Twenty-five years after September 11, Craig R. Smith, MD, reflects on the patients, colleagues, and moments that remain vivid from that day, and on the meaning they have gathered in the years since.
On 9/11 my first operation was just getting underway when the first plane hit the North Tower. On TV I watched the second plane hit the South Tower just before I scrubbed. I was finishing up when the anesthesiologist relayed the news that the towers had fallen. I canceled my second case and sent him home. When he came back for his operation, he thanked me for saving his son’s life—his son worked in the North tower and had taken 9/11 off for his father’s surgery.
I emerged from my sanctum sanctorum into a different hospital. Staff scurried about talking to each other in the soft, flat pitch of purpose. On one of the glass skybridges over Fort Washington Avenue I passed housekeeping staff urgently tightening sheets on extra beds. From my office I saw something I’d never seen before, or since—completely empty streets, and an empty George Washington Bridge with tiny police lights winking at the Jersey end of the roadway. Jet-fighter finger-fours flew low up and down the Hudson. As so many others have observed, it was a piercingly beautiful day with a deep blue sky and not a single cloud in sight. Everyone stood by until dusk, waiting for injured survivors who never came.
I’ve always thought of my first patient that day as my Rip Van Winkle patient. He went to sleep in one world, and woke up in another. Beginning later that day he was told repeatedly about the events he’d missed, but it took him several days to accept that it was real. The eponymous Rip missed 20 years, including the American Revolution. My Rip only missed 8 hours, but his new world may have been harder to imagine. At the time I had no way to know—nineteen years later—that Covid patients fortunate enough to survive weeks of mechanical ventilation in our ICUs would also be Rip Van Winkles.
On the twentieth anniversary, when I rounded on my patients in the ICU, I was particularly worried about a middle-aged man who was struggling to recover from a very difficult operation (he died in the hospital a few months later). On my commute I had listened to NPR using the occasion of 9/11 to pick scabs off our national character. Perhaps that reminded me that my patient was a 9/11 first responder, whose ground-zero exposure probably contributed to the damage already done by radiation treatment of a childhood lymphoma. Like so many similar professionals who had a dangerous job to do, he exposed himself to the hazards of ground zero without dwelling on the personal consequences. I’m sure he would have been granted a medical waiver, if he’d asked for one. He was just another guy, doing what he could for something larger than himself. Some of you will recall that the Trade Center cleanup was accomplished in 75% of the estimated time, at 14% of the estimated cost.
Also on the twentieth anniversary one of my cardiac surgery colleagues, Tasnim Raza, forwarded to me a simple, two-paragraph email he’d received from his brother, Abbas, on September 12, 2001. Abbas began:
As time elapses, I am more clearly able to identify and articulate what it is that has been making me so sad about this attack. It is this: some cities do not belong to any particular country but are treasures for all people; cosmopolitan and international by nature, they are the repositories of our shared world culture and artistic production, testaments to what is common and binding among diverse peoples, and sources of creative energy. They come to stand for our notions of community and brotherhood.
I won’t even try to improve on that description of the place that has become my city, too.
Continue reading Dr. Smith’s 9/11 reflection on his Substack, Long Incision.
Related:
- Lessons Learned: Surgeon Craig Smith Reflects on Career in the OR
- Nobility in Small Things: A Look Back at The Leadership of Craig Smith, MD
- The Scenic Route, with Dr. Raza