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At Ground Zero
NIH'ers Respond to Tragedy in NYC

By Rich McManus

Photos by Van Hubbard, Susan Orsega, Rich McManus

On the Front Page...

Whether summoned by duty or conscience, a cadre of NIH employees found themselves at ground zero at the World Trade Center in the weeks following the terrorist attacks of Sept. 11, and though all emerged stunned by the devastation they had witnessed, all expressed deep honor at having answered the call to serve.

Continued...

Message in post-tragedy dust

The most substantial form of assistance was the response of the PHS-1 Disaster Medical Assistance Team (DMAT), a 120-person squad composed primarily of health care professionals, many of them NIH'ers. Less than half that force was deployed to New York, however, as it became clear that there were far more fatalities than injuries.

Commanding the team is a soft-spoken pediatrician who is normally so low-key that friends say he has to signal when he has told a joke, so sober is his usual demeanor. A DMAT member since 1987, Dr. Van Hubbard of NIDDK is one of those NIH'ers whose heaping platter of routine responsibilities and extracurricular efforts has already won him a slew of honors and thickened his resumé. His two main titles — director of NIH's Division of Nutrition Research Coordination, and chief, Nutritional Sciences Branch — keep him busy enough, but the morning of Sept. 11 found him almost madly engaged. Paged during a staff meeting, he soon found himself juggling four phone lines and a beeper as the Office of Emergency Preparedness put the DMAT team on alert within minutes of the New York attack.

PHS-1 DMAT Commander Van Hubbard in his office with hard hat and respirator — reminders of a tragedy.

At right are hat, respirator and multiple ID cards needed to work on site.

Then a plane struck the Pentagon, and Hubbard's team was suddenly redirected there. With the help of team member Ann Ellis of the Clinical Center's Office of Facility Management and others, he quickly contacted DMAT members — "basically anybody we could get hold of by email or phone." Ironically, Hubbard had been scheduled to fly out of Dulles, bound for Indianapolis, that day.

By 10 a.m. on Sept. 11, the team had its activation orders and was converging on the DMAT warehouse in Gaithersburg; some 45 members had assembled by mid-afternoon. Hubbard keeps a duffle bag packed with 2 weeks' worth of clothes and equipment ready, in addition to a "go bag" stuffed with emergency medical supplies — the kind you can tear into without having to wait for the team's tractor-trailer-load of supplies to set up.

DMAT member Ann Ellis works in facility management at the CC.

But all that hurrying was for naught as the team learned that it was not officially requested by the state of Virginia or the District of Columbia to assist at the Pentagon; again, fatalities outnumbered injuries there. So team members went to the Gaithersburg Hilton overnight, awaiting orders. "Everybody wanted to do something," Hubbard said, "but we recognized that [the rescue effort] had to be organized. Unfortunately we had to hold tight."

By the following evening, the team was demobilized for the Pentagon site, and most went back to their regular jobs. However they remained on high-alert status. They were called up Sept. 20 for routine deployment downtown for President Bush's address to the nation; a DMAT team is always on hand for State of the Union-type addresses in case of disruption on Capitol Hill.

On Wednesday, Sept. 19, PHS-1 learned that it was to report to New York on Saturday, Sept. 22 to relieve other DMAT teams that had been first responders there. Members got back on a bus in Gaithersburg for the drive to New York City, and arrived there late in the afternoon for a 10-day mission.

Rescue workers and their trained dogs take a break on the perimeter of the pile. Note bandages on the dogs' feet.

The Sheraton New York is not the typical bivouac for DMAT members; they are far more used to cots, tents, and sleeping under the stars. But the five-star hotel at the corner of 52nd St. and Second Ave. became the center of operations for PHS-1, whose management team met with authorities on the hotel's 50th floor. Prior to Sept. 11, Hubbard and other NIH team members say they had been used primarily to post-hurricane medical assistance, which, though physically more demanding, was not nearly as emotionally unsettling as what they saw in New York.

Hubbard was issued a phone/radio set and told to be ready the next morning to go by bus to another site to get special ID cards issued for the response. A tour of ground zero followed.

Hubbard pauses for photo in medical tent.

"I can't express it in words — the enormity of it, the feelings," he said, his face tightening. It would turn out that Hubbard lost not only a childhood friend, who had captained a ladder company in New York, but also a close and promising young colleague who had been aboard the jetliner that slammed into the Pentagon. "But there was still a glimmer of hope, even then. There was still active fire when we got there. And it was there when we left, too."

Portion of WTC impales nearby building.

Five medical assistance sites — named after the streets on which they were located — ringed the WTC rubble, nicknamed by fire fighters and police "the pile" or "the Devil's Tower." Hubbard visited them all as his team mainly cared for rescue workers injured while sorting through the wreckage. The most common ailments were respiratory problems, from breathing grimy air, and "a fair number of lacerations needing sutures, as well as aches and bruises. The men would get stitched up and go right back to work." Hubbard said some rescue workers declined further evaluations of suspected problems in order to return to the rescue effort, saying, "Nah, I'll do that later."

Hubbard says PHS-1 also offered fluids, respite "and conversation if they needed it. We saw more and more foot problems as the week went on — the workers spent so much time in wet boots."

The DMAT team was supposed to work 8-hour shifts, but with security so tight and the effort so unrestrained, most shifts stretched close to 12 hours. The five medical tents saw roughly 500 patients per day.

A workman surveys the damage at ground zero. The dented ball in the center was allegedly an ornament in the WTC courtyard.

Team members had to travel in pairs and report their whereabouts hourly as changing conditions at the site and shifting winds altered their risk exposure dramatically. Hubbard said the girder removal clanged like church bells; Clinical Center nurse practitioner Susan Orsega said it sounded more like the building itself "was screaming and crying; it sent chills down your spine." Nurse Alice Rosenberg of the CC's 11th floor outpatient clinic, who went to New York for 2 nights on a solo mission of mercy, said her fellow Red Cross volunteers were alerted to three signals: "One horn meant be alert. Two horns meant move a block away. Three horns meant run like hell. I wasn't going to wait around after horn number two."

Though Hubbard said the DMAT deployment was as well-staffed and supplied as any he has been on, and lauded his teammates as "willing to put in the time needed," the witness he bore proved more taxing than the work itself. "I don't think anyone could be prepared to see this site," he said. "Realizing what happened, and the number of people involved..."

Crane-borne bucket carries rescue workers to the top of the pile at ground zero.

Hubbard joined the DMAT team the year after he'd switched from intramural NIH to extramural; he'd read about the opportunity in the NIH Record. "I did it to do something clinical," he said. "Once I got involved, I thought it was the right thing to do." In the past, he has been deployed primarily to hurricanes — Andrew, he says, was the worst — and his most recent storm was Georges in Puerto Rico and Key West. Until the WTC deployment, he had never had to say no to normal NIH duties during DMAT engagements. "The number of times we are actually called up isn't that great," he said. "The question is, can you stay interested in the times in between?"

Hubbard is grimly aware that PHS-1 may be called up again, and soon. He says the team is always willing to take on new members, and concludes on a note of pride: "It does make you feel good to go out and do this. You know you've made a difference. It's an internal reward."

Passerby lights candle at one of many impromptu sidewalk memorials.

Administrative officer Ann Ellis, who had helped Hubbard contact the DMAT team members, and whose husband had participated in the Pentagon search-and-rescue mission, has offered to assemble a team album from the WTC deployment, as both recruitment tool and remembrance.

"Seeing the destruction was so incredibly sad to me," she said. "I didn't feel anger until I saw it. All of the surrounding buildings were affected. I kept wondering what it must have been like that day."

One of the five medical sites erected by federal responders to the disaster at the World Trade Center.

Like everyone else from NIH who went to ground zero, she has taken something positive from the holocaust: "It was such an honor to go out with the DMAT team, and to be part of it. It's an experience I'll never forget."

Other NIH participants in PHS-1 DMAT deployments during September included Linda Brown, nurses William Campbell and Rosa Clark, communications officer/pharmacist Albert Lock, safety officer Ed Pfister, Dr. Eric Mann and pharmacist Michael Montello. NIH'ers who served in New York with the CCRF included research nurses Lucienne Nelson of NCI and Ann Knebel of NINR, and NIDA nurse scientist Angela Martinelli.

A three-story flag adorns a building in New York City in the tragedy's wake.

'Food I Can Do'

Alice Rosenberg is a nurse case manager on the 11th floor outpatient clinic in Bldg. 10; she came to NIH 2 years ago after directing nursing care at the Whitman-Walker Clinic in D.C. and loves her work here, primarily with HIV/AIDS patients.

She learned that her daughter, in graduate school at New York University, and her friends had been feeding firemen at the WTC scene, and decided, "Food I can do — I've been feeding people for years...So I got in my car and went."

A plaster-of-paris pillar becomes an instant message board and memorial.

She left on Sept. 25 and spent 2 nights volunteering at a Red Cross shelter set up in a small college "a block from the hole." She showed up out of the blue, and almost wasn't needed, but was willing to do most anything, anytime. "It was, 'Do you want to wash pots or make beds?' so that's what I did."

Rosenberg said the firemen "were incredibly grateful to sit on a chair and eat a meal with a fork and a knife on a plate, rather than sitting on a sidewalk eating out of a styrofoam box. You couldn't get a lot of guys to lie down — they just wouldn't lie down. The rescue workers wouldn't even unstrap their tool belts.

"Some would talk," she continued, "some wouldn't. It wasn't disrespectful, they just didn't want to do it."

Rosenberg would put stuffed animals, donated by the boxload to the Red Cross, on each cot, along with Hershey's kisses and letters sent from kids to their new heroes, the rescuers. "It was very sweet to see that," she said.

Rosenberg is glad she went, and intends to return again late this year to see how else she can help. "It was just incredible to see this hole, and pile of rubble. The ground is still hot. The big cranes that they had looked like toys — like an Erector set — in perspective to the pile."

She is also newly evangelical about the Red Cross: "They are my new big thing," she enthused. "For the rest of my life, when I make a contribution it will be to the Red Cross. They're just an amazing group of people."

'Same Church, Different Pew'

Nurse practitioner Susan Orsega of the 11th floor outpatient unit in the Clinical Center also spent 10 days at the World Trade Center site, not as a DMAT member, but as one of a 43-person Commissioned Corps Readiness Force, or, as she defines it relative to DMAT, "Same church, different pew." An NIH'er for 11 years, the Pittsburgh native joined the CCRF in 1997.

"The CCRF was created by the Office of the Surgeon General in 1994 to improve DHHS response to public health emergencies," she explained. "CCRF is like a DMAT in that we respond to disasters or other public health emergencies but the key difference is that we respond to domestic or international requests. DMATs respond only to national disasters, and trains regularly as a solid team."

Alice Rosenberg (l) and Susan Orsega

Orsega was initially called in to provide nursing "backfill" at the National Naval Medical Center when nurses there were called to staff the USS Comfort hospital ship. She spent almost 3 days at Navy, then was redeployed to New York City, where she provided medical care at the same 5 medical assistance sites that were staffed by the PHS-1 DMAT.

"I saw patients ranging from iron and steelworkers who needed blister care management to burns, lacerations and corneal abrasions," she said. "We were treating 150-200 patients per shift at all five clinics."

Despite witnessing what she called indescribable horror, Orsega "really felt honored to represent those who couldn't go, and to represent PHS. It's a great way to feel like you're responding on behalf of the nation. And there were so many good people that were there," she continued. "The fire fighters were never, ever going to stop...So many people lost their friends. It was a war zone, really."

Paperwork from the WTC disaster collects on the fire escape of a nearby building.

Orsega documented much of what she saw in photographs. Dust from the destruction piled so thick that hand-scrawled messages were everywhere: "Dana, I love you always. Mom" and "We miss you Father Mike" and "We came, we saw, we cried."

"I hope I never see anything like this again," Orsega said. "It does move your soul, and put things into perspective."

Once she got back to Bethesda, she couldn't resist tuning in news coverage of the disaster. "I felt the need to stay connected," she said.

Ed Pfister's Diary

Ed Pfister works on a pile every day, but normally the pile is composed of building blueprints, which he reviews by the acre in his role as environmental compliance officer in the Office of Research Services. His Bldg. 13 workspace is awash in drawings that depict neatness, order, rationality. Chaos, danger and evil intent are not spoken here.

So the shock was acute when he arrived in New York City with the PHS-1 DMAT team; he is its preventive medicine/safety officer. A team member for the past 8 years, he makes sure his mates have the proper equipment, in this instance mainly respirators. He believes "it is part of the calling of the PHS to respond to disasters — it is part of the duties of a commissioned officer to 'go outside the box,' so to speak, and do some interesting things to help people."

Ed Pfister

A veteran of three hurricanes and two flood relief efforts, he was not prepared for the destruction he saw in New York, so he resorted to diary-keeping as a way of managing his emotions. "I sent what I wrote to my family while I was away," he said. "It really helped me to write it down, and resulted in some encouraging emails. It helped with the mentally distressing aspects of the deployment. I get choked up just thinking about it."

Some excerpts:

Sept. 22Day 13 of the disaster and day 1 for us. Travel by bus to NYC. We were briefed by the incident command chief. He had been on the scene since day 1 and was visibly affected by his recent experience. A veteran of 30 some years as a police officer and fire fighter himself, he broke down as he described a vivid scene of the recovery of the remains of a fire fighter. Only the crushed helmet, a limb, a boot and a segment of turnout coat was left of the recovered man and yet he was identified. As the remains were brought out to the street, all work stopped and rescue workers lined the street with bowed heads to pay their respects to their comrade.

Sept. 28I made a point to visit as many of the impromptu memorials around the site that I could. Also, in the city, the people have come and placed hundreds of flowers, candles, cards and photos around the fire halls. At fire station 57, "The Pride of Midtown," the activity board still is dated Sept. 11, 2001, and bears the names of the shift leader, crew and responding truck that was lost on that day. We also had a scare regarding the potential for the freon gas tanks, which provided air conditioning for the towers, to rupture. Freon tanks are under pressure and if ruptured in the presence of heat and water will form a toxic acid gas (phosgene) which displaces oxygen and causes severe burns in the lungs and on the skin.

Sept. 29Today, our last day and being Sunday and as I'm not a habitual churchgoer, I visited the "Pride of Midtown" fire battalion station again. Lynch, Twitty and a host of other names and pictures of the first responding fire fighters were posted with candles and letters from all over the world. I spent about an hour there to pay my last respects and ponder on the meaning of all this.

The funeral day took on added meaning as we took our shift at 4 p.m. Reports surfaced that a stairwell (Tower 1, I think) had been accessed and hundreds of intact bodies had been found. Now, in this driving rain, the big cranes and other rigs on this side of "the Pile" came to a halt, as fire fighters climbed up the mound and formed bucket brigades to remove debris by hand...

A memorial to lost police officers and fire fighters gets a visit by a responder.

I spent several hours tonight, walking "the pile" and attempting to soak it all in for the last time and find a bit of closure...deep below ground a portion of the pile was still on fire and boiled with molten material. Sometimes, open flame would erupt as a crane pulled debris out and air rushed in. Fire hoses constantly poured streams of water causing huge billowing steam clouds to rise up over the site into the huge lights above.

I watched at least six bodies pulled out at about 20 minute intervals and I moved in closer to the scene. I joined the scene with the fire fighters just as the flag-draped remains of one of their comrades was removed. I joined the yellow-jacketed responders lining both sides of the rubble roadway and we saluted this fallen hero as he was placed in an ambulance and removed.

Today was the most solemn day I have ever experienced in my life.


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