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9/11, Chief Nurse's Description

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Chief Nurse Describes 9/11 Response

Excerpts from an interview with Maj. Lorie A. Brown, chief nurse, DiLorenzo TRICARE Health Clinic, the Pentagon, regarding Sept. 11, 2001.

Interview conducted Sept. 27, 2001 by the Office of Medical History, Office of the Army Surgeon General.

On the day [Sept. 11], very fortunately, we probably had seven or eight primary care physicians onboard [in the Pentagon clinic], and then our normal support staff. So probably [the staff numbered] in the 80s and 90s.

So it was a normal clinic . primary care was open, all of the specialty clinics were open, patients coming and going. And then we saw the twin towers. Of course, we had CNN playing in our waiting rooms throughout the clinic. The twin towers crash was on the TV and . everyone was aghast. I was trying to get people back, we need to kind of focus on business, and try to get our people energized back to getting people taken care of.

We did not feel a plane hit the building. Our lights didn't even flicker. We didn't lose electricity or phones. Nothing. There was no physical impact for us. . Someone came running in the clinic and said, "You've got to get out. You've got to get out. Something horrible has happened." I stopped him and grabbed him by the shoulders and said, "Sir, who are you and what do you know? You've got to tell me." He was very panicked, in shock. He said, "I don't know, but it's horrible."

And then patients started streaming in the clinic. Horrible burns, and singes, and head wounds, and hundreds of people just pouring out the corridor because the crash site on the west side of the building was such that we were . opposite. We were clear, a clear avenue for people to escape. . People then [began] bringing patients up our way, knowing where we were. And that was it. As soon as I saw two or three patients coming our way, we called the MASCAL [mass casualties event], started galvanizing all of our assets and put our plan in action, the plan that we've been practicing for the year that we've been here. That made a huge difference, having practiced our roles and worked our pieces.

My role that day was to manage the scene. [The clinic commander] was not here. He was at Walter Reed and wasn't able to get here, of course, with the traffic being stopped. We have radio communication, which is also outstanding and absolutely necessary in any kind of magnitude tragedy like this.

So via the radio, I directed one triage collection site out front, by what we call the POAC [Pentagon Officers' Athletic Club], the gym, a grassy lawn area. And people were streaming and carrying patients that way.

We treated some patients in the clinic that had come in, that we started triaging. . but before this we had teams going to center courtyard as our primary scene. The two scenes developed largely were the one out front by the POAC and the center courtyard.

But then DPS [Defense Protective Service] was calling saying, "We need help on Corridor 3 and 4." "I need a team on 5." So then I would create new teams out of my medical assets pool that we had started creating. But people were coming down to join us that we never even built that into our scenarios. "Hey, I'm a doc. I work here." "I'm an EMT. What can I do to help?" So then creating medical teams out of these people. "Okay. I need a doc, a nurse, and three medics. Okay. Come with me. Grab this stuff. Go to Corridor 3 and 4. Grab this radio. Put these vests on. [The vests identified people as medical personnel.] . Go to the scene. Here's your radio, and then report back and let me know what you find, what you need, and we'll support you that way."

So I was managing the front, out front, the POAC, the center courtyard and [corridors 3, 4 and 5] at any given time during the initial, I don't know, maybe half hour. Then gathering up other supplies. Everyone has a role . By then, reports were coming in: "I need O2," "I need splints."

But then the report of a second plane came and that's what hindered us. DPS, the Pentagon police, told us "A second plane is coming. You've got to get out. You've got to get out". So then evacuating the clinic. . Getting every supply we could possibly grab our hands onto. . We have these things called Omnicells that are like cupboards that are locked, and you put your code in to get [things] out, and it automatically reorders your supplies. But my medics are on the scene. I don't have a code. So we broke them. I just said, "Hey, you, throw something at that. Break that. Get those medical supplies out." Throwing them into blankets and anything we could just to get whatever we could out of the clinic before this second plane came.

We didn't have a lot of civilian ambulance assets. They were all on the south side at the crash site, where it was a horrendous scene, of course, but the patients were coming our way out, and we didn't have any assets.

So I stopped civilian cars and said, "Stop that car," and threw patients in. Then anybody with an SUV. I stood up on a car at one point saying, "Anybody with an SUV, or a van or whatever, if you've got your keys, bring it here." Then we would put the litter patients that could be moved in there. Then we would put a doc in there, or a medic in there, and send them to Arlington, because with reports of a second plane coming, we weren't safe. Our scene wasn't safe, and we had no assets to [evacuate patients]. So we used lots of civilian vehicles and put our patients in them and sent them up to Arlington [Arlington Hospital in Arlington, Va.], which is the closest hospital, to get them away and safe.

I really don't know how long that took. Once we [evacuated] the patients . via civilian means, then I created more medical teams, gathered up our supplies, put them in anything, grab them and let's go. We went to the center courtyard and set up triage again . so we were prepared again to treat patients. But by that time, there were no other patients that came out from the initial [attack].

[The initial teams] that I sent to the [center courtyard], they went into the building before it collapsed and got patients out and treated those patients. And not just medics. I'm telling you the med tech, the logistics guy, the radiology guy, this young 18-year-old guy . from lab. Going in the building, putting towels or t-shirts over their faces, anything they could, because the smoke was just unbearable. You couldn't see your hand at the end of your arm.

But going in not once, but more than once—two and three times—to try to find people and rescue them. Into that burning building before it collapsed.

Corridors 3, 4 and 5 collapsed sometime around 40 to 50 minutes after the initial [impact]. That was due to new construction, the things they built into the walls and into the support that let those floors stay and [allowed] enough time for people to crawl out and for people to be dragged out, and a few people saved because those floors stayed elevated for about 30 or 40 minutes, and [allowed] my teams to go in. Thank the good Lord that no one else got hurt in the rescue that way.

Anyhow, [after the patient evacuations] we stayed in center courtyard and set up more triage and treated firefighters for exhaustion, heat and smoke, and those kinds of things.

Once that was stable, then I went to South [the south side of the Pentagon, near the impact site] and joined up with [another nurse] and took over the acute care there. . By that time, the initial onslaught of patients from the crash site was gone. .. But then it was all a matter of getting ready, because we didn't know other patients weren't going to come out. . That was it. That initial hour or two, maybe, of patient care and then it was treating more firefighters, and injuries with so many people on the scene and that kind of thing, but it was no more patients from inside of the building.

We saved many lives. Medics and everybody, because it was more than medics that went into that building. [Volunteers] saved many, many lives—getting those people out and getting them to the hospital by any means we could, made a huge difference. . It was just, whatever, luck of the draw that it was not our side [of the building that was damaged], and that we were able to be here immediately and respond.

But there are lots of medical people hidden in the Pentagon I found, too. In every nook and cranny, or in their previously life. "I used to be," "I was," "Let me help." It's a great story of volunteerism, people that clearly should have left the building and didn't, and stayed to help. People that were singed themselves. People that had been close to the fire and should have gotten out, stayed to help and went back with us more than once to get people out. Pretty amazing.

It [personal safety] really never entered my mind. . Clearing the clinic, number one, making sure everyone is out, and then my only goal was to get more equipment out. . Getting those patients out. Just busy, busy, busy, doing what we were supposed to be doing. And even with the medics going in. Now I think, oh my God, their young faces and [they were] going in. . Let me tell you. There weren't any "I's" in those young kids. They just jumped in. They didn't even ask. . Just so many courageous stories of folks going in. Just many heroes.

But it was the right thing to do, and it was the only thing to do.

For immediate release, Sept. 6, 2002.