Remembering September 11, 2001: A Global Critical Care Community Reaches Out

Members of the International Critical Care Internet Discussion Group (CCM-L)

Disclosures

Introduction

As the terrorist attacks were unfolding on September 11, 2001, a group of physicians accustomed to dealing with trauma and disaster on a smaller scale were trying to understand what was happening in the United States and determine what would be needed to help the people affected by the worst act of terror in US history. The following is a selection of email messages that were sent through the International Critical Care Internet Discussion Group (CCM-L) hosted at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, and run by David W. Crippen, MD. Most of the posts are placed in chronological order, but some are broken out by discussion. The time on the posts reflects the time on the East Coast of the United States when the post was received and not the time at the place of origin. Some posts were edited for clarity and spelling.

9/11/01, 9:50 AM
Subj:

Not more than 10 minutes ago, I witnessed a jumbo jet crash into the World Trade Center on live television. It was most certainly intentional. I am almost without words. This world has turned into a somewhat ugly place to live at times. My heart goes out to all of the victims involved and their families. I wish God speed to all of those involved in the care of these victims. It will be a very long day for those working in surrounding trauma centers. Unbelievable.

Keith D. Lamb, RCP, RRT
Christiana Care Hospital
Newark, Delaware

9/11/01, 10:32 AM
Subj:

I am located here in New York City uptown from the World Trade Center on 30th Street. Looking south on 6th Avenue you can see a gaping hole about two-thirds up in the north World Trade Center tower, with a huge plume of smoke coming out of it. All bridges and tunnels are closed. All police and fire personnel have been mobilized. All businesses, including ours, have been closed and people are basically marooned in Manhattan. I just heard that the south tower has blown up and debris is spilling everywhere. Things are going to get much worse. God save those people in the World Trade Center.

Alfred J. Saint Jacques, MBA
Editor, Medscape Critical Care
New York, NY

9/11/01, 10:58 AM
Subj:

Folks,

Numbness beyond tears... fingers are shaking over my keyboard.

From my view, all I can see is smoke billowing over the area where the World Trade Center towers used to be. I can't believe that I just wrote those words. As I was driving over the Throgs Neck Bridge to the Bronx to teach my class, I looked left and saw smoke billowing from the first crash, and then, in clear view, a fireball emanated from the second tower. That will never leave my consciousness.

I can see the bridges leading from Long Island with no traffic so I am, in essence, stranded here. My wife was fortunate to have the tunnel shut down right before she was about to enter so she turned around to go home.

Perhaps one day, I will put into print what I see and what I feel. Providence may have shone upon me today (at least up until now), but it avoided so many others.

Numb numb numb.

Don Chalfin

9/11/01, 11:53 AM
Subj: Terrorist Attack in New York

If anyone has not yet heard, there has been a catastrophic terrorist attack in New York City and both World Trade Center buildings have been leveled by hijacked aircraft plunging into them. There have also been aircraft crashes into State buildings in Washington, DC, including the Pentagon. A hijacked aircraft has crashed near Pittsburgh, apparently en route to a target destination. We do not yet know if this is over. There are thousands dead. A Palestinian fundamentalist group has apparently claimed responsibility. This is a clear declaration of war, and knowing Bush, we are likely to be in a shooting match very soon. The situation here is very unstable. All aircraft have been grounded and all tall buildings have been evacuated.

Don Chalfin and his wife are OK. I am still getting reports from others.

CCM-L will be alert for ANYTHING its members can possibly do in this crisis, including networking for physicians and families.

My pager is: 0 000 000 0000

We will be alert for any possible help we can offer.

David W. Crippen, MD

9/11/01, 1:23 PM
Subj: Today's Events

Not sure this will get through because I hear the whole net is chocablock.

But anyway, we have all been watching in absolute astonishment today's events; if you wrote the book, no one would think it all possible... it's like a Bond movie.

I hope all my CCM-L colleagues are OK, but guess most of them will be working flat out at the moment.

We are thinking about you.

Good Luck,

Anna Batchelor

9/11/01, 1:48 PM
Subj: re: Terrorist Attack in New York

What can we say?

Our thoughts are with you.

Best wishes,

Tony Pickworth
Lead Clinician ICU
Princess Margaret Hospital
United Kingdom

9/11/01, 1:58 PM
Subj: Terror Attack

God bless you all. Our thoughts are with you.

Jean Levasseur, MD
Canada

9/11/01, 2:13 PM
Subj: re: Terrorist Attack in New York

A true national disaster. All our people seem to be OK at this point. No hazmat contamination reported. It will be a long night.

Vlad Kvetan

9/11/01, 2:17 PM
Subj: re: Terrorist Attack in New York

We are with you.

Dr. Sergio Galan
Monterrey, Mexico

9/11/01, 2:20 PM
Subj:

Folks,

Providence so far has shone on my family and I, but oh so many others were not so lucky.

I was driving to teach my class at Albert Einstein Hospital when I saw the smoke billowing from the first building and saw a fireball from the second when it too was struck. From my vantage point, I saw the buildings immediately after they crumbled down. "Numb" is too weak a term to describe how I feel.

I'm now at my hospital trying to help, as some casualties have arrived and more are obviously expected.

As Vlad says, it will be a long, long night, not measured by hours on the clock.

Donald B. Chalfin, MD, MS, FCCP, FCCM
Director, Division of Research
Attending Intensivist
Department of Emergency Medicine
Maimonides Medical Center
Brooklyn, New York

9/11/01, 3:35 PM
Subj: Today's Events

Our thoughts are with you all. May God bless and help the victims and their families.

Noel Gibney
Edmonton, Canada

9/11/01, 3:38 PM
Subj: re: Terrorist Attack in New York

Shanksville and Somerset Airport are quite near Johnstown; we sent a rescue team to the crash site, only to find a huge crater, small pieces of metal, and no survivors. If any CCM brother/sister in NYC needs help for whatever reason, my pager number is 000-000-0000.

Mark Mazer, MD

9/11/01, 3:59 PM
Subj: re: Terrorist Attack in New York

God bless.

A few years ago, we in Bombay were faced with a similar terrorist attack. Numerous buildings were blown up by a senseless and ruthless terrorist group. On that Friday afternoon, thousands of people died. Like Manhattan, Bombay is the financial capital of India; the stock exchange building (situated at a financial hub like Wall Street) was one of the targets, located close to our hospital. Within 30 minutes of the incident, we had over 300 patients with blast injuries turn up. I can never forget that day; the lobby leading to the ER was so bloody that it seemed like we were walking on a carpet of blood. The terror on the victims' faces was enough to tell what they must have experienced during the blasts. One is never really geared to handle such major calamities. However, we tried -- we closed down all our OTs (4 cardiothoracic, 4 neurosurgical, 8 general surgical, 4 orthopaedic theatre, 2 ophthalmology; we are an 840-bed hospital) and used these OTs for primary resuscitation. We even used the corridors of the ICUs to resuscitate. Every available consultant, fellow, and resident participated including the pathologist, radiologist, etc., who toiled for hours together. Of the 300 odd patients, 200 were admitted, we lost about 9 patients, and 28 were brought dead. In the midst of this crisis, the citizens of Bombay rose to the occasion; the blasts took place at about 1.30 PM, and by 5 PM all the blood banks in the city were full and many potential donors were sent back due to lack of storage facilities for the blood products.

Some of the culprits have been caught, while the bigger fish roam around freely in neighboring countries and are in fact protected by them. In this country, terrorism is prevalent and too many innocent people have died. In the name of religion, people fight these proxy wars targeting only the innocent. I don't think any religion preaches this cowardly act.

It is time that world leaders recognize this truly hidden danger lurking in our midst, which needs to be totally eradicated.

I pray to the Lord to heal the injured, and give courage to the family members of the deceased.

Pravin Amin, MD
Consultant Physician and Intensivist
Bombay Hospital and Medical Research Centre
Bombay, India

9/11/01, 4:07 PM
Subj: re: Terrorist Attack in New York

After sitting glued to the TV screen and phone (trying to get hold of friends and relatives in New York and Washington) the whole afternoon, I can only say that my heart reaches out for the people there! Viewing the current situation, I'm scared of what is next to come. Here in Germany, security levels have been raised, too; although I'm on maternity leave until March 2002, I've been asked to arrange for a person to take care of my 6-month-old daughter in case something big comes down here. I live near Frankfurt, Germany's financial center (and one of Europe's biggest airports), and should something similar happen here (terrorism experts think that it's a possibility that cannot be ruled out at the moment), Frankfurt, Berlin, and the Hardthoehe (German Ministry of Defense) in Bonn will be the targets. I'm praying for all of us!

Stefanie Beer
Rettungsassistentin (ie, Paramedic) and student at
Justus-von-Liebig-University's med school
Giessen, Germany

9/11/01, 4:59 PM
Subj: re: Terrorist Attack in New York

Our thoughts and prayers are with all in the US, especially New York and Washington, today.

Eric Hodgson
Durban, South Africa

9/11/01, 5:31 PM
Subj: Waking up to what has gone on in the USA

All our thoughts are with you as you struggle to cope with what has happened. Love and support to all our friends working in NYC.

Stephen Streat

9/11/01, 6:33 PM
Subj: re: Terrorist Attack in New York

The news came during a rather quiet on call. I wished I could have helped with the terrible effort our New York colleagues are facing right now. The entire team skipped dinner because we were so shocked and saddened by what has happened. I'm glad all the familiar names in the US are still there. Hope Louis Brusco is alright too.

Daniel Weyandt
Jena, Germany

9/11/01, 6:33 PM
Subj: Our Responsibilities for Disasters

Note from SCCM

In light of the tragedy in the United States today, the Society of Critical Care Medicine has received numerous phone calls from members volunteering to assist healthcare personnel working round the clock to care for the injured. But, more are needed now and in the weeks to come.

I am in contact with Don Chalfin, who is proceeding toward St. Vincent's, and Vlad Kvetan is already out in the field. I am told that the EMS system in the New York area is functioning as well as can be expected. The disaster plans are working. They have called for available physicians to go to St. Vincent's Hospital Center in the Village for aid, but in fact this is going to be extremely difficult. There is little progress in getting around in New York anyway and with this I'm sure the only way to get there is walk.

This is not the time for well-meaning folks to physically go to New York and help. It is the time to be ready in case something happens where patients are evacuated to other areas that could potentially be staffed by critical care physicians, as in the casualty plans for the Gulf War in which such patients were to be shipped to Germany. By and large, critical care is a second echelon care plan. The vast majority of work that needs to be done is simply triage, identification of degrees of salvageability, and movement of the injured out to rear areas.

If and when that plan is implemented, it is conceivable that some of us could be tapped to help. Therefore, our current responsibility is not to jump in where angels fear to tread, but simply to be available if a specific need arises for which we can be of assistance. Those who might be in a position to drive to the New York area under the direction of some responsible body, please send a post to CCM-L with your pager number and other ways to find you. This is most likely to happen over the next few days and not for the immediate future.

David Crippen, MD, FCCM

9/11/01, 6:33 PM
Subj: re: Our Responsibilities for Disasters

David,

Hold the phone. While we have entertained some thoughts of going into the city to St. Vincent's, right now we are staying put and listening for word from authorities. Probably best to wait and see!!!

DBC

9/11/01, 6:57 PM
Subj: re: Terrorist Attack in New York

There is an eerie quiet here on the Upper West Side of Manhattan, about 4 miles from the World Trade Center. We have been on a disaster footing since the plane hit. We have had all our ORs open, but we have had nothing here yet. Very little at our Roosevelt site, which is in midtown Manhattan a bit closer, just some smoke inhalations. Talking to my SICU codirector, he says that this reminds him of Hurricane Andrew in Florida -- nothing for 24 hours, then they got inundated as people were extricated. We are now going to a lesser stage of alert, and some docs are going home, but need to be readily available. The prevailing hope is that not all are dead, that they will get some people out for us to work on. Most of us are just now coming out of a daze from the whole thing.

If there is one thing, it seems to us, is that there is poor planning. We have been sitting here all day ready, just 4 miles away, yet they are not sending anything to us from other hospitals closer to the scene. They should be triaging the less seriously injured to us, and just taking the criticals. What is going to happen is that they will be full and they will try to get the critically injured to us, and the extra distance will make the difference between life and death. We did not seem to learn many lessons from the bombing of the WTC in 1993, and what could have happened then happened today. I don't think we were as prepared for it as we might have been.

Thanks to all for their best wishes -- we will need them tomorrow.

Louis Brusco Jr, MD
Director, Critical Care Anesthesiology
Co-Director, Surgical Intensive Care Unit
St. Luke's-Roosevelt Hospital Center, NYC

9/11/01, 7:24 PM
Subj: Current Events

Currently, we are in a waiting mode, to see what is going to transpire over the next day or so. The President is getting ready to address the country in the next hour or so, and we will then get some idea what is going to happen next politically. It is very difficult to predict what he will do. He is not known as a deep thinker, but he is definitely in charge, and there will be a lot of pressure on him to do "something." We are all hoping that he has the wisdom to think this out fully before mounting an emotional retaliation.

The unfortunate reality is that little if anything can be done to address people who care enough about a cause to die for it. And there are a lot more Islamics in the world than there are Americans.

If you are a praying person, pray for Bush to lead firmly and decisively. Like him or not, he is in charge, and he'll need that support.

David Crippen, MD, FCCM

9/11/01, 8:02 PM
Subj: re: Our Responsibilities for Disasters

Our thoughts and prayers go out to all those affected by these acts of terrorism.

Michael Parr
Liverpool Hospital
Sydney, Australia

9/11/01, 8:13 PM
Subj: Such a great sadness

My heart goes out to all the thousands of souls who perished needlessly in today's tragedy.

To those who are working, at their own peril, to save the lives of others, I wish you Godspeed.

And finally, to the Kafirs who perpetrated such a horrendous crime against humanity: I trust the ghazls will not be kind.

Gordon S. Doig

9/11/01, 8:33 PM
Subj:

[In response to the post: 9/11/01, 10:32 PM Subj: ]

> Things are going to get much worse. God save those people in the World Trade Center.

Al,

Unbelievable. I am sitting here in the ICU waiting for some of the overflow patients to start coming in by helicopter around 3 am here to North Shore. There is total silence here in our disaster command center.

Dana Lustbader, MD, FCCP, FCCM
Assistant Professor Medicine, NYU School of Medicine
Medical Intensive Care Unit, Division of Critical Care Medicine
North Shore University Hospital
Manhasset, NY

9/11/01, 8:34 PM
Subj: Triage and Efficiency

[In response to the post: 9/11/01, 6:57 PM Subj: re: Terrorist Attack in New York]

Lou Brusco:

If there is one thing, it seems to us, is that there is poor planning. We have been sitting here all day, ready, just 4 miles away, yet they are not sending anything to us from other hospitals closer to the scene. They should be triaging the less seriously injured to us, and just taking the criticals.

Well, remember that the first casualty of disaster is efficiency. I have little doubt that they would like to do a lot of things, but can't put them into effect. There may not be any practical way to move great volumes of victims to you or anyone else.

We must assume that everyone is doing everything possible. We can only wait until we are called to help, it if it possible for us to do so.

I'm glad you're OK, Lou.

David Crippen, MD, FCCM
Listgrupenmeister
CCM-L The International Critical Care Internet Group
St. Francis Medical Center
Pittsburgh, PA

9/11/01, 8:39 PM
Subj: A Great Sadness

Dear New Yorkers,

Our prayers and thoughts are with you all, as you come to grips, as you must, with this immense sadness and the most tragic day in many people's lives. The sheer enormity of the attack and the loss of innocent lives are beyond moral reasoning.

Despite advancements in science and life, mankind still harbors evil segments within it. Sad.

We pray for courage and fortitude to all the staff and volunteers involved in disaster response, rescue, relief, and rehabilitation.

God bless America. God bless freedom.

Cheers,

Ramesh Nagappan, MD, FRACP
Critical Care Physician
Intensive Care Unit
Monash Medical Centre
Melbourne, Australia

9/11/01, 9:23 PM
Subj: President's Talk: An Unofficial Assessment

A few minutes ago, President Bush gave the generic "all is well, we're in charge" speech written by his speech writers. They didn't spend a lot of time or creativity on it. It was the usual fare for mass disasters, "this is terrible, someone's gonna pay, we will all pull together, and God bless America." Not terribly reassuring that someone is in charge that knows how to do anything but give reassurances. The only thing he said that caught my ear went something like: "we will seek out and punish those responsible and we make no distinction for those harboring them." That means they may well organize military strikes against Afghanistan, which has consistently harbored the big league terrorists. They have threatened to bomb Afghanistan in the past for the same reason. This time it may happen. The entire population of the military in this country is on full alert to be shipped within 2 hours.

The problem with that is they cannot really know exactly where the terrorists are, and if they simply bomb Afghanistan, it makes the US government little different from the Soviets who found out it was a war action that couldn't be won then and can't now. And it makes the US government look like blundering bullies striking out of anger at mostly innocents just to show the world they are mounting "some" response. And further reality is that this whole attack was more than likely fashioned from terrorist cells within the United States. They found 4 people experienced in flying jet airliners that were willing to die for a cause. They didn't get them in Afghanistan. I beg them also to remember that the vast majority of Islamic people are gentle and peace loving. A backlash at Islams per se will do nothing at all to address extremist wackos and simply cause more strife in the world.

These are trying times. But to be fair, the reality is that there isn't really anything anyone can do much at this stage in the game but try to address the damage. Our role in this will be to wait and see what our role is.

Our prayers and support go out to those on the front lines: Don Chalfin, Vlad Kvetan, Dana Lustbader, Lou Brusco, and many others in the New York area. If you need us, we will be here.

David Crippen, MD, FCCM
Listgrupenmeister
CCM-L The International Critical Care Internet Group
St. Francis Medical Center
Pittsburgh, PA

9/11/01, 9:42 PM
Subj: re: Terrorist Attack in New York

My heartfelt condolences to the American members of CCM-L in this sad hour, and I hope that you are all safe.

Marcello R. Lobato

9/11/01, 9:46 PM
Subj: Next Steps

The first task of this nation is to care for the injured, their families, and the families and friends of those who lost their lives.

The second task is to put a stop to the terrorism. Our President made it clear: those who harbor terrorists will be held accountable as the terrorists themselves. The enemy is most assuredly not those of the Islamic faith. The enemy is the terrorists, those who harbor them, those who aid them and abet them, whatever their faith. They must be found, and they must be stopped. Our futures, and our children's futures, depend on that resolve.

Timothy G. Buchman, PhD, MD

9/11/01, 9:50 PM
Subj: re: Triage and efficiency

[In response to the post: 9/11/01, 8:34 PM Subj: Triage and Efficiency]

And don't forget it's difficult to control the walking wounded, who will show up on your doorstep unannounced. At least the injuries are usually less serious and can wait. Also, there was an access issue, and according to the news reports, the more seriously injured patients did not arrive for a while after.

Jeff Myers, DO, NREMTP
PGY-I Emergency Medicine
SUNY-Buffalo

9/11/01, 10:39 PM
Subj: re: Next steps

[In response to the post: 9/11/01, 9:46 PM Subj: Next Steps]

The second task is to put a stop to the terrorism. Our President made it clear: those who harbor terrorists will be held accountable as the terrorists themselves. The enemy is most assuredly not those of the Islamic faith. The enemy is the terrorists, those who harbor them, those who aid them and abet them, whatever their faith. They must be found, and they must be stopped. Our futures, and our children's futures, depend on that resolve.

And the only way to rid the world of terrorism is for the global village to decide it isn't something they will tolerate and quit hiding them. Until that happens, this will continue.

David Crippen, MD, FCCM
Listgrupenmeister
CCM-L The International Critical Care Internet Group
St. Francis Medical Center
Pittsburgh, PA

9/11/01, 10:42 PM
Subj: Terrorism : It was lurking somewhere

My deepest condolences to American friends. It is the worst that has ever been perpetrated on the mankind in the name of God/religion. After seeing the images on Fox TV, what strikes me is the terror and plight of the onboard civilians in the aircrafts that banged into the buildings. I remember the prophecies of Nostradamus; he has mentioned something like this very vividly. But there it was not the end; rather, it was a start of something more drastic.

Though the celebrations in western Asia are a very deplorable act, I dread the reprisals like Hiroshima and Nagasaki. As a civilian of a country that is tormented by the terrorists of the same breed, I can very well understand the anguish of the Americans; yet these were the terrorists who were at one point in history about 15 to 16 years ago prompted to serve some other acts. Nevertheless, free world has to resolve to fight this menace to the end.

Sanjniv Vij
India

9/11/01, 10:48 PM
Subj: re: Current events

[In response to the post: 9/11/01, 7:24 PM Subj: Current Events]

The unfortunate reality is that little if anything can be done to address people who care enough about a cause to die for it. And there are a lot more Islamics in the world than there are Americans.

Johnstown, PA, USA...30 miles from a blackened crater in what was once a peaceful, sylvan field...no survivors to wait for anymore, no one to triage. Here, our martyred countrymen are all dead, all patriots, killed in a war they did not start, but one which the living are sure as hell are going to finish...despite the mounting rage, and before any hasty conclusions are drawn, those who are truly culpable need to be identified. Despite initial speculation, it was an American terrorist who killed Americans in Oklahoma, and let's not forget the suicidal resolve displayed by the Davidians [in Waco, Texas].

Marquo

9/11/01, 10:53 PM
Subj: God bless Americans--We are thinking about you all--Terrorism must stop now!!

To All Americans,

We, as Australians, probably as far away from you all as anyone could get, were shocked, stunned, and horrified to be woken up to the early morning news channels all continuously bombarding us with news of this terrible tragedy. None of us could ever have considered or contemplated such a terrible chain of events ever happening out of wartime.

I know this is a Web group primarily for emergency medicine information and exchange; however, I just wanted to take the time out to at least try to give some consolation or sense of emotional aid to our American colleagues in such a torrid horrible time as this. I am sure all other Australians, and others throughout the world, would agree with my and others' thoughts. We really sympathize and mourn the loss of the innocent Americans involved in this terrible incident. We hope that all those suffering from injuries in your hospitals currently receive all the very best attention we know they will get to recuperate from this disaster. We have seen images of the disaster continuously beamed here by satellite, and I am sure all will agree with me that we admire the heroic and unselfish attitudes we have seen by your firemen, ambulance officers, rescue workers, and doctors and nurses at the scene. We have also just discovered that a lot of your firemen and other rescue workers have died as a consequence of their assistance -- this must be the saddest thing to have heard from the entire saga. There is nothing more heroic and dedicated than to be risking your own life in an attempt to assist other human lives at stake. We all commend those of you emergency workers involved and who have helped in this way, as I am sure the families of the rescued ones would agree.

Another thing we have admired coming from total outsiders is the amazing sense of unity of all the Manhattan people and indeed all the American people in rallying together to try and help as a unified group -- selflessly donating blood, volunteering for emergency assistance, etc. And all this focus on assisting the dead and wounded at the expense of trying to point the finger at those responsible.

This horrendous event in American and indeed world history has really brought home to all of our minds the state of affairs of world terrorism in the 21st century. We all hope that this terrible uncontemplatable event will make world leaders finally amalgamate and unify their attempts at trying to rid the ugly world of such international terrorism attacks. Violence and terrorism are performed by ugly cold-blooded people who have no respect for human life and the living spirit. They don't deserve to get the gratification from this horrible attack. We all plead to the world leaders able to do something to finally draw the line as this has gone too far. Let's head forward to stop and stamp out terrorism. We cannot keep living in a world of terror at what might or could happen to our loved ones as they work, travel, commute, or literally live their normal existences. Hopefully this will happen but unfortunately, as we will all agree, it will have happened too late, and such a horrific event as this should not have happened before we all decide enough is enough.

Now we can all understand or get a rough idea what life would be like in countries where citizens suffer these sort of acts of terrorism every day of their lives, such as our counterparts in countries such as Israel and Northern Ireland. It is hard for us Australians to contemplate this event because our country would have to be one of the safest and least violent or threatened countries on this Earth. We cannot understand the possible feelings or fear that must run through the minds of innocent people every minute of the day in countries who are threatened every day by terrorism -- the thought that the bus you are in may be blown up, or the restaurant you are eating in may be blown up by a suicide bomber, or where your loved ones are and whether they will be safe. It is hard to understand the fear these people must have within them. I sure could not live a life like that. It's not worth the worry. This is starting to happen everywhere around the world now. So the only way out of this is to attempt to stamp out international terrorism.

Anyway, I had better stop going on about my personal thoughts and ideas, but I would like to ensure you Americans, our friends and colleagues, that we are all behind you 100% in all regards. We wish you and your families and loved ones all we can -- love, best wishes, mourning, and any help we can. Don't give up physically or emotionally as your colleagues overseas are all behind you. We will rally together to offer help in any form we can (supplies, doctors, experts, finances, and most of all prayers and thoughts), even if this means allied assistance in a military attack on the responsible parties. God bless you all and our hearts and tears are with you all during this terrible time in history. Please let us know if there is anything at all we Australians can do for you at a time like this, please. Take care, all of you.

God bless all those involved and also their families and loved ones from just a single ordinary Australian doctor Down Under and his family (and I am sure most other Australians too).

Dr. Brian Morris and family

9/12/01, 12:52 PM

Subj: re: Our Responsibilities for Disasters

David:

Thank you for keeping us in you thoughts. Our hospital has a mixed MD (surgery, burn/critical care)/PA team in Manhattan in the triage area and at some of our affiliated institutions. Sporadic action, some heavy and stressful to PAs. Our hospital made 35 to 40 med-surg ICU beds immediately available, and can go to 50 prn. Layered critical care attending/fellow call teams ready for 3 bad days. Follow-thru GO team prepared to move downtown as needed to help with triage/care/transport. Smoke inhalation, a few burns (Jacobi Hospital), and start of critical diversion transfers from Manhattan and regional trauma places. Pearl Harbor mentality with some 300 police/fire dead out of some 700 reported mortalities in Manhattan so far; Pentagon reportedly has about the same. St. Vincent's is immediately on site and got some 60 critical care cases; sounds quiet now. They are the true guys on the spot. I do not expect a large volume of extractions, and we expect to get hammered in the early morning. Hope this is not the end of common sense, civility, and tolerance. Resources seem adequate so far, both general and specialty. Hope there is no phase two, or chemical/biological/nuclear second hit directed at site rescue teams. All of our critical care friends seem OK so far, but a few places got hammered hard.

Vlad Kvetan

PS: Reminds me of the worst days of running around with the disaster ICU teams. You will recall that we were able to recruit some 800 ICU docs/nurses for the international disasters almost immediately; and for Desert Storm we got 2000 ready to go within 10 days. The volunteer spirit and know-how is amazing; hope we do not need it in any large sense.

[Many travelers were stranded when the air space over the United States was closed after the terrorist strike.]

9/11/01, 1:27 PM
Subj:

If anyone is stranded in the Orlando, Florida area and needs a place to stay, please let me know. We have extra space here. Mi casa es su casa.

Kind regards,

Sara Ann

9/11/01, 4:43 PM

Same for us here in the San Francisco Bay Area. Home phone number is: 000-000-0000.

Best,

Robert A. Fink, MD

9/11/01, 8:25 PM
Subj: re: Terrorist Attack in New York

As you all know, a huge number of US-bound planes were diverted to Canada. A number of them landed in the [Toronto] area. If any CCM-L members have friends or family stranded in Toronto, please feel free to give me a page. 000-000-0000.

My prayers are with my southern neighbors.

Ted S. Rogovein, BA, AGDM, MDCM, FRCPC, FCCP
Director, ICU
St. Joseph's Health Centre
Toronto, Ontario, Canada

9/11/01, 8:34 PM
Subj: re: Our Responsibilities for Disasters

If anyone is stranded in/near Detroit...

William M. Coplin, MD
Wayne State University
Detroit, MI

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