Chapter 3: How did I get here? Some Background Information
I was sitting with my wife, Beth in our home in Lancaster, Pennsylvania, when I saw the World Trade Center leveled, live, on television. I am a physician trained in pulmonary and intensive care unit medicine, and we knew that there would be an overwhelming need for doctors to help treat the massive casualties. As the day unfolded and planes hit the Pentagon and crashed in western Pennsylvania—possibly en route to our local nuclear power plant, Three Mile Island—it became increasingly clear that the country and the world were facing unprecedented challenges. I called and volunteered to help with the Red Cross and the Pennsylvania Medical Society.
No one called during the next two weeks. People either survived without much injury or died, as innocent victims or as heroic rescuers. I was saddened by all of the fatalities, but relieved that I did not need to leave my family to face the uncertainty of working in a war zone. My greatest fear was that anthrax would be found in the dust of the World Trade Center, as part of the terrorism attack, because I knew that by the time anthrax would be discovered among the carnage, thousands would be infected. I also knew that we were ill-prepared as a nation to deal with a bioterrorism threat or attack. Although I am a lung specialist trained at Mayo Clinic, who has practiced for twenty years, I had never seen or heard a presentation on an anthrax case and felt ill-prepared to handle such a case.
Since I knew no way to help, I settled down on trying to get InnerLink, Inc., my hands-on and internet-based education company, off the ground. We had risked everything financially to make this company a reality and had just closed on the funding of it to launch in earnest on September 9, 2001. One project my company was in the process of developing was to have a surprising connection to my work at Ground Zero, although we did not know that the outset.
That was our InnerSpace, our health education project, which we call Project Breathe. When Project Breathe was created, of course, we did not know that terrorists would attack the World Trade Center and the Pentagon or send another plane that would crash in Western Pennsylvania. The goal of Project Breathe to create an interactive education experience, encouraging students to refuse to begin smoking, or to quit if they already have. Using virtual reality images, students learn about the lungs, how to prevent illness, how to screen for undiagnosed illness, and how to build a medical record on paper, as well as online. One of the highlights of the experience is the T.E.A.M. machine, and it was this aspect of the program that was to become so vital to my post-9/11 work. The T.E.A.M. device is an acronym based on its functions: Telecommunications, Education, Administration, and Measurement. It is a laptop computer customized to allow for building an electronic health record and to do actual testing of the heart with electrocardiography and the lungs with spirometry and pulse oximetry measurements.
It was this function of the machine that I thought of when I received a call from Dr. Archie Roberts on September 28, 2000—a call that would lead to my work at the Ground Zero site. Archie is a retired cardiothoracic surgeon whose Living Heart Foundation had set up a program to help the Ground Zero rescuers. He had learned that the police officers of the NYPD were starting to develop symptoms of chest tightness and cough. There was no mechanism in place to determine who had critical levels of exposure and who had been, or was being, injured in the rescue effort. When the buildings fell, thousands of humans, computers, insulation, and other materials were pulverized, vaporized, and then burned. This meant that dust and debris was thick in the air, and the rescuers were breathing that air. The respiratory exposures were unprecedented, and a management team needed to be organized to determine the health of the rescuers at the scene.
There was also a need to determine the effects of the contaminants on the health of the thousands of lower Manhattan workers who also breathed potentially contaminated air.
Like many others in the country, I felt impotent, frustrated, and unable to help in this time of need, so I was glad to learn of a way to help. The nation gave blood and sent money, but somehow, this does not feel as fulfilling as many of us wish. It was also obvious that anthrax had not been spread in the cloud of smoke and dust we saw on TV.
My family gave their blessing for me to go. I asked Archie when I was needed in Lower Manhattan. “In twelve hours,” came his reply.
How do you prepare for work at or near Ground Zero? I sure did not know. This was unchartered territory for me. I simply grabbed some clothes, the T.E.A.M. machine, some spare clinical instruments, and my CEO’s laptop. Within three hours, I left my home to catch a train to New York City.