Dr. Emil Chynn, ‘Ground Zero’ Volunteer

WTC-9-11-MeAsMDVolunteerACSH Scientific Advisor Emil W. Chynn, M.D., a native Manhattanite who lives on Sixth Avenue in Greenwich Village, seems a very busy Renaissance man. He is, for example, a sportsman, a part-time M.B.A. student, a writer, a researcher, an inventor, and a private practitioner of laser surgery for vision correction (Iwant2020.com). On the day of the in-flight attack on the World Trade Center, this ophthalmologist headed purposefully and unselfishly toward “ground zero”—unbidden, unaccompanied, unguided, and ill-equipped. He volunteered there daily for six consecutive days.

During the first half of October, I asked questions of Dr. Chynn by email and by phone concerning this experience. His account follows.

On Tuesday, shortly after 9:00 A.M., a friend of mine called me as I was about to leave for work. She told me that a plane had hit the World Trade Center. I went to the street with my neighbors and saw the twin towers on fire. Sixth Avenue in Greenwich Village was filled with pedestrians; no cars were moving. It seemed a tragic variation of a scene from Times Square on V-E Day.
WTC-9-11-RescueDogsI called the downtown hospitals I’m affiliated with—New York Eye and Ear Infirmary (where I’m an eye trauma surgeon) and St. Vincent’s (which is one of the two downtown hospitals designated as a major trauma center)—to let them know that I was available for emergency duty. Both hospitals advised me to “stand by,” as they hadn’t received any victims. From my experience as an intern on call the day the World Trade Center was bombed, in 1993, I knew that significant time could elapse between the primary incident and the first arrival of victims in the ER. So I decided to go to the site unofficially and see if I could provide any immediate help.

I returned to my apartment to gather ophthalmic paraphernalia: (a) 30 eye kits Bausch & Lomb had provided for my LASIK practice, each consisting of “eye shields,” goggles, tape, antibiotic drops, and artificial tears; and (b) other ophthalmic paraphernalia, including saline solution and the eye surgical kit I had first used during study in India as a resident with the Massachusetts Eye and Ear Infirmary.

Physicians, nurses, and EMTs seeking to volunteer at the WTC site went there separately from one another but met en route, informally. I was one of the first doctors at the scene; the group I was in arrived around 11:00 A.M. The chaos was total, with fire engines burning, cars exploding, debris falling, and a thick blanket of ash and paper over everything in sight.

My group—initially of about 12 healthcare workers—included an anesthesiologist, a trauma resident, and a few nurses. None of us had hardhats, thick gloves, walkie-talkies, or masks capable of preventing inhalation of the particles of concrete in the air.

There was no triage center at the site. So we decided that our first need was to set up one. Ambulance crews waited as others and I walked toward the area of densest smoke. We first considered as a possible triage site the remains of a firehouse. I re-jected this place because what was left of the station appeared shaky, lacked electrical power, and was riddled with debris. I spotted a Burger King restaurant that looked relatively intact. It was at One Liberty Plaza, across the street from the firehouse site.
WTC-9-11-TiredRescueWorkerThere, we were moving a bunch of apple pies to make space for our IVs when we discovered our lack of crucial items: catheters, basic surgical instruments, and ACLS (advanced cardiac life support) supplies. If any victims were brought to us in critical condition, there would be real trouble. One doctor cried in frustration, beating his head on a wall.

Around 1:00 P.M., the dense smoke suddenly thinned, and we saw vestiges of 2 World Trade Center directly for the first time. We came to a standstill, realizing that very few victims of the attack would become available for treatment.

Later that afternoon, a podiatrist was asked to perform an amputation to free a victim from rubble. The podiatrist refused on grounds that the surroundings were unstable. Eventually the victim was freed without amputation. This style of decision making was characteristic among physicians volunteering at the site; each doctor was deciding on the fly and without any official guidelines. We treated only two victims the day of the attack, and only three the following day—by the end of which my group consisted of 20 to 30 healthcare workers.

Outside a hospital hierarchy, healthcare workers from different facilities lack a chain of command. For the first three days of the crisis, no one was officially coordinating medical care at the site. In default of such coordination, my companions and I took turns in leading our group. For the first couple of days, every hour a fire department commander or police chief would approach us and ask: “Who’s in charge?” We would accede to whoever of us seemed the least tired. Occasionally, even a medical student took charge.

On Wednesday afternoon, a firefighter burst into our triage center and yelled that everyone must evacuate the building, which apparently was buckling. All of us ran out.By Thursday, my group consisted of 40 to 50 healthcare workers. That night, we set up a replacement triage center near the Millennium Hilton Hotel, about a block away from One Liberty Plaza.
WTC-9-11-AmericanFlagWTCRuinsBy Friday, September 14, well equipped members of Emergency Disaster Medical Services (EDMS) arrived at our triage center to take it over. We were relieved at this. In a disaster area such as the World Trade Center site, coordination problems are almost inevitable. But in such circumstances any medical team needs organization, and resources, equivalent to those of the firefighters and police officers at the scene.

I treated no life-threatening injuries at the site. Most of those we treated in the six days I volunteered at the site were rescue workers. Mostly, I
treated abraded corneas and eyes affected by foreign bodies. I had expected that I would treat more lacerated corneas and ruptured eyeballs than I treated. If hundreds of victims of the attack had survived its aftermath, probably many of them would have died during triage for lack of both preparation and equipment.

Dr. Chynn was interviewed at the World Trade Center site on national television. Afterwards, he coordinated some of the donation efforts of ophthalmic companies and began to drum up charitable contributions through his LASIK practice.

It is not reasonably deniable that unorganized medical volunteers aren’t likely to meet the medical needs of an emergency of the magnitude of what prompted the exodus from the World Trade Center site and its environs. Advises Dr. Chynn: “Each American city should found, fund, and staff a local emergency medical response team similar to that of EDMS, which is federal. Doctors, nurses, and EMTs would be on call throughout each day to establish triage and to coordinate ongoing medical services.”

Read Dr. Chynn’s newest 9/11 interview with undicisettembre

The full interview can be found at this link.

World Trade Center: an interview with doctor Emil Chynn

by Hammer. An Italian translation is available here.

Among the many people who took part in the rescue and recovery work on and after 9/11, in addition to firefighters and police forces, an important role was played by medical workers. Although they are mentioned rarely, they helped greatly in treating injured civilians and in helping other rescuers as well.

Undicisettembre offers its readers the account of surgeon Emil Chynn, who was the first doctor to arrive at Ground Zero and organized the first triage center for the injured near the site of the disaster. Dr. Chynn, MBA, is also the proprietor of the Park Avenue SafeSight practice in New York.

The photographs in this article are courtesy of Emil Chynn, whom we wish to thank for his kindness and willingness to share his experience.

Undicisettembre: Can you give us a general account of what you saw and experienced on that day?

Emil Chynn: I was the first doctor to arrive at Ground Zero on 9/11 – when I arrived it looked like a war zone. At the time, I lived on West 12th Street, which is about a mile away from WTC. I remember going to work and seeing people staring up at the Twin Towers, which had both been hit, and were on fire. I decided to go down there myself to help out.

This wasn’t as crazy as it sounds. I was also involved back in 1993, when terrorists set off a truck bomb in the parking garage of one of the Towers. At that time I was an intern at Saint Vincent’s Hospital and was about to get off call, and hospital administration told us all to just stay at the hospital, since that was the closest Trauma Center to WTC. However, it took at least 4 hours for any victims to arrive by ambulance, because of logistical delays (like getting the ambulances downtown, triaging the patients, and having them come back uptown). So I thought I would be much more useful if I were at the scene this time to accelerate the process – so I headed downtown.

I first tried to catch a cab, but that was impossible. First of all, almost all of them were occupied. Second, you can imagine the reaction of the cabby I found who didn’t have a fare, when I asked him to take me to WTC. So to save time, I rollerbladed down to WTC in my scrubs. By the time I got below Canal Street, there was like a foot of paper on the ground, so I had to take off my blades and walk. A few more blocks downtown, like Worth Street, you started to see some stuff on fire, with people running past you, uptown towards safety. By the time you got to Chambers Street, it was really scary; nobody on the street, with abandoned ambulances and fire trucks on fire. I had a cop car explode near me. It was like a post-apocalyptic, World War III movie.

Near where I thought WTC should be, I came across a few other brave or stupid healthcare workers like myself, who were also disoriented. Visibility was about 20 feet because of all the dust and smoke and ash in the air – it was literally as dark as dusk at Ground Zero, although it was a beautiful, perfect sunny fall day up on 12th St. We thought we were lost, because we couldn’t find WTC – and it’s hard to miss two 100-plus-storey buildings, even with that much smoke. I remember walking around the block with one nurse, one EMT guy, and one girl who was a PT student or something, looking upwards like tourists in Times Square, but never being able to find the Twin Towers. Finally, the EMT guy said, “I think that’s the Tower, guys” and pointed to a small pile of rubble, about 100 feet high. I argued with him, saying “Are you nuts? How could a 100 storey building be reduced to something only 4 stories high?” so we all walked around the block again. You have to understand that when we started downtown, both towers were burning on top, but still standing. We didn’t have access to TV, or radio, and all cell phones didn’t work downtown. So a person watching CNN in Japan would know more about what was going on than us, a few dozen feet away.

Finally, we all realized that he was right, and we just sat down and stared at the rubble pile. I don’t know what the others were thinking, because everyone was silent. I was really numb from that emotional shock, thinking about the enormity of the situation, the sheer destruction we were witnessing, and all the people who must have died. The PT girl started to cry, but quietly.

Undicisettembre: Why were there no professional rescue efforts going on when you arrived?

Emil Chynn: Many weeks after 9/11, after I went back to work as a LASEK surgeon, I figured out why, and there were several reasons. First, the Command and Control Center for emergency response for all of New York City had been coincidentally and tragically located at 7 WTC. A month before 9/11, I almost signed a lease to move my LASEK center to the retail arcade of one of the Towers, but decided against that because rent was too high, so I just missed making a similar tragic decision. Unfortunately, 7 WTC was hit by a lot of debris from the collapse of 1 and 2, which set the building on fire. It didn’t help that they had huge backup generators to supply electricity to the Command Center on the 23rd Floor of 7, plus a tank of over 1,000 gallons of diesel fuel to power that generator – which also ignited. So that wiped out a lot of the resources for emergency response.

Plus, you have to understand that before 9/11, the US had never been attacked on home soil ever, and it was before terrorism was a recognized threat around the world. So it’s understandable that the NYPD and other government agencies weren’t that prepared, as this hadn’t happened before.

Undicisettembre: Tell us about your efforts on 9/11 itself, and those of other first responders that day.

Emil Chynn: Well, I got there very early, and you can imagine the emotional toll the collapse of both towers had on all the cops and firefighters. I saw a few just sitting down and crying. That made even more of an impact than seeing a firetruck on fire, because those guys are incredibly tough, so it’s really disconcerting when you see them sobbing. Of course, unlike them, I didn’t lose any close friends or colleagues myself that day, or else I probably would have been less functional than I was.

After the PT girl got her shit back together, as well as the rest of us, our little group decided that we’d better set up some kind of triage center, since it was pretty clear that there wouldn’t be any organized medical response at the scene that day. Not with firefighters crying, and cops saying to us when we asked who we should report to “beats me – your guess is as good as mine.”

So we took over the nearest store that was still standing, and that looked structurally sound – like, not with a huge shard of WTC sticking out of it. That turned out to be a Burger King across the street, which had most of its front glass blown out but at least it wasn’t on fire. We cleared out the Burger King and most places in the area didn’t have running water, but the Burger King did, maybe because it was a restaurant or something like that. There were a couple of ambulances standing around with no crew. I’m not sure to this day what happened to them – maybe they died during the tower collapse, maybe they ran to safety when that happened. Who knows. All we knew is we desperately needed supplies – so we looted those ambulances and took their IVs and trauma kits.

Undicisettembre: Did you have any contact or coordination with government agencies at that time?

Emil Chynn: Well, after we set up a makeshift triage center and ER, I remember a firefighter handed me a walkie talkie, and put me on with his Battalion Commander or something like that, who asked me, “can we send in the ambulances yet?” I looked around, and realized that the debris, mostly paper, was about knee deep all over, so there was no way that any ambulance would be able to arrive. I told him, “We need to clear a path for the ambulances, can you send a bulldozer or something?” Let’s just say I didn’t get a positive reply. But there was some hippy-looking construction worker who was nearby, and he said “I can help with that.” Five minutes later, he arrived with a Bobcat, and started plowing the street, piling up paper in these huge mounds, like they’re snowdrifts. Later on he told me that he hot-wired the Bobcat, and stole it from a construction site he saw a few blocks away.

Undicisettembre: Were there many episodes like that, of regular folks risking a lot, just to help out?

Emil Chynn: Yes. There were hundreds of episodes like that every day. People were literally falling over themselves to help out in any way they could. There were people digging in the rubble with their bare hands, “on the pile” is what we called it, searching for survivors. Everyone was so dedicated, and generous, and giving. It’s what made being there tolerable, because amidst all the death and destruction from all that evil, you could still also feel the kindness and humanity of all the volunteers and first responders. Everybody was just pitching in, doing their part, without thought of pay, or glory, or anything selfish. I was nice to be a part of that.

I was interviewed on some network TV station the next day, and was asked if the first responders could use anything, and I mentioned that we needed masks, because there was so much dust in the air it was sometimes uncomfortable breathing. The next day, somehow, hundreds, if not thousands of masks arrived. It’s like the entire country wanted to help us help those people at Ground Zero.

Undicisettembre: What can you tell us about the victims at Ground Zero? What were their conditions?

Emil Chynn: They were bloody with lacerations because all the glass blew out. I didn’t see many people with major trauma or severe concussions or stuff like that – unfortunately, those people were probably all dead. Most people either had injuries that weren’t that major, or they were dead. We were expecting people to come in missing a leg or an arm or something like that, but that wasn’t the case.

In retrospect, that was because of the way the buildings collapsed – they went straight down, and compacted themselves, rather than falling over. So if you were inside the buildings when they collapsed, you were dead, whereas if you were a block away, you were basically fine.

Undicisettembre: What happened in the next days? How long were you there?

Emil Chynn: I volunteered at Ground Zero for nearly one week straight, working between 12 and 18 hours per day. The first day was totally chaotic and you didn’t get any real visibility until the afternoon, when all the particulate matter settled down and you got normal visibility and could see at least a block. Before then you couldn’t really see much of anything, so you didn’t realize the scope of the situation. That’s when you saw both towers had collapsed, and there was another skyscraper nearby with part of one of the towers embedded in it, and by then WTC7 had also collapsed.

There were ambulances pulling in and out, evacuating trauma victims, a lot of whom were first responders with relatively minor injuries (like broken bones). At that point, it was somewhat more organized, with cop cars pulling up with cops inside, rather than abandoned cop cars on fire.

But again, we were expecting major trauma victims to arrive at our triage center, but no victims were arriving. By that evening, all of us healthcare workers were starting to realize that there were going to be very, very few survivors. That was really sad, and also disappointing: you work so hard all day, preparing to help people – and we did help hundreds of people with minor trauma like abrasions and lacerations and fractures – but we didn’t help one person on the major trauma side.

FEMA didn’t arrive until the second or third day. Of course, NYPD and FDNY was there from the start. At midday on 9/11, I already saw guys with FBI jackets, and even ATF, which I thought odd, but maybe there was an ATF base nearby. I never saw a single FEMA jacket until the second or third day. Not that I blame FEMA, because pre-9/11, FEMA was only involved in natural disasters like hurricanes or floods for which you have more warning, like at least a day or so. So FEMA probably needs a couple of days to prepare a fast response for a natural disaster. But in the case of 9/11, there was zero warning, because it was not a natural disaster – it was man-made.

Undicisettembre: Doctors are rarely mentioned among the heroes of that day. How do you explain that? What do you think about it?

Emil Chynn: First of all, I want to make clear that everyone there, like all the firemen and policemen, were very dedicated and professional, as well as humble – no one was trying to get credit for anything because we were all there on a pure humanitarian mission.

That said, it’s unfair that the vast majority of healthcare workers who were there on 9/11 were not only “first responders” but true volunteers – they weren’t going down there as part of their jobs, and they weren’t getting paid. This leads to even more unfairness, although it’s really nobody’s fault.

If you developed a medical problem while at Ground Zero, and were a cop or firefighter, you would get lifetime disability and lifetime pay, because you were on the job, and your disability was “work related.” However, if you were a true volunteer, you would get none of that. It’s not like I think that the lifetime benefits of city employees from their work at Ground Zero are unfair. Of course that’s fair – they risked their lives, and lost friends, protecting all of us.

But what about the true volunteers, like the healthcare workers, and myself?

I never had any respiratory issues before 9/11. At Dartmouth, I briefly raced on the cycling team, which was a club sport back then. When I was a medical student at Columbia, I ran the NY Marathon in 3:36, which was a pretty respectable time, especially since I didn’t really get to train, because they were working me like a dog. So I was always in top cardiovascular shape.

After volunteering at Ground Zero for nearly a week, working 12-18 hour days, I developed asthma about a month or two afterward, for the first time, and I’ve had that since, and will have that the rest of my life. But I received no disability for this, and that’s why I’ve had to work every day of my life since. On the positive side, that’s how I’ve managed to treat over 20,000 LASEK patients!

Undicisettembre: Did you medical volunteers receive any recognition at all?

Emil Chynn: A few months after 9/11, I got a call from someone saying they were organizing a tribute to first responders at Yankee Stadium, they were inviting cops and firefighters and their families, and wanted me and the other medical volunteers that day to participate. I was briefly happy, as I thought that finally we would at least be properly recognized. (The only free meal I was offered for my service was at a place called Bar 6 across from my apartment in the West Village, and when I showed up a month later for dinner, the owner reneged on his promise of a “thank-you dinner”.)

Well, that happiness lasted about 5 seconds. Because the NYC official calling then said, “We would like to ask you if you would be willing to provide free medical services that night, in case someone at the Stadium has a heart attack or something.” I hung up the phone on him.

Look, as a doctor it’s not like I need or want the free dinner. But some fair recognition for the hundreds of medical workers who were true volunteers at Ground Zero would be nice.

Undicisettembre: Did you have psychological consequences after 9/11?

Emil Chynn: I’m a surgeon and when you are a surgeon you learn how to block a lot of stuff out – this is a necessity to do your job properly. I have the largest Refractive Surgery fellowship program in the US, so I train a lot of doctors on how to be eye surgeons – at least 20 doctors from over a dozen different countries over the past 15 years.

Right now I’m training a doctor who’s very good at treating patients medically, but she gets very nervous in the operating room: so nervous she sometimes she says she cannot proceed. I tell her “What do you mean you cannot proceed? You are a surgeon – you must proceed!” Eye surgery is different from other kind of surgeries because the patient is awake (we just anesthetize their eyeball), so in that sense it’s harder than most other kinds of surgery. Like, I’ve scrubbed in on neurosurgery when I was at Columbia, but those patients are unconscious.

So eye surgeons are operating on people’s eyes while they’re awake and fully alert! So that means, to be an excellent eye surgeon, you must get good at always being in control, no matter what. I’ve done 30,000 cases of different types of surgery: mostly laser vision correction but also “real surgery” like corneal transplants. I think almost all good surgeons (as opposed to all doctors) would be good in a war-like setting, like 9/11 was, because we have to deal with blood and sometimes death or blindness routinely.

Having said that, after 9/11 I thought I was perfectly fine for a couple of months, and thought I would happily not have any PTSD, but then I started not be able to sleep. I went to psychological counseling provided by New York City and NYU (I was a part-time MBA student at the time), and went once or twice a week for three months. It was very helpful. You cannot speak freely with nonprofessionals, because there are too many things going on and you don’t want to talk about this with a relative, say with your mom, because she would get very upset for me. I think anybody who is in a very stressful situation should seek some counseling,

Undicisettembre: Has 9/11 given you a new insight into being a doctor?

Emil Chynn: I was already taking trauma call for Manhattan Eye and Ear and for New York Eye and Ear, and even though I was just teaching residents how to sew up ruptured eyeballs, it is often part of other major trauma. But this is part of your job as a surgeon, so it probably doesn’t affect you that much as a person, because you perceive it as somewhat normal.

But 9/11 was not at all normal or acceptable because it was an intentional act, not an accident. So you tend to dwell on that far longer than another kind of accidental trauma. It’s like grieving for a relative that was killed in a car accident, versus one who was murdered. The latter is much worse.

Being the first doctor to arrive at Ground Zero on 9/11 changed me as a person, by giving me a new perspective on life, in terms of what’s a big thing, and what’s a small thing. After 9/11, everything is a small thing.

I’m not going to lie and say that I don’t get upset about small things, because I am a perfectionist, am known as a perfectionist, and that’s why people choose me for LASEK, and why I can get most of my patients seeing better than 20/20.

I would say that volunteering at 9/11 for a week, enduring incredibly challenging and even scary conditions, has made me impervious to getting rattled by anything. It’s given me strength – or more accurately, given me total confidence that I will be able to perform at a very high level, under any condition, no matter what. That kind of confidence is not normal for civilians, probably only something that soldiers who have gone through combat can understand. So 9/11 was my combat.

Undicisettembre: What do you think about conspiracy theories that claim that 9/11 was an inside job?

Emil Chynn: This is ridiculous and those people are nuts! I am very logical and rational. If you apply Occam’s razor: the simplest answer is usually correct. These conspiracy theorists drive me nuts. They say there were explosives hidden in the WTC 7, for example, and that building came down because of that. What about the 1,000 gallons of diesel oil? Why invoke some hidden explosives? Plus, I was born in NYC, and was in WTC 7 before it burnt to the ground. There is no way anyone could plant shaped charges throughout that building and not be detected. That’s impossible. Or have these people forgotten that the NYC Emergency Command and Control was on the 23rd Floor?

Undicisettembre: Did you get a chance to see World Trade Center 7? Was is burning? As you know conspiracy theorists say that the fire inside WTC 7 was not enough to make it collapse.

Emil Chynn: Yes, it was burning. What do they mean with “not enough”? Are they going to qualify how much each building should burn? It’s so stupid.

Undicisettembre: Have you been to the 9/11 Memorial Museum yet?

Emil Chynn: Yes. A couple of months ago, because someone wanted to interview me for the museum. I think they did a remarkable job. I was reading all of the controversy about portraying Muslims unfairly. I think they consciously made good efforts not to portray Islam or Muslims negatively.

For instance, there is a simulation where you hear the cockpit recording of United 93. If you pay attention, they only play voices in English of the pilot and the air traffic control. They purposely cut out the part where the terrorists speak and say “God is Great!” in Arabic. They were very conscious to present things so that it doesn’t represent a religion or a race negatively. They did a remarkably good job. I challenge anyone who thinks they could do it better, given all the constraints.