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VOLUME 1: BEYOND GROUND ZERO, SEPTEMBER 2011 I can’t believe it is 10 years since September 11, 2001. It really seems almost like a movie—a terrible movie. here’s nothing more pow- were there. The ripple effect of to participate in it. But after 10 erful and compelling than the pain inflicted that terrible day years, several say they may finally Thearing the facts about continues to affect and hurt many be ready for it. It should be made an incident directly from a first- families, friends and loved ones. available to them. person source. We have done We found that many marriages We found that counseling has that in the development of the and relationships dissolved or been offered to the children of four-volume historic report, Out ended in unfortunate divorces responders, but in many instanc- of the Darkness, presented here. after 9/11 because some indi- es, it hasn’t been offered to their To do so, we spent time with key viduals couldn’t understand or spouses and significant others personnel in each involved city accept the commitment, respon- who have been left to deal with to discuss the events of Sept. 11, sibilities or emotional baggage the ramifications on their own. 2001, and the aftermath of that being carried by the responder They need help too. unforgettable day. they loved. Those who were hired after We chose the title because so Yet, the people we spoke with 9/11 must be sensitive to those many of those we spoke to report- carry on with their lives. They who were there. And EMS manag- ed how that day went from being shepherd their children to school, ers must be mindful that assign- a picture-perfect day, to one of visit their mom, get promoted and ing affected crews to the same death, darkness and despair in a fall in love. Since 9/11, some have response zones and locations as matter of minutes. Many report- retired, and some have moved on their original source of emotional ed being trapped under debris in from EMS. Most remain with the trauma is not advisable because complete darkness and having to agencies they love, the agency the sights and sounds they’ll be crawl toward a ray of light or the that has been their second home forced to see and hear again can light from another person’s cell and source of comfort when they trigger horrible anger and anxiety. phone to find a source of fresh are down or depressed. It has been our great privilege air. And many report still having But what most understand to get to know these responders. dark, emotional days as a result now, with 10 years of hindsight, They aren’t superheroes. They’re of their experiences, as well as is that they belong to an exclu- ordinary people who did the the sights and sounds associated sive, dreadful club. A club none of very best they could in extraor- with their incident. them asked to join and every one dinary situations. We were struck by the lasting of them would rather not have We wish we could have inter- damage caused by the attacks been inducted into. However, viewed all of the 9/11 responders, on 9/11. For many, time has not they recognize that they have but we could not. However, we healed the emotional scars they been set apart from the rest of hope that what we have crafted sustained. For others, health humanity—damaged in a way no for you are documents that pres- issues caused from breathing one but other 9/11 responders ent not just important historical super-heated, microscopic dust and witnesses can understand. In facts about 9/11, but also the will plague them to the end of fact, many of the responders told many command and control, their lives. For a few, the emo- us they will only talk about 9/11 accountability, resource man- tional damage is less visible and, with others who were there that agement and emotional lessons perhaps, even more insidious. day—other members of the club. that have been learned at each What’s more, the damage from Many could benefit from coun- incident and must be passed on 9/11 doesn’t just affect those who seling but have been reluctant to others. 2 JEMS OUT OF THE DARKNESS Dr. Glenn Asaeda saw the smoke kind of hovering and thought, “Today must be that day for the bioterrorists.” 39 CAUTION: Because we wanted to represent the actions and words of these providers as true to the events as possible, we have broken our normal policy on not publishing profan- ity. Therefore, some of the portions of the material you 47 are about to read contain graphic language. 52 54 Vice President/Publisher: Jeff Berend Editor-in-Chief: A.J. Heightman Out of the Darkness is a supplement sponsored by Boundtree Medical, Demers Managing Editor: Lauren Hardcastle Ambulances, Disaster Response Solutions, Emergency Products + Research, Laerdal, Oxygen Generating Systems and Southeastern Emergency Equipment, and pub- lished by Elsevier Public Safety, 525 B Street, Ste. 1800, San Diego, CA 92101-4495; Contributing Editor: Teresa McCallion 800/266-5367 (Fed ID # 13-1958712). Copyright 2011 Elsevier Inc. No material may be reproduced or uploaded on computer network services without the expressed per- Art Director: Liliana Estep mission of the publisher. To subscribe to an Elsevier publication, visit www.jems.com. Advertising rates are available on request. Contact Elsevier Public Safety, Advertis- Director of Production: Tim Francis ing Department, 525 B Street, Ste. 1800, San Diego, CA 92101-4495; 800/266-5367. Production Coordinator: Pippin Schupbach Production Assistant: Matt Leatherman SEPTEMBER 2011 3 I started hearing this terrible sound in the background. I heard, “Jumpers, jumpers, everybody be careful!” EMS Editor-in-Chief A.J. physician respond, we can actu- The impact and full tanks of Heightman, MPA, EMT- ally do a treat and release of the jet fuel set off a vicious chain P, and EMS Insider Edi- remaining patients. J of events. tor Teresa McCallion, EMT-B, We have 2,300 EMTs, 800 para- set out on a journey to each of medics and almost 500 super- the sites affected by the horrific visors in our system. It helps terrorist attacks on 9/11. They me to get to know them when didn’t know what the lives of I respond in the field, go to the those involved would look like stations and even to some gen- or how they’d been affected 10 eral calls. I’m really there to lis- years later. Although every per- ten, help them with their patients son interviewed in New York was and see if there are any issues. I present for the same incident, also assess what kind of educa- the stories are dramatically dif- tion they want or need. ferent—both of that day and their I can’t believe it is 10 years present lives. The most important since Sept. 11, 2001. It really goal they had was to let each per- seems almost like a movie—a son tell their story. Here’s what terrible movie. People just dis- they had to say. appeared. I know that they’re gone, but it’s almost like, OK Glenn Asaeda, MD everybody, come on out now, In New York City, we have mul- because unfortunately we didn’t tiple MCI [mass casualty inci- find bodies. The sheer energy and dent] 10-32 ground transport destructive forces generated by incidents daily, particularly with the collapsing structures pancak- school bus accidents. And it just ing down floor by floor in seconds doesn’t make sense and expanding the to bring all 40 kids forces and mass GLENN ASAEDA to the hospital, par- exponentially ticularly if they aren’t just vaporized really hurt. That everything. would really start to shut our EMS sys- Arrival on tem and hospitals Scene down. We’d have That morning, I was to place the hospi- actually headed to tals on diversion. an American Heart So of the 40 kids, Association meet- let’s say, maybe five Division Medical ing and coming off or six actually have Director - FDNY the Long Island ­Office of Medical an injury that will Expressway. I was Affairs require transport. stuck in traffic and Read his 2001 story here. And by having a just happened to 4 JEMS OUT OF THE DARKNESS I realized at that moment that all the medical training we had was absolutely worthless as we were helpless to do anything for these people. look over to the side of the Trade air, it’s a bad day for terrorism, hovering and thought, “Today must Center towers and saw what looked particularly biological terrorism, be that day for the bioterrorists.” like a line of smoke. I thought, “Oh, because anything that’s released I was in a marked department that’s interesting.” will go straight up into the air. So vehicle at the time, and the next Just one week earlier, I had if it hovers or even sinks, he says, thing I know, a big red truck next taken a CDC course held at FDNY that’s the day you have to really be to me started flashing its lights at on terrorism, particularly biologi- careful because that’s what terror- me, honking its horn and rolling cal terrorism. And I remembered ists want. They’ll release a product down his window. So I’m thinking the senior instructor saying, “Look so that it actually hovers close to it’s not unusual.

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