HOW SHE SEES IT Thousands willing to help; few to save

I am one of the doctors who work at St. Francis Hospital in Jersey City, right across the river from Manhattan and the World Trade Center. I wrote this summary of the past two days from my perspective, mostly to unburden myself, but because friends and family have been asking me what has been happening. I thought I should share it with you.
Today our hospitals were not flooded with victims ... the good news. The bad news: Mostly, they're pulling out people who didn't make it. The occasional rescue of a living person sends ripples of hope through the hospitals in our city. We received a few patients here, but the thousands expected never came. Even the NYC hospitals aren't flooded with patients.
Ellis Island is now a morgue, I hear.
It is only now beginning to sink in, and the full emotional impact has yet to hit me. Yesterday I was running on pure adrenaline, my whole focus on helping those in need.
Ready to help: The first eight hours I spent triaging the patients who came to our hospital, which received the bulk of the "walking wounded" from NYC. The patients were shell-shocked, mostly quiet, stunned. Covered in thick, grayish, clay-colored soot and debris, they streamed into our ER. Some were bleeding, some had makeshift splints on broken limbs. I gave a lightning quick exam and directed them: To the left, those who could walk and were without life-threatening symptoms. Straight back, those who were bleeding, had fractures, or were suffering secondary symptoms, like asthmatics and people with chest pain. The hustle and bustle of the emergency room was still quite muted, almost churchlike. No shouting. No pushing. No demands. Just people helping each other, caring for each other. The smell was overpowering -- wet sheet rock overshadowed by smoke.
Then I was transported by state police to the front lines of New Jersey -- Liberty State Park, where I remained for another six hours. An incongruous place to be, I thought, when our very liberty is threatened.
The doctors were there -- hundreds of them, 150 of them general surgeons who were attending a board review course in Jersey City. Thousands of EMTs and literally hundreds of ambulances from all over this state and Pennsylvania were there. Hundreds of nurses. Volunteers who came to help do anything. We were about two to three thousand strong.
Then there were the quiet heroes -- the couple who spent their own money to bring in cases of baby food, formula, and diapers. The office mates who went out and bought hundreds of McDonald's burgers out of their own pockets, just to feed victims and volunteers. Trucks with emergency supplies came across the grass in a steady stream. The local and state police, FBI, and military forces were there. Helicopters took off and landed in a roped-off section of the park.
Thousands of willing hands, ready to bring succor and help. Hundreds of patients had been triaged already, and sent on to our hospitals. We were divided into four sections -- no injuries, minor injuries, serious but not life-threatening injuries (BLS) and those with life-threatening conditions (ALS -- this last was my group).
Images that haunt: Strange images will forever remain with me: Stunned, watching with the residents from the hospital on the hill, as the second plane deliberately crashed into the second tower. Somehow, I couldn't connect the plane and the explosion together. Who would do such a thing -- ergo, my brain insisted that it couldn't have happened. Viewing the NYC skyline without those two towers staring back was just plain eerie. Watching the third building collapse on itself silently from across the river was surreal. The huge, billowing cloud of smoke that continues to dominate the east today was strangely multihued -- some areas white, some gray, some black as night. The flames that were intermittently visible from across the Hudson River were a testament to the fact that our brave firefighters were still hard at work after hours of backbreaking work.
The seagulls are no longer white -- they're black.
No one came: We got the word -- 500 to 1,000 victims were expected imminently -- within 15 minutes the ferries should begin to arrive. I don't know where that information came from, because nobody ever came. We were sent home with promises that we would be called back again if needed.
Today, again we stood ready. There were only a few people for us to help. The tragedy in the fact that we were not busy lies in the reason for our idle hands -- most of the victims did not survive.
We are now focusing on helping to heal the emotional scars of yesterday's events. Making sure that the displaced injured and healthy alike have found a place to stay. Making sure everyone is fed. Coordinating blood donations and volunteer efforts.
Sinking in: Today was the day that the emotions began to force their way through our professional focus. Faces that had been previously stoic began to crumple into tears.
Through it all, the voices were hushed. The only loud noises came from military planes and helicopters patrolling overhead, from the scream of sirens as they raced to help. The people have yet to find a voice.
A dear friend last week shared with me her favorite saying, and it has haunted me over the past 36 hours:
"Dream as if you'll live forever.
Live as if you'll die tomorrow."
So many uncounted thousands now have no tomorrows left. I hope that we will still remember to dream, after we've found our way through this dark time.

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