Five Years and One Month Later By Neal E. Flomenbaum, MD, Editor-in-Chief

In our September issue, I reflected on the events of September 11, 2001 ("Five Years Later"), and the progress made in preparing for and dealing with such disasters in the future. I had no intention of revisiting this subject so soon, but on October 11, 2006, a small plane (piloted or copiloted by New York Yankees pitcher Cory Lidle) accidentally crashed into the 30th floor of a 42-story residential and professional building one block from our emergency department.

So how well did we do this time?

In the first draft of my September editorial, I wrote that upon first hearing news reports of a "small plane crashing into one of the twin towers," I immediately thought of the only similar event in New York City history. In 1945, a U.S. B-25 bomber flying in zero visibility crashed into the 78th and 79th floors of the Empire State Building. Thinking of that event led me to start planning for receiving severe burn victims, whom I correctly assumed would be brought to our emergency department and hospital because of our designation as a major burn center.

When Lidle's single-engine plane crashed into the building on the Upper East Side of Manhattan last month, I was finishing a late lunch in the hospital cafeteria. By the time I reached the emergency department, the hospital disaster plan had already been initiated—as it should have been—and groups of attendings, residents, nurses, social workers, administrators, and staff were assembling. In our emergency department, the attending emergency physician assigned to the South Bay, which contains the major resuscitation rooms, is designated the "lead" attending. As soon as I arrived, Doodnauth Hiraman, MD, one of our youngest and extremely capable attendings, came up to me and announced, "I am the lead attending." Looking around at the way he had organized activities thus far, I told him, "Then keep leading," which he did, magnificently, for the next several hours.

One block north, at the crash site, things were understandably a bit more chaotic. Nevertheless, there was clearly better and tighter control than I recalled in the not-too-distant past. Everyone—including the two women who saw the plane fly directly into their apartment, shattering the windows and bursting into flames—evacuated the building in a rapid and orderly fashion. Communications among police, firefighters, and emergency medical services were timely, accurate, and first-rate. Partly as a result of these coordinated efforts, no one other than the pilot and copilot was killed.

Clearly this unfortunate accident was on a far smaller scale and magnitude than the terrorist attacks of 2001, but there were lessons to be learned. Two things in particular come to mind: we are, in fact, better prepared to deal with disasters like this than we were five years and one month ago, and emergency medicine should be proud that we have trained a new generation of emergency physicians fully capable of dealing with such events in the future.

A B-25 bomber crashes into what was then the world’s tallest building. Fifty-six years later, two commercial jets are deliberately crashed into the World Trade Center. Only five years after that event, a small plane crashes into yet another tall building—all in the same city.

Who could write such an improbable script?

But then again, the unpredictable nature and sequence of events that might confront us on any given day is one of the reasons we choose to practice emergency medicine, isn’t it?

Emerg Med 38(11):6, 2006