The Victim Is the First Responder. Are You Ready?
Twenty-Five Years After Ground Zero, We Need Ready and Resilient Communities
In the fall of 2001, one of the first electronic medical records in the rubble of the World Trade Center began as a science project I built with my middle-school daughters at the kitchen table.
We called it Marstronauts in Training. The idea was simple: to be an astronaut headed for Mars, you have to be as healthy as a human can be — and that starts with understanding your own body. So we wired a laptop to a spirometer and a pulse-oximeter sensor. Learn how your body works. Live in a way that keeps it strong. Share what you learn. That was the philosophy — my daughters helped me build it.
When the towers fell, I went to New York. Alongside the Living Heart Foundation, I helped set up a clinic for the police officers working the pile. I wasn’t paid for it, and I’ve never regretted a minute. But I brought one thing that turned out to matter: that jury-rigged laptop. We called it the T.E.A.M. Machine — for Telemedicine, Education, Administration, and Medical records — and connected a spirometer, an electrocardiograph, a pulse oximeter, even a radiation detector. Over the following weeks, more than two hundred volunteers helped us screen some eighteen hundred rescue workers. My mentor at the Mayo Clinic, Dr. Edward Rosenow, connected me with two colleagues there — Dr. Paul Enright, who read our spirometry, and Dr. Gregory Poland, who guided us through the anthrax fear gripping the city that autumn.
And we did one more thing that mattered most. We asked questions — a simple questionnaire about what each person had been exposed to, the dust, the smoke, the days on the pile — because I knew we would someday need to understand what this place did to the people who saved it. You cannot measure harm you never recorded. What we built helped position the data that became the official World Trade Center Health Registry — letting responders, workers, cleaners, and residents opt in. Others stayed after I went home to build the clinics and fund the care; I was only a small part of the guidelines that came later.
I say this now because the twenty-fifth anniversary is here, and there is unfinished business.
The good news is real: Congress has finally secured permanent, lifetime funding for the World Trade Center Health Program. But a budget is not the same as care. The program is running roughly a quarter short-staffed, with a hiring freeze that leaves residents and responders waiting to enroll and waiting to be seen. We funded the promise and then walked away from the people who keep it.
Here is the deeper lesson I carry out of Ground Zero.
Readiness was never about winning a case. What I watched that fall taught me something plainer: the people who could help were the ones healthy enough, trained enough, and calm enough to do it. Fit enough to run when the ground gives way. Strong enough to carry a colleague out of a building. Steady enough to stop the bleeding from the arm of the person next to you. Health-literate enough to know what to do, or where to get help. Disaster does not schedule itself around our good intentions. It arrives, and it asks a single question: Are you ready? Is your neighbor? Is your town?
Most communities aren’t. Not because they don’t care, but because readiness has been treated as someone else’s job — the fire department’s, the hospital’s, the government’s. The truth I learned is that in the first terrible minutes, the victim is the first responder — and sometimes the second. Help is whoever is standing there. It might be you.
My ask, on this anniversary, is not for money or a monument. It is for a mindset. I want every community — including the rural one in central Pennsylvania where I now work, struggling like so many to keep its emergency services supplied and its hospital staffed — to become ready and resilient: its own first responder. And the same preparation that readies us for the extraordinary makes us better at the ordinary, too — every day brings a car wreck, a heart attack, a mental-health crisis — and you may be the first to respond.
That is the work I’ve spent the years since giving away, the same way I gave away the clinic — not to sell anything, but because the officers I treated taught me what it costs when a community isn’t ready, and what it’s worth when it is.
Twenty-five years later, the smoke is long gone. The lesson isn’t. Be a force for your own health, and for the health of the people and organizations around you. Someday, someone standing next to you may be very glad you were.
