Susan Briggs, M.D., was in surgery at around noon on Sept. 11 when the deployment order came from the federal government.
The trauma surgeon at Massachusetts General Hospital, Boston, launched into her other role as unit commander of a disaster medical team and rounded up more than 40 Boston-area medical professionals.
"Six hours later we were on our way to New York by ground," she said.
Fifty miles west, in Worcester, Mass., a 56-member unit came together at UMass Memorial Health Care-10 doctors, 17 nurses, 21 emergency medical technicians, a respiratory therapist and other medical personnel-and headed for the same hangar at Stewart Air Force Base in Newburgh, N.Y., 40 miles north of Manhattan, where teams from Rhode Island, New Jersey and New York also were congregating.
It was the biggest call-up yet for the National Disaster Medical System, a joint venture of HHS, the Federal Emergency Management Agency and the Department of Veterans Affairs that has responded since 1978 to situations calling for massive mobilization of medical resources.
Composed of volunteers, all 80 disaster teams across the country were put on alert by HHS Secretary Tommy Thompson hours after the attacks in New York and Washington. The units are selected for their mix of expertise or proximity to the disaster site. Of the 80 units, 25 are capable of supplying Level 1 trauma readiness (See map).
The disaster marked the first time all 80 teams had been put on alert.
Responding physicians and medical professionals are "federalized" for the duration of their duty, their expenses and normal salary reimbursed by the U.S. Public Health Service. Truckloads of special supplies and equipment are stored and ready for deployment to the sites of hurricanes, floods, earthquakes or civil disturbances such as the violent protests during the 1999 World Trade Organization conference in Seattle.
Proximity to the disaster site was the deciding factor last week for which teams to mobilize, said a spokesman for the HHS Office of Emergency Preparedness, which coordinated medical relief assistance. Teams had to charter buses and load equipment on trucks to reach the areas by convoy. The Boston contingent arrived at the Stewart AFB staging area at 3 a.m. Sept. 12, Briggs said.
But in the time it took the five units to get there, the complexion of the medical emergency had changed significantly, she said. Instead of supplementing local hospitals with emergency physicians and burn-trauma specialists, the Boston team stayed put just as did thousands of other volunteers who were ready for massive casualties but instead found precious few survivors. The same situation greeted teams from Atlanta and Winston-Salem, N.C., reaching the nation's capital to assist with medical casualties from the Pentagon.
The North Carolina unit initially thought it would be demobilized, but instead it was reassigned to go to New York because of a new focus on rescue workers forced to breathe acrid air from the rubble, said Harry Bailey, the unit's public information officer.
The North Carolina team includes a special medical-response team, one of only a few in the nation, that can immediately address threats of chemical contamination, the HHS spokesman said. A second contingent of 24 members left Winston-Salem around 8: 30 p.m. Sept. 12 and met up with the first team of 35 outside Washington for the trip to New York, Bailey said.
Meanwhile, the Boston team moved to a closer staging area on Sept. 13, where they waited to relieve exhausted New York medical workers and support more the recovery than the rescue.
Last week the federal medical-disaster system turned attention to helping with identification of victims, dispatching seven volunteer teams trained to care for mass casualties. Called disaster mortuary operational response teams, they each include about 10 morticians, anthropologists and forensic specialists.