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Medicine responds to terrorism in the US

BMJ 2001; 323 doi: (Published 22 September 2001) Cite this as: BMJ 2001;323:700
  1. Ronald M Davis, North American editor (rdavis1{at}
  1. BMJ

    Adefining event in the history of a people can be said to occur when virtually everyone remembers where they were—and what they were doing—when they heard news of the event. In my lifetime, the first defining event was the assassination of President John F Kennedy. The second occurred on 11 September 2001.

    Our human spirit is renewed when we see selfless and tireless efforts…

    On that day, at 8 20 am Eastern Standard Time, I arrived at a hotel in Washington, DC, on Pennsylvania Avenue, about two blocks from the White House. I was to participate as a representative of the American Medical Association in a press conference hosted by the World Health Organization. The WHO was preparing to release a global strategy for containment of antimicrobial resistance.

    Shortly after 9 am, about an hour before the scheduled start of the press conference, we heard the horrific news of the terrorist attacks on the World Trade Center in New York City, soon to be followed by an attack on the Pentagon just outside Washington. Today's killer was not an antibiotic resistant microbe but large commercial aircraft commandeered by suicidal terrorists. The press conference, needless to say, was cancelled.

    A group of us who were there for the press conference attempted to leave the hotel by car. Traffic was at a standstill, except for police cars and emergency vehicles that forced their way through, with sirens blaring. A Walter Reed Army Hospital bus followed, presumably carrying emergency medical personnel. Members of the armed forces in combat fatigues ran down the street between stationary cars. Had the White House been hit, we wondered worriedly. Or would it be the next target for attack?

    For the next six hours, my colleagues and I tried to find transport home. All commercial aircraft in the United States had been grounded. Interstate trains and buses were not running. No rental cars were available. So I rented a U-Haul truck for a 12 hour ride to my home in Michigan. While searching for transport, and during my long drive home, I remained transfixed to radio coverage of this apocalypse. Towards the end of the day, I saw the video on CNN of the two aircraft slamming into the World Trade Center, and the burning towers collapsing to the ground a short time later. These surreal images are now seared indelibly into our memories.

    Three dominant emotions gripped me throughout the day: profound sorrow at the enormity of the human suffering and loss of life; shock and anger at the malevolent destruction inflicted on our citizens; and deep admiration and gratitude for the service of healthcare workers in responding to the crisis. In his address to the nation, President George W Bush mentioned the 23rd Psalm, as legions of healthcare personnel and rescue workers were toiling in the valley of the shadow of death.

    Emergency medical personnel, physicians, and nurses provided trauma care and triage in the field and in our hospitals. Healthcare administrators, public health officials, and other community leaders implemented disaster plans. Special blood donation operations were set up. Burns centres kicked into high gear. Forensic pathologists began the grim task of caring for corpses and body parts. Psychologists and counsellors provided a service to schoolchildren. During my ride home, close to the airplane crash site in Pennsylvania, I heard on the radio that the Children's Hospital of Pittsburgh was offering guidelines on its website to help parents talk with their children about the terrorist events.

    Hotlines were set up in New York for doctors and nurses to call to volunteer their services. New York governor George Pataki reported an outpouring of response, which is critically important as fresh medical personnel are needed to relieve those who are exhausted by their early efforts. In addition the American Medical Association compiled a list of physicians willing to help.

    Words are impotent in describing the tragedy. Many media commentators compared it to the attack on Pearl Harbour. But it was worse than Pearl Harbour in some respects. The toll will be much higher. And the perpetrators, and their accomplices and protectors, were not immediately known.

    Like many tragedies, this dark cloud has a silver lining. Airport security, which is weak in the US compared with that in Europe, will be tightened. Anti-terrorism efforts will be strengthened. Funding for international intelligence activities will be increased. “It's really the end of the sort of naivety that Americans have allowed themselves to experience,” said a spokeswoman for St Luke's-Roosevelt Hospital in New York. “It's like, ‘Welcome to the rest of the world.’”

    But above all, our human spirit is renewed when we see, in a time of crisis, selfless and tireless efforts by healthcare workers, rescue workers, public officials, and groups such as the American Red Cross. In New York, a city not known for brotherly love, neighbours are helping neighbours. As noted by the Danish philosopher Søren Kierkegaard (1813-55), “Adversity draws men together and produces beauty and harmony in life's relationships, just as the cold of winter produces ice flowers on the window panes, which vanish with the warmth.”


    • Dr Davis is a member of the American Medical Association's Board of Trustees. This article was first published on on 12 September

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