Their 9/11 Response: Be Prepared

Kevin Clark is a second-generation cop, a street-tough police commander steeled in the cocaine wars of the South Bronx. Dan Hanfling is an Ivy League doctor. And Jim Schwartz spent his formative years answering fire alarms in suburbia.

Yet Clark, Hanfling and Schwartz have three things in common:

First, each was personally involved in responding to the terrorist attacks that struck the World Trade Center in New York and the Pentagon in Arlington, Va., on Sept. 11, 2001.

Second, each believes deep in his heart that such attacks will happen again. “I come to work every single day thinking today is going to be the day,” Schwartz said recently.

Third, since Sept. 11, each has played a front-line role in the grass-roots struggle to get ready for next time -- the nationwide effort to help local police, fire and emergency medical teams improve their readiness for new terrorist attacks or other mass catastrophes.

Working in the arena of first responders and local preparedness, they have seen the war on terrorism from the bottom up. And their experiences offer insight into why, despite measurable progress in many areas, the overall effort remains longer on plans and promises than on final results.

Clark, Hanfling and Schwartz, like local officials in towns and cities, state capitals and federal agencies across the country, have wrestled with tight budgets, red tape, politics and confusion -- all the while driven by their memories of Sept. 11.

Clark, now police commissioner in Baltimore, is a native New Yorker and commanded the 44th Precinct in the Bronx two years ago. “When the first tower actually collapsed,” he said, “it was like somebody put a sword right into your heart.”

Schwartz was directing rescue efforts and the firefighting after a fuel-laden airliner smashed into the Defense Department’s massive headquarters. He had to order police and firefighters to form a cordon and physically restrain military personnel from rushing back into the building to search for comrades. Minutes later, a huge section of the structure collapsed into flaming rubble.

“Many of them suddenly faced the reality that if we hadn’t given that order, they’d have been dead,” Schwartz said.

Hanfling, as head of emergency management for the largest hospital system in Washington’s Virginia suburbs, put emergency rooms on alert for the expected flood of trauma cases.

Hours later, as medical director of one of the first search and rescue teams to penetrate the Pentagon’s shattered interior, he received the news that no one inside was likely to be alive. There was nothing left to do but tell his trauma teams to stand down.

Small wonder these three have played their roles since Sept. 11 with singular determination.

Life on the Street

If there are a million stories in the Naked City, as has been said of New York, then Kevin Clark probably heard the worst of them.

The son of a New York patrolman, Clark joined the force in 1981. He spent nine years in the South Bronx and three years in Spanish Harlem, “when the crack wars were in full effect.”

On Sept. 11, 2001, Clark was driving to work across the George Washington Bridge and happened to glance downriver. To his astonishment, he saw the top of the trade center engulfed in a mushroom-shaped cloud.

When Clark called the NYPD operations center, a sergeant laconically informed him that they were sending a squad car to investigate. It was going to take more than that, Clark suggested.

At precinct headquarters, he said, “I told the radio dispatcher we weren’t going to respond to anything except major crimes -- robberies, murders, serious things,” Clark said. “We just assumed it was an all-out attack on any symbols or infrastructure.”

Last fall, when he accepted Mayor Martin O’Malley’s invitation to come to Baltimore, Clark brought with him his wife, five children and two decades of experience fighting the drugs and violent crime that were ravaging Maryland’s largest city.

He also brought a commitment to homeland security.

Supported by O’Malley, who has taken an aggressive stance on readiness, Clark has pushed hard for better equipment and organization. “It’s a new world since 9/11, and police and fire and other first responders need new equipment like this,” he said recently when the city announced that all 3,350 of its police officers would get biochemical masks and protective suits.

Such gains have been hard-won, however, and the police commissioner’s frustration sometimes boils over.

“We’re not prepared, whether people want to believe it or not,” he said. “But everybody is playing politics, and it’s with people’s lives.”

Part of the problem is that Baltimore, though it shows signs of revival after years of stagnation, is an old city with too many needs and too few resources.

And with almost all federal aid passing through the state, city officials say the Maryland Emergency Management Agency has been a bottleneck. A small agency that, until the war on terrorism, dealt mainly with natural disasters, it was not prepared for its new burdens.

The $1.15 million worth of biochemical protective gear for the police is a case in point.

Originally, the emergency agency sought to standardize first responder gear throughout the state and make itself the central purchasing agent. “Interoperability” is generally considered a good thing.

But the agency went so far as to specify models of equipment, Clark said, and it created a purchase list that betrayed the state officials’ lack of expertise.

In the case of biochemical gear, the agency approved only traditional gas masks. Clark wanted his officers to have a model that could use gas-mask filters but could also be converted to use air tanks -- the same masks firefighters use.

Police would have to work alongside firefighters in a major disaster, city officials reasoned. They had memories of July 2001, when chemical tank cars derailed in a tunnel beneath the city and shut it down for four days.

Eventually, the state agreed to release federal funds for the more advanced units. The breakthrough is a morale booster for officers, who had felt their safety was being ignored, Clark said. The only problem is, it will be a year or more before all the funds come through, the equipment is delivered and the whole department is trained to use it.

“If we started on our own goal line Sept. 11,” O’Malley said, “we’re probably up to the 20- or 30-yard line now.”

Outside the Circle?

Absurd as it may sound, Dan Hanfling says his biggest problem has been persuading homeland security officials to see hospitals as part of the first-response system.

It’s not that anyone thinks hospitals aren’t part of that system, he said. It’s that many officials make an unconscious assumption that, when disaster strikes, the hospitals will be ready. As a result, preparedness programs have tended to focus on bolstering police, fire and emergency medical units.

“We needed to reset the focus of what is a first responder,” Hanfling said. “Funding for hospital preparedness has been low and it has been slow.”

For instance, last year the state of Virginia received $23 million from the federal Health Resources Service Administration. The state health department took $20 million. The remaining $2.8 million was divided evenly among the state’s six administrative regions.

Northern Virginia, home to the Pentagon, the CIA, two important Army posts and a plethora of other federal installations, as well as Reagan National Airport and hundreds of thousands of residents, got $383,000.

While growing up in New York and going to medical school at Brown University in Rhode Island, Hanfling never thought he would end up in disaster medicine, much less that terrorist attacks on the trade center and Pentagon would launch him on a crusade.

Almost every Sunday when he was a boy, he and his family traveled down the west side of Manhattan to have dinner with his paternal grandfather in Flatbush.

Hanfling began to notice a huge hole being dug east of the elevated highway. “What’s that?” he asked his mother.

“They’re building the world’s tallest buildings,” she replied.

Two years ago, he visited colleagues working at ground zero. “In my mind, I flashed back 35 years,” he said. “I was seeing the exact same thing I was seeing as a child -- a gigantic hole in the ground.”

Hanfling wears multiple hats in the field of disaster medicine, in addition to his work for the INOVA Fairfax hospital system and the highly regarded Fairfax County Urban Search and Rescue team.

So he had a bird’s-eye view of what went wrong in the Washington, D.C., area on Sept. 11, and of what’s happened since.

For example, although INOVA’s huge Fairfax hospital is the designated Class I trauma center for northern Virginia, and it dispatched its two helicopters to the Pentagon, none of the injured was sent to Fairfax.

For complicated reasons, the injured were scattered among other hospitals, some of them overburdened and less well-equipped for severe traumas.

After the terrorist attacks, Hanfling took a leading role in a campaign to make the system better. He helped organize all metropolitan hospitals into an alliance committed to common goals. Another organization was started for the whole emergency-response community.

The groups gave members a stronger political voice. They also made it easier for the organizations, which are spread over two states and the District of Columbia, to work together. “Prior to Sept. 11, the Potomac River was more like the Potomac Ocean,” Hanfling said.

One result: A public-private partnership has put together a new radio network that ties all area hospitals together to share information about patient loads, emergency room status and other data. Previously, the hospitals relied on a shaky system of faxes and phone calls.

Gospel of Togetherness

Among first responders, none had a more comprehensive view of the attack on the Pentagon than Jim Schwartz. And he came away from that experience preaching a gospel that sets him apart from many involved in emergency management.

“I don’t think money is the answer to all our problems,” he says.

Schwartz believes that it is more important to develop regional programs that knit neighboring police, fire, emergency management services and public health units into teams. Sharing common procedures, holding joint exercises and developing trust among senior officials before trouble strikes, he says, will enable disparate organizations to function almost as one.

The approach can improve effectiveness, he says, and save money.

“Every community in the country doesn’t need a bomb team, but every community in the country needs to know where it is going to get a bomb team,” he said by way of illustration.

Schwartz believes the virtue of approaching emergency response on a regional basis was demonstrated at the Pentagon on Sept. 11. “All the work we had done prior to 9/11 is what made it possible,” he said.

It was decades in the making.

Growing up in a semirural southeastern suburb of Washington, Jim Schwartz wanted to be a fireman. And when he joined the full-time Arlington County Fire Department, he said, he thought he would “spend 20 years riding a truck, going to building fires and medical emergencies.”

He did all that, but Schwartz’s abilities turned out to extend beyond the back of a single firetruck. As a lieutenant, captain, battalion chief and assistant fire chief for operations, he played a role in bringing about a remarkable transformation: Although Washington’s northern Virginia suburbs are divided into half a dozen independent municipalities, the fire departments serving the largest of them have integrated their operations to a rare degree.

Going beyond “mutual aid pacts,” Arlington, Fairfax County and the city of Alexandria intertwined their independent fire departments so completely that today, when alarms come in, dispatchers send the nearest equipment.

In Schwartz’s view, that compatibility made all the difference two years ago.

Alerted by a call from Arlington Engine 101, which was returning from a training exercise and radioed that it was “watching a plane go down,” Schwartz was at the scene within five minutes.

What he and others found transcended their experience and their imaginations. Dead and wounded were strewn over the lawn. Thousands of workers streamed from the building.

Yet operations unfolded with remarkable smoothness. As fire, police and rescue units arrived, most knew their roles and how to plug into the command and communications systems.

It may have looked like chaos, but it resulted in a remarkable fact, Schwartz said: “Ninety-four people were sent to hospitals from the Pentagon that morning. And only one of them subsequently died of their injuries.”

Two years later, while money for better equipment and training is needed almost everywhere, what is needed more, Schwartz believes, is the local political will to create that kind of teamwork.