Simply Doing Their Jobs

Edition: November 2001 - Vol 9 Number 11
Article#: 1100
Author: Repertoire

True tragedy and horror often bring out the best in people. That certainly was the case in New York on Sept. 11 and the days and weeks following.


Repertoire spoke to readers and their customers about the events of that day and those following it. Their stories have a common theme: What began that morning as an expectation of a massive influx of wounded, slowly turned to the realization that only a few would survive. At that point, their main concern became the well-being of rescue workers.


There's another common theme: Every person to whom we spoke insisted that he or she had simply been doing their job that day. They were seeking neither congratulations nor adulation, two things which they said should be reserved for the rescue workers who risked and in many cases, lost their lives. Nor were they looking for sympathy, which they said should be reserved for the victims of the tragedy and their families. In fact, several people with whom we made contact didn't want to participate in this article at all.


We thank those who did speak with us, and we promise to be sensitive to their wishes, just as we respect the wishes of those who chose not to speak with us.


Manny Losada, Vice President, Caligor Medical, Pelham Manor, NY


''You can plan for situations like 25-inch snowstorms, but you're never prepared for what happened [on the 11th],'' says Caligor's Manny Losada. Even so, he has been at the company through some tough times, including the first bombing of the World Trade Center in 1993.


Caligor was notified of trouble at the World Trade Center on Sept. 11 even before the second plane hit. Quickly, the company moved into its disaster mode. Key personnel – managers, operations people, those in MIS and customer service, and others – were convened. ''You had two things to balance: the general population of our customers, who were panicking, and the New York City emergency teams dealing with the designated Trauma 1 hospitals,'' says Losada.


Ninety-six minutes after the first attack, Caligor was delivering trauma products to St. Vincent's Hospital's emergency room, which was the center of so much activity that day.


Getting there wasn't easy. Both the Lincoln and Holland tunnels going into Manhattan were closed to traffic. Anticipating trouble, Caligor had notified the Department of Emergency Services that its trucks would be seeking entry into Manhattan. The trucks got a police escort from the company's distribution center in Secaucus, NJ, to the Lincoln Tunnel; the New York Police Department took it from there. The trucks had to exit via the George Washington Bridge at the northern tip of Manhattan throughout the day and night.


On Day 1, Caligor sent three containers of contributions into Manhattan, including respirators, gloves and body bags. One of those containers went to the site of the World Trade Center, which came to be known as ''Ground Zero,'' while two went to Chelsea Piers, where a MASH-type triage center had been set up. Caligor's last truck left Secaucus at 1:30 a.m. on the 12th. ''We had accommodated all of the area's trauma hospitals who had ordered from us,'' says Losada. St. Barnabas Medical Center in the Bronx, for example, had asked for supplies to care for burn patients, while St. Vincent's, which was waiting for massive numbers of casualties, had needed ''anything and everything.''


Reflecting the spirit of cooperation that marked the 11th and the days and weeks afterward, Caligor's truckdrivers led vehicles from direct-shipping manufacturers into Manhattan, adds Losada.


While Caligor was responding to the needs of the trauma centers, it had to continue its low-unit-of-measure delivery service to its stockless accounts, who in many cases work on 48 hours worth of inventory. ''By the time we were finished, everybody had product,'' says Losada.


A core group of people stayed at Caligor's headquarters in Pelham Manor, NY (Westchester County), on the night of the 11th, sleeping on air mattresses. Some of the systems people were put up at a nearby Ramada Inn. ''We went to sleep, woke up three hours later, and dealt with Day 2,'' says Losada.


Speaking of the Secaucus distribution center, Losada observes that ''the people there had gotten farther into it than any of us did. They saw the destruction. You could see in their eyes that it touched them.''


By the morning of Day 2, it was clear that few of the thousands of patients who had been expected to need treatment would indeed be treated at local hospitals and triage centers. For that reason, Caligor began focusing its efforts on shipping items that rescue workers would need, e.g., eye wash and respirators.


Manufacturers' support was incredible, says Losada. ''I had more manufacturers calling me asking, 'What do you need?''' Companies such as Medical Action Industries, Sempermed, Smith & Nephew, Johnson & Johnson, Dukal and Busse all responded immediately. Distributors from neighboring states, including Buffalo Hospital Supply and Claflin Co. (Providence, RI), called to offer their assistance in terms of products, drivers and trucks.


Losada finally headed for home at 8 p.m. on Wednesday, Sept. 12. He recalls looking down the Hudson River from his car, seeing the plume of smoke from what had been the World Trade Center, and punching the steering wheel with his fists.


Since Sept. 11, Caligor has faced its share of challenges. What with tunnels being closed and vehicles getting spot-checked, the company has had to alter some of its delivery routes. Drivers have been pulling out for their destinations at 3 or 4 a.m. instead of 5 or 6. Because of driving restrictions in Lower Manhattan, some of the company's sales reps have had to change their routines as well. Some travel to their accounts by subway, others share cars with cohorts.


Many Caligor employees knew firemen, policemen or others who lost their lives on the 11th. But throughout it all, people have been doing what they have to do, says Losada.


''It's really brought our company together, knowing that we're in the medical distribution business,'' he says. ''That's why we're here.''


Kevin Molloy, Vice President Purchasing and Materials Management, Continuum Health Partners, New York


Through a system of seven hospitals – including Beth Israel, St. Luke's-Roosevelt, Long Island College Hospital and the New York Eye and Ear Infirmary – Continuum Health Partners operates nearly 3,100 beds in the New York metropolitan area.


Located at First Avenue and 16th Street in Manhattan's Lower East Side, the Beth Israel Petrie Division was Continuum's closest facility to the site of the attack, says Kevin Molloy. Long Island College Hospital, located in Brooklyn Heights, close to the Brooklyn Bridge, was also close.


At the time of the attack, Molloy himself was in his office located four blocks from Beth Israel Petrie. He and some of his staff went up to the 10th Floor to see the World Trade Center in flames. He quickly descended and walked to the hospital.


Continuum immediately activated its emergency disaster plan. Each of its facilities had a manned command center, so all could keep in touch with each other via phone and audiovisual links.


''As we got started, everyone was thinking, because of the sheer size of the tragedy, that we'd be in a multi-day crisis,'' says Molloy.


As patients began to arrive at Beth Israel and Long Island, he and his staff assessed the availability of such things as pharmaceuticals, food, med/surg supplies and portable oxygen. Because Caligor is its chief distributor, it was one of the first suppliers that Molloy's department contacted.


Continuum had a special concern as well. ''We're a low-unit-of-measure hospital,'' says Molloy. ''We don't run warehouses, we don't have a lot of product in the hospital.'' So, in addition to serving those injured from the attack, it had to continue to take care of the patients who had been admitted before it.


Given the number of patients suffering from smoke and dust inhalation in the first two to three hours after the attack, Continuum quickly decided that its Beth Israel Petrie and Long Island campuses would need portable oxygen tanks. They called their inpatient and outpatient facilities, and began to send tanks to the two hospitals.


Caligor offered its Secaucus, NJ, distribution center as a staging area for supplies from companies whose products it didn't even carry, says Molloy. ''In case our oxygen supplier from Pennsylvania couldn't get in, they could stage it in Secaucus,'' he says. Caligor also diverted tetanus vaccine intended for Continuum's other campuses to Long Island. IV solutions were sent to both Long Island and Beth Israel.


Within just a few hours of the attack, the number of patients coming into Beth Israel and Long Island fell off dramatically, says Molloy. ''We expected a second influx, and our staff felt they would be more critically injured than the first.'' But they never materialized. ''The sad thing is, we were prepared to treat many more patients than we actually did,'' says Molloy.


Molloy didn't leave Beth Israel for his home in Westchester County (north of the city) until midnight on the 11th. He took the train in to the city the next morning. His car was stuck at Beth Israel for four days.


Bob Hall, Vice President Health Systems, DeRoyal, Knoxville, TN


Soon after DeRoyal Industries received news of the attack, managers from its surgical, orthopedic soft goods and wound care divisions convened to evaluate what providers in New York and Washington would need. Its mill in South Carolina began bleaching 100,000 yards of gauze, an essential step in the production of burn dressings. By 2 p.m., the company's sales managers from across the nation were on a conference call.


''We talked to our reps in New York and Washington, to make sure everybody was OK,'' says Bob Hall. ''And we had stories from some people who said they had been contacted by distributors who were trying to respond to hospitals' needs.''


The company established a 24-hour hot line, which anyone could use to call in requests or questions. Indeed, a handful of calls did come in during the night. ''But the sad part of the story is that the next day, as we were getting ready to ship orders on some of the orthopedics goods, we got a call back from a distributor who told us the medical facilities didn't receive as many injured as they had expected,'' says Hall. ''They asked us to hold the order.''


Nevertheless, the customer service people stayed in an ''up'' mode, he says. ''They felt they were doing something useful.''


John Baccello, Transportation Manager, Northeast Distribution Center, Allegiance Healthcare, Montgomery, NY


Located about 75 miles north of the city, Allegiance's distribution center in Montgomery, NY, serves Connecticut, New Jersey, parts of Pennsylvania, as well as New York City and Long Island. On a normal day, it ships out 40 to 45 truckloads of products.


Like many others, John Baccello figured that it probably had been a private plane that accidentally crashed into the World Trade Center. But when the second tower was hit, he and others realized a massive attack was underway. ''At that point, our director of operations called the management team together to lay out our plan,'' he says. Everyone in the building was notified what was going on, then responsibilities were assigned.


''My responsibility was to round up as many drivers and equipment as I could, back up the trucks and get ready to roll,'' says Baccello. He managed to assemble about 10 drivers, some of whom had already been dispatched but were still within 25 miles or so of the facility. While he was doing that, some managers began pulling products – mostly IV solutions – and lining them up on the dock. Then they started loading them onto the trailers.


At around 11 a.m., the distribution center started getting requests for supplies from Allegiance's region directors (who head the sales groups). St. Vincent's Hospital – which Allegiance supplies on a low-unit-of-measure basis – was looking for masks, because of the smoke and dust in Lower Manhattan, and products for burn patients.


Allegiance loaded four trucks, some of them relatively short (to negotiate the streets near the attack site), and equipped them with lift gates, in case the drivers had to unload products in the street instead of at the hospital loading dock. ''That was a quick thought,'' says Baccello. ''Under the circumstances, it was amazing we even thought of it.'' When everything was loaded, they called the local police for an escort to the city and headed for Manhattan.


Throughout the day, Allegiance sent trucks to other New York hospitals as well as Liberty State Park in Jersey City, NJ, which had been set up as a triage center and a place to bring bodies recovered from the wreckage. ''We just weren't sure where support would be needed,'' says Baccello, who spent the night of the 11th in Montgomery.


In the days following the 11th, Allegiance shipped many loads of gloves and masks to St. Vincent's and New York Hospital, another low-unit-of-measure account.


For two weeks or so, Allegiance trucks were required to convene at Yonkers Raceway, north of the Bronx, to pick up a convoy into the city. But the company had an advantage. The brother of one of its sales reps was part of the New York Police Department's team that was investigating the terrorists. ''Whenever one of our trucks had a problem, we'd call him and he'd call his brother, who would dispatch a New York City police officer to take us where we wanted to go,'' says Bacello.


Greg Mascola, Outbound Tractor-trailer Driver, Allegiance Healthcare, Montgomery, NY


A 10-year veteran of Allegiance, Greg Mascola started his day on Sept. 11 at about 2 a.m. Working a four-day week (with extended hours), he typically spends three days in northern New Jersey and one in Queens, making two to eight stops a day.


On the morning of the 11th, Mascola was on Route 80 in New Jersey when he heard about an accident at the World Trade Center. Crossing a bridge, he saw bright white smoke coming from the North Tower. As he was unloading his truck in Elmwood Park, NJ – his last stop of the day – he heard about the second crash. Driving back on I-80, the twin towers once again came into view, except now, both were smoking.


''I tried calling Allegiance, but I couldn't get through,'' he says. As he pulled into the yard in Montgomery, he saw a number of state troopers with their lights on. He panicked momentarily, thinking that perhaps terrorists had struck the distribution center. But he quickly learned that the police were there to escort Allegiance trucks into Manhattan. Already, three of them were on their way. ''I was amazed they got them loaded so fast,'' he says.


Mascola and a colleague were asked to drive a rig to the triage center at Liberty State Park, escorted by a Montgomery, NY, police car. By this time, the New Jersey Turnpike was closed to routine traffic. But with the escort, they made it through.


The scene at the park was hectic. ''There were hundreds of ambulances, safety workers and state police,'' says Mascola. ''Tarps were set up with stretchers and medical supplies.'' For reasons he's still not sure of, he was asked to move to the other side of the park, where still more ambulances were parked.


The two Allegiance drivers waited at the park until 8 p.m., but not one survivor was brought there. Finally, a site commander told them that their supplies wouldn't be needed, so they took the load to the Jersey City Medical Center, which was still preparing for casualties. Mascola made it back to Montgomery at 10:30 that night.


Mascola's days have been longer ever since. Traffic is a mess. At press time, the Holland Tunnel was closed to inbound traffic, and the outbound lanes were reserved for cars. All vehicles traveling through the Lincoln Tunnel were being checked, and on the George Washington Bridge, all commercial traffic was restricted to the upper level. Even some hospitals were checking incoming trucks before being allowed to pull into the dock.


But of all the scenes Mascola witnessed on the 11th, he vividly remembers standing with a police offer at Liberty State Park looking eastward. ''The Statue of Liberty was to my right, and beyond that, to my left, was Manhattan. The towers were down and all of Lower Manhattan was just smoke. It looked like a scene out of World War II.''


Ray O'Hara, Vice President, Busse Hospital Disposables, Hauppauge, NY


Among the manufacturers responding to calls on the 11th was Busse Hospital Disposables in Hauppauge, NY, near I-495 in Long Island, about 25 miles east of Manhattan. The company makes a variety of sterile kits and trays and protective wear, and it carries the dubious honor of being a leading supplier of post-mortem kits, says Ray O'Hara.


''When we heard what happened, and we knew how many people visited and worked at the World Trade Center, we knew [demand would be high],'' says O'Hara. As the day wore on, Busse did indeed begin to get calls for post-mortem kits from several distributors. Busse employees working multiple shifts began assembling the kits, which include body bags and items used for identification.


Moving supplies quickly became a problem, because police had all but shut down the Long Island Expressway (I-495), which leads into the city. But police escorts helped Busse deliver products directly to hospitals and distributors in the metropolitan area.


'It's amazing how everyone rallied together,'' says O'Hare. ''There wasn't a lot of confusion. Everybody knew what they had to do, and they did it.''


Fran Dirksmeier, President, McKesson Medical Surgical, Richmond, VA


As McKesson Medical Surgical received the news about the attack, the company activated its emergency corporate command center in Richmond. Managers from purchasing, sales, operations and customer service were convened to strategize and take action. A phone line was opened up so that manufacturers, customers and McKesson employees could call in. At 9 a.m., 12 noon and 5 p.m., the team got on the phone for a conference call, to get updates on what was happening.


Among the first emergency orders McKesson Medical Surgical processed were those from AMR, the emergency response company; and other key accounts, such as Mount Sinai NYU Health, says Fran Dirksmeier.


Truckdrivers, warehouse personnel and other employees from several company branches were dispatched to the two centers closest to New York City – Dayton, NJ; and Cheshire, CT. Three regional customer service centers focused pretty much all of their efforts on the needs of the company's New York customers.


Truck drivers were required to check in at the Meadowlands Sports Complex off the New Jersey Turnpike, and were then escorted by authorities to their destinations. Still, they faced as many as four or five checkpoints along the way, and their trucks were subject to search.


With leadership from Sonny Fitzpatrick, McKesson's regional sales manager, sales reps accompanied some of the trucks into the city and helped unload them when necessary. This was particularly helpful in situations where the trucks couldn't get close to a dock and products had to be hand-carried to the hospital or triage center.


''I don't think anything we did constitutes heroics,'' says Dirksmeier. ''The rescue people, firefighters, caregivers – they were the heroes.''


Don Simpson, Purchasing Manager, Eastern Region, American Medical Response,

New Haven, CT
.


Aurora, CO-based AMR operates emergency transportation services and 911 response systems in large and small communities across the United States. Don Simpson manages purchasing for the company's Eastern Region, which serves New York, Pennsylvania, New England, Ohio, Indiana and Michigan.


The company's prime vendor is McKesson Medical Surgical, which ships product on a weekly basis to a number of AMR facilities throughout the region. AMR in turn outfits its vehicles with necessary supplies, including gloves, oxygen administration equipment, masks, IV equipment, electrodes, etc.


''Initially, we didn't have much solid information,'' says Simpson, speaking of the morning of the 11th. ''We were trying to prepare for a large number of survivors.'' All kinds of rumors were flaring in the first hours. According to one, patients were going to get transferred to facilities in Connecticut and New Jersey, some by train.


Meanwhile, Simpson exercised some common sense in listing items AMR would be likely to need. Speaking of McKesson, he says that ''it took me longer to think of what I wanted than for them to deliver it.'' The distributor remained staffed throughout that first night ''until we started to know what the real story was,'' he says.


''They couldn't have done anything more. People in their warehouse were ready to go wherever somebody told them,'' he says. ''Our oxygen vendors did the same thing.'' Other AMR vendors, including Medtronic, offered anything they had, he adds.


Altogether, AMR received about a month's worth of supplies. The company ended up sending back only a small amount to McKesson, absorbing the rest in its internal system, says Simpson.


Debra McCarthy, Director of Corporate Materials Management, and Mike DeMartis, Director of Corporate Purchasing, Mount Sinai NYU Health, New York


Formed in 1998, Mount Sinai NYU Health network is comprised of five merged hospitals and an affiliation of 17 other health care facilities in the New York metropolitan area. Its hospitals include Mt Sinai, which serves the Upper East Side and Harlem; Mount Sinai Hospital of Queens in Astoria; NYU Hospitals Center, comprising Tisch Hospital and Rusk Institute of Rehabilitation Medicine (on 34th Street); the Hospital for Joint Diseases Orthopedic Institute (17th Street and 2nd Avenue); and NYU Downtown Hospital, serving the Lower East Side and Wall Street.


As soon as news of the fire in Tower One was reported, all five hospitals enacted long-established disaster plans, setting up command centers and assembling key personnel. McCarthy, who was at her Uptown office on 102nd Street, took a train, then a cab, and finally walked the rest of the way to the NYU command center at Tisch Hospital to establish the supply chain link between support departments in what are referred to as the ''northern and southern hemispheres.''


Mike DeMartis ran the six blocks from his office at 660 First Ave. to the ER at the Tisch campus. But when he got there, he was asked to return to his office so he could handle all the requests for supplies that were certain to follow. (McKesson maintains an office in the 660 First Ave. building as well.)


The NYU supply chain team, including On-Site Storeroom, Central Sterile Processing and Receiving, began implementing procedures they had practiced for responding to a significant external disaster. Inventories at the Emergency Room and Operating Room, in addition to satellite triage areas, were reviewed and updated, with particular attention paid to items associated with burn, respiratory or crush injuries. Staff was posted at these locations to await the anticipated rush of patients and to address ongoing needs related to the developing situation.


The Receiving Department cleared the dock of deliveries and prepared for bulk shipments, as dozens of supplies were moved from the Health Services Organization (HSO) Distribution Center, located north in the Bronx. The HSO Purchasing Department, under DeMartis' leadership, began contacting all key medical distributors and putting them on alert for the emergency needs that might materialize. Sample boilerplate ''shopping lists'' were faxed to distributors' warehouses in advance so that only the quantities requested would need to be added later.


Using whatever means still worked (cell phones, walkie-talkies, e-mail, faxes, etc.), the supply chain staffs at all Mount Sinai NYU campuses began in earnest to coordinate their needs.


''We started treating people suffering from smoke inhalation and trauma injuries,'' recalls McCarthy. ''We assumed many more were getting treated in the triage centers, but as the hours wore on, we got a clearer picture that there weren't a lot of survivors. The mood in the hospital became quieter.'' Indeed, after the first 24 hours, it became apparent that the focus of supply chain efforts would be on the triage centers that had been established around Ground Zero.


By noon of Day One, NYU Downtown – located less than a half mile from the disaster site – lost all utilities, and was operating and treating victims and rescue workers from emergency power alone. This hospital became the focus of bulk deliveries of oxygen tanks and bottled water, in addition to medical supplies. The Hospital for Joint Diseases was called upon to provide sterile processing services to Downtown.


Victims' families, desperate for information about loved ones, were redirected from Ground Zero to the Office of the Chief Medical Examiner, located adjacent to NYU Hospitals Center on 31st Street. Hundreds of family members congregated on First Avenue while the staff of NYU collected names, provided food and offered early grief counseling. Meanwhile, smoke billowing up from Ground Zero covered much of Lower Manhattan, so the NYU staff distributed surgical masks and tissues to the crowd outside.


Physician groups (trauma physicians, ophthalmologists, pathologists, pulmonologists and other specialties) who had set up their own treatment centers for rescue workers around the Wall Street area began contacting Mount Sinai NYU for supply support as well.


With the Mayor's Office of Emergency Management


(located in building No. 7 of the WTC complex) being destroyed, normal coordination of supply chain logistics was disrupted. With the support of key suppliers, Mt. Sinai NYU purchasing and materials managers began directing shipments to the triage centers at Chelsea Piers, Borough of Manhattan Community College, the Javits Convention Center and Pace University. The Greater New York Hospital Association (GNYHA) became a clearinghouse for directing requests from the various agencies (FEMA, SEMA, EMS and Red Cross) to the Mt. Sinai NYU team.


As requests came in, DeMartis and his managers began activating their vendor network and coordinating deliveries directly to these various locations. By Tuesday night, McKesson dispatched a convoy of medical supplies directly to Chelsea Piers. Other suppliers, including Agilent/Philips, Caligor, Abbott, Pharmacia and Medline, provided med/surg, pharmaceutical and respiratory equipment and supplies as well. Specialty vendors such as Tartan Textiles, TW Smith Oxygen, Culligan and Great Bear Water joined the list of suppliers who responded without hesitation to the critical needs among the various treatment locations, adds DeMartis. The 3M Corporation sent representatives to the Javits Center to fit-test rescue workers for HEPA masks, to protect them from the growing threat of airborne asbestos.


The difficulty of these efforts was compounded by the 'lockdown' that shut off Manhattan from the outside world. Suppliers' trucks coming from New Jersey reported to the Meadowlands to have their vehicles searched and manifests examined, and their contacts called and verified.


To help these suppliers and others, DeMartis and staff faxed various documents to them, one listing the triage center destination with contact names and cell phone numbers, another with a letter on hospital letterhead giving authorization for the shipment, and one that contained a police contact name, shield number and photo ID. When all else failed, a call to a supply chain manager – with help from GNYHA – usually secured a police escort. ''This coordination was often the most difficult part of the process,'' says DeMartis. ''Without these documents, all our work would have been in vain.''


The drivers and their managers who went to Ground Zero, exhibited ''incredible courage,'' adds McCarthy. ''They did so with little concern as to what chemical, biologic agent or even asbestos might also be present there. Here we were, asking suppliers for products related to barrier protection, like respirators, and then asking them to deliver these items directly into the danger zone.''


Both DeMartis and McCarthy remain overwhelmed by the support they received from the vendor community. They agree that life has changed for Mt. Sinai NYU and for New York City at large. Security remains tight at each hospital and all public buildings, and negotiating roadways takes longer due to the various checkpoints.


Yet, the teamwork that carried them through the ordeal remains, they say. In fact, patience and teamwork are no longer buzzwords, but a way of life, they say. And it's a rare day when a business partner doesn't offer help or just encouraging words. They agree that in the context of such devastation and suffering, this may be one of the few positives that linger.