THE PENTAGON ATTACK: 11 SEPTEMBER 2001
Around 9:00 AM, I was simultaneously coordinating the care for my wife who just fractured her ankle while working up a female patient with abdominal pain and a female patient with knee pain. While ferrying my wife on wheelchair to the patient waiting area I caught a glimpse on TV showing a burning World Trade Center (North) and an incoming big jet hitting the second tower. My first reaction was horrible, how the terrorists can do that, they could not do it alone, the jumbo jet cannot be handle by a lonely suicide bomber like kamikaze. My second reaction was at least there is some luck because they only hit the upper third of the Towers not realizing that the whole building will collapse due to the shear intense burning jet fuel which melted down the supporting frame.
Returning to my abdominal pain patient who was waiting for the lab tests, I told her it will take sometime for the lab tests results and told her briefly that the World Trade Center just had been hit by terrorists. Then the clinic loud speaker announced a code yellow is in effect meaning that there is an upcoming mass casualty. The Commander of our clinic asked all personnel to evacuate the clinic. At the time we did not know why we had to leave the clinic. Someone later told us that an explosion occurred at the Pentagon and they need medical support. A couple of doctors at the clinic and I rushed thru Henderson Hall (a close by Marines barrack) to the Pentagon. Along the way, debris of an air plane wing was seen on the grass. Passing an ambulance, a person gave me a yellow jacket which I saw a word physician sewn on. Thinking that everybody on the scene are required to wear a jacket for identification, I readily put it on. I did not read fully the whole sentence because I cannot read upside down. Later I saw the large characters of SENIOR PHYSICIAN on the reflecting jacket.
We stopped to examine briefly a couple of patients who were not seriously injured, only puncture/abrasions of the hands and arms. Being almost the first medical personnel on the scene and not knowing that continuing danger is a possibility, we were able to come close by the helicopter air control tower, passing that portion of the Pentagon which was burning (not collapsed yet). We stopped by and examined one black female patient in emotional distress with rapid breathing. Dr R. asked questions while checking her status. I listened to her lungs and heart sounds which seem alright. Reassured, we moved forward; then someone called that they need docs at the staging area. We rushed in the direction of the yellow tarmac near a bridge overpass. We treated a couple of more injured patients. Then someone yelled for everybody to move under the bridge because an unaccounted – for hijacked plane was reported on our way. We helped carry the above patient on a stretcher to the underpass. As we were setting supplies under the bridge, orders were given for us to move out, and volunteers were helping carry medical supply boxes, the yellow nylon tarmac and the yellow flag. We tried again to spread the tarmac then someone said we have to move it back under the bridge because of another plane is coming. A Navy doctor was examining the head of a black female on a stretcher, I look at her legs and saw second degree burn on her thighs, I called silvadene but someone said she is allergic to sulfa. I called for IV fluids and handed it to the personnel helping the Navy doc who was putting an IV line. That patient was the most serious patient we had so far. Realizing that she was being taken care of, I moved to see a male patient with smoke inhalation. He said he was OK, with no chest pain or shortness of breath. I listened to his lungs and found normal heart sounds, no rales or wheezes, I told him to sit down and rest his back on the wall and I call for oxygen. Someone brought an oxygen canister and hooked the cannula to his nose. I went to another patient with head injury which I found to be benign.
At that time, another Navy doctor, Dr. F., a Colonel, was with me, I bonded with him and suggested that together we checked what medical supplies we have to be familiar with our capabilities. We found only one box of IV normal saline. While accounting we stumbled on a Lifepak, we decided to play it on to be familiar and ask a nurse medic for instruction for use. A Chaplain came. We discussed and located an EXPECTANT (BLACK) area and a close-by but out of sight an area for cadavers/human debris.
A very energetic and effective Air Forces officer, MAJ (Major) M. (I learned later he was designated as the Triage Scene Commander) was giving orders to medics, he asked me and Dr. F who is in charge here, Dr. F. look at my yellow jacket with the well read SENIOR PHYSICIAN and pointed to me.
So here I am, defacto leader of the Yellow staging area team, called first as an overflow triage team. I designated COL B. as my chief nurse and Dr. F. as my deputy and a Navy LT nurse P. as the core team. Yellow ribbons were tied to the arms as a way of identification. I asked an Army Major Q., a medical service officer to collect the name of our team and keep a ledger. I tasked a non-medical volunteer to attach disaster tag to all incoming patients. Other medical personnel started to trickle in and Col B. was charged to form smaller teams with one doc and a couple of nurses and physician assistants in each team. While forming our team we also treated trickling patients as soon as they arrived.
Around 13:00 bottled water arrived and later food came to our delight because we started to feel thirsty. Then inevitable nature call surfaced, I was thinking about nearby bushes but a man suddenly appeared mysteriously and asked me to pass the info that the toilet room and rest area can be provided on his VIP air conditioned bus. Also garbage cans were provided (someone is thinking); everybody pitched in, Major Q. grabbed a bag and collected it around the area. During the meantime FBI evidence collection teams arrived with their black bags and began to sweep the area for plane debris.
Reinforcements arrived: Doctors, physician assistants and nurses from Walter Reed Army Hospital and nearby civilian hospital (rheumatologists, a pediatrician with his ambu bag and endotracheal tubes). Also An Army Major nurse from a burn unit showed but was soon taken away to the RED area. Our area seems as the first assembly point for medical personnel, non medical volunteers and medical supplies to be cannibalized later for the ‘FRONT’. We keft re-inventorying our medical supplies and re-forming our small teams. A review of disposable medication was done: there was no morphine nor bronchodilators … I relayed the message and amazingly those supplies were provided a few minutes later by COL (Dr.) U., an acquaintance of mine while we were in the commander’s circle.
With nothing else to do I decided to go to do a recon at the “Front” with MAJ Q. While approaching the command tent, a medic gave me a suction apparatus which I gave to MAJ Q. to carry. Now, with a SENIOR PHYSICIAN on my yellow jacket and accompanied by a field grade officer, we looked like a very official team to survey the “Front”. At the command tent, Dr. F. asked me if I was one of the two person volunteers to enter the burned section of the Pentagon to recognize the dead, decapitated, or human debris. My answer was negative but I was ready to volunteer if asked. He told me to wait outside and a few minutes later he said he had enough volunteers already. While at the “Front”, we saw Major General J. the Military District of Washington commander and his staff. Along the road, crews are demolishing concrete mid road barriers for easy access to the Pentagon, scores of K9 police cars, police cars, and motor bikes as ambulances and buses. FBI personnel and firefighters in heavy gears are positioning and waiting for order to proceed to the building while water was pouring in the collapsed section of the Pentagon. Fire kept burning, later I learnt the fire was not put off many hours later because Pentagon was of WWII vintage and lots of horse hair was put under the roof for insulation and it is difficult to extinguish it. Few sandals and shoes with yellow ribbons tied on for identification were scattered on the grass. Now and then thumping helicopters circled above us swirling the dirt and grass around us.
We returned to the yellow staging area and waiting for events to unroll. Major General T., the Walter Reed Medical Center commander, and his staff passed by and shook our hands. Mainly we waited and waited. Nothing happened until MAJ M. called us or a briefing at around 15:30. The assumption at that time is probably by now all the gravely injured are either dead or evacuated at the other side of the Pentagon but we had to be ready for casualties like heat injuries, crushed fractures, dehydration… from the rescuing party.
A Treatment civilian physician from OPCON (Operation Control) arrived. After a quick briefing by MAJ M. he realized that we were much organized and well sheltered against the scorching sun so he expressed his idea of moving the out “Front” team to merge with us. We also discussed procuring electricity for the expecting long night coverage. Around 17:30 I started to think about my wife with the fracture ankle (I did call earlier asking the clinic personnel to relay the message to her that I am doing OK). I talked to Dr. F., COL B., COL U. and MAJ M. about I leaving for a couple of hours to check on the status of my wife who is from my understanding till at the clinic from the early morning. I was asking for ways to come back in, eg. their phone numbers to contact or passes in cases I was stopped at the gates and denied entry. COL U. said there is no need for me to come back, they have plenty of physicians. He predicted that most likely after the fire fighters stop the blaze, no survival will be found. Nevertheless, I asked for their phone numbers.
While debating myself how to get back to the clinic (about a mile as the crow flies) not only because I did not know how to get back on foot but also how to get thru all these gates in between the Pentagon, Henderson Hall and Ft Myer. I flagged a passing unmarked minibus with a FBI agent on and asked for transportation back to my office. With again my easily recognized yellow jacket SENIOR PHYSICAN on, he readily agreed to transport me: barriers on the road were no obstacle for him, he just crossed over and dropped me at the front gate of Ft. Myer. Although the gate was closed and heavily guarded with guns and machine guns, the soldiers recognized me and opened the gate for me to enter.
Passing the gate, I proceeded on foot to the clinic which is about a couple of blocks away, suddenly from nowhere an ambulance approached. I flagged it and found out it was our ambulance returning from the Pentagon. At the clinic headquarters, the clinic staff was listening to the radio conference called by Major General T while a TV was running close by. I asked where is the whereabouts of my wife and I was told she just went home thanks to the help of a coworker.
Tired, I decided to go home and plan to grasp a quick bite and a short shower before rejoining my yellow team. While driving out of the post, small groups of well armed soldiers were posted at different corners. An HUMMV mounted with machine guns was patrolling. The post was eerily silent, no activities. Getting out of gate, there was a long line of incoming vehicles waiting their turn to be inspected thoroughly. I started to think how to get back to the clinic. At Rosslyn, there was a traffic gridlock going on, bumper to bumper cars, for automobiles trying to get o Highway 395 or 50 East. I could not get on GW Parkway, maybe it was closed because it passes thru CIA. I made a U-turn and got to 50 West and headed home without difficulties; the traffic was much lighter than usual at rush hour.
Close to home a house with a large American flag was seen covering its window.
At home, reassured after a short inquiry of my wife’s health status. I ate quickly, took a shower and got ready to depart. But first I called the clinic headquarters and CPT E. told me that the Commander of the clinic left home with instructions that the clinic will be open tomorrow. I told him that I will try to get back to my team and if he had any calls for me, to reach me at home. (I will contact my home from the road now and then). I also called the yellow team staff but only Dr. F. answered. He said all is doing well, albeit slow, no action and there was no need for me to come back: they were sending people home. Reassured I started to watch TV and the unimaginable horror rolled in front of my eyes: “Sep 11 will be a day of infamy…”
A half-staff American flag is flying…
Duong Nguyen, MD
COL (R), US Army
Former Division Surgeon 1st. Armored Division, US Army (participated in Desert Shield/Desert Storm)