Perspective

Remembering 9/11

September 10, 2019
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LMI's Maureen Merkl, RN, was a clinical specialist in the emergency department at Virginia Hospital Center (VHC) in Arlington, VA, when the Pentagon was attacked on September 11, 2001. She continues to work at VHC part time.

My 12-hour shift started uneventfully that morning. Some of the nurses and I were discussing an article in U.S. News & World Report about the state of emergency departments (EDs) in the country while stocking supplies.

As I entered a room to assist with a woman’s pelvic exam, emergency medical technicians (EMTs) asked whether we were aware of what was going on in New York City. That’s how we learned a plane had crashed into the World Trade Center. A few minutes into the exam, the woman’s husband, who had been in the waiting area, banged on the door and said, “A plane went into the Pentagon.” He had been abrasive when they first arrived; now he sounded frightened. I turned to the doctor I was assisting, who was new to the hospital, and said, “You know we’re first responders to the Pentagon?” He said he did.

A disaster code was called to mobilize all medical personnel in the hospital. The onsite pharmacy and central supply arrived with drug carts and equipment such as tetanus shots (assuming a lot of people with dirty wounds would arrive), surgical assistants readied the operating rooms, and nursing supervisors discharged patients who could go home safely to make more beds available. A real-time communications center, which would normally connect the ED and Arlington County Police Department and first responders, was set up to include federal authorities.

Communication was key, because there was a lot of misinformation. We heard the daycare at the Pentagon may have been hit, so we prepared a pediatrics area that we thankfully didn’t need. There were reports of a bomb threat to the hospital, but we were too busy to give it thought. Almost our entire nursing staff came to work, scheduled or not. Some had to leave young children and spouses at home; I imagine that was terribly difficult. My children were grown, including my son, a senior at West Point at the time, and my daughter, who was in the ROTC program at Georgetown. Their careers, and that of another daughter who now works at the Department of State, were directly shaped by 9/11.

The doctors and nurses were paired to receive patients as they came in. The hospital was close enough that some of the injured who had exited the Pentagon were picked up by motorists and arrived before the ambulances. Many patients suffered from smoke inhalation and were intubated to prevent respiratory distress. As more patients came to the ED, we started to notice an unfamiliar odor. Later we learned it was the smell of jet fuel.

Many members of the community came to the hospital to help. Some offered to give blood; others, including a veteran who had suffered burns from mustard gas in World War II, wanted to offer hope and comfort to burn victims. People brought food throughout the day; a hospital in Arizona sent us pizza. Folks wanted to help in any way they could. We later wrote thank you notes in appreciation of the kindness shown to us.

By 2:00 p.m., nearly all of our patients from the Pentagon had arrived, about 50 in total. Some were transferred to hospitals with burn units, but we cared for the majority at our hospital. Given the extraordinary circumstances, I am proud of how our team and community worked together. Our nurses and physicians had great working relationships with our EMTs, firefighters, and police officers. Their mutual trust and respect made a difference that day.

Emergency responders at the Pentagon, like those in New York, have experienced higher rates of cancer and chronic health ailments than we would otherwise expect. They bore a burden that day, yet they continue to sacrifice for us. Seeing firefighters and EMTs bring patients into the ED every day, I had this thought often, but after 9/11, the whole nation began to express a greater appreciation for their service. I am heartened to see that continue today with the permanent reauthorization of the September 11th Victim Compensation Fund, helping first responders receive critical medical care, and the establishment of National First Responders Day, observed annually on October 28 since 2017. These are great steps in recognizing their contributions and the risks they assume to help all of us.

In the local Arlington community, nurses and physicians continue to train with first responders and the Pentagon—from nearly daylong, live-disaster drills to simply exchanging information with each other about respective capabilities and emergency response plans. These exercises can be time- and resource-intensive, but they are worth it; they afford critical insight into how our teams can support each other in a crisis. This community has done great things to enhance disaster preparedness and is now highly regarded as a model for other communities to follow.

A recent social media post from an EMT I worked with on 9/11 said it best: “Honoring the 184 who perished in the Pentagon, those who were injured, those who are still suffering and the Brothers and Sisters I served with that day. We will definitely never forget.”

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