Bob Horton: 9/11 memories still fresh for doctor in ER closest to ground zero
Collectively we use major anniversaries such as 9/11 to strengthen memories and burn lessons into our civic consciousness. We must never forget those we lost. We must never drop our defenses. We must be ever diligent. It is not a time that allows for much nuance or interpretation.
As individuals, though, we don't require the arbitrary turning of a day on the calendar to trigger our memories. Memories have a life of their own, especially memories of horrific events like Sept. 11, 2001, and they force themselves on us at the oddest times.
One friend forever changed his life after being at ground zero that late summer day. He left investment banking for the world of first responders, becoming an emergency medical technician. When I asked him to share his thoughts on the 10th anniversary of the World Trade Center attacks, his reply was simple, yet poignant. "I'm living the dream. I have 9/11 in a place where I'd like to keep it." Enough said.
Then I turned to Tony Dajer, another friend whose life changed that day. We had met many years ago, the way so many people do in Greenwich and other suburban towns: our children went to elementary school together.
Tony works with the memories of 9/11 every day. He speaks of them with a studied calmness, one that has served him well over his years practicing emergency medicine. Ten years ago today, Dajer was the attending physician running the emergency room at NYU Downtown Hospital, the trauma center closest to ground zero. The facility is now known as New York Downtown Hospital.
The Harvard- and NYU-educated physician had prepared his whole professional life for a day like 9/11. When the call came into the hospital announcing a jetliner had crashed into a building in lower Manhattan, Dajer knew what had to be done in the 10 minutes before the first wave of casualties arrived.
"We had no idea of the enormity of what happened, but we knew to expect a massive, sudden inflow of civilian casualties," Dajer said.
Just two months earlier he had led the ER staff through a disaster-preparedness drill. He knew they were ready. But he didn't know that his hospital, the smallest one in Manhattan, would treat 1,500 shocked and injured people during the next 24 hours.
When the doctors, nurses and support staff were in place, Dajer took his post outside the hospital's Gold Street entrance where he would meet the arriving ambulances and perform triage, a method of prioritizing patient treatment. He quickly examined every dust-covered, fully clothed patient, searching for the injuries that demanded immediate attention, letting the less seriously injured wait a little longer for treatment.
In those first few minutes, Dajer saw horrific burns and injuries. Then things got even worse.
"We heard a humongous roar. I thought another jet had crashed. But then we were suddenly engulfed in a dust cloud. It was so thick, so dense. It completely blocked out the sun. I literally could not see my hand in front of my face."
The first tower had collapsed. Being a doctor, the first thing Dajer thought about was how to keep an area sterile enough to protect the injured. "Do I close the hospital? How do I keep conditions sanitary?"
Fortunately, NYU Downtown had inner and outer entrance doors, so the staff quickly turned them into a makeshift airlock. The inner set of doors remained closed as the patients were brought in the outer ones. Once the outer doors closed behind the stretchers, the inner doors opened. Crude but effective.
The dust storm brought with it the eeriest sight of the whole nightmarish day: pairs of hands banging against the hospital doors and windows, trying to find a way inside to get away from the throat-choking, nose-clogging dust. "All we could see were hands, nothing else. No faces. Just hands hitting the windows."
"The surgeons were going full tilt. There was just so much coming our way. But we had to take time and step back. There is a temptation to take shortcuts in treatment so you can see more patients more quickly. But then we said, no, people deserve the best care we can give them. Cut no corners. That was an important lesson."
In the hospital that day, Dajer was the calm doctor, part of a well-trained, well-prepared team. And several hours into the horror, he had been able to use a satellite phone to call his wife, Daniele, in Old Greenwich. She was able to tell their three children that Dad was safe.
Then, that night, a call came to go to ground zero, where rescuers needed help with a victim trapped in the rubble. Dajer rushed to the site.
"That scene, coming up to the pile, coming up to ground zero and seeing the remaining shards of the tower's skin. That was the first time I was actually scared, and I remember thinking, I have a wife, three kids. Should I be risking my life? Is this really smart? That's when I found out how unbrave I was."
No one else would call him "unbrave," but Dajer shares a feeling that is common with people who have performed heroically. "What we did seemed so puny. There was so little we could do compared to the enormity of what had happened."
The work continued literally for weeks. The bizarre workload became the normal routine. But the atmosphere around the hospital changed quickly.
"It seemed we were flooded by ghosts. People looking for their loved ones, showing us photos. Asking if we had seen them. It was a very human time. Everyone wanted to take care of each other."
In the years since that awful day, Dajer has lectured around the country, sharing what he learned about emergency medicine and preparing for unspeakable disasters.
"It all comes down to communication. Forget all the emphasis on fancy equipment. Communicate. Get back to basics. Know where the keys are for everything. Know how everything works. Trust your gut. Trust your people. Do not panic," Dajer said.
That seems like easy-to-remember, common-sense advice. But Dajer says it is not incorporated into typical emergency response drills and protocols.
"People still protect their turf. Police drill separately from firemen, who drill separately from others. If you don't practice your response together, you are just wasting time."
"Every department has its own set of protocols, and most of those protocols have a military foundation. But in the civilian world, we have more resources nearby," he said. Instead of rushing people to hospitals, first responders follow their protocols, which call for treatment at the scene. "It is unsterile, unsanitary and dangerous. Keep the hospitals well-equipped, and get people there as quickly as possible."
Dajer has also played a part in the collective memorialization of 9/11. He was one of about 20 subjects whose portraits comprised a startling exhibit by photographer Joe McNally. That exhibit has been resurrected for the 10th anniversary and can be seen at the Time Warner Center in New York City. It is worth a trip.
While the 10th anniversary of 9/11 is a time for all of us to remember and to reflect on how our world and lives have changed, Dajer had that brought home to him in a very specific way this May, when U.S. Navy SEALs killed Osama Bin Laden.
Tony's son Matt, now 19, excitedly announced to his father that Bin Laden had been killed.
"He was very excited, and that's when it hit me that 9/11 and its aftermath is really all Matt has known. He was only 9 then, and it's been with him his whole life. And it will be with us for a long, long time."
Bob Horton can be reached by email at email@example.com.