
A Cardiologist’s 9/11 Story - extarial
http://nautil.us/issue/64/the-unseen/a-cardiologists-911-story
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zuppy
Something similar to the beginning of this article, from the Las Vegas
shooting: [http://epmonthly.com/article/not-heroes-wear-capes-one-
las-v...](http://epmonthly.com/article/not-heroes-wear-capes-one-las-vegas-ed-
saved-hundreds-lives-worst-mass-shooting-u-s-history/)

It's the story of the doctors.

~~~
btown
> In preplanning, I knew that as we started to get some of these red tags
> stabilized, the anesthesiologists and surgeons would start arriving and we
> could open up more ORs. That’s the first major choke point. I can
> resuscitate four or five people, but that operating room was going to be the
> key to stopping the bleeding and saving lives. In a high volume penetrating
> MCI like this, you really need flow. You need people to get stabilized and
> into the operating room, not sitting around perseverating about what test to
> order next. Getting those ORs staffed and opened was my biggest priority.
> With potentially hundreds of incoming patients, it was going to be a matter
> of eyeballing patients or feeling for carotid pulses because we didn’t have
> enough monitors. Everything was 100% clinical judgment. You’re looking at
> all these patients, and you’re just waiting for them to declare
> themselves—and then you start to work on them.

Wow. It's rare to see someone who can, in a crisis situation, handle both
"macro" and "micro" tasks with such foresight and effectiveness. Menes was
doing the equivalent of solving a scalability problem - identifying
chokepoints, modeling flow, thinking about optimizations in layout of physical
bodies, handling morale - all while implementing experimental treatment
procedures and making snap judgements about patients' individual statuses. How
someone can keep all this loaded in working memory for hours on end is mind-
boggling to me. Truly inspirational.

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mavidser
Tangentially related: There's an excellent documentary from BBC about a
hospital during London's Westminster's bridge terrorist attack. They were
there to shoot a planned documentary when the attack happened. Not anywhere at
this scale, but it gives a pretty good behind-the-scenes look at the doctors
and hospital staff preparing for the victims of a mass-causality incident.

[https://www.youtube.com/watch?v=0pjUNZSajuE](https://www.youtube.com/watch?v=0pjUNZSajuE)

~~~
netsharc
Did they say, somewhat tragically, that they were getting experience handling
such mass casualty incidents due to the number of attacks happening in 2017?

~~~
willyt
Bah those IS dudes are total amateurs. Check out what the IRA and UVF were
able to achieve:
[https://en.wikipedia.org/wiki/The_Troubles#Chronological_lis...](https://en.wikipedia.org/wiki/The_Troubles#Chronological_listing)

~~~
slededit
A domestic insurgency will always be more effective than an outside group.

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frebord
Very interesting story! Reading about arrhythmia always gives me anxiety, this
story even more so because now I'm thinking my elevated anxiety can cause a
feedback loop that makes my heart beat differently causing even more anxiety
until I ultimately go into cardiac arrest. LOL I'M FINE THOUGH!

~~~
homero
Same I wonder if my panic attacks would make a heart attack more fatal because
I'd fully panic if I got one

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deelawn
For anyone interested in this story, the Household Name podcast has an
excellent episode covering this story. The title is "The Bodies at the Brooks
Brothers."

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EADGBE
I'm extremely interested in the story of the woman who survived the rubble.

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chris_wot
I know it's not about cardiology, but I remember the day after the attacks. As
I'm an Australian, I had gone to bed early so I didn't see what happened till
the next morning, when I turned on the television.

There aren't too many events that you can say utterly changed your view of the
world. I remember listening to Triple M that day, and listening as grown,
gruff Australian men who listened to rock music called in to Andrew Denton,
crying and in distress.

I can only imagine what it must have been like for the doctors who had to do
to identify bodies, and bits of bodies. The thing that hit me most was that
they were doing their job, waiting for patients that never came. They were all
dead. I can barely comprehend this.

I will never forget September 11th as long as I live. I work with young guys
now, mostly 21 to 24 years old. None of them truly understand what happened
that day, they were all too young. I'm glad in many ways they don't, but they
also don't understand how truly profound that day was. I hope they never do,
nor never need to.

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M_Bakhtiari
>We treated firefighters suffering from smoke inhalation

American firefighters don't use SCBA?

~~~
JshWright
You had thousands of folks working 24/7\. Assuming you had that many SCBA in
the first place (generally you just have enough for a given shift plus some
spares, not enough for all the off duty shifts working at the same time as
well), how would you propose keeping that many bottles filled? When it takes
an hour or more to get to the work-site, are you supposed to take a half dozen
extra bottle with you just for the commute?

This was obviously an extraordinary situation, and it seems bizzare to me that
you would draw the inference that SCBA is not used in the US...

~~~
M_Bakhtiari
I obviously don't believe they never use SCBA, but doing physically demanding
labour while breathing a toxic atmosphere is not an exercise in heroism, but
in futility. Supplying bottles in such a situation is challenging for sure,
but I find it hard to believe that going without was at all productive.

I hear a lot of remarks in passing from firefighters that their American peers
are rather careless with their personal protection equipment, it would be
interesting to hear from one of them.

~~~
JshWright
This event was so far beyond the scale of what is reasonable to plan for
though. Consider an engine company that may have 4 firefighters on a typical
shift. They probably have 6-7 SCBA to account for equipment failures, etc. So,
what happens when you recall all 4 shifts and suddenly have 16-20 firefighters
trying to use less than half that number of SCBA? It's a situation with no
"right" answer.

I was not at ground zero, but have friends and colleagues that were, and my
understanding is that SCBA use was prioritized for the "most" IDLH areas, but
that still left a huge number of folks working in areas where, under normal
circumstances, you'd absolutely be wearing a pack.

I can only speak for myself and my agency (a suburban combination
career/volunteer dept in upstate New York), but we are were careful about PPE
usage, air management, etc.

