrous scene: 1 World Trade Center and 2 World Trade Center had been transformed into a five-block radius of rubble at which thousands of rescue workers feverishly worked. I was surrounded by lights, generators, cranes, Caterpillars, bulldozers and dump trucks with tires higher than my head. Soot, ash and concrete powder covered the trees. Windows below the 30th floor of every building in the surrounding area were blown out. One building had its top sheared off, and only its skeleton remained. A 40-foot-tall section of the outside wall of one of the towers had ripped a 30-story hole in the front of another building and was lodged precariously about 20 stories up. The Millennium Hotel had been completely sandblasted in the front. In its lobby lay masses of shattered glass, articles of clothing, reading materials, debris-covered couches and—an eerie sight—the hotel “welcome” screen on a front-desk computer, the only working electric-powered item in the building.


And then there were the World Trade Center towers. A portion of both outside walls still stood, but there were stories upon stories of rubble, and fire and smoke spewed from a 50- to 75-foot-deep crater—presumably the towers’ lower floors.


In all of this chaos, I was able to find one of the two triage units in the area. (All the other units had been converted into morgues.) I bumped into some other medical students, and we banded together. We were assigned posts, and then we waited. The only injuries we treated all night were those of rescue workers. No victims were found alive. Only body parts were discovered.


Feeling helpless, many of the medical students decided to aid the rescue effort. We grabbed work gloves, goggles and breathing masks and climbed the mountain of debris. The hundreds, if not thousands, of firemen, emergency medical technicians, policemen, nurses, physicians and other rescue workers looked like a sea of yellow and blue on the mass of rubble. People from all over the country—even the world—were helping. Buckets were filled with debris and passed along lines of hundreds of workers. At the end of the lines, they were emptied in the path of bulldozers, which transferred the debris to dump trucks. We ended up at the front of one of these lines, right next to the crater.


The level of this effort’s organization was amazing; massive quantities of water bottles, sandwiches, hamburgers, fruits and snacks were available for workers at every street corner. Hot meals and showers had been set up for anyone in need. Sledgehammers, shovels, crowbars, steel clippers, steel-cutting saws, acetylene torches, fiber-optic cameras and canine units were all used at some point by the teams. Every so often a team would yell “quiet!” and hundreds of workers would echo that call until it became absolutely silent—they were listening for any sounds of life coming from underneath the rubble.


At one point, one of the canine units signaled a specific area and fiber-optic cameras showed a leg buried underneath two feet of rubble. Surrounded by an audience, we dug feverishly only to realize the grimmest of our fears: It was just a leg, mangled and shattered. It was placed in a bucket and passed on down the line. Later, we thought we saw a flashlight from the 40th floor of a building right above our heads; a helicopter rescue unit went up with a floodlight only to discover it was a reflection off shattered blinds. At another time in the night, the ground shuddered and everyone ran, many falling as they attempted to navigate the debris field. Eventually the rescue organizers cleared the area of workers and brought in the big guns—cranes and torches.


It was evident the cleanup would take many months, if not more than a year, to complete, and by 6:30 a.m. I was exhausted. But before I left, I had the chance to treat an injured fireman, putting five stitches in his finger (unsupervised!). We won’t go into how I accomplished this in a completely dark room using only a flashlight for illumination or how much sterile technique was used. The nice thing was that the fireman was genuinely thankful.


I had to walk the same 30 blocks on my return to the subway station, but somehow they seemed a little less dark. It wasn’t because the sun was coming up but because I felt I had played a role, however insignificant, in the rescue effort. The train ride home was somber, but all sorts of people approached me to thank me for the job I was doing. This made me feel good, but I didn’t deserve their thanks. The rescue workers who are constantly risking their lives are the heroes. No wonder they call them “New York’s bravest and finest.”


THURSDAY, SEPT. 13


On my second evening at the site, we were asked to write our names and social security numbers on our forearms, “just in case.” I considered the danger and felt like I should leave, but something made me stay.


The main story of this night was rain—a very cold, heavy rain. My stethoscope will forever smell like the acrid air because rain leaked into it. During the night, there was the occasional discussion of how long the search for the living would continue. Some firefighters estimated 12 days. Others said it could be more like 14 to 16 days if the weather remained cool and if it rained every once in a while. Rain can hamper rescue efforts, but it can also be a source of life to those trapped underneath. The rain helped reduce the dust and debris in the air, but it made us all so cold. Fortunately, donations provided us with new, dry shirts, socks and underwear, as well as food and drink. The local Burger King (with windows blown out) was the staging area for the food relief.


At daybreak we were told that all nonessential personnel were to move the triage center from the firehouse because the 60-story building next to it was showing increasing signs of instability. Apparently nearby workers could hear the building groaning; lasers had also been placed on the building to detect any movements.


After a frantic move of our triage center from the firehouse to the Burger King and back, I went with a cardiologist into the rubble, where we helped by passing buckets. Even though I got soaked, and we didn’t find anyone, it felt good to be doing something worthwhile. We stopped our work when a battalion chief kicked everyone off that part of the hill because the area had become unstable. It was amazing to see many firefighters reacting with disgust. Most of them didn’t care about their own safety; they wanted to keep digging. After all, 200 to 300 of their brothers lay underneath.


Our group quickly moved to another side of the rubble, close to where we had been digging the night before. It was the only place that was almost too warm to work in; despite all the rain, fires were still burning below, and hot steam was escaping from the crater. We started digging (this time I deferred the bucket-passing to a firefighter). Every once in a while, during a break, a rescue worker would break down in tears. My eyes welled up from time to time also, and they still do when I think about the tragedy. The per-
sonal effects we unearthed profoundly touched us—teddy bears, caps, toys, monogrammed satchels, photographs, and ID and business cards. One of the business cards had a Web address, and when I later signed on to the site, I discovered the card’s owner was alive!


The cardiologist and I went back to the triage center and helped for a while with eye washes, after which we decided to put in one last effort outside. As we worked, we were surrounded by giant bulldozers, dump trucks, diggers, workers with powerful electric cutting saws, and welders who cut through the massive beams. Sparks flew in every direction. Sounds of grinding and crunching steel filled the air.


Then the sun came out. American flags flew from the beams above our heads and from the tops of emergency vehicles, bulldozers, cranes and many workers’ helmets. There was red, white and blue everywhere. One gets the sense that if this disaster accomplished anything, it made us realize again, much more than before, that every human being is precious. The attacks and responding relief and rescue efforts bring us closer together and unify us as a nation. Eventually, they will unify us as a world.
Herald Ostovar is a fourth-year medical student at St. George’s University School of Medicine in Grenada, West Indies.