A Decade of Remembrance

It’s been 10 years since 9/11. And the battle EMS is facing today is a much different one than it was then.

Then, we had the mountain of homeland security to conquer. Targets needed hardened, plans developed, assets acquired, concepts tested, people trained, communications bolstered, fail-safes implemented, capacities grown. We didn’t perfect it, but across the board, in the emergency services and even in the oft-forgotten realm of EMS, we improved a lot.

As they say, getting there is one thing, staying there another. The recession of the latter decade kicked us all in the teeth, hitting many communities so hard that even public safety—once holy and untouchable to leaders currying local favor—came to the chopping block. Whole departments fell, many lost personnel, and everyone’s fiscal existence came under unprecendented levels of scrutiny.

That continues, with no end in sight. So the challenge for EMS and rescue systems today shapes up much differently than a decade ago. Today, it’s not about getting, but about sustaining what we have. It’s about maintenance—keeping up capabilities and the level of preparedness communities expect and deserve, even as revenues dwindle and operations are stretched. That may ultimately prove the tougher task.

On the occasion of the 10th anniversary of 9/11, EMS World surveyed six top EMS leaders about what’s changed for the better, what’s not changed enough, and how we might navigate an uncertain future in a world that’s still plenty threatening. There aren’t a lot of easy answers—so perhaps we’d better get busy on the hard ones.

Connie Meyer

President, National Association of Emergency Medical Technicians; Captain, Johnson Co. Med-Act (Kan.)

Coming out of 9/11, what did you see as the greatest needs for EMS in its preparedness for terrorism and major MCIs?

It was a wake-up call for all of us. I think that was hard for some people to get their minds around the fact that we might not be safe or welcome on scenes—that someone might try to hurt us. And I think it became clear that we weren’t really prepared to deal with mass casualties, and having that many patients at a time, and we were not ready to deal with our own losses of the magnitude we experienced that day.

How would you evaluate our preparedness efforts over the last 10 years? Where are we better off today, and where have we fallen short?

I think a lot of EMS agencies have made and improved their plans for what to do in catastrophic situations such as that. There has been some help from the federal government to obtain equipment and training for those things. But I don’t think we’re as prepared as we need to be yet. There are a number of agencies that still don’t have the proper equipment and training to deal with those kinds of situations.

What’s changed the most for you locally there in Johnson County?

Well, even before 2001 we were doing mass-casualty drills. So we just magnified those a bit, and we were able to get appropriate equipment—monitoring equipment and protective gear and things like that—through grants. We’re fortunate to be a government-based service; that gives us an advantage in getting grants and equipment and training that some private and hospital-based ambulances don’t have. There’s still a disconnect on that.

Do you see any of our gains being threatened by cutbacks in this tough economy? How should we go about sustaining what we’ve achieved?

The only way we can sustain what we’ve achieved is to continue to advocate for protecting our level of preparedness. I don’t think we can focus completely on 9/11-type disasters; we have disasters every day in communities across the country. I live in a town of 300 people, so for a small service like mine, a mass-casualty situation might be a big accident with 10 patients, because that would really tax our resources.

But every service has to have a plan to deal with those situations, and I think you have to depend on your neighbors to help you. I don’t think it’s realistic that any service can handle any major incident without mutual aid. We can’t live in that bubble anymore, thinking we’re the only ones who can take care of our county, and we’re never going to need help.

Moving forward, what should be our top priorities?

There are actually some parts coming up in the field EMS bill, when it gets reintroduced, that provide funding to the states to do regional planning and response. That’s going to help. But at the basic level, I think it’s incumbent on local EMS agencies to develop whatever plans work the best for them in their circumstances. And with the way the economy is now, we have to be as self-sufficient as possible.

As 9/11 recedes into history, what are the big lessons younger providers should take from it and carry forward?

The big thing they need to know is that EMS is an important profession, and it’s not just about taking care of people, but taking care of yourself too. You have to be safe. You can’t help a patient if you’re not safe yourself.

Randy Kuykendall

President, National Association of State EMS Officials; State EMS Director, Colorado

Coming out of 9/11, what did you see as the greatest needs for EMS in its preparedness for terrorism and major MCIs?

As an industry, along with our partners in fire and law enforcement, we were probably naive in terms of what the potentials are, and what the dangers are. The world has changed an awful lot, and I don’t know that we fully understood that. And 9/11 was a terrible way to come to that realization, but I think it helped our industry begin to think about the importance of regionalization, and of being able to generate large-scale responses to incidents of this nature.

How would you evaluate our progress toward that goal?

We’ve made some significant strides. I think the changes in our capabilities, our ability to communicate, our ability to generate larger-scale responses in shorter periods of time, have come at a much faster rate over the last 10 years as a result of what we’ve come to understand of the world today. That’s true of both routine healthcare and being able to respond to large-scale events.

Are there areas where we’ve fallen short or not progressed the way we’ve needed to?

I think the area where we’ve probably continued to fall a little short is making sure we’re fully inclusive of all the various models of EMS and patient transportation systems across the country. We need to make sure all the components that move patients from point A to point B—whether they’re public or private, single- or dual-role—all are equal partners in terms of being able to respond. I don’t know that we’ve done that real well. With the variety of large programs we’ve had over the last 10 years, I think the focus at times has jumped around a bit. There are segments of the EMS community that haven’t benefited as they might have.

How much variation is left among the states in terms of preparedness for acts of terrorism or major MCIs?

We’re closer to standardized responses today than we’ve ever been in my career. That’s a tribute to the federal initiatives that were driven post-9/11—we are very much closer. I’m able to use the same vernacular and have the same levels of understanding, particularly talking about all-hazards or mass-casualty response, with people from other parts of the country. That is tremendous.

Do you see any of our gains being threatened by cutbacks in this tough economy? How should we go about sustaining what we’ve achieved?

In a state like Colorado, where many of our agencies are local tax districts, the decline in property values has resulted in sort of a double whammy for local agencies. Federal funding for disaster response is dwindling at the same time local ability to fill the gaps between costs and patient revenue is declining as well. That is a significant concern. I don’t think any state director or agency has a magic answer, but I know it’s something we need to address. We need to be fully engaged in discussions with third-party reimbursement agencies, and we need to be fully engaged at the political level in making sure we secure a baseline resource level to maintain the progress we’ve had over the years.

As 9/11 recedes into history, what are the big lessons younger providers should take from it and carry forward?

It should make us more aware that we’re part of a worldwide community, and that we live in a world that’s more dangerous than it used to be. Disasters come in a variety of forms, and working within a system of care that you use every day and can upsize to address larger issues is an extremely important part of the EMS provider’s repertoire.

Stephen Williamson

President, American Ambulance Association; President, Emergency Medical Services Authority, Okla.

Coming out of 9/11—and, in Oklahoma, the Murrah Building six years before—what did you see as the greatest needs for EMS in its preparedness for terrorism and MCIs?

With events like the Murrah Building and 9/11, the Metropolitan Medical Response System and things like that have been born, and Incident Command has taken on a greater role. On an emotional level, having an event happen in Oklahoma City made people aware that it can happen anywhere—and you don’t have to live in a major population area for it to happen to you. That made all the concerns more real, and really put tensions on organizations to stay equipped. I know there’s been some grant money for that, and some of us have been pretty fortunate with that, but there are a lot of costs the grants don’t cover, that have to come out of revenues. That makes it tough.

Is that still the greatest challenge still facing your system and private systems today—just a need for funding?

It’s kind of a perfect storm right now. We have so many people turning 60, and they’ll need Medicare and Social Security, and they’re at least 50% of what we transport in our business nationwide. And we know we’re getting 6% below cost, by what the GAO says. So if you have higher transport numbers and reimbursements below cost, that doesn’t work.

How have grants come around for privates? Are they generally eligible now for as much as others, or are whole pots still not available?

There is still a discrepancy in what the private sector has access to vs. the public. A lot of what we have comes through with partnerships with the public side. There has been a break in the dam, a little, but it’s still not 100% equal.

Can you elaborate on those partnerships? What’s working well?

In various communities, equipment has been made available through stockpiles for use in disasters. Besides preparedness, that’s helped open up avenues of communication, whether it’s directly to federal program authorities or locally with whoever’s applied for and gotten the resources, and made them available to the private side to use in emergencies.

Do you see any of these gains being threatened? How should we go about sustaining what we’ve achieved?

That’s something we’re trying to figure out right now, as we hear about these grants coming to an end. How will we sustain things? Can we get the hospitals, since they’re such big proponents now of these teams and things we have in place, to help fund them? It’s something we’re concerned about. We know the value of these things, so we just have to find ways to fund them.

For private services and EMS in general, what should be our priorities moving forward?

If the funding is not going to be available to sustain the present equipment and training and so forth, we have to determine if there’s a better way to provide those services. Now that we have some experience, are we researching the best practices being demonstrated through these tough times? Can we institute those in a more focused way? With anything new, we had to make some assumptions as to how it all would work, and I’m sure there was money that could have been spent better. So can we now provide the protection at a lesser cost, and still fund it?

As 9/11 recedes into history, what are the big lessons younger providers should take from it and carry forward?

I think new providers today actually are coming into the business more prepared than we were. They know the risks involved and what can happen. I think they’re more attuned, and I’m glad they understand that. We don’t have to ask them twice to get the training. The younger employee now takes it very seriously, and it’s part of their decision-making to get in the profession.

Gary Ludwig

Deputy Chief, Memphis Fire Dept.; Chair, IAFC EMS Section

Coming out of 9/11, what did you see as the greatest needs for EMS in its preparedness for terrorism and major MCIs?

I think one of the biggest was just the ability to prepare, train and actually respond. There was very little training that went into handling WMD or terrorist events. You had major agencies that couldn’t talk to each other on the radio. And there were resource issues that still challenge us today—a lot of our metropolitan areas struggle to deal with surge capacity. We have to have resources in place to deal with surge.

How would you evaluate how we’ve dealt with those challenges? Where have we been successful, and where have we fallen short?

I’m going to be blunt and say I think we’re still unprepared. We have done training, but it’s never been an organized effort for what we’re trying to accomplish. We’ve thrown a bunch of resources and money at systems without any real comprehensive national plan; in fact it’s up to each community to decide how they’re going to spend things like MMRS and UASI money, without regard to how it’s going to interface with the regional or national picture. Some communities have used that money to buy stuff based on what their daily need is, as opposed to what fits into the bigger picture. I’ve even heard of exercise equipment being bought under the premise of terrorism prevention.

And while we’ve made some strides, the states aren’t close to where they should be in developing national mutual aid plans—strike teams of fire and EMS. If another Hurricane Katrina comes, how will we ramp up resources from other states in an expedient manner and get them to Louisiana? Whatever major event happens, it may stretch people’s resources [to where help is needed]. And some states have done good jobs, but there are others behind the curve. There’s not been enough guidance in that direction.

Do you see any of what we have gained being threatened by cutbacks? How should we go about sustaining it in these tough times?

I don’t think we’re going to be able to prevent [cuts]. Congress continues to look at what they can cut, and as we continue along without another major attack, I think those monies are going to continue to dry up. Each year we see MMRS zero-funded, and then somehow the money gets put back in. But if we continue down our current path, that money’s going to dry up, as we’ll slide backward as the material stuff we’ve bought deteriorates.

Moving forward, what should be our top priorities?

I think the biggest is developing a national system that spells out the wheres and hows of deploying patients. If, all of a sudden, we had an earthquake in Memphis with 100,000 casualties, how would we distribute them across our region and nation? Who would control it, and how would it be managed? Where do we fit those patients into the right resources? That’s something I see as a real urgent need.

As 9/11 recedes into history, what are the big lessons younger providers should take from it and carry forward?

One of the biggest issues for me is safety. I think they need to continually train—resource deployment training, incident command training, that sort of training, knowing how to use and protect their resources. We can’t become complacent. We lost a significant number of people on 9/11, and we need to know what’s happened in the past and learn from it.

Lawrence Tan

President, International Association of EMS Chiefs; Chief, New Castle Co. (DE) Dept. of Public Safety, EMS Div.

Coming out of 9/11, what did you see as the greatest needs for EMS in its preparedness for terrorism and major MCIs?

New Castle County EMS sent a group of ALS personnel with a contingent of BLS ambulances from Delaware to the Meadowlands in northern New Jersey that day to stage for possible response into New York City, and one of the things we immediately noticed was a need to address our surge capacity—the ability to field additional paramedic units without decreasing the existing resources for our own jurisdiction. We encountered hurdles in our effort to send ALS resources out of state. One of the ways we addressed the issue after 9/11 was to change our agency to a dual-fleet configuration. For every 24-hour paramedic unit we deploy, we maintain two fully stocked vehicles that are assigned to that EMS station. The crews rotate which units are in use, which enables us to routinely check our medications and make sure all vehicles assigned to an EMS station are always response-ready. It also helps divide up the fleet mileage. More important, it gives us the ability to rapidly deploy additional personnel and vehicles with a full ALS capacity. We now have the ability to increase the number of paramedic units in service for any local or regional major incident. This can also be accomplished by holding paramedic crews over beyond their scheduled shift, if needed.

Are there areas where we’ve not achieved as much as we should have? Where still need to do some work?

There’s still a need for more integrated communications and intelligence sharing between EMS and other public safety agencies. It’s improving, but there are some agencies that struggle to be in the loop on these issues. Certainly from a safety perspective, you’d want EMS personnel to have improved situational awareness about potential and emerging threats, and from a security perspective, EMS personnel can be a valuable source of information about what’s going on in the community and may be able to identify potential threats before they create a public hazard. We all want to protect our communities, and EMS providers are a ready resource and intelligence asset.

The other issue that could use some additional attention would be the need to integrate security considerations into our daily EMS operations. Examples include credentialing of EMS staff, EMS facility security, and the security of EMS uniforms and vehicles. It’s a significant enough issue that in 2008, the IAEMSC posted a position statement offering EMS chiefs information on methods to improve the operational security of their agencies. [Find that at www.iaemsc.org.]

Do you see gains being threatened by cutbacks in this tough economy? How can we sustain what we’ve achieved?

The hard part is that we still struggle to have the same type of resources that are available to other public safety agencies. When the American Recovery and Reinvestment Act was enacted, it included funding to support fire service and law enforcement positions, but EMS positions were not eligible for that level of support. The EMS profession, as a public service, is dependent on the personnel who are ultimately going to sustain the operation and enable us to respond to a catastrophic event.

How do you sustain it? Maintain ongoing training and don’t become complacent. We all need to remain vigilant. New employee orientation should include reviews of contingency plans, participation in exercises for major event operations, and routine communications. It is imperative that EMS organizations maintain a level of operational readiness even in these difficult economic times. Collaboration with other EMS agencies at the local and regional level to share resources and formalize mutual aid arrangements may provide better utilization of pooled resources.

As 9/11 recedes into history, what are the big lessons younger providers should take from it and carry forward?

My advice for chiefs looking to continue and enhance the preparedness of their agencies is, No. 1, take advantage of training opportunities that will provide you with the skills to not only plan but execute the mission during a major event. Second is to network—have a collaborative relationship with fellow EMS chiefs, and lean on those types of resources to stay in tune with changing national policies and politics. That’s one of the things the IAEMSC tries to do for its members, both through our communications and our annual EMS Leadership Summit hosted in Washington, DC, each year. Additional information regarding the annual summit will be available on the IAEMSC website.

Ken Knipper

Chair, National Volunteer Fire Council EMS/Rescue Section; NVFC Kentucky Director

Coming out of 9/11, what did you see as the greatest needs for volunteer EMS in its preparedness for terrorism and major MCIs? And how have we done at meeting them?

The thing I see is that, looking at the overall picture, the government pumped a tremendous amount of money toward the emergency services, every aspect, to be ready if something like that happened again. And I’m not so sure EMS ever really got its full part of that. I think in my area, the greater Cincinnati area, EMS came out better with UASI [Urban Areas Security Initiative] funds in getting the trailers, decon units, things like that, than we did under the FIRE Act [Assistance to Firefighters] grants. There’s money available to EMS under FIRE Act grants, but it’s not enough, and it’s not taken advantage of as much, quite frankly, because of the complexity of the forms and things like that.

Is that body of knowledge required to work the grant process more of a problem for volunteer services than for paid?

Yeah, because they’re part time and have other things to do. The states have spent a lot of time—Kentucky has, anyway—educating people on how to do it. There’s a lot of help available, but I find a lot of times the volunteer departments just don’t take advantage of it, or they get involved in the process and say, ‘Well, it’s too much, we can’t do this.’ Some of the volunteers have just given up. They really have, and that’s unfortunate.

Are there states where the volunteer community is doing better than in others?

I think so. New Jersey is the first state group that’s asked to be a member of the NVFC’s EMS/Rescue Section. New York is one of the premier states in the way they handle volunteers. I mean, they have a retirement home for volunteers that doesn’t cost a guy a dime! It’s amazing what they do up there.

Do you see gains being threatened by cutbacks in this tough economy? How can we sustain what we’ve achieved?

It’s going to be be tough. They’re trying now to cut the grants down to about a third of what they were at the start. So you have that, and you have all these cities in trouble, costs are increasing, and volume’s increasing. It’s a lot of pressures from a lot of angles right now.

For volunteer services, what are the priorities moving forward?

Community involvement is extremely important—we have to recruit constantly. And the other thing is retention. You have to be flexible and empathetic about scheduling, and take what you have available from people. One of the things I keep saying at NEMSAC is, whatever we do, let’s not take away the opportunity for a couple, or two women, or whatever, in some remote community to provide some level of EMS. Let’s not make it so difficult out there that we just take away the opportunity. In many states that’s a problem.

As 9/11 recedes into history, what are the big lessons younger providers should take from it and carry forward?

One of the things I like to cite—and very few people know this—is that after 9/11, EMS in the city of New York, I’ve been told by people up there, was basically run by volunteers for over 40 days. Across America, the backup is very often volunteer. The public has to know that. In the last 2–3 years, the biggest department in my county went from 15 people per shift to 11. The backup comes from two combination departments and volunteer department that sits right below them. And the volunteer department, sometimes I kid, they’re probably spending more time in the other station than their own.

The need for the volunteer just is not going to go away. About 80% of this country’s geography is covered by volunteers. They’ve made some good gains and provide excellent service for their community, but things happen, and right now it’s difficult to maintain.

‘I Only Knew What Was in Front of Me’: the WTC In Their Own Words

Based on his years in the fire service, Firehouse Magazine’s editor in chief, Harvey Eisner, knew the firefighters who responded to the World Trade Center attacks in 2001 would need to talk about their experiences. In November of that year, Eisner began interviewing firefighters from many different stations, asking for their stories. The result of more than 100 interviews is WTC: In Their Own Words, a collector’s edition in commemoration of the 10th anniversary of 9/11.

As the number of interviews grew, Eisner began writing in a notebook names, numbers and fire companies, and how each firefighter was involved. “We wanted to do a book many times over the last 10 years, but it just didn’t work out,” he says. In December 2010, he got out the notebook and began tracking down some of the people he’d interviewed, and ended up with about 40 new interviews. “We tried to get stories from people who operated in different areas at different times and doing different things on 9/11,” Eisner says. “That day, a person who was operating on the north side of a site didn’t know what was going on on the south side. People who were at the scene have read some of the stories and said, ‘I didn’t know that.’ Several of them told me, ‘I could only concentrate on the two square inches right in front of me. It didn’t matter what was going on 5 feet to my right, half a block away or in another building. I only knew what was in front of me.’ Many of the firefighters told me they had never told their stories to anyone.

“One of the main reasons for the book is to document history,” Eisner adds. “So 30 or 100 years from now people will have at least a partial glimpse at what happened. It’s not a tell-all book of everything. It’s a small look at what some of the fire service members did that day.”

The 276-page publication contains around 250 photos and comes with a 52-minute DVD, The Battle Continues, which includes video and radio traffic from the event. “The book provides the history of the area before the World Trade Center buildings were built, as well as information about the planes: how many passengers were on them, how much fuel they were carrying, how fast they were going when they struck the buildings and what damage was done,” says Eisner. “We included maps of the buildings in the area, locations of firehouses and names of the firefighters who responded.”

A portion of the proceeds from book sales will benefit four firefighter-support organizations: the FDNY Foundation, the National Fallen Firefighters Foundation, the Uniformed Firefighters Association (UFA Elsasser Fund) and the Wounded Warrior Project. The book is now available through Amazon.com, as well as some fire service bookstores. For more information, go to firehouse.com/wtcbook.

—Marie Nordberg, Associate Editor

‘I Went From Not Being Able to Walk to Sprinting’

Excerpt from WTC: In Their Own Words: Firefighter Joe Falco (now retired)3

Engine 1, Garment District, Manhattan

I received a call to come in and work overtime on Monday morning. When I arrived I was told they found several firefighters to work and I wasn’t working the day tour. They said I could work driving the engine Monday night. I hung around and worked Monday night. I had been out for a while, and my first tour back was September 6. I was supposed to get early relief Tuesday morning. I was the only one going off duty.

At about 8:30 a.m. we had an EMS run to Penn Station a block away. I heard Battalion 1 radio in that he had a plane into the Trade Center. I drove around the block back to the firehouse. Within seconds of me backing into the firehouse, the tones went off for a run for the engine. I said, “I’m supposed to go home.” The incoming chauffeur was there. I asked him, “Do you want to drive?” He said, “You take it.”

I worked my way to the West Side Highway. We parked on the south side of the North Pedestrian Bridge. The guys got off the rig. I was getting dressed. The mask for the chauffeur was out of service. I met the officer inside. He said, “No mask, go outside and get water.” It was hard to leave the building. People were jumping. I saw the chauffeur of Engine 65. I helped him hook up. An engine pulled up and parked right in front of the North Tower. As soon as the engine pulled up, someone jumped from above and landed on the roof of the engine. The rig took off.

I helped put the suction hose on a hydrant at Liberty and West Street. There was a walkway to where the standpipe connection was located. It offered a little bit of protection. We were next to the parking lot at the southeast corner of the complex. A couple of cars were on fire. There was plane debris everywhere. We hooked up to another hydrant and tried to put out a van that was close to the apparatus.

Stuff was falling off the building. People were trying to get out of the hotel. Cops were yelling that there were about 20 people in wheelchairs and they needed stretchers. EMS directed the civilians.

Firefighter Kevin Shea was an extra man on Ladder 35, and had gotten separated from his unit. He asked if we needed help with the car fires. He was on the nozzle with me backing him up. The chauffeur of Engine 65 was looking out. Kevin was trying to put out the car fires when I yelled “Run.” The South Tower was collapsing.

I ran west. This wind comes and knocks my helmet off. My hands go out in front of me like I’m Superman. I’m flying through the air. I said, “I’m not dying like this.” I heard my daughter’s name. I go head over heels rolling into the center divider of the West Side Highway. I go up and over the divider completely into the southbound traffic lanes. I wake up. Everything is black. There is no light, no sound. There is debris everywhere except where I landed. They say you see light when you die. I said, “I’m in trouble, because there is no light.” I was getting pounded on my back, like getting punched by small pebbles that were landing on me. I had about 30 lumps on the top of my head.

I thought I had heard Firefighter Muldowney while I was lying on the ground. “Hey, boy” is what we used to say to each other over the handie-talkie. He was working and was killed. The dust started to clear. I thought I was buried. I reached around me and found I wasn’t buried. Lights from an ambulance were visible in the distance. I thought a piece of the building came down, not the entire building.

I was still sitting near the debris when a firefighter yelled out, “Anybody here”? I yelled back. He asked if I was OK. They came over to see if I was OK. I heard a firefighter yell out that he was trapped in front of an ambulance about 20 feet from me. My leg was hurting me so I couldn’t go. The other firefighters that had left me came back. The firefighter was only wearing a turnout coat. He was bleeding from his head. The debris that was blocking the front of the ambulance was moved and the bleeding firefighter walked away.

Two firefighters assigned to Ladder 24 in my firehouse had just escaped the partial collapse of the hotel when the South Tower collapsed. They each grabbed one of my arms. There was so much debris, it hurt more as they pulled me. We made it in front of the North Tower when the North Tower collapsed. I went from not being able to walk to sprinting towards the Hudson River.

The wind and the dust started again. I put my head inside my coat and said, “Whatever happens.” I walked in a straight line down some stairs to the bulkhead. I walked north until I was out of the dust cloud. I saw one of the firefighters, Grillo, who I had been with. I said, “Where is Tyrone?” I was going to go back into the dust until I saw a shadow and it was Tyrone. Grillo had injured his arm and his nose was bleeding. I sat on a park bench. I was in so much pain.

A sightseeing boat pulled into the bulkhead. I get on the boat. I couldn’t walk down the stairs; I had to slide a ladder. They took me to Jersey City with several firefighters. They put me on a bench. There was no one around, so a lady called my wife.

Finally they took me to the Jersey City Medical Center. They triaged everybody in the lobby. Hundreds of people were in the lobby. There was a lot of damage to my legs. They stitched me up. They put the cops, firefighters and EMS in one room. I was fully covered in dust.

I said I wished I could talk with Father Mike [Mychal Judge, fire department chaplain]. I didn’t know what happened to him. A lieutenant said, “Don’t you know? Father Mike got killed.” I was so close to him, it was heartbreaking to hear. [Father Judge worked in the church across the street from Engine 1 and Ladder 24. He parked his fire department vehicle inside the firehouse and ate every meal with the firefighters.] It took the wind right out of my sails to hear that. He was such a nice man. He made everybody feel you were important to him.

They were sending guys two at a time to take a shower. I had scrubs on and was on crutches. “Do you want to take a shower?” They kept asking me over and over. I said let someone else go. I was the last one to take a shower. I saw what I looked like in the mirror. I was the dirtiest one there. I was transported back to New York. Two friends drove in to take me home. That was my last day at work. I suffered injuries to my left side, left knee, broken knee cap, torn ACL, torn PCL, broken tibia, joint and bone crushed, left eye injury and left shoulder replacement. I had a right torn ACL and a bone/knee crushed.

‘The Same Guy I Was on Sept. 10’

Excerpt from WTC: In Their Own Words: Capt. Al Fuentes (now retired)

Acting Battalion Chief, Marine Division

Brooklyn Navy Yard

I started work at 7 a.m. The secretary came running in screaming that a plane hit the World Trade Center. From the Brooklyn Navy Yard I could see both towers. I couldn’t believe my eyes. I thought we should surround the Battery with fireboats, because that would be the best way to get the injured out…via water. We could use the boats to move companies into the area.

I took the super radio. When I was a lieutenant in Rescue 2, I constantly drilled with the members that there is no time to rely on messages in an emergency, call the dispatcher.

I traveled on Marine 6 across the harbor. We pulled up to Vesey Street. I looked up and saw the second jet slam into the South Tower. I knew we were under attack. Proceeding to the command post, I reported to Chief of Department Peter Ganci. Chief Ray Downey was there. He said Al, stay here with me. Marine 1 and 6 were on scene with a spare boat, the Smoke. Marine 9 was standing ready at their berth. Companies were getting assignments. People were jumping from the South Tower. Chief Downey said we better give Tower 2 more attention. It was hit lower and there are more people inside. I saw the four corners of the South Tower and knew it was going to come down. It started to collapse. I ran into the garage doors of the World Financial Center, located directly behind the command post. I made it in about 10 feet. I crouched down, put my head between my legs and said a Hail Mary.

The wind blew through. Debris was hitting me. It was pitch black. I tried to breathe through my coat. I found my way out through the interior. I emerged and couldn’t believe my eyes. There was six feet of debris, gray dust all over. We better start searching West Street. Deputy Commissioner William Feehan walked by and asked if I was all right. I said I wanted to start searching. Two firefighters stopped and I told them to get tools. Chief Ganci walked by and gave me a look and shook his head. Chief Downey said we just lost a lot of guys. Where are the fighter pilots? He thought there might be further attacks.

Six firefighters appeared across the street near the Marriott Hotel lobby. Debris was still falling from the North Tower. Chief Downey said “I’m going over there, let me know when it is safe to come back out.” Several of the firefighters came out, including Chief Brian O’Flaherty.

Then the North Tower came down. I was trapped from the neck down for 90 minutes. Several firefighters dug me out and carried me. I was covered by a piece of silver facade. [Ed’s note: Firefighter Jack Flatley heard the radio Fuentes was carrying and located him.] I was removed via boat to New Jersey. They did a tracheotomy on me. I was in a drug-induced coma for a week, on a respirator, intubated. I had six broken ribs, a collapsed lung, skull fracture and needed a couple hundred stitches on my scalp, a broken wrist and fingers.

I was in the surgical ICU and then moved to a hospital in New York. I was placed in pulmonary ICU. I woke up one night at 4 a.m. I was having nightmares. I told my wife I needed to talk with the fire department chaplain, Father Mychal Judge. She was quiet for a while. “Is Father Judge dead?” I asked. Yes. “Ganci?” Yes. “Downey?” Yes. “That’s enough, don’t tell me any more.”

I realized the second tower came down and got me. [Several weeks after the incident, Fuentes learned about the 343 firefighters who were killed.] I saw six doctors a week. I just want to be the same guy I was on Sept. 10. People have been so nice to me. I am humbled.