Well, it's all over now, and for most Americans, 911 will slide back into the recesses of their minds.
Sunday I was invited by my old friend, Jane, who is a Deputy Chief with the Livermore-Pleasanton Fire Department, to co-write and present a piece on USARS and DMATs at Ground Zero. It was an honor. As a federal government employee with the National Disaster Medical System, it's forbidden to wear the uniform for anything but official trainings and deployments, but they made an exception in the case of 911 10th anniversary tributes. The event itself was amazing. It was in a huge theatre (almost filled to capacity) and included all branches of the military with police and fire honor guards. There were speakers, bagpipes, videos, the flag folding, and the tolling of the bell. Quite impressive. Afterward there was a very nice reception where the folks could meet the participants and the Search and Rescue dogs which included Orion, the only Ground Zero dog still alive in Northern California.
I had written this piece for another purpose, but decided to use it here instead. I looked back at the things I learned while deployed at Ground Zero - the things can still impact me today. I wanted to share them with you.
Twenty-Five Lessons
from Ground Zero
Sam Bradley, BS, EMT-P
“I think the
essence of life is laying down your life for others. If you’ve ever felt that
no one loves you, just look at a fire truck going by. Then you’ll know that
somebody does.”
Regina Wilson, firefighter, Fire Department of New
York.
Quoted from the book, “Women at Ground Zero – Stories
of Courage and Compassion”
by Susan Hagen and Mary Carouba.
I received a gift last year. It was
one of those large patches that honors the World Trade Center disaster. Embroidered
within it are the patches of FDNY, NYPD and the Port Authority. If was left for
me at our county EMS agency by someone in Public Health. It was to show her
appreciation for a lecture I did for the County Medical Reserve Corp on my
Ground Zero experience. The focus of the discussion was on critical incident
stress in disaster. I spoke to a packed house. It was nice to know that, even after
9 years, people still cared.
In thirty-two years as a paramedic,
I learned how each patient interaction, no matter how mundane or redundant, creates
a certain level of stress. Some reach you on a very personal level - others will
change you forever. A major airline crash and responding to the traumatic
arrest of one of my fellow paramedics did it for me. Unfortunately, I discovered the meaning of post traumatic stress disorder by
experiencing it.
By the time I joined a federal
disaster medical assistance team in 1997, I had taken a significant amount of
training in critical incident stress management (CISM). I felt prepared - better
than most, I thought. It was that training that qualified me to be put in
charge of CISM for the sixteen of us that responded to New York City to provide
medical support for people working on the “Pile” at Ground Zero. Saying it was
a life-changing experience is like saying Hurricane Katrina was a squall.
Lesson
#1: It’s hard to manage someone else’s stress when you’re in the thick of
it yourself.
Lesson
#2: You can’t effectively defuse people (or yourself) when you’re in a
“work” mode.”
Lesson
#3: Everyone will react differently to events based on their individual
experiences and coping skills.
Lesson
#4: Going to a memorial service to honor one of the fallen firefighters was
difficult, but gratifying.
Lesson
#5: Meeting his family, learning more about him as a person, and making him
one of our own was even better.
Lesson
6: Three horn blasts meant a body was found. Heavy equipment would be
silenced and all work would stop as everyone honored the fallen. The same
ceremony was repeated several times a day as firefighters walked along side a
flag draped body on a gurney which would be loaded into an FDNY ambulance and
taken to the morgue for processing. It was painful to watch, until I realized
that one more family had closure. Most never would.
Lesson
#7: Wearing steel toed boots on ground that was still 800 degrees below the
surface was painful.
Lesson
#8: Disconcerting can be defined by opening the back door of a treatment
tent to see the headstones of a church graveyard covered in 6” of dust and the
trees above decorated with brightly colored and torn clothing.
Lesson
#9: It was gratifying to know how much the world cared based on the donated
supplies from boots to teddy bears, and well wishes from people on the streets,
for helping New York by being “out there”. We appreciated the ever-present hot
meals made available to us by local restaurants and served up by local volunteer
agencies. The largest pot of jambalaya I’ve ever seen was transported and cooked
up by a contingent from New Orleans.
Lesson
10: The cards from children that decorated our “respite” spoke of anger,
patriotism and the kind of fear that kids in this country should never have had
to experience. Firefighters were their new heroes, but they also acknowledged
the ironworkers, trash truck drivers and volunteers. The cards had messages of,
“I hope you’re not dead or I’ll be sad”; “remember your family”; and “relax and
take some time for yourself”; We didn’t.
Lesson
#11: Children are smarter than adults.
Lesson
#12: We were told the air we breathed probably contained the DNA of 1000
people. If so, I carry them with pride.
Lesson
#13: Taking a special mission onto the Pile itself during a caving
operation was the singular most intense experience I have ever had. In the
deepest part of the most infamous place on the planet, it became very clear
that myself, my partner Andy, and the firefighters were not alone. All I could
do was tell them, “I’m sorry” ….
Lesson
#14: Talking to firefighters who were already psychologically (and, most
likely physiologically) crippled tore my heart out.
Lesson
#15: Hot french fries and cold martinis (with three olives) after a shift
at 0100 was the best part of the day. We could share experiences with the other
half of the team and make peace with the events of the day ... as much as that
was possible.
Lesson
#16: We wrote a message to the firefighters on a plywood board the day we
demobilized. We learned later that teams that came after us followed our lead
(and the team before us). That board was secured, sealed in Plexiglas and was
transported to Atlanta for our annual conference the next year. My handwriting
is now in a museum somewhere.
Lesson
#17: Trying to assimilate back into “real” life was extremely difficult.
Lesson
#18: I was really pissed then.
Lesson
#19: I still am.
Lesson
#20: When it comes to Ground Zero, emotions still sit very close to the
surface.
Lesson
#21: The person that left Northern California in October of 2001, isn’t the
same person that returned two weeks later. My temper is shorter, I’m much more
skeptical, and I have way less tolerance for stupidity.
Lesson
#22: Disaster workers aren’t easily discouraged, even in the worst of
times. A few of those that deployed with me have left the team and disaster
work. Others went on to experience other deployments like Hurricane Katrina and
the Haiti Earthquake. Disaster work is what they live for.
Lesson
#23: Each disaster takes a piece of our sanity, yet we’re driven to go back
for more.
Lesson
#24: I’d do it again in a heartbeat.
Lesson
#25: Memories of feelings, sounds, and odors from Ground Zero live in the far
reaches of my mind, but, comparatively, I’m lucky. I met a pastor from Iowa
several years ago. He had also been at Ground Zero. At the time I met him he
would become incapacitated whenever he heard heavy earthmoving equipment, music
he associated with a movie about Ground Zero, or three blasts of a horn. He has
recovered, although not completely.
Am I still angry? Yes. Why? Because
343 firefighters, police and EMS people died along with thousands of civilians?
That responders still need to have government physicals every year to see if
the poisonous air we breathed has turned our cells to cancer? That too many Americans
have forgotten that day like it was just another bad “B” movie? That we hear
more about a pop star’s latest addiction or infidelity more often than the
ongoing suffering of those firefighters and their families? Because there are
radical extremists that still focus their lives on destroying ours because they
don’t agree with our way of life? That good Muslims are chastised for the acts
of a few radicals? Yeah ... all of the above.
It mattered to me that people came to
the meeting that night to listen to my story. To know that firefighters, law enforcement, EMTs,
paramedics, nurses and docs are willing to go out there every day and brave
those dangers, face their demons, and fight the good fight tells me that the
bad guys will never win. They can take our lives, but not our spirits. They
sought to weaken us with fear, but initial shock turned to resolve and a level
of patriotism this country hasn’t seen in a long time. I am proud to have had the
honor to take care of those heroes at Ground Zero and form a posthumous friendship
with a young firefighter that died way too soon on September 11, 2001. We’re
still in touch with his family. Christian,
you will always be in my heart.
This brings home the importance of
being physically and mentally prepared for what we face, not just in disaster
work, but every day on the streets and in our ERs. Situational awareness can’t
be taken for granted. The bad guys are still out there and first responders are
their targets. That’s why I believe in the efforts of all the experienced professionals
who strive to make sure that every cop, firefighter, disaster worker and
medical practitioner is aware, well-trained, and safe. It’s a new world … a much
more dangerous one, and we need to prepare each other for 21st
century threats.
Stay safe out there!