Doctors Who Tried to Help

Hospitals Prepare for the Worst, and Then Wait

Dr. Jonathan Svahn first witnessed the end of New York as we know it through the windows of Bellevue's intensive care unit, which afforded a "perfect view" of the World Trade Center. Braced for a barrage of victims, doctors across the city waited with emergency plans in place on Tuesday morning. The absence of patients led them to a chilling realization: People had either made it out mostly unhurt, or they had not made it out at all.

Dr. Jennifer Svahn, Jonathan's sister, a vascular surgeon at Beth Israel and the wife of a surgeon, would soon realize the same thing. She was at her Brooklyn Heights home reading a book to her son Jack when the first plane hit. Thinking the plane had accidentally torn into the tower, Svahn began filming. The camera was still rolling when the second craft cut like a comet into the other tower. Svahn, who lives at the foot of the Brooklyn Bridge, immediately attempted to make it to Beth Israel.

"I couldn't get over the bridge," she said. "Phones and beepers didn't work." But, in scrubs, with her identification, Svahn found police who would escort her up FDR Drive. Fearing that a major thoroughfare leading into Manhattan would be a prime target, Svahn said the ride was bizarre and terrifying. At long last she reached her destination, recalling emergency plans set into place for occasions that had proven to be non-events, like the millennium festivities that went off without a hitch.

"We found ourselves implementing trauma disaster plans we never thought we were going to use," Svahn said. "Fear was controlled. Everyone functioned and cooperated. Everyone was waiting, waiting, waiting. And then nobody was coming. It just wasn't a good sign."

While Svahn was treating victims of minor smoke inhalation and slight lacerations, her brother Jonathan, chief resident of general surgery at NYU Medical Center, was caring for his first three patients of the day at Bellevue.

"A woman had been trampled," he said. "There was a fireman who had already died, and another person with a head injury. Then it got quiet. We all expected a lot of people who'd been showered with shrapnel when the second plane hit. There were a lot of rumors. It was very frightening. Was this it? Was it just beginning? Was it biological warfare? Nobody knew exactly what we were dealing with."

Tuesday night, Jennifer walked six and a half miles home, this time crossing the Manhattan Bridge. She feared being underwater in a tunnel, but the walk home, alone in the dark, proved no less terrifying. The long walk was punctuated by thoughts of the day's cataclysmic events and images of people "crying, vomiting, running, screaming and closing windows."

When Jennifer returned to Beth Israel the next morning, few people requiring medical help had arrived. "There had been no barrage of trauma victims arriving in the night," she said. "There was nothing coming."

In frustration, wanting to do something, Svahn walked to Third Avenue and flagged down police who drove her to "the wreck." Once there, her scrubs and identification afforded her a privileged position. She passed FBI agents on her way to the epicenter of the destruction.

"It was a bizarre kind of freedom in that zone because it was restricted," she said. She described the dangerous heat and stench of the site, the instability of the surrounding buildings, the asbestos, so cautiously removed from so many structures, clogging the air. "There were all kinds of rumors about body parts and that kind of thing, but that's not how it was. There were sneakers here and there and children's toys. People wrote things in the dust with their fingers, like God Bless America. But mostly it was like walking through a gigantic crematorium."

After a brief hesitation, Svahn decided to take pictures. Some of the photos appeared in The New York Times on Wednesday, after Svahn realized that members of the press had no access to the restricted zone. Her brother later made a trip to the site with an organized group of physicians hoping to offer assistance to victims found in the rubble.

"We were afraid of falling buildings," said Jonathan. "And gas lines could have been severed, anything could have happened. We went there hoping to help, but there was nobody to help. Then pandemonium kicked in because somebody who feared a falling building started to run and the herd mentality took over. Get the hell away from whatever's happening. In a situation like this, it's every man for himself."

These individualistic impulses were balanced, fortunately, by a sense of unity. "In a relatively quick time, we were all standing together, ready to do something," Svahn said. "On New Year's Eve we had a plan, but nothing happened. As doctors, we make sacrifices, sleeping in the hospital, doing what we have to do. But that doesn't compare to what the rescuers have been out there doing. The human emotions experienced by the different groups involved in this change based on distance. The medical community sees trauma victims regularly. People with their arms and legs ripped off, and we're buffered by that. I haven't seen much of it in this instance. I'm less traumatized as a doctor than I am as a New Yorker."

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