The widespread anguish everyone was feeling on Sept. 11 finally hit home with me late that night on a street near my facility, NYU Downtown Hospital. A television reporter, who had in tow a family searching for a loved one who they believed was at the hospital, approached me. I escorted the missing man's wife, his parents and the rest of the family through the dust and darkness of lower Manhattan back to the hospital. And I listened.
The missing man had worked on an upper floor of the second World Trade Center tower. His family told me he was a wonderful husband, son and brother. They had been walking from hospital to hospital, hoping. We tried to help but he wasn't on our list of patients. Our phones were out, complicating our efforts to communicate with others. The family's anger and deep sense of loss coupled with our inability to help have troubled me to this day-and it was a scene repeated more times than I want to remember.
But as horrifying as the events of Sept. 11 and the subsequent anthrax attacks were, they taught me some important lessons.
First, the bar for medical preparedness has been raised. Located three blocks away, NYU Downtown is the closest hospital to the World Trade Center site. In the first few hours we treated 320 victims of the attack, many with very serious injuries; all told, some 500 people who had been injured in the collapse of the twin towers came through our doors. Our hospital sheltered 450 others who had escaped injury but who didn't have anywhere else to go. We escorted 206 more on foot over the Brooklyn Bridge and uptown out of the dust cloud enveloping lower Manhattan. A team of 21 physicians and nurses was dispatched to ground zero to help treat survivors pulled from the wreckage.
NYU Downtown was dealing with several simultaneous crises: Normal telephone service was out, additional emergency generators had to be hauled in, steam and gas service were cut, water pressure was severely reduced and the air quality was poor. In addition, rumors were rampant about other buildings on the verge of collapse. Throughout this chaos, the courage and commitment of our physicians and staff, as well as help from other facilities, including our Mount Sinai NYU Health partners, NYU Medical Center, Hospital for Joint Diseases and Mount Sinai Hospital, made the difference in helping victims.
Though the events of Sept. 11 were horrific, experts say biological, chemical, nuclear and even conventional weapons could cause many more casualties in future terrorist attacks, truly testing the nation's medical readiness system.
The Greater New York Hospital Association reported that between Sept. 11 and Sept. 26, 91 hospitals treated 6,000 emergency-room patients related to the terrorist attacks. Two of those hospitals, NYU Downtown and St. Vincent's Hospital Manhattan, cared for more than 1,000 patients. The Centers for Disease Control and Prevention has reported 22 cases of intentional anthrax. But we now must prepare to face even greater challenges given the threats that exist in this new world we live in.
We also learned on Sept. 11 how large-scale disasters can broaden a hospital's responsibilities. Because of access and communications problems throughout downtown Manhattan, our role in the community extended well beyond medical care. In the days following the attack, NYU Downtown provided medical services, comfort, counseling and food, and filled prescriptions at a nearby apartment complex that has 5,500 residents, more than half of whom are older than 65. This complex also lost power and phone service, and our volunteers walked up as many as 20 floors to help. The planning, coordination and communications net must be cast over the widest possible range of emergency-response organizations before we can be called sufficiently prepared for crises of the scale of Sept. 11 or worse.
Another, and perhaps most important, lesson of Sept. 11 involves people. NYU Downtown accomplished much because our team of experienced physicians and staff pulled together under extraordinary circumstances. Yet this experience took-and among a few continues to take-an enormous emotional and psychological toll on them. The challenge for healthcare executives is to support our current staff while recruiting more people at all levels who are capable of working under increasingly difficult clinical and fiscal circumstances.
I believe that America's national security is threatened by a new type of war for which it is not yet prepared. I also believe that hospitals, community-based medical professionals and public health services are true "first responders" to any significant catastrophe. Based on these two premises, I believe the government must play a major role in financing this response infrastructure. Vital resources must be provided to ensure efficient and quicker communications, facilities that are retrofitted or rebuilt to deal with the potential injuries of this new warfare, adequate supplies, and ongoing staff recruitment and training. Further, local disaster plans should be amended to reflect a more comprehensive integration of government, law enforcement, public health, emergency agencies and healthcare providers.
None of us who came into contact with the victims of Sept. 11 will ever forget the experience. We owe the victims, their families, those who work in our hospitals and the communities we serve a commitment to work tirelessly to train and support our staff and to fight for the resources needed to do the job. Let the public debate begin.