202: The Long Shadow: What if you ran the ER five blocks away?
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This Is Actually Happening features real experiences that often include traumatic events. Please consult the show notes for specific content warnings on each episode and for more information about support services. 20 years after the attacks of September 11th changed the world as we knew it, this month, the This Is Actually Happening podcast dives deep into the stories of four survivors whose jobs brought them face-to-face with the unthinkable.

We wanted to focus specifically on the workers in and around the Twin Towers on 9/11 to explore not only what it was like from a personal perspective and how it changed their lives, but to find out what happened for those who had a responsibility to manage the tragedy in some way. We'll hear from an overwhelmed ER doctor working in a hospital five blocks from the towers, a Port Authority Public Affairs chief caught in her office on the 68th floor.

a woman who sued to become the first female firefighter in the New York City Fire Department, and a cardiologist who volunteered at a temporary morgue set up inside a nearby Brooks Brothers.

As special content for the show, we're calling this limited run series "The Long Shadow." However, these episodes will still continue in the traditional style of "This is Actually Happening," raw first-person accounts of a life-changing day among those called to manage an impossible tragedy. We explore the personal experiences, struggles, and life circumstances they brought with them into the day itself, the work they were called to perform under catastrophic circumstances,

as well as the long shadows of trauma and resilience that continue to inform the looming uncertainties that remain with us today. For long-time listeners of the show, this will be a familiar format, but with additional sound design from the very talented Marcelino Villalpando. For those of you just tuning in for the first time, welcome, and I hope you enjoy the series.

Also for this series, we have additional bonus material exclusive for those who subscribe to This Is Actually Happening on Wondery Plus or Apple Podcasts. The bonus content includes an interview with me and Dan Taberski, who created a series honoring September 11th as well, called 9-12. We also have a special segment on 9-11 syndrome, and finally, a raw, unedited, full-length interview version of the first episode, so you can get a window into the process behind the making of This Is Actually Happening.

All of this bonus material is available if you subscribe to This Is Actually Happening on Wondery Plus or Apple Podcasts. Today we begin with part one of The Long Shadow, featuring Tony Daher, a doctor in charge of the emergency room in a hospital five blocks from the Twin Towers. Thank you for listening.

You get almost fatalistic at that point. You're thinking, all right, this is never going to end. You brace again. You just try to keep your eyes shut and not breathe too much. And the world looks like it's coming to an end. Another cloud comes over. Everything goes dark. And the world is covered in dust. From Wondery, I'm Witt Misseldein. You're listening to This Is Actually Happening with our special series honoring the 20th anniversary of 9-11, The Long Shadow.

Episode 202: The Long Shadow, Part 1: What if you ran the ER five blocks away?

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I come from a mixed background. My father is Nicaraguan and my mother is born in New York, but her father is also Nicaraguan. My trajectory to medicine is a little bit preordained in that my grandfather, my mother's father was a doctor, as was her brother. He got a scholarship to go to Georgetown to study medicine and ended up settling in the United States after marrying my very American grandmother.

So my mom is basically a New Yorker who grew up on the Upper West Side, but neither one of my parents wanted to live in the other one's country. So my mother did not like Nicaragua, my father did not like the States, and they settled on Puerto Rico as a compromise. I grew up in Puerto Rico after being born in New York City, and so always had that dual culture of growing up bilingual,

Growing up in Puerto Rico was a lot of fun. It was a time when Puerto Rico was really booming. It was all kinds of economic progress and new things happening.

So I moved to Puerto Rico when I was six years old and I would spend summers in Jersey City. I would come back up for one or two months in the summers and spend those with my grandparents. My mother's parents stayed in New York City and I loved visiting them. Went to the World's Fair in New York when I was a kid and I could not ever get enough of Manhattan and New York City.

When the World Trade Center was being built, I was spending summers in Jersey City across the river and read about how they were built and watched them go up.

So as the Trade Center went up, I would read articles about the construction and how it was an architectural innovation in that the strength of the building was in the skin of it. The covering of the building, the outer panels were where the strength was. And it was considered a pretty innovative design at the time in that it allowed a lot of internal space because it didn't require internal girders like the Empire State Building. So it allowed for much more usable office and gathering space.

But it was literally almost in my backyard as it was being built, so it was really fun to watch the whole thing as that area of the city developed.

So my dad is from a Lebanese family that immigrated to Nicaragua at the turn of the century. And he was raised in a very strict, old school, old country type of setting. But he is very Latin. He loves the Spanish language and Rubén Darío, the Nicaraguan national poet, and is a fiercely patriotic Nicaraguan. And he's a very

He is a fish out of water when he's not able to use his Spanish. And so I always had that old school, you know, any immigrant family is be a professional, be your own boss, do well in school and keep going. And so his approach to my education in high school was anything below an A plus was really disgraceful. Mom was much more lenient and is a fairly uniquely loving person.

Growing up, she was the center of my universe. I was very close to her, shared everything, told her all my stories. She was the counterpoint to my dad's old school strictness. She gave me that feeling of I could do no wrong. Probably the central reality was protecting my mother. I felt like I was her emotional support, the only son. So it was a pretty powerful gravitational pull that she and I had on each other.

I think from my mother, I got a pretty strong sense of compassion. When we lived in Nicaragua, we lived there for a brief period and beggars would come to the door and she would bring plates of food for them. She was always very compassionate.

And I went to a Jesuit high school once in Puerto Rico, Colegio San Ignacio, which I adored. It was six years and small school, 100 kids in my class, a lot of personal attention and really, really great level of education. And so I was very lucky. We too much was given, you know, would owe something back. And that sense of social commitment was pretty strong. And the Jesuits at the same time were also pretty emphatic about that.

Again, I knew in high school I would be a doctor. It wasn't ever in dispute. My father, I think, always felt frustrated that he was not able to be a professional and he probably would have been a fine doctor. And all those expectations were placed on me. But on the other hand, I felt it seemed like a natural fit, obviously, of if you really do care about social justice and do care about how the world works, then be a doctor and do something about it.

Went through high school in Puerto Rico and then came up to the States for college and medical school and have stayed in the States ever since, working mostly in New York City.

I hadn't thought a lot about it, but I thought I'd be a family doctor eventually. But I'd always had an attachment to Bellevue Hospital in New York. I'd read a couple of books about being an intern at Bellevue. And the idea of being in the trenches, you know, where everything was happening was very appealing. And so that was kind of my dream choice.

The social commitment and dedication at Bellevue, which the motto of that hospital is, we take them all, we treat them all, and this is a world-class hospital, and nobody does it better than we do. It was an amazing place. At the time, it was the early 80s, the Nicaraguan Revolution had just happened. Fourth year of medical school, I had figured out a rotation to do two months in Nicaragua. By then, the Sandinistas were in power, and I wanted to go see it.

Because I'd been there multiple times as a kid and growing up, my dad would take me back and we'd visit family and friends. And when I announced that I was going to Nicaragua, he disowned me. And that pretty much blew our relationship apart, at least for a time. But I loved it. I went to Nicaragua for two months and worked in a clinic outside of Managua. And it's incredibly fulfilling, but it also made me want to go back.

So my mission in residency was to train myself as best I could, learn all the specialties, because I was going to go back to Nicaragua when I finished. Between 83 and 86, when I did my residency, was when the Contra War was really getting serious. Reagan was hell-bent on crushing the revolution. It was an all-out war, and I would obsess on a daily basis of what was going on.

So to make money for my adventure, I would do extra hours in ERs in Seattle, which I discovered I really liked. The rapid-fire ER was appealing to me. I knew that me going back down was going to be another nuclear explosion, but I wasn't going to not do it, and I figured I'd deal with the fallout with my father later.

And so I met my current wife. We met at a party in Seattle. She's French. And after explaining my own crazy plans, she went back to Paris. And when I graduated from residency, I went to visit her first and then went back to Nicaragua. And I told my parents that I had moved to France. So I would send letters from Nicaragua.

via Paris that she would then re-mail as if they were from Paris to make it look to my parents like I was in France, not in Nicaragua. I got myself posted to a hospital up in the north. I knew it was in the war zone, but I didn't realize just quite how much it was in the war zone. You know, we would get battle casualties as well as take care of the community there. And I was so naive that the sugar cane workers would come in and say their lower backs hurt, as you might imagine, you're bent over all day cutting cane.

And I would recommend, well, go home and take a warm shower and put some hot water on it and stuff. And I had no idea what their living quarters were like until I finally, one of the other docs there said, let me show you around and showed me that basically they were living on wooden pallets in the middle, just under the trees. There were no hot showers, of course. I was very much a middle class idiot.

The one story that sticks with me the most from my time in Nicaragua was a young man they brought in. He was probably in his early 20s who had had a leg blown off on the landmine. His lower leg had been completely blown off. He was alert and conscious. And so all of us congregated to take care of him.

I'm arguing with the other docs about how many IVs we should start and how much pain medication we should give. And I gave him more than I would have otherwise. And that can drop your blood pressure and decided that we were OK with just one IV, which is not trauma doctrine. Trauma doctrine is to give to put in two IVs in case you lose one. Just at that moment, the surgeon arrives, was told that there was a trauma. So we said, OK, great, we can take him to the operating room. We'll complete the amputation. And he looks like he's otherwise intact.

So we take him to the OR, we're proceeding with the amputation and we lose his heartbeat. So to resuscitate him we needed an IV and of course the one IV that I had said we were okay with failed and so we needed an IV but we got him back and the surgeon got another line. He had to do a cut down but he did it and we thought, "Oh, we're out of the woods." Patted ourselves on the back, got away with that one, kid's gonna be fine. Came back an hour later and he was brain dead.

And I blame myself ever after that I had given him too much medication that probably dropped his blood pressure, you know, for not having given him the two IVs. What probably happened is the mind probably caused a bleed in his head that we didn't detect. But it was very impactful for me. I felt like a failure. If I had managed my relationship with the other docs better and been more heads up about the trauma management, he would have survived.

You know, I came out of Nicaragua feeling like a failure in the sense that I had not saved everybody. That sense of crusading mission that then doesn't quite meet expectations was something that hit me pretty hard. I had charged down figuring here I am saving lives and reality had other opinions.

The experience of making a mistake for a doctor and why we ruminate on it so much or why it's so damaging, I think for doctors it's partly the shame of it. Normal human beings make mistakes, but you're not held on a pedestal before that happens.

Aside from the obvious tragedy of causing harm to somebody, which is already pretty devastating, we're so used to being recognized and praised and respected as the doctor that anything that attacks that, anything that undermines it, shatters that image, is so doubly devastating. And it's especially bad if you think it was an unavoidable mistake, if there's something you could have done differently that would have been reasonable.

is a feeling of failure that after all that training, you're still stupid.

The most consoling thing you can hear is a fellow doctor that you respect saying, oh, I've done that, that they've made a similar mistake or an equally grave mistake. You realize at that point that it's a contact sport, that you're all in this together, that if you do enough medicine, you will eventually have this happen to you. You know, it's like barnacles on your hull. You can never scrape it clean again, but you just have to live with the barnacles and the ship will keep sailing, but you have to

Except that you're no longer pristine. After I got back from Nicaragua, I worked in the Navajo Reservation for two years and then did another two years in upstate New York as a family doctor and realized that the slower pace was not suited to me, that I really had not understood my own personality. And so I was doing a lot of ER moonlighting there as well, just because I liked it.

My residency and board certification is family medicine, not ER medicine. But because of the ER I worked in in upstate New York, they had an opening in a hospital in Manhattan. And it was in lower Manhattan at a place called Beekman Hospital. And this was in the early 90s. The hospital was in flux. The ER docs who had been there before were leaving. And so after about four months, I became the chief of the ER, which was kind of hilarious.

Danielle, in the meantime, came to the US. She's a lawyer, came to the US, got a master's at NYU. So three years after I started as an ER doc in New York, we went to France and we lived there for five years. And I would fly back and forth to the US to do shifts. Every two months, I had a cycle where I would fly to New York, do 18 or 20 shifts in a row.

and then come back to France and be with my two kids who at the time were three and four years old. And I'd be a house husband by myself. My wife is a full-time corporate lawyer and she worked long hours and so I was on my own. Raising two little kids, being with two little kids all day long is so much more stressful and difficult than being an ER doc. And so I developed a deep admiration for anyone who can do that well. I think the appeal of ER medicine is

You get to do something useful on people's worst day. That when all hell is breaking loose, you get to be the one that puts it back together.

One of the cases that drove that home was like a 50-year-old who he got himself into the ER feeling dizzy and weak. And we put him on a monitor and he was in ventricular tachycardia, which is a lethal rhythm. His heart was about to quit. And everybody around me, the nurses, and I was like, oh, my God, he's in VTAC. He's in VTAC. You know, and everybody was scrambling to, you know, do the right thing and grab the equipment we needed and the medications we needed.

And I just stood at his bedside and I don't think I held his hand, but I was just clearly parking myself right with him. And, you know, we fixed him. We gave him the right meds. He responded beautifully. And he wrote me a lovely letter saying later that, you know, what he felt most was that I was with him in the life raft and was going to accompany him down these rapids no matter what.

And I think that is the epiphany to play that precise role of both holding someone's hand while at the same time your brain is trying to figure out what the hell you do next.

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This Is Actually Happening is sponsored by ADT. ADT knows a lot can happen in a second. One second, you're happily single. And the next second, you catch a glimpse of someone and you don't want to be. Maybe one second, you have a business idea that seems like a pipe dream. And the next, you have an LLC and a dream come true. And when it comes to your home, one second, you feel safe,

And the next, something goes wrong. But with ADT's 24-7 professional monitoring, you still feel safe. Because when every second counts, count on ADT. Visit ADT.com today. In 1993, I was working at St. Vincent's Hospital. I was trying to see the different ERs in Lower Manhattan and which one I felt most comfortable in. So I went to the biggest hospital, and that was St. Vincent's on 12th Street.

and had been working there for about a month. And suddenly we got the notice that there was an attack on the World Trade Center. And that was the attack where they drove a van into the parking lot filled with explosives, almost blew out one of the corner columns that could have brought the whole tower down. It was so well built that it resisted that, but we got hundreds of casualties. Six people died in that attack. Most people forget that. We got most of them because we were the trauma center nearest to the trade center.

That attack prepared the towers. It dramatically beefed up their escape procedures, their training for it. So it was almost a test, dry run of a future attack that dramatically improved the capability of the towers to both withstand an attack and also evacuate.

It taught me what happens when there is a disaster response, is that everybody clusters and everybody wants to be where the action is and you need very strong discipline to figure out who needs to be where. I then transferred a few months later, I went back to lower Manhattan to New York Downtown Hospital. St. Vincent's is about a mile and a half north of the towers. New York Downtown, where I then made my career, is five blocks from the World Trade Center.

It had about 150 beds total. By comparison, hospitals like St. Vincent's or Bellevue Uptown have close to 1,000. The hospital, because of that experience, was pretty diligent about disaster drills. And so in July of 2001, we did a disaster drill.

And I happened to be on call. They're always a surprise. You're not allowed to advertise them. So there I am, the ED attending. And so there's like 35 young doctors all pretending to be casualties flooding into the ER. And I was like, oh my God. When you see the bodies coming in, you're going, where do you just put them?

The morning of September 11th, I had stayed overnight in the city because I had back-to-back shifts. So the little apartment where I stayed in had a small balcony and I remember stepping out on that and looking up at the sky and it was the most perfect blue September sky. And I remember that morning thinking, "Oh my God, this is perfection." Walked across the street to my shift. I was the only attending, I'm the only ED doc in the ER at the time. It was a quiet morning. We had very few new patients.

And at one point I went to the bathroom. So I'm in the bathroom and I hear this overhead page saying,

for respiratory therapy to the emergency department, which is odd because only I can call that. I was the only senior doc there and thinking, who's calling respiratory therapy? That means we're intubating somebody. And I was the only one that could do that. And I was in the bathroom. And so that was odd. I figured, you know, let me just check and stumbled out. And one of our nurses was running across the ER shouting, a plane has hit the towers. A plane hit the towers.

I just remember thinking, "Oh my god, it's four blocks away. They're going to be here in a minute." Running around quickly, try to organize the treatment areas, try to hang IV poles, just grab everything you could and have it be visible.

First patient we saw was an elderly Chinese lady who'd had a stroke. And I was thinking, you know, oh my God, I can't deal with this right now. This is, you know, we're about to have a big disaster. And so I grabbed one of the residents and said, you know, please go evaluate this patient, see what she needs and take care of her. You stick with her. And then about one minute later, this human wave just broke over us.

They rounded the corner, I'll never forget it. It was like something out of one of those silly movies where, you know, a crowd is running away from something and barreled to the ER.

As the senior doc, my job was to triage the patients as they came in. So I had a stack of paper tags with little strings to tie around patients' necks. And the ER nurse manager, Mary, we divided it up. We said, OK, I'll be outside. I'll triage. I'll bring them in. You organize inside. And we'll work back and forth and keep in close touch. So I'm out there holding my stack of triage cards. And bloody hysterical people come charging in.

The first patient we had was the young woman lying so low in the stretcher that I didn't really quite understand how that could be physically possible. And it turns out that she had been hit by landing gear from the second plane and it had sheared off most of her backside. She had lost so much tissue that she was lying low in the stretcher. The muscles were flayed open and I just remember looking at her and saying, "I need surgeons now. I need surgeons here immediately."

One surgeon who had come down from NYU, he's British, I'll never forget his accent, said, you know, it's a battlefield situation, we need to amputate right away. And she was awake. So she was fully conscious. She was eyes open, looking around. And two of our regular surgeons came barreling in and took a look and said, yeah, maybe we can do something here. Let's not get hasty and let's take her to the operating room. And then the avalanche came.

I tried to tie tags around one or two patients and realized that was utterly absurd, that there was absolutely no way I was going to get anywhere near dealing with the patients and the numbers they were coming in. Again, partly remembering what I'd done in July, grabbed the residents, the interns and the R2s and the R3s, clustered around me and I would assign them one by one as the patients came in. Severe, moderate, not so bad, take them back to the red area or the green area, yellow area.

And they would, in some cases, make the diagnosis as they were wheeling the patient in or escorting the patient in, grab a surgeon, the surgeon would put in a chest tube. It was phenomenal. I came back just to quickly see how we were doing in the back, and the room was a shambles. There's blood everywhere, there's supplies everywhere. I figured out, oh my God, we're losing our treatment rooms. We're not going to be able to use this again.

But the housekeeping staff was on it so quickly that they would come in, just be a tornado of getting it back in order, and it would be back in service again five minutes later. The way people rose to the occasion is something I'll never forget. You really have no understanding of how well people can function if they're well organized and well directed and trust each other.

When you see the human wave coming at you, first instinct is to feel helpless of how on earth am I going to take care of all these people all at once? You almost get tunnel vision. Your brain can only handle so many things at once. You cannot process it because you'll freeze.

But then you get it. Then you realize, look, I do have resources. I do have people with me. And if I keep my head, I can get most of these people well taken care of. And I think that keeping your head and not being overwhelmed by, oh, it's too much. I can't do it. It is the key.

Some of the patients were horribly burned. The jet fuel in the first tower, the plane hit the elevator shafts and the jet fuel cascaded down the shafts and burst out into the lava. So people waiting for an elevator were basically roasted alive. And we had patients coming in looking like wooden statues who had been burned from head to toe.

The injuries were mostly due to the falling debris and the jet fuel. So people walking on the sidewalks outside the towers were hit by falling debris. We had a number of open head injuries, just skulls split open, chests crushed, a combination of burns and blunt trauma. One patient who was visiting from Boston and he just was walking on the sidewalk and the debris and the fuel hit him and caused a spinal cord injury at around halfway down his back.

And it burned his chest. He was severely injured, but fully conscious. One of our nurses tells a story of taking care of him and him reaching up and saying, I'm not going to die, am I? And she reassures him that he's not. But he did three months later.

One of the shocking things about 9-11 among many was that everybody was young and healthy. It was all young working adults from the tower. There were no retirees. There were no children. It was all a very specific age group of young, healthy adults. And seeing them so badly hurt and so

you know, burned and leg fractures and chests crushed was pretty dramatic in the sense of they were all perfectly healthy, you know, an hour ago. And here they are.

For me personally, I had to be sure I didn't get too bogged down in a given patient. Just make sure that they had the care they needed, stabilize, make sure nothing needed to be done right that second, grab the nearest surgeon or the nearest unoccupied doc and say, this is your next patient. It was like a radar sweep, just making sure that all these patients had somebody on them. That sense of being the one with the overview to make sure that nothing was falling through the cracks.

The ER entrance looks towards the East River and many people in the hospital saw the plane hit, the second plane hit. And they also, from some of the conference rooms, you could see the people jumping off the towers. There was no escape and they figured that was the least painful way to go. A lot of staff in our hospital saw that happen. For some reason, almost in a self-protective way, I was so concentrated on dealing with the patients as they were coming in that I didn't look up.

You know, to me, the towers were a million miles away. I was just dealing with the reality of what I had in front of me. Everybody who heard about it came right to the ER. I mean, one of our clerks was on the Brooklyn Bridge, heard the radio go off about the attack, looked up and saw the tower and turned around and came back in jumping police barricades. Nurses did the same thing. You know, people were heroically rushing into the hospital to help when they, you know, they could have gone home or thought that it's too dangerous.

At one point later in the morning, about an hour in, we needed to transfer patients uptown. We had a lot of fractures and orthopedic cases that we couldn't handle. Our ORs were full. And I had no idea how to contact ambulances. And just then, our ambulance director, who was a close friend, appeared at my side. And he had been on his way to work.

So the towers hit, thought the hospital was probably destroyed, but kept coming downtown, jumping police barricades and running away from the cops and pops up at my side exactly when I needed. So we were rapidly getting the help that we needed. How everybody rose to the occasion was something that's hard to describe. It was so remarkable. About an hour in, the world just exploded.

You just hear this deafening roar. It was freight, train, artillery all combined in one and thinking, "Oh my gosh, they're taking out more buildings."

In the meantime, of course, the Pentagon had been attacked and the other plane had gone down. And so I was getting these updates and you got the sense that the world was ending, that it was the apocalypse, that there are still 30 planes in the air that could be terrorist planes. And rumors start flying very quickly. You have no idea how extensive it's going to be. Anything at that point is possible.

And then a few seconds later, the smoke cloud came. And I was, the ER is on Gold Street. It's one of the narrow lower Manhattan streets. And I looked south and this 10-story tall smoke cloud came barreling up the street. It was like an onrushing flood. And, you know, I looked around quickly and thought, there's no place to go. Just kind of, you know, braced myself and the thing washed over us. And it was so dense, I did the, can I see my hand in front of my face thing, and I couldn't.

As that dissipated a little bit over the next few minutes, it didn't even occur to us then that the tower had collapsed. The South Tower was the first one to go down.

But it immediately struck us that with all this much contamination in the air, the ER is now unsafe. We need to close the doors. And so, somewhat idiotically, we tried to close the doors, but there were still patients coming in. So I know people that were up in the lobby upstairs where patients were being sheltered saw these ghostly hands pounding on the pane of the windows to try to get into the hospital lobby.

In the ER, Mary got two construction guys, two hardhats, to rig up an airlock so we had an inner and outer door so that they would open sequentially as opposed to together so that we could try to keep some of the smoke out of the ER. But the whole ER then looked almost like a stage scrim, like there was a screen in front of everything. Everything was kind of hazy and smoky. And you're debating, you know, should I even keep patients in this hospital? Should we shut down and not contaminate wounds or patients or you name it?

But we kept, you know, we stayed open. Now more patients came in because after the tower collapsed, a whole new set of injuries happened. People had respiratory issues. People had been struck with more debris. And now they're covered in dust and you couldn't tell at all what was wrong with them. They would come running in and you had to first kind of hose them down. By the time we caught our breath after the first tower came down in the smoke cloud and tried to rig up the doors and deal with the new wave of casualties, the second tower came down.

You get almost fatalistic at that point, thinking, "Alright, this is never going to end." You brace again, you just try to keep your eyes shut and not breathe too much. We were starting to distribute masks, but again, same exact roar. The ground shakes, the world looks like it's coming to an end. Another cloud comes over, everything goes dark, and the world is covered in dust.

You almost can't move at first because you don't know if it's safe or whether you should breathe or whether you should walk or what.

The casualties even at that point were still horrendous. One young man who was hit by the falling tower had a crushed pelvis and choked on the dust and came in and the trauma team couldn't figure out where he was losing blood and just had a really hard time controlling his blood pressure and intubating him and just because he was so covered in dust and so difficult to assess and so unstable.

What people did to get out of the towers and get to the hospital was astonishing. There's one story of a young woman who was in an elevator. Elevator stops at the second floor. It jams or is braked at the second floor. She's with another woman and three men, and there's a little space between the elevator and the wall. So she was fairly petite, was able to squeeze herself through that space and fell one or two stories in the elevator shaft.

gets herself out of the elevator shaft into an ambulance, breaks some ribs along the way. And just as she's getting in the ambulance, the other tower comes down, buries the ambulance in dust. She gets out of the ambulance and then walks the four blocks of the hospital with a broken rib and pneumothorax. You're trying to absorb all these different stories of people in such dramatically individual situations. Everybody's story was different. Every injury was different. And just try to be with them.

One guy became hysterical. He had an injury to his arm and an injury to his leg. And one of our PAs had to throw herself across him to pin him down so the surgeons could set his arm.

That was unusual. Most patients were calm and cooperative and almost had a sense of, look, we get that there are many injured people here and I'm not going to make a scene because you guys need to be able to concentrate on who's sick and what they need. And so that part was extraordinary of how the patients themselves were heroic.

So the power went out at around 5 o'clock because of the collapse of the Office of Emergency Management. At that point, there was no steam, so we couldn't sterilize instruments. The water pressure was pretty low. The air filters were dying. They were choked with dust. So we were still doing our best to take care of patients, but it was getting kind of tenuous that we were losing systems and starting to become non-functional. And again, you know, the debate is, are you putting patients at risk by staying open? But they kept coming.

We tried to control entry into the hospital, but patients would come in through other doors and other things that were open. There was no choice. You couldn't stop. The patients kept coming. My fear, my terror was that I was going to miss something, that I was not going to connect the dots well enough or make sure that things had been supervised well enough that a patient would be lost or damaged.

The reason I can sleep at night is that we did everything that could have been done for every patient that came through the doors. And as far as any of us can tell, no patient was missed and nothing treatable was untreated, which all of us will take with us forever. And that's just a testament to how everybody trusted each other. And I think there was a contagiousness to the organization and surveillance and clinical oversight that was very effective.

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So that night, as we were winding down, the ER was getting under control and at that point we were taking care of rescuers. And Peter, the ambulance director, and I went up to City Hall Park to see just what was going on. And, you know, the dust cloud, it looked like the end of the world. Lower Manhattan was completely deserted, buried in this dust.

The casualty totals at that point were beyond imagining because there were 30,000 people in the towers and so we thought, you know, how many people had died? So we were desperate to make sure that anybody rescued or any attempt at rescue that we could provide immediate care. Word came that there was a transit officer trapped under the rubble and that we needed a bone saw to do a field amputation. So of course, a bunch of us went running over

Everything was black. There were searchlights, there was dust everywhere, there were water mains broken and fire hoses everywhere. It looked like we were going to the dark side of the moon. As we came upon it, I was thinking, "Do I really want to go into the rubble? A, I don't know how to do a field amputation. I could certainly try to muscle my way through it, but I do have three children and that sounds really dangerous." And so I felt a wave of fear for the first time that day.

You could see the searchlights on the rubble. It was like the rolled up skin of the building was this huge cylinder lying on its side. As you got closer, you thought something was moving on it and it was dozens of firefighters crawling over the rubble looking for survivors. I felt like a pretty big coward that I was afraid to get close to it and these guys were already climbing all through it.

So nothing happened that night. There was one or two rescuers who had fallen and broken an ankle, and we whisked them off to the hospital. I think they continued to try to extricate the transit cop. He was the Port Authority policeman. We came back early the next morning, and they had gotten him out. And we formed a human chain in the rubble so that the stretcher could be passed between two lines of people. And it was the first hopeful sign the whole time.

Finally, there's a small victory. Something is saved. Something is salvaged out of all this horror. He was badly injured. He had a lot of muscle mass damage, but he was taken to Bellevue right away and he made it. We felt it was unforgivable that we had not reversed the disaster, that in the face of something like that, even though, you know, rationally you understand that there's not much you can do, you feel guilty that you somehow have not made it okay again.

Lower Manhattan was cut off. Nobody was allowed south of Canal Street. I went down with one of the other docs to look around the site and try to run into a TV crew so that we could announce to the world that we were still open and available for anybody that needed us because phone lines were out. What was truly unbelievable in that your mind had a hard time getting around it was that the towers had disappeared.

they had vanished. And, you know, there was rubble all around, but there wasn't, you know, a toppled tower somewhere. They had just pancaked all the way down and vaporized. And the power of that was so intense that to this day there are over a thousand people that are still completely unidentified from the towers. Even though they sifted the rubble and tried to identify any scrap of tissue that they could do a DNA analysis on, a thousand people were completely vaporized in the collapse of those towers.

What had looked so mighty and powerful before was just dust. We were just trying to get our heads around the violence of what had happened the day before. I spent the night, went home the next day, and above Canal Street, the world was normal again.

We had a sense of being so cut off from the world, both physically and communications-wise, that this idea that you could just walk up to Canal Street, grab a subway, and go to Grand Central and get home to Connecticut was so ridiculous. And so I got home, and the neighbors were out, and they clapped for me, and I got home and watched the evening news. And Peter Jennings was on, I think, ABC and showing a map of Manhattan with the hospitals.

but there was no marker for my hospital. So we were effectively invisible. By then the word was out that the hospitals had stood empty, that there had been no patients to take care of, which was already kind of shocking that after going through all that and then to be literally invisible.

You know, in the subsequent weeks, there was some acknowledgement and Oklahoma City sent us teddy bears. There was a van that they sent a week and a half later just as an acknowledgement that we were in it together. And Jefferson Medical School in Philadelphia sent us Philly cheesesteaks. That invisibility factor had kind of traumatized the staff.

St. Vincent's was getting so much publicity and free food from restaurants and all this, you know, glorious recognition for their heroism. And again, it sounds really, really petty, but that simple acknowledgement of, you know, we know what you guys did, we know you went through the same thing we went through was so healing. And again, it sounds idiotic, but someone reaching out, just patting you on the head and going, you know, we're with you, was enormous.

I was watching the news on September 12th and they were showing footage from around the world and people lighting candles and holding vigils and the famous French headline of "We are all Americans." And that was the first time I cried. After feeling so isolated and cut off for all that time, to come back and realize the world was right there was very powerful.

A week into it, we heard that that young woman with the flayed legs, they had taken her to the operating room, they tried to repair the legs, and then she was septic. So we thought, we can't even rescue one patient who might have made it. That was probably the low point of futility, of thinking, Jesus, you know, can we just catch one? Again, like rescuing the transit officer. You take it very personally, but Debbie, as her name, got better.

She ended up keeping her legs, getting married and having two kids. And it was a happy ending. I mean, she's sustained significant damage, obviously, and I'm sure has chronic health issues, but she has a fairly normal life. So there was a victory there eventually. It took a long time. And I think that if she had died and if we had missed patients, if I had lying awake at night thinking what I could have done differently, I think that would have been devastating.

But by the grace of whatever, that did not happen. The fear of missing a patient, that was the hardest thing, was what more can I do? What more can I do? I'm checking with Mary, checking with everybody. What am I missing? What else do I need to think about? I felt kind of the self-appointed person in charge, that if anything went wrong, it would be on me.

I think for me, the rescue was not losing any patients. I mean, again, several patients did die, but they were, you know, horrendous open head injuries and there was nothing really anyone could have done.

The one thing I didn't anticipate was also the sense of not just camaraderie, but of trust and bonding you get with the people that you went through this with. Gave me a glimpse of maybe what combat veterans feel towards each other, that when the chips were down, I knew I could count on you and you came through. There's just this quiet loyalty to each other that you always know, you know, that we'll have each other's backs.

You have no idea what people are capable of. What you think you can do versus what you can really do when the chips are down and you have people that trust each other is astronomically different. It's the only thing we have, right? In the face of a universe that is always traumatizing us, there is a human counterattack. And what you also underestimate is how profoundly people can take care of each other.

9-11 was a moment of everyone in it together in a way that certainly in my lifetime has never been replicated. New York City became a tender place. You'd be on the subway and people would walk out for each other. You could sense that there was kind of a caring and a tenderness about the city that everybody was in mourning, everybody was grieving, but everybody was looking out for each other.

And, you know, to me, one of the big tragedies of 9-11 is that feeling that the world was with us. That sense I got the next night of watching the footage from around the world of people lighting candles saying we're all Americans. You know, I feel that that moment in history was almost a tearing in the time-space continuum where if we had used that goodwill, taken advantage of it and deepened it, you know, we could have done so much healing around the world. And that moment was squandered.

It's hard to remember that moment. It's hard to remember how the world, in a way, glowed with a new light after 9-11. That sense of we're all mortal and we're all in it together and this is a small planet and all you can do is take care of each other was pervasive. And that's what everybody was feeling. And we didn't realize it. We didn't keep it, which makes me sad.

But the final story is an old buddy that I went to med school with said, "Hey, that patient with the crushed chest and the burns with the T6 injury, he's at NYU now. He's in the ICU at NYU, but it's not looking great. He's in pretty bad shape." He worked for the IRS and he lived in Boston.

The problem for him was that the chest injury, any lung damage that interferes with breathing, the best therapy is to walk and to be active. But he had been rendered paraplegic so he couldn't move. So it was a very difficult clinical situation of immobility plus the need to be mobile.

This was about three weeks into it. And I figured at this point, the wife's been here sleeping in the ICU, basically, or, you know, with an acquaintance nearby and must be completely distraught, harried and impossible to deal with. But I had this need to have a face, to know of somebody that we had taken care of that I could get to know a little more. That the emptiness of it all being so fast and the devastation being so complete, you need something to grab onto.

And so I went up to NYU with him to meet the family. Very beautiful family, very tight. So the wife shows up and it was probably the most unexpected moment of grace in my whole life. She was just, "Look, you saved him. Whatever time I have with him, without you, he wouldn't even be here." And just left us speechless.

She was radiant with gratitude and love and, "Oh my God, what you guys must have gone through on 9/11, and thank you for saving my husband." They transferred him back up to Boston. He just kept deteriorating because there were too many organ system failures, and he died in December. But I've been in touch with the family ever since.

We just kind of prop each other up and remember the day and she visits every now and then. It's a touchstone that keeps me connected and forgiven and understanding of what happened. What she showed me was that even in the depths of her grief, that somehow her love for him spilled over to us was almost a miracle. That sense of her taking care of us when it's supposed to be completely the other way around was what was so powerful.

I've never seen another human being so represent what grace means. It's a human standard that because she can do it means it can be done and it is possible to be that way.

Today's episode featured Tony Daher. Tony was born in New York City, grew up in Puerto Rico, and has been practicing as an ER doctor in New York City for 30 years. You can read one of Tony's articles called Vital Signs, featured in Discover Magazine. See the link in the show notes.

From Wondery, you're listening to This Is Actually Happening. With our special series honoring the 20th anniversary of 9-11, The Long Shadow. If you love what we do, please rate and review the show. You can subscribe on Apple Podcasts, Spotify, the Wondery app, or wherever you're listening right now. You can also join Wondery Plus in the Wondery app to listen ad-free. In the episode notes, you'll find some links and offers from our sponsors. By supporting them, you help us bring you our shows for free.

I'm your host, Witt Misseldein. Today's episode was co-produced by me and Andrew Waits. A special thanks to all who helped out with this series to make it happen. Ellen Westberg, Andrew Waits, Marcelino Villalpando, Gabriela Quintana, Emily Caldwell, and Jason Blaylock. The intro music features the song Illabi by Tipper. You can join the This Is Actually Happening community on the discussion group on Facebook or at Actually Happening on Instagram.

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I'm Dan Taberski. In 2011, something strange began to happen at the high school in Leroy, New York. I was like at my locker and she came up to me and she was like stuttering super bad. I'm like, stop f***ing around. She's like, I can't. A mystery illness, bizarre symptoms, and spreading fast. It's like doubling and tripling and it's all these girls. With a diagnosis, the state tried to keep on the down low. Everybody thought I was holding something back. Well, you were holding something back intentionally. Yeah, yeah, well, yeah.

No, it's hysteria. It's all in your head. It's not physical. Oh my gosh, you're exaggerating. Is this the largest mass hysteria since The Witches of Salem? Or is it something else entirely? Something's wrong here. Something's not right. Leroy was the new dateline and everyone was trying to solve the murder. A new limited series from Wondery and Pineapple Street Studios. Hysterical.

Follow Hysterical on the Wondery app or wherever you get your podcasts. You can binge all episodes of Hysterical early and ad-free right now by joining Wondery+.