WEDNESDAY, Sept. 11, 2002 (HealthDayNews) -- This morning unfolded around St. Vincent's Hospital in New York City much like it had one year earlier. Streams of people walked to work in brilliant sunshine; trucks and cars clattered over the asphalt.
But Sept. 11, 2002, was no ordinary day in America. Nor was it for St. Vincent's.
As the nearest trauma center to the World Trade Center, the Greenwich Village hospital was first in line for the victims of the terrorist attacks that killed 2,801 in this city alone. Its doctors and nurses were the first to brace for the flood of patients. The sidewalk outside its clinics became a blood and supply line for emergency crews who trudged bravely back and forth to the hell blocks below.
This morning, St. Vincent's Manhattan, one of eight clinics in the Saint Vincent Catholic Medical Centers system, marked the first anniversary of the terrorist attacks with a solemn Mass at the Wall of Remembrance, the south face of the building that now holds a vigil to the dead.
Hundreds attended. Young, old, hospital workers and passers-by, filling the 200 chairs neatly lined up beneath a temporary tent, standing dozens deep in the cleared street when all the seats were taken.
The Mass began with a processional against the background of the choir singing an elegiac hymn. "Behold a broken world, we pray, Where want and war increase. And grant us, Lord, in this our day, The ancient dream of peace."
A jet passed overhead, and a few sets of eyes turned skyward. At 8:46 a.m., a bell signaled the moment of silence to mark when the first hijacked airliner struck the North Tower. Many wept quietly.
As the sun crested the hospital building, the wind picked up, and with it a hundred rock doves took flight. A woman with a portable radio walked past; from it came the voice of Rudy Giuliani, the city's mayor a year ago, reading the names of victims at Ground Zero: Angelo Amaranto, James Amato, Joseph Amatuccio.
A doctor in green scrubs stared down Seventh Avenue at the void where a year ago the Twin Towers stood, broken and bleeding but not yet buckled -- and where, a year before that, they held court in the skyline as the undisputed royalty of concrete, glass and metal.
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St. Vincent's took in more than 800 patients a year ago this week, not an unusual amount for the trauma facility. Many, many more had been expected, however, especially when initial estimates of the missing topped 7,000. But most of the people who worked in the World Trade Center were safely evacuated from the buildings. Those who didn't get out would not be patients anywhere.
"The last few days have been very difficult," said Suzanne Pugh, a nurse who manages the hospital's emergency room. Pugh hadn't been on the ward very long on Sept 11, 2001, when the first tower was hit. What followed was "extremely chaotic," she remembered, but she said it was orchestrated chaos to a certain degree.
St. Vincent's had been the point hospital for the 1993 bombing of the World Trade Center. After that experience, officials prepared a disaster plan to ensure that responses to future catastrophes ran smoother.
"The changes we made then worked," Pugh said. In 1993, it took six hours to set up overflow emergency facilities. Last year, it took a mere 20 minutes to get the six satellites up and running.
By 9 that morning, Pugh had enough doctors and nurses on hand to staff all 35 of her beds. "Everyone had come in. It was one of the most amazing things I'd ever seen," she recalled, still awed by the response. "I had to send people home."
For Dr. Steven Garner, chief medical officer for the medical centers, last year's most vivid scene was this: "I was standing next to a secretary whose husband was a firefighter. We were watching TV and saw him run into a building. She said, 'There he is,' and it was a moment of exhilaration. Three minutes later, it fell," Garner said. "There were no words to be spoken."
As a sign of the way things have unalterably changed, Garner pointed to the Friday last fall when the hospital was deluged by 300 reporters who had converged because they'd heard a patient there might have had anthrax. "It was pandemonium," he said. The lesion proved to be a pimple.
Garner and Dr. Paul Karis, chairman of emergency medicine for the St. Vincent system, agreed that September 11 and the subsequent anthrax attacks transformed the way doctors and hospitals deal with the public they serve.
As a physician, Garner said, "usually you're out to help the patient. You're not thinking that the patient might be a weapon that could hurt the hospital."
And he added, "You look at everyone coming now with suspicion."
A year ago, bioterrorism wasn't in the consciousness of Garner's doctors. Since the anthrax mailings, the hospital has devoted a "massive" effort to educating its employees, from those in white coats on down, to be vigilant about possible nuclear, chemical and infectious attacks.
That mindset has added a new dimension to the doctor-patient relationship, Karis said. "When we were in medical school, it used to be one-on-one. Now, it's a public health mindset" that demands attention to not just the individual's condition but the welfare of the community.
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Across the street from the hospital this morning, people stopped to take in Tiles for America, thousands of hand-painted tiles hung like notes from a chain-link fence. One carried a quotation attributed to Winston Churchill: "If You Are In Hell, Keep Going"; another was from Miss Harvey's 4th grade class at Curlew Creek Elementary School in Palm Harbor, Fla. Some had patriotic designs, others had names of victims. One said simply, "For Mac."
Mark Hagensicker, who stood through the Mass, bore tribute to the day with a black tie emblazoned with the Twin Towers and the words "United We Stand." Hagensicker, a computer services contractor for St. Vincent's, moved to New York from Kansas City in November. "We all lost something that day as Americans. I bought the tie as a show of support for New York."
Paramedic Frank Rella had been driving home to New Jersey last year after finishing a double shift when he received the call to turn back. He'd just returned to the hospital when the first tower fell. He and his partner headed for Ground Zero. They were within a block of the second tower when it, too, began to crumble.
"At first it sounded high-pitched, like metal scraping, and then it was like a railroad train, and then it was like a nuclear explosion," Rella recalled. "We took cover, then we went into the cloud [of dust and debris.]" The first person they found was a city firefighter in the throes of a heart attack. The two paramedics administered CPR, then ferried the man back to St. Vincent's. He survived.
Rella finally went home to his family three days later. Many of his colleagues lost their lives in the destruction, so to memorialize them, and to help himself come to terms with what he saw, Rella wrote a memoir of his experiences over those 72 hours. The book, New York Medics, will be published in September 2003 by Princeton Books.
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"Twelve difficult months have passed," Jane Connorton, the hospital's president, told the gathering. "The images remain overpowering. We continue to struggle," she added, "with the large hole in the city, and in our hearts." She hoped, she said, the morning's mass would be a "small source of comfort" for those who attended.
When the Mass ended, people began to return to work, slowly, lingering to hear the very last of the choir and the music, lingering in the warm wind as if to preserve the feeling of communal grief and healing before heading off into another year.
