Unused emergency gurneys, a defining image from 9/11, have much to tell us today, when there isn't a bed to spare. A veteran E.R. nurse explains.
From careful planning and much drilling, medical workers knew without being told that they should roll a fleet of gurneys and wheelchairs onto the sidewalk outside St. Vincent's Hospital in Greenwich Village on the morning of September 11, 2001, New York's last mortal catastrophe.
But there they remained, empty.
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Nothing spoke louder than those mute, unused stretchers. People got out of the World Trade Center mostly intact or not at all. For days, thousands of flyers were taped around hospitals with pictures of those who had not made it home, or even as far as any gurneys.
Two decades later, the coronavirus pandemic has turned that moment inside out: We have more sick people than beds to put them in. Hospital morgues are oversubscribed.
Suzanne Pugh, the manager of emergency services at St. Vincent's on 9/11, now does the same job at NewYork-Presbyterian Queens in Flushing, one of many hospitals where people sick with coronavirus seek help.
"Some of my staff were very young 19 years ago," said Pugh, 60. "I speak on disaster preparedness, and sometimes I have to shake my head — 'Oh, yeah, you were 5 years old when this happened.'"
New York is living the coronavirus disaster a few days before most states on the epidemiological curve, so it offers a cram course on getting ready. It is as if the towers were falling in slow motion. As of Sunday, just under 60,000 people in the state had tested positive, and 1,000 have died.
The US government can print infinite money; no one can fabricate experience. Knowing what has been done right and wrong in New York might save lives as the crisis spreads from the coasts to the center of the country.
About 360 patients a day have been coming to the emergency room at Pugh's hospital. Of those, she said, roughly 75 are admitted. The rest are sent home.
"The overwhelming number are relatively well, with none to minimal symptoms," Pugh said. "But they are worried."
The hospital initially triages patients just past the front door, and then in more depth under a tent. At a command center, administrators handle logistics like bed control, food for staff, parking spots.
"The people on the front lines don't have to figure this out," Pugh said.
The new coronavirus, like any virus, is a snippet of chemical memory that will repeat itself quadrillions of times, telling the same story until it is muted by other forces. It is simple. Far more complex are social calamities that survive as memories only for as long as there are people around to tell about them.
"I lived through the beginnings and peaks of the AIDS epidemic," said Pugh, who graduated from nursing school in 1979. "And the 1993 bombing at the World Trade Center."
Six people died in that attack, 5km from St. Vincent's. The ambitions of the bombers were to kill thousands. A generation of emergency medical leaders in New York rewrote mass disaster plans.
"By the time I got to St. Vincent's in 1995, they were having incredibly realistic drills, where people were called upon to act out the scenarios, so on 9/11 you didn't see people running around saying, 'Where do I go, what do I do?'" Pugh said.
She added: "Every secretary had registered a mock patient at some point; every doorman, every transporter, every engineer, had been a deputy security person during a drill. Everyone knew where they were supposed to go and what they were supposed to do. Every single bed had a nurse and a doctor, we had treatment spaces set up, satellite areas already set up."
A few severely injured patients arrived in the early going. Then the walking wounded came by the hundreds, many spitting out fragments of the pulverised buildings, their eyes needing a wash. But the expected masses of badly hurt people did not turn up. The gurneys went unused.
No one ever faulted St. Vincent's, which closed in 2010, or other hospitals for being too ready.
As Governor Andrew M. Cuomo and his team search for thousands of ventilators based on projections by infectious disease experts of the number of people who may become grievously ill, President Donald Trump has scoffed.
"I don't believe you need 40,000 or 30,000 ventilators," Trump said.
That would be a pandemic milder than forecasts, a cause for jubilation.
"You don't need 140,000 beds today, of course not," Cuomo said Sunday. "We need them at the apex."
No two mass emergencies demand identical responses, but they seem to be met by familiar drives and passions. Just before Pugh started a 12-hour shift this weekend in Queens, she spoke about that long day at St. Vincent's in 2001.
"I would've given anything," she said, "to see 3,000 more patients."
And if the empty stretchers of September 11 have a message for these times, it surely is not that it was wrong to have more than what was needed to keep people alive. They tell us how precious every chance is.
Written by: Jim Dwyer
Photographs by: Caitlin Ochs and Gabriela Bhaskar
© 2020 THE NEW YORK TIMES