9/11 Chronicles: Breast Cancer Takes a Backseat

I remember driving down the FDR Drive in Manhattan on the way to my office in Brooklyn on 9/11/2001. Yes, it was a beautiful late summer, early fall day, as so many have noted. A busy day was planned at work. In ten days I was going on a long needed vacation.

The FDR in Manhattan runs down the East Side along the East River. As the island narrows at its southernmost point, the FDR disappears in a mini tunnel and then emerges on the West Side of Manhattan as the West Side Highway. The Downtown Athletic Club, where they award the college football Heisman Trophy every year, is on the immediate right when emerging from the mini tunnel. The second right turn out of the mini tunnel is the entrance to the Brooklyn Battery Tunnel and the borough of Brooklyn.

A few blocks north of timages-5his is the World Trade Center twin towers. Depending on what lane I am in, I can sometimes see the lower floors of the towers before entering the tunnel.

On 9/11 I turned into the tunnel to go to Brooklyn. I usually come back through this area after work and late at night when it is dark. I didn’t know that in a few hours at the height of the day I would be revisiting this spot where sunlight had no chance.

I emerged from the tunnel in Brooklyn. The phone rang. It was my wife. She knew my route to work and mentioned that a small plane has flown into the World Trade Center. Had I seen anything when I passed through there? Nope. Nothing unusual.

images-4She called again ten minutes later and said something awful was happening. I pulled into my office parking lot and ran down the stairs to my office. The waiting room was already full. It was quiet. All my patients were focused on a small television set in the waiting room. Two towers were billowing smoke.

By this time it was clear this was no accident. I called my wife and asked her to call our two boys. I called my nephew who was staying in my apartment and told him to stay abreast of developments. He had just moved to New York City three days earlier.

A sales rep was in the office for a meeting. He was previously in the military. I asked him what was going on. Where were the F-15s? We went upstairs to talk some more business….and then two fighter jets roared across the images-8sky. Blackened fuselages. Steely. Impressive. That was reassuring.

I went back downstairs and gathered the staff together. We brainstormed to see if anyone from the practice or friends or family of the staff would be in the vicinity of the Trade Center. I called my computer consultant. He was safe. I didn’t know of any specific patients who worked in the trade center.

I asked the staff if we should go on with office hours. Nobody wanted to work. I went out to the waiting room and asked the patients the same question. Some had already left. Nobody was focused at that moment on breast cancer. Breast cancer had taken a backseat to this event. We sent everyone home and called the remaining patients to cancel.

I then went up to the roof of the building that afforded a better view across the river. The plume of smoke was drifting eastward and somewhat southward. And then the building collapsed. Horror. The debris and dust storm hit the ground and then spread itself all over, mixing with the black plume from the plane fuel. I went with theunknown-1 super to his apartment and watched on television. Seemingly minutes later, the second building collapsed. I went back down to my office. My office manager told me they were asking all doctors to report to their hospitals.

The city was already closed down. No cars were allowed in. The tunnels and bridges were closed. Subway service was frozen. I couldn’t get into Manhattan. Do I walk in? Through the tunnel? I would late learn of a fireman who ran through the tunnel in full gear only to perish. There is now a race commemorating his efforts.

Do I go across the Brooklyn Bridge? I asked my office manager to close up the office and cancel tomorrow’s OR cases. Surgery was scheduled for the next day, but I knew it wouldn’t happen.

I knew there was a police precinct house a few blocks away. Perhaps I could go through them to get into Manhattan. I put on a white lab coat, grabbed a few surgical masks, and walked a few blocks to the precinct house to hitch a ride into the city. I went to the front desk, explained my situation. With a wave of the hand I was directed by the officer to an idling school bus outside. I took a front row seat behind the driver.

And then the bus started to fill, slowly at first. Policemen with heavy weaponry. Looked like a swat team. A few of them nodded at me when I tried to catch their eye. They seemed pretty grim and determined. I felt kinda safe, as safe as one could feel on this day. And I wondered what they thought of me, their doctor help riding shotgun, a damn breast cancer surgeon in clean white coat. Where are the trauma surgeons, the open heart guys, the orthropods, the neurosurgeons, the real surgeons?

The bus started towards the tunnel. The Brooklyn Queens Expressway was most empty except for emergency vehicles. In the distance was the noxious plume heading East and South to cover parts of Long Island and Brooklyn. In the distance was the new emptiness where the towers stood hours earlier.

The commander of the group in the bus was seated across from me and asked where I was headed. He nodded and didn’t say much more. The bus was stopped at the toll gates, inspected quickly, and waved through. We entered the dark tunnel. I had taken this drive hundreds of times. This was different. Halfway through the tunnel the driver turned on his wipers to take care of the oncoming dust and debris.

images-10We emerged from the tunnel expecting to see daylight, but it was dim. Confetti like particles, atomized particles of the buildings settled onto the ground, followed by more and more. I let the guys with the heavy weaponry file out and then they were lost in the dark, particulate, opaque fog. I got off the bus, alone. There was nobody around or so it seemed. I realized I really wasn’t with anyone. I was on my own in a ghost town, in the seventh ring of Dante’s hell.

The debris kept falling and for a moment I realize that the debris did not just contain asbestos and parts of the buildings. Humans had been vaporized in the crash and crushed when the buildings collapsed. In that debris must be fragments of body parts, human DNA, atoms freed from their human role  now mixing with building debris. I wanted to hold my breath, didn’t want to inhale the noxious and creepy brew that the terrorists had concocted. I was glad I brought surgical masks. I doubled them for added protection. I tried not to take deep breaths.

I had been dropped off more north on the Westside Highway than I wanted. unknownI could see some of the crushed debris, large fragments of the building’s facade languishing awkwardly in uncharacteristic postures. Fire trucks were covered in dust. A few bedraggled, dust covered fireman limped by–I didn’t know at the time that they were the lucky ones. There was a low, droning din, but it was impossible to find its source. A death din punctuated by an occasional siren struggling against the dust and debris. Or was it the muted collective screams of the dead struggling to be heard.

images-9I doubled back figuring I would walk back up the FDR to the hospital, up the same route I had taken in my car to start my day only hours earlier. What a difference a few hours makes! A soot covered ambulance was parked awkwardly in front of the Downtown Athletic Club. The thought jumped into my mind: what were they going to do with the Heisman Award Ceremony this year? Would things get back to normal soon or not?

The driver was at the steering wheel, listening to a dispatcher.  I approached and  asked if he was okay. He nodded vacantly. He looked stunned. I asked if he could take me uptown to the hospital. Sure thing, doc. I am sure that he never thought he would see a doctor hitching a ride on an ambulance to get to work.

generic-med-red-cross-smallI asked him where he was dropping off the victims, what hospital? Don’t know. I haven’t had a call yet. I was his first fare. He said very little as we drove to the hospital. He dropped me off. I thanked him, wished him good luck. He nodded indifferently.

My white coat and my shoes were a mess, covered with the death debris. I rushed into the hospital and into the locker room to change into my scrubs. I wanted to take a shower. I dusted myself off.

I had been trained in Trauma Surgery, but hadn’t done it for years. I was ready to do what I could. I made it to the emergency room and then to a lounge with my fellow surgeons. We waited for the victims to arrive….we waited and waited….drinking coffee, talking nervously, watching the news, making calls, talking nervously…waiting some more….

Nobody arrived except a few respiratory cases and a few bumps and bruises.

A flurry of activity to make it here, a journey from Brooklyn through the horrors of Ground Zero….and then nothing. We slowly drifted out of the hospital knowing that there weren’t going to be any survivors. I learned that from the ambulance driver three hours before. There was not much middle ground between life and death on 9/11….no lives to save.  Breast Cancer took a backseat on this day as did the ability of the helpers to help, to ply our trade heroically in a moment of tragedy.

I hailed a cab. There were already people in it. I squeezed into the front seat. A communal cab ride –something new in New York City. A woman sat behind me behind the driver, sobbing quietly. A friend was trying to console her. A businessman was on his cell phone. The cab driver dropped us off somewhere. We paid what we thought the ride was worth.

images-6I got into the apartment, dropped off my stuff, and went out in the street with my nephew. Folks were milling on the sidewalks, in the crosswalks, and in the street. The taxis and the cars moved slowly and cautiously among us. New York was somehow different, transformed. I just wanted to be out among people who had somehow survived and had the wherewithal at that moment to mill on the streets. My nephew and I eventually went upstairs to watch the coverage, to hear the President. I ordered Chinese food, comfort food.

I awoke the next day to a new world. Nobody at that moment knew how our lives were about to change. My car was fifteen miles away in Brooklyn. I took the subway for the first time to Brooklyn and my office. I chatted with my office manager and decided we would work tomorrow, Thursday. I skirted Manhattan and drove up to Connecticut to watch my kids play sports. What a relief.

I returned to the office the next day. I tried to get my mind back around Breast Cancer. We limped through the day. Late in the afternoon a frantic, weeping, hysterical patient called me on the phone claiming that I had saved her life, that she would be eternally grateful to me, that she would light a candle for me everyday for the rest of her life. How so? I asked.

Through her tears she explained that she had worked on a high floor in the South Tower. I had called her a few days before 9/11 and wanted her to come in for further work up of an abnormality on her mammogram. She made the appointment for the morning of 9/11 and took a day off from work. She was convinced that she would have been killed had I not scheduled her for 9/11.

Thank God you found that problem. Thank God. You saved my life, really, without a doubt.

I told her that I was happy for her and unhappy for those who perished. But I told her I had done nothing heroic, that I didn’t deserve any credit for this coincidence. She wouldn’t hear anything to the contrary. Eventually, I gave up and suggested that she make another appointment to address the problem, which turned out to be a false positive. She was okay. The terrorists were not going to kill her and she didn’t have breast cancer, still now in the backseat.

I drove home that evening through the Midtown Tunnel. The Brooklyn Battery Tunnel, now a conduit to Ground Zero, remained closed. Having come through the Midtown Tunnel, I opened the window for some fresh air. I was greeted with an acrid, putrid smell. It was the smell of death hanging over the city.

fleeing-sodom-and-gomorrah-by-julius-schnorr-von-carolsfeld-1860I closed the window, drove uptown, gathered my nephew out of the apartment and in biblical fashion fled the city, ahead of the locusts, ahead of the coming plague.

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