Ground Zero Heroes

Amidst the profound loss and grief that rocked the nation on September 11, the heroic efforts of police officers, firefighters and volunteers have helped renew our faith in the American spirit. But at Ground Zero and beyond, nurses responded to the terrorist attacks with equally inspiring acts of courage and compassion.

From mobilizing on-site assistance for rescue workers to caring for victims from the World Trade Center and the Pentagon to consoling families who searched for missing loved ones to quelling fears about anthrax and bioterrorism, nurses played a critical role in healing the nation’s wounds—not only in the immediate wake of the attacks but in the traumatic weeks that followed.

The nurses who banded together to tackle this unprecedented national emergency came from a variety of backgrounds, regions and organizations, including hospitals, visiting nurses’ associations, the Red Cross and the military. As one New York nurse put it, “I was just doing my job, but it was a life-changing experience.” Here are the stories of four minority nurses who can now add the title of “hero” to their professional credentials.

“Nothing Can Prepare You for This”

Lucille Yip, RN, BSN, an Asian-American nurse who works at St. Vincent’s Catholic Medical Center in Manhattan, lives on the 44th floor of a high-rise building in New York’s Chinatown. On September 11 she awoke at 3 a.m. and for some unknown reason felt compelled to gaze out her window at the breathtaking skyline. She never suspected that the view–and her life–would change forever within hours.

Yip re-awoke to the sound of an explosion and sirens. When she looked out the window again, she saw the Twin Towers burning. After calling family members to make sure they were safe and to reassure them of her own safety, her next impulse was to get as quickly as possible down to her post at the ER.

No subways or cabs were moving and ambulances were racing to the scene, but she spotted a sanitation truck stopping to give a police officer a lift and flagged it down in time to convince the crew to drop her off at St. Vincent’s. “Never would I have thought that I would hitchhike in New York, but it was total chaos in the city,” she recalls.

For the next two days, Yip worked grueling 13-hour shifts in the triage unit. The pain and grief she encountered in her patients during that time was worse than anything she had ever experienced before. “Nothing can prepare you for something like this. Nothing,” she says. In the face of such devastation, the usual humor that the staff typically relies on to help cope with life in the ER no longer seemed appropriate.

“Probably my most memorable patient was a young firefighter,” Yip remembers. “They said it was a crush injury to the chest. He was sitting up and talking, but he looked ashen and gray. In my heart I thought, ‘He’s OK, he’s going to make it,’ but in my head I knew there was no way that a person who had suffered this kind of injury was going to make it. I heard later that he died on the operating table.”

But her most heart-wrenching memories aren’t of patients but of families who had hurried to the hospital in hopes of finding their loved ones there, only to have their hope turn to despair when their search remained fruitless. A woman who worked in one of the Trade Center towers was looking for her husband, who had worked in the other tower. One family rushed into the ER after seeing a false report on the Internet that their son was there.

“They were hoping I could give them some kind of positive news, like ‘Yes, he was here,’” Yip says. “Not being able to help them really affected me. By the second day, I broke down and cried. I’ve never felt that sense of helplessness before. I’ve always been in control, no matter how chaotic it is in the ER. But this time, I just felt like, ‘There’s nothing I can do.’”

By the end of her shift on the second day, she was compelled to visit Ground Zero. “A lot of people asked me why I would want to go,” Yip recalls. But, she explains, working in the ER without any windows or TV or radio made her feel out of touch with what was going on, like being insulated in a sort of Noah’s Ark. “Firefighters, police officers…we were taking care of them and then sending them right back out there. I just wanted to see it for myself, to make a surreal experience real.”

She convinced a police officer to take her to the site. Although she had long been familiar with the area—it had been a favorite shopping destination of hers—she says that when she saw the devastation, she didn’t even know where she was. “I had to hold on to his arm. He asked if I was going to be OK and I said, ‘Yeah, yeah, I’ll be fine. You go on ahead.’ But of course I wasn’t fine. I stood there for half an hour. I felt literally numb.”

On her walk back home, the nurse encountered a seminary student who consoled her and led her to a church across the street from the towers that, amazingly, had remained unharmed. “I just sat there in the church and wept,” she says. “I wept for the firefighter who died, I wept for my sister who thought she was going to die on the smoke-filled train, I wept for the families I was unable to help. I wept for all those bodies that are still buried there.”

Although colleagues had marveled at Yip’s composure in the ER, she broke down at home. She couldn’t sleep more than a few hours each night for that next week, she couldn’t eat and she started losing weight. Her husband, a New York restaurateur, finally took her away for the weekend to visit family in New Hampshire. Only after going to church there did she start to recover.

Looking back on her unforgettable experience in the ER on September 11 and 12, Yip feels more than ever before that she made the right choice when she decided to become a nurse. “I’m hoping that I did make some impact on the families,” she says. “It’s so rewarding to touch a person’s life, whether it’s by healing them or just saying something comforting. I don’t believe you have to be a nurse to do that, but it’s at the heart of what our profession is all about.”

As for the impact on her own life, “I never took life for granted,” she states. “But [the events of September 11] have sort of made the colors in life a little brighter. I’m more introspective now, more thoughtful and I am even more thankful for what I have.”

Coming Together in a Crisis

Just a year ago, nurses at Washington Hospital Center in Washington, D.C. walked off the job as part of a bitter labor dispute over working conditions and staff shortages. When the strike was settled six weeks later, some of these nurses did not to return to the facility. Yet when the Pentagon was attacked on September 11, many of them put aside their differences and returned to the hospital to pitch in.

“They knew they were needed and that they had a valuable skill that not many people have, so they came in to help us in whatever way they could,” remembers Melissa Velazquez, RN, a nurse in the hospital’s Burn Intensive Care Unit who had been on the union’s negotiating team during the strike.

To Velazquez, who had testified on nursing shortages before the House Committee on Education and the Workforce just two weeks after the terrorist attacks, her former colleagues’ loyalty underscores the dedication and sacrifice that characterizes the nursing profession as a whole.

“It made me very proud to be among people of that caliber,” she says. “It was so gratifying to know that when people are faced with adversity and crisis, they can put away whatever negative feelings they might have and simply do the task at hand.”

Velazquez, who is of Puerto Rican descent, was not scheduled to work on September 11. But when she learned that the Pentagon had been hit, she made arrangements for someone to watch her seven-year-old daughter and drove the 40 miles from her home to the hospital, which was the nearest regional burn center to the site.

Her help was urgently needed. The 10-bed burn and surgical unit, which already was full, took in six new burn patients that first day. “That may not seem like a lot in terms of numbers. But in terms of intensity, acuity and the amount of time it takes to care for those patients, it’s a huge number,” she explains. The least severe patient had endured burns to 40% of his body.

Three or four nurses working for half an hour are needed just to get one burn patient bathed and to apply dressings. Then the patient needs to be resuscitated and IV fluids must be administered. “Not only is it mentally overwhelming, it’s also extremely labor-intensive,” Velazquez says. She ended up working 12-hour shifts for the next two days.

One patient she cared for during those days only started talking again months later. “It was the first day he ate food—pizza–and [the nursing staff] were all cheering and screaming,” she smiles. “It’s just little things like that, the turning points we can get patients to, that just tickle us to no end. Those moments are what makes it all worthwhile.”

Velazquez says her pride for what she and her colleagues accomplished in the aftermath of the attacks is bittersweet. While the heroism of police and firefighters has received national recognition, the equally heroic efforts of nurses still remain largely unsung.

“Nurses are very much a group among themselves that really has to rely on each other for support and accolades and things of that nature,” she points out. “Sometimes it seems like the public really doesn’t understand how much work we do and how much heart and soul we put into that work.”

What will she remember most? “The way everyone came together to just do what needed to be done,” Velazquez replies. “We kicked some butt! I will always remember that–the teamwork, the camaraderie, the individual moments with patients. Those are the things that are going to stick with me for the rest of my life.”

A Muslim Nurse’s Perspective: “We Are Americans, Too”

At the cue to carry the American flag across the stage at the opening ceremony of the Transcultural Nursing Society’s 2001 conference in October, a nurse from Pittsburgh did the honors.

Only this was no simple act of patriotism. Kawkab “Kay” Shishani, MSN, a PhD student at the University of Pittsburgh School of Nursing who had come to the U.S. from Jordan just 10 months earlier with her husband and four children, was hoping to send a strong post-9/11 message to her colleagues, fellow students and friends.

“I wanted all the people at the conference to know that the flag means the same thing to me as it does to them,” explains Shishani, who drew thunderous applause as she strode to the stage in traditional Muslim dress. “There’s a general feeling [in the U.S.] that Muslim people are barbarians, people who hate America and like to die. That’s not true.”

Her voice breaks with emotion and she struggles for composure as she talks about the biased stares and vicious comments her family and other people of Middle Eastern descent who attend the mosque in her neighborhood have endured in Pittsburgh’s streets and shopping centers since Osama bin Laden became a household word.

“We are people like everybody else,” she says. “We love to live. We have children. We care for ourselves, we care for others. By carrying the flag, I hoped that people would see someone like me presenting these American values and realize that the stereotypes about Muslims that they see on TV are not right.”

Like everyone else in the world on September 11, Shishani and her family were glued to the television screen in horror as the Twin Towers collapsed and survivors fled through the wreckage. For her, these images were not only tragic but a painful déjà vu of her own experience during the Gulf War and the ongoing tensions and violence that still flare across the Jordanian borders in Iraq and the West Bank.

“[As nurses in Jordan,] we saw many horrible things—many, many patients who came from both sides [of the conflict],” she remembers. “We saw severely injured children and many kinds of cancers and amputations.” Never had she imagined when she temporarily left her teaching position at Hashmite University outside of Amman to study in the United States that she’d be witness to the same kinds of events.

“Since September 11, all my past memories are intensified,” says Shishani, who points out that some of the World Trade Center employees who died that day were Muslim. “My family was watching the TV and we saw the families who had lost loved ones and were in pain. We wanted to help them bear their pain and grief. We wanted to do something.”

Her first impulse was to join the relief efforts and fly immediately to New York. “My husband was very encouraging. He said, ‘OK, I’ll take care of the kids and you go.’”

But as revenge-inspired acts of violence against Arab-American communities began to erupt in many parts of the country, Muslim women were being encouraged to remain indoors to avoid retaliation, since their traditional dress was easily distinguishable. So Shishani stayed at home for a week, suspending her class study and keeping a close eye on her children, who were having difficulty coping with the confusing messages on TV and at the public schools they attended.

“My kids were so traumatized by this,” she says. “They know that Muslim beliefs do not advocate violence, and yet they were hearing something completely different on the TV, people saying that Muslims are killers and terrorists…It was like they were being attacked too, because of their beliefs.”

So instead of flying out to Ground Zero, the Jordanian nurse responded to the crisis with a different mode of healing. She and other Muslim parents who attend her mosque formed a support group for their children to let them vent the emotions they were feeling. They held one session every few weeks for about 15 children ranging in age from seven to 14.

“Our main goal was to let them express their feelings of anger, frustration and depression,” says Shishani. “We also wanted to reassure them that they should not feel ashamed of who they are or what they believe in, and that they should always stand up for themselves.”

In contrast to the angry reactions she and her family encountered in parts of the city, Shishani says other nurses have been especially warm and welcoming to her in the wake of the terrorist attacks. When she didn’t go to classes, she received many calls from professors and classmates offering to help her with shopping or getting to the campus. “They were highly supportive,” she emphasizes, “and I think that without that support I would never have been able to go back to school.”

Like the message she hoped her flag-bearing role at the nursing conference conveyed, she believes that Muslim nurses in the aftermath of September 11 have an important opportunity through their work to help the nation heal its wounds—including those caused by prejudice and stereotypes.

“Nurses work with a wide range of people in public and community settings,” she notes. “Muslim nurses go can out and talk about their religion and represent [our people] for who we really are. I think that people will listen and that perceptions can be changed.”

Next Stop: Anthrax Education

As a nurse educator, Peter Allar, RN, says he’s always trying to figure out the most effective way to provide public health training. But in the days following the World Trade Center attack, he discovered an unlikely podium: the New York City subway.

It was Allar’s job as the clinical nurse instructor for the ER at St. Vincent’s Catholic Medical Center in Manhattan to help teach the medical staff and patients about how to deal with the risks of different forms of bioterrorism, particularly as reports of anthrax cases suddenly started to surface in Florida, New York and elsewhere.

Since cyanide antidotes and plutonium decontamination are more the stuff of science fiction novels than nursing school textbooks, he had to teach himself about the subject–and quickly. For days he pored over medical journals, the Internet and books from the Defense Department.

Surprisingly, though, his message transcended the hospital walls. On the subway ride home one night, Allar (who is Caucasian but is considered a minority in the nursing profession because he is male) noticed that he had attracted the attention of a captive audience as he was rattling off information to a group of nursing graduate students about the best strategies for fleeing a chemical attack.

“In New York, everybody listens to what everybody else has to say,” he explains. “So other passengers around us started saying, ‘You know, that’s a really good idea’ and ‘You mean I’m in the safest spot right here?’”

Allar seized the moment. “We had mini-lessons right there in the subway,” he recalls with a laugh. For instance, he told his fellow riders that the safest place to stand in a crowded train is next to an emergency exit, rather than in the middle of the car, so that it’s easier to get out fast if the train is infiltrated by chemical agents.

He also demonstrated how to stand on top of the seats if you can’t get out, since chemicals are usually denser than air and will sink. “If you act fast and act smart and keep your wits about you, you can not only keep yourself alive but help other people escape, too,” he notes.

Despite their surreal quality, Allar’s words were welcomed. “A lot of people were saying, ‘We really appreciate that you’re telling us these things. You’re calm about it and you’re really focusing on the positive things we can do to handle the situation.’”

Allar had played a similar role in providing a sense of calm amidst the madness around him during the ER’s two 17-hour shifts immediately following the World Trade Center attacks. “Every single person who came in to the unit was falling apart,” he remembers. “Everybody’s idea of stability was wiped out.”

There was the veteran firefighter and batallion chief who told him, “I saw my entire crew die before my eyes.” Or the young rookie who rescued his partner from one of the burning towers only to find outside that the body he was carrying had no head.

“What can you possibly do for people like that?” Allar says with a sigh. The answer he settled on: “You just kind of console them, try to make them feel OK and safe, and give them time to verbalize their feelings.”

He believes the ER staff, notorious as “the wild bunch” of the hospital, gained a newfound respect that week. Cardiac surgeons readily took orders from ER nurses to search the hospital for more burn ointment and tetanus shots. People from the community visited the ER, bringing with them not just injuries and fears, but plates of food and other offers of help.

“They were saying–and they still say—‘I don’t know how you people do what you do down there,’” Allar relates. “I was really proud of us, actually, for the job we did. You’re never really totally prepared [to deal with such a huge crisis] and you’re always looking for what’s going to come next. You just kind of hope and pray that it’s nothing too terrible.”

Does he consider himself a hero? “No. But I feel good about the contribution I made. I feel it’s made me stronger as a person and also stronger as an American. I feel like if something terrible happens to my country or my community, I know I’ll be able to deal with it and respond in a good way.”