Editorials @ Applelust

Let Them Speak: Reflections from a New York ER Physician

©9-28-01 Dr. Jeffrey Fine

[Editor's Note: At Applelust we have received several pieces by our readers who have lived or are living in New York. It seems they just want to say something. We understand. So if it helps us all, then we are glad to give them a voice... DKS]

I've had so many thoughts and feelings about the events of the past few days. I want to put them out there although I'm not sure why I think anybody else would want to know what I am feeling; I put them out them out there as part of my own need.

I live in midtown Manhattan at the corner of 3rd Avenue and 28th street — about 10 blocks away from the Empire State Building, 20 blocks from the UN, about 50 blocks from the World Trade Center, and two blocks away from the Armory where family members of missing persons are bringing DNA samples and holding vigils. I'm a pediatric emergency physician at Bellevue Hospital, a large municipal hospital (not just a psychiatric hospital) in midtown Manhattan. It is a Level 1 trauma center.

I hear on the news that nobody can believe that this catastrophe happened here. Although I didn't live my life in fear, I am not at all surprised it happened here. Isn't this exactly we worried about for Y2K. NY is a perfect target — it has many national and international symbols, it has easy access, almost anyone can fit in here relatively unobtrusively. The most extremely different people all live together in NYC. I've often said, what I love about New York is the same thing I hate about New York — all the people here.

I was finishing my overnight shift on Tuesday morning when one of my colleagues called to say that he was driving in from Long Island and saw smoke coming from the World Trade Center. I said I hadn't heard anything. He called back to say a plane had hit the WTC. Soon after that that hospital was put in disaster mode. All patients are either sent home from the emergency room or immediately admitted to the hospital. As many patients as can be are discharged from the hospital. Extra staff, supplies, and equipment are mobilized to the ER. Within about an hour, we had at least 50 doctors in the Pediatric Emergency area alone. We normally have 2 beds ready to receive critically ill patients, now we had 20. After about 3 hours, we had received about 5 patients in our area. Since I had already been working all night long, and since we'd presumably have to work in shifts, I left for a while to get some sleep. On that day, the whole ER saw only about 200 patients, mostly smoke inhalation, eye injuries, and orthopedic trauma. By the evening there apparently wasn't much happening. It's still unclear to me what really happened that day. I've heard that may people were evacuated to New Jersey. It's possible it was just too hard to get to my hospital from the site.

During the first day, all north-going avenues were totally congested with cars. Then sometime around 5 pm it seemed as if all the cars were gone. There was very little traffic. The weather was lovely — clear skies, not too hot. People were out, mostly quiet. Most businesses had closed, but faithfully as always, the restaurants, delis, and Korean grocery stores were open. How else are New Yorkers going to eat? The Starbucks in the ground floor of my building, however, was not open. I will say though, that Starbucks has been delivering truckloads of coffee to the armory, volunteer sites, and my hospital.

I came in to work the next day. There were only a handful of patients and the only people from the scene were firemen injured during the rescue work. Sirens were blaring all day long, but there were no patients.

At the end of my shift, a group of people were going to the rescue site to relieve other staff members who had been sent earlier. Our van snaked its way through lower Manhattan to arrive at Ground Zero. I couldn't really remember what it had looked like down there before the blast. Now, it looked like other sites where there had been a large fire or explosion, except these were huge, towering sky scrapers. Large buildings with blown-out windows, huge piles of metal and debris. Everything in the immediate vicinity was covered with a grey dust as was almost all of lower Manhattan. Somehow, as grisly as it looks on television, it seems prettier on the TV. Down there it was all grey and dirty, with the acrid smell of smoke in the air. I was told when I arrived, if I heard 3 blasts of the claxon, it meant there was a possible building collapse. I was there for about 2 hours. We were on standby to receive patients. Again, we attended to rescue workers suffering mostly from exhaustion and breathing difficulties. There were hundreds of people there, mostly standing around waiting to do things. There was a squadron of national guardsmen, whose job I was told, was to create a corridor if one was needed. There were many EMTs, paramedics, firemen, and construction workers. All of a sudden that claxon sounded, and there was a mad dash. There weren't all that many places to go and everyone was going. And of course we had no idea which building was maybe going to fall. And anyway, how far away do you need to go to be safe. After we went about 2 blocks, there was a rescue worker having trouble breathing, we were attending to him when there was a second panic-stricken rush of people, and we all just started running. At that point, I realized just how scary it was there and it seemed to me that I wasn't going to be much help down there. The whole place was unstable, we had limited protective gear, and really, we were more likely to become victims.

Some of us joined up and convinced a police officer to give us a ride back to the hospital. Whew. After I got back, we were notified that a building had collapsed and that they would be bringing in many patients. As we had the day before we mobilized, but this time, it was mostly a false alarm.

The second day had been strange. The city was virtually closed, so there was no traffic. After I got home, Jocelyn and I went outside in the evening. We live in an area which has many Indian and Pakistani stores and restaurants. Outside my building, at the street corner, was a man who was dressed like the pictures I have seen of Mullahs, with a white headdress, long white beard, and long gray robe, bent down on the sidewalk in prayer towards the east. He was being talked to by several policemen who were trying to get him to move on. I read the next day about a similar encounter further uptown and I wondered if this guy was making the rounds. We have our share of bizarre characters in this neighborhood. I don't know if this fellow was one of them, but I have never seen anyone praying on the sidewalk before.

We saw humvees and troop carriers driving through the streets. That was strange. Now soldiers in camouflage gear seem normal at street corners.

We walked around for a little while when we began to feel a weird vibe in the air. It seemed like people were walking hurriedly and nervously south, talking on their cell phones, and looking up at the darkened Empire State building. When we asked someone what was going on, we heard there was a bomb scare at the Empire State Building and they were evacuating nearby buildings. So what's the best thing to do if there really is a bomb? Go home, stay inside, stay outside? We went home to be with Sam the cocker spaniel. It was a false alarm.

Sam, in fact, didn't like the vibe those first two days; I don't know if it was all the people outside moving around or if it was the smell.

On Thursday, the city was supposed to start to get back to normal. I didn't really see what the point was. Why have all those extra people in the city. And was anything productive likely to get done. But Jocelyn, for example, who works in children's television production, didn't want to sit around anymore and watch exploding buildings so she went to work. I spent the morning sleeping in and then calling some of my Israeli relatives to let them know that I was OK. Its usually the other way around.

I went into work later and things were much the same. The main difference from our usual status was that things were slower than usual. Instead of the usual 100 patients a day which we usually see, now we're seeing 10 a day. The main thing we've done at work the past few days is eat. We had a vanload of sandwiches delivered from a local deli. Boxloads of uneaten school lunches are there. And we even had a delivery from the Zone, a company that delivers nutritionally balanced meals to your door.

On Wednesday night we walked down to Union Square where an NYU student had started a "thing", I don't know what to call it. Large rolls of brown paper were spread out, and people were writing messages and drawing pictures. There were so many. I saw one I had seen on the TV news. The twin towers were outlined and filled in with many faces. The mom who drew it wanted to emphasize to her daughter that the towers, which they had been able to see from their apartment, were not a physical structure but a place filled with people. At the same time there was a group of Tibetan monks leading a prayer service wishing for peace. It was a beautiful coming together of people. We went with a friend to eat at the Zen Palate, a vegetarian restaurant near the park. They were playing oldies. When we finished and went outside, the smell of that acrid smoke was very strong in the air. It was just another example of the weirdness and the normalcy sitting side by side with each other. I saw a reference in the paper to Berliners sitting at outdoor cafes while they watched the city burn although I don't exactly know when this was.

On Friday morning I went in to work. Another day as the Maytag repairman. I read the whole NY Times. From the first I started to become really tearful. I wasn't really sure what that feeling was, but I really wanted to cry. We received a bouquet of flowers from the Pediatric Emergency Staff at the Oklahoma City Children's hospital. I called information, got their phone number, and called the ER. I spoke to one of the docs there who told me that they had received something from us during the Oklahoma City Bombing and wanted to let us know they were thinking about us. I really got choked up and each time I remember it I get teary eyed. I'm not sure what it is about that particular gesture that gets me.

We were told that President Bush might come to visit. It didn't seem likely to me, since there was none of the typical Secret Service activity that typically preceded high profile visits in the past.

On Friday evening we headed back to Union Square for the scheduled 7 PM candlelight vigil. There were probably 5,000 people (my guesstimate) all with candles. Again it was another moving scene. There was a single trumpeter player the Star Spangled Banner , New York, New York, and some other tunes. I guess New Yorkers are still a little too uptight. Although people were singing quietly to themselves, there was no loud communal raising of voices in song. It needed someone to take the lead. It wasn't me. There were pockets of people around the park, talking and singing; everybody had candles. In another part of the park it was business as usual; young people practicing their skateboarding moves and bicycle acrobatics. People were starting to place candles along the walls in different parts of the park. I was a little worried that all of these candles might cause a fire. In one part of the park some people had formed a peace sign out of candles. I stood looking at it when I noticed that standing next to me was Mark Green, one of the NY mayoral candidates. It turns out that Jocelyn knows his wife who was also there. After the vigil we went to a coffee bar and I saw someone from work. His girlfriend told me that her mother had met me at a wedding in San Francisco a few years ago and had mentioned that her daughter would be coming to NY. I remembered the wedding but didn't remember the conversation. Still, it was a weird night to be meeting new people.

One of the frequently repeated commentaries is how this event is reminiscent of Pearl Harbor. Probably, the main difference is that so many people here are getting back to normal with sushi and sake.

I hear how the rest of the country supports us here in NY. I have so often thought that NY is not really like the rest of the country and that most of the country actually wishes NY wasn't part of it. It has always seemed to me that Europeans are more interested in visiting NY than Americans are. Maybe I was wrong.

On one of those nights I was walking around, I saw a car with a surfboard on the roof rack. I really don't remember seeing many surfboards in NY. I was told that with the tropical storm that was brewing along the east coast, so the surf was really good. Maybe the guy was just heading back to the West Coast.

On Saturday morning we went to the Union Square farmers market. Elizabeth, one of our folk dance friends, has an apple orchard in upstate NY and sells in one of the NY City farmer's markets. The market seemed full and active. People were buying plants, apples, and vegetables. This was the closest I had felt to the city getting back to normal, but I can't get a sense of how much of it is role playing, doing what we're supposed to be doing.

On Saturday afternoon , Jocelyn and I got out of Dodge. I needed to get away for a little while. We came to hang out with friends in Rhode Island. Life outside of NY seems pretty different. On the surface it seems almost like business as usual except that there are a lot of flags around. People are going to Sunday brunches, meetings, school. Of course people are also talking a lot about the attack. I've had some very depressing discussions about all the geopolitical ramifications of Tuesday's attack as well as our response. Is doomsday near?

Its almost painful to be away from NY. I thought it would be relaxing, but since no one else here has had the experience, its really difficult to share. We're getting tired of telling our tales and it seems to me that nothing else is really that important or interesting or amusing. So I bury myself in the NY Times. There at least it is all NY all the time. The columns and the stories are really good, I think, and they at least seem to reflect a lot of my feelings.

I don't know what the feelings are in different parts of the country. In NY, I don't get a sense that anybody wants blind revenge. I'm quite fearful of what's to come, and it's hard to believe that any good will come of whatever it is. But all we can hope for I guess is that someday, things will be better than they feel today.

I was in Turkey two summers ago during the big earthquake. Although I feel like there are many similarities in people's experience of the events, I don't really have the writing energy left to describe it all, and of course the human cost there was astounding. But very briefly - Although I felt the quake, I wasn't injured. Nonetheless, walking around Istanbul after, you felt the quiet and the pain and the fear. And in a strange way, we were more connected to Turkish people after the earthquake. We had transformed from being tourists to sharing some profound experience. There were a lot of similarities this week in NY. Most people were not hurt yet everyone was affected. And in many ways, the community of citizens felt closer.

Also after the earthquake, Turkish TV which had been characterized by variety shows, American sitcoms, music videos, and other Middle Eastern Music programs, went to 24 hour-a-day earthquake disaster coverage. It was the same for television in NY. Although outside of NY, maybe only CNN had continuous coverage, in NY all the local stations also had continuous coverage. So we had a choice of cartoons, old movies, old sitcoms, QVC, or exploding planes. After Wednesday, I had to stop watching.

Dr. Jeffrey Fine is a Pediatric Emergency Room Physician at Bellevue Hospital in New York City.

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