Index xiii

Bibliographical Note

Attack on the Pentagon: The Medical Response to 9/11 is based largely on oral 

histories of medical responders obtained by Defense Department oral history 

teams and myself; primary documents mainly from the Surgeon General’s Medical History Office; and e-mail exchanges between me and individual responders. 

Chapter references reveal the extent and variety of those sources.

Primary documents helped me to understand the sequence of events, the consequences of the attack, the decision-making process, the actions of responders, 

and the recommendations and plans for future crises. Some of the more significant 

ones were the after-action reports of hospitals and the Armed Forces Institute of 

Pathology, and those written by Roser, Wallace, and Gum; the North Atlantic Regional Command’s historical summary; the US Army Center for Health Promotion and Preventive Medicine’s health assessment surveys and 2001 annual report; 

updates to the surgeon general (daily briefings on the medical response to 9/11); 

Embrey’s environmental health response to the attack; the Environmental Protection Agency’s summary of environmental monitoring operations at the Pentagon; 

Army Medical Command emergency management planning documents; Peake’s 

plan for enhancing medical nuclear, biological, and chemical readiness; and Army 

Medical Command memoranda for the record. A different kind of primary document, Nelson-Firing’s essay on therapy dogs, enhanced the mental health story.

Published sources also contributed to my knowledge of the military medical 

response. In highlighting the community’s response, Titan Systems Corporation’s 

Arlington County After-Action Report on the Response to the September 11 Terrorist Attack on the Pentagon helped me appreciate the views and actions of 

participating organizations and of individuals at different levels of command. The 

9/11 Commission Report provided invaluable background reading for the causes 

of the attack, a reliable timeline, data, and statistics. Another account, Goldberg 

et al’s Pentagon 9/11 (Defense Studies Series; Historical Office, Office of the 

Secretary of Defense, Washington, DC; 2007), was published after my manuscript 
xiv Attack on the Pentagon: The Medical Response to 9/11

was completed. Although not focused on the medical response, this publication 

is a broad and well-researched study of what happened at the Pentagon on 9/11 

and for days afterward. It enabled me to compare facts among sources. Many 

articles enriched the narrative; noteworthy were those from the Washington Post;

Defense Link News; Washingtonian; Time; The Pulse Tricare Northeast; Journal 

of Burn Care Rehabilitation; American Journal of Preventive Medicine; Navy 

Medicine; US Medicine, An Independent Newspaper for Physicians; and Military Medicine. Military Medicine’s September 2002 issue consisted of 30 articles 

written by Department of Defense psychiatrists, psychologists, social workers, 

family assistance experts, and mental health administrators. Their experiences 

and insights increased my awareness and comprehension of mental health issues 

resulting from the attack. 

While I was in the process of writing this book, the Medical History Office 

brought out Soldiers to the Rescue: The Medical Response to the Pentagon Attack. This book of quotations from transcripts of interviews with Army Medical Department responders was published in house to honor the brave men and 

women who responded to 9/11.

Copies of unpublished sources, transcripts of interviews, reports, summaries, 

surveys, and essays used in this book can be found at the Office of the Surgeon 

General Medical History Office, Fort Sam Houston, Texas.
Index xv

Abbreviations and Acronyms

AAR after-action report

ABA American Burn Association

AFIP Armed Forces Institute of Pathology

AFME Armed Forces Medical Examiner

AMEDD Army Medical Department

BDU battle dress uniform

CB citizens’ band

CHPPM Army Center for Health Promotion and Preventive 

Medicine

CIA Central Intelligence Agency

CISD critical incident stress debriefing

CMHS Center for Mental Health Services

CONUS continental United States

CPR cardiac pulmonary resuscitation

CTT common task training

DAC Department of the Army civilian

DASG Department of the Army Surgeon General

DCE defense coordinating element 

DoD Department of Defense 

DOEHRS Defense Occupational and Environmental Health 

Reporting System

DOMS Director of Military Service

DPS Defense Protective Service

DSCA Defense Support of Civil Authorities

DTHC DiLorenzo Tricare Health Clinic

EMT emergency medical technician

EMS emergency medical services

EPA Environmental Protection Agency
xvi Attack on the Pentagon: The Medical Response to 9/11

EOC emergency operation center

ER emergency room

ERMC European Regional Medical Command

FBI Federal Bureau of Investigation 

FEMA Federal Emergency Management Agency

FDC Fife & Drum Corps 

FDNY Fire Department of New York

FD fire department

G-2 intelligence directorate [US Army]

GRMC Great Plains Regional Medical Command

HAZMAT hazardous materials

HCO Health Care Operations

HHC headquarters headquarters company

HQ headquarters

HVAC heat, ventilation and air conditioning

ICU intensive care unit

ID identification

IM/IT information management/information technology

IMO Information Management Officer 

INOVA In Northern Virginia

IV intravenous

J-4 Joint Chiefs of Staff—Logistics

LBJ Lyndon Baines Johnson 

LCWS low-cost work-station 

LNO liaison officer

MASCAL mass casualty

MC Medical Corps 

MEDCOM Medical Command

MC, FS Medical Corps, Flight Surgeon

MEDCOM MSC Medical Command, Major Subordinate Command

MEDCOM RMC Medical Command, Regional Medical Command

MEDEVAC medical evacuation

MedSTAR Medical Star

MOS military occupational specialty

MTF medical treatment facility

NARMC North Atlantic Regional Medical Command

NBC nuclear, biological, chemical

NCO noncommissioned officer

NCOIC noncommissioned officer in charge

NDMS national disaster medical system 

NRMC Northern Regional Medical Command

NTSB National Transportation Safety Board

NVHA Northern Virginia Hospital Alliance

NYARNG New York Army National Guard

NYC New York City
Index xvii

NYPD New York Police Department

OAFME Office of the Armed Forces Medical Examiner 

ODCSPER Office of the Deputy Chief of Staff for Personnel

OEM Office of Emergency Management

OHMIS Occupational Health Management Information 

System

OPSCENTER operations center

ORI operations readiness inspection

OTSG Office of the Surgeon General

PAAR psychological after-action reviews

PAM pamphlet

PCB polychlorinated biphenyls

PERS Casualty Assistance/Prisoner of War and Missing in 

Action/Retired Activities Branch

PERSCOM Personnel Command

PGI Portland Group Incorporated [surveillance software 

program]

PPE personal protective equipment

PRMC Pacific Regional Medical Command

PROFIS professional officer filler information system

RDML rear admiral

RMC regional medical commander

S-3 operations division

SAR search and rescue

SERMC South East Regional Medical Command

SMART special medical augmentation response team 

SMART-SM special medical augmentation response team–stress 

management

SRMC Southern Regional Medical Command

SUV sports utility vehicle

TDI Therapy Dogs, International

TOE Table of Organization and Equipment

TRICARE triple care [Army, Navy, Air Force]

TSG the Surgeon General

USACHPPM US Army Center for Health Promotion and Preventive 

Medicine

USAF US Air Force

USANC US Army Nurse Corps

USN US Navy

USNS US Navy Ship

USPHS US Public Health Service 

VA Department of Veterans Affairs

WHS Washington Headquarters Services

WMD weapons of mass destruction 

WRAMC Walter Reed Army Medical Center

Abbreviations and Acronyms xvii
xviii Attack on the Pentagon: The Medical Response to 9/11

WRMC Western Regional Medical Command

WTC World Trade Center

WTCHAS World Trade Center Health Assessment Survey
Index xix

Index

A

AFIP. See Armed Forces Institute of Pathology

Air masks. See Personal protective equipment

Air quality. See Environmental health and safety

Alexandria, VA, fire and rescue department response, 21

Allen, Dr. Yorke

emergency response working group and, 184–185

relief of Dr. Vafier by, 40

AMEDD. See Army Medical Department

American Burn Association, recommendation for the triage and transport of burn patients 

during disasters, 184

American Psychological Association, Mental Health Community Response Coalition and, 

151

American Red Cross

Department of Mental Health Services, 141

Mental Health Community Response Coalition and, 151

mental health response, 130, 139, 141, 142, 150–151, 152

provision of food for rescue workers at ground zero in New York City, 165

transition to recovery period role, 36

workshop on mental health and mass violence and, 206–207

Andrew Rader Army Health Clinic. See Rader Army Health Clinic

Andrews Air Force Base, MD

environmental health and safety role, 110

Medical Center, mental health response and, 132

movement of remains to Dover Air Force Base and, 65, 68

Anthrax contamination incident in Washington, DC, investigation of, 198–200

Applied Environmental, Inc., role in environmental sampling, 109, 119

Arlington County After-Action Report on the Response to the September 11 Terrorist Attack on the Pentagon, 42, 67

Arlington County Emergency Medical Services

after the all-clear and, 33
xx Attack on the Pentagon: The Medical Response to 9/11

command issues, 43

communication issues, 40–41

initial response efforts, 9, 18–19

lack of coordination with DiLorenzo Tricare Health Clinic and, 28

supply issues, 40–41

Arlington County Fire Department

after the all-clear and, 31

environmental health and safety role, 110, 122, 123

initial response efforts, 18–19, 21

mass casualty planning and, 8

mental health response and, 130

recovery operations and, 65

safety issue meetings, 124–125

transition to recovery period and, 35–36

Arlington Emergency Communications Center

evacuation helicopters and, 42

initial response to the attack and, 21

notification of area hospitals about the attack on the Pentagon, 81

shortcomings in disaster preparedness, 101

Arlington Navy Annex clinic, 3

Arlington Urgent Care Center, number of survivors treated, 96

Armed Forces Institute of Pathology, role in the identification of remains, 68–76, 77

Army Center for Health Promotion and Preventive Medicine

anthrax contamination incident in Washington, DC, and, 198–200

antiterrorism policy and procedure development, 197

chemical and biological warfare agent inspection, 121

coordination/command and control/communications issues, 122–123

decontamination efforts, 124

Deployment Environmental Surveillance Program, 200

drinking water issues, 121, 197

environmental health and safety role, 109–121

“Fact Sheet on Countering Terrorism of Water Supplies,” 197

Field Preventive Medicine Division, 200

Geographic Information System, 200

initial response, 114–116

Laboratory Consultants Office, 118–119

Laboratory Sciences Directorate, 118–119

lack of protective equipment, 115

location, 109

mental health response and, 132

mission, 110, 114

numbers, types, and results of samples collected during Pentagon sampling after 9/11, 

using direct reading instruments (table), 120

organizational listing (table), 111–113

post-9/11 revisions and improvements to emergency preparedness, 197–201

radiological threat concerns, 121, 197–198

risk communication courses, 125

sampling analysis and results, 118–120

sampling efforts, 116–118

sampling objectives, 117
Index xxi

special medical augmentation response (SMART) teams, 110, 114, 116, 121

summary of environmental health and safety efforts, 125–126

types of hazardous materials found, 119–120

Army hospital liaisons

Mrs. Birdwell’s experience with, 98–99

role of, 99–100

Army Medical Command

agreement with the VA to provide medical support to New York National Guard 

troops, 174

biosurveillance activities, 188

contingency planning workshops, 193–194, 196

crisis action team, 61

data collection, 61–62

Federal Response Plan and, 52

joint exercises with FEMA, 195

mental health response and, 132

Pamphlet 525-1: Medical Emergency Management Planning, 187, 194, 195

peacetime operations and, 62–63

personal protective equipment improvements, 188

Plans Division, 187–189

post-9/11 revisions and improvements to emergency preparedness, 187–190

Regulation 525-4, 187–188

response to the attack on the Pentagon, 60–64

responses to Col. Wallace’s recommendations for improvements in emergency preparedness, 190–197

standardization of decontamination equipment, 187

stockpiling of chemical agent kits, nerve agent antidotes, and protective suits and 

masks, 190

Web-based training courses, 193

Army Medical Department

coordination between installations and medical facilities and, 189–190

emergency preparedness planning and, 188

hospital liaisons, 99

mental health response and, 152

operations officials’ arrival at the Pentagon, 46

support for the World Trade Center disaster response, 176

Army Medical Department Center and School

courses on emergency preparedness, 192

response to the attack on the Pentagon and, 62, 64

Army Medical Research Institute of Chemical Defense, “The Management of Chemical 

and Biological Casualties” course, 103

Army Medical Research Institute of Infectious Diseases

anthrax contamination incident and, 200

“The Management of Chemical and Biological Casualties” course, 103

Army Office of the Surgeon General

identification of remains and, 72

inspection of medical commands for systemic issues, 194–195

response to the attack on the Pentagon and, 60–64

Association of the U.S. Army Medical Symposium, 191

Attack and rescue
xxii Attack on the Pentagon: The Medical Response to 9/11

after the all-clear: west and south sides, 29–34

background, 1–3

burns as the highest percentage of injuries, 29

color coding for triage areas, 23

command and control issues, 43–47

command changes, 37–38

communications issues, 43–47

continuation of the response: DiLorenzo Tricare Health Clinic, 27–29

death toll, 28

description and personal accounts of the attack and the immediate aftermath, 4–8

DiLorenzo Tricare Health Clinic triage areas and parking zones (map), 11

early triage and treatment sites (map), 20

evacuation, triage, and treatment sites after the all-clear (map), 30

evacuation issues, 41–42

helicopters and, 23

incident command system and, 19–20

initial medical response: DiLorenzo Tricare Health Clinic, 8–16

initial medical response: west and south sides, 16–27

last triage, treatment, and rehabilitation sites (map), 35

needs of recovery workers and, 34

summary, 40–47

supply issues, 40–41

transition to recovery period, 34–40

treatment of rescue workers, 28

B

Barbian, Lenore, Disaster Mortuary Operational Response Team role, 76

Baxter, Col. John, medical response and rescue efforts, 15–16, 27

Bechtel Corporation, commercial safety program at ground zero, 170

Benson, Sam, medical response and rescue efforts in New York City and, 158–159

Bents, Marcie, death of, 152

Bessette, Todd, medical response planning and, 62

Birdwell, Lt. Col. Brian, rescue and treatment of, 14–16, 29, 85, 90, 92

Blecksmith, Special Agent in Charge Bob, command issues and, 46

Block, Dr. Lisa, environmental health and safety role, 123

Bloesch, Special Agent Tara, recovery operations and, 64

Blunt, Capt. Edward, medical response and rescue efforts, 19, 21, 27

Bolling Air Force Base, MD, environmental health and safety role, 110

Bolton, Col. Larry, Walter Reed Army Medical Center’s response to the attack on the 

Pentagon and, 54–55

Bonzano, Battalion Chief James, relief of Chief White, 37

Bowers, Dr. Ron, medical response and rescue efforts, 22

Bowman, Ramona, role in Virginia Hospital Center’s treatment of survivors, 93, 94

Brockmann, Maj. Kent, mental health needs of recovery workers in New York City and, 

172

Brown, Dr. Martin, Inova Alexandria Hospital’s response to the attack on the Pentagon 

and, 95

Brown, Maj. Lorrie

after the all-clear and, 32
Index xxiii

command issues, 43

continuation of the response and, 27–29

initial response to the attack and, 8–16

issuance of blue vests to medical personnel and volunteers, 11

news of the attack and, 4

Budinger, Lt. Col. David, medical response and rescue efforts in New York City and, 158

Bukartek, Maj. John, MEDCOM’s response to the attack on the Pentagon and, 61, 62

Bureau of Alcohol, Tobacco, and Firearms, incident command system and, 19–20

Burgher, Maj. Floyd, medical response and rescue efforts in New York City and, 162, 170

Burney, Col. Bruce, MEDCOM’s response to the attack on the Pentagon and, 61–62, 63, 

189

Bush, First Lady Laura

visit to Walter Reed Army Medical Center, 85

visit to Washington Hospital Center Burn Center, 91

Bush, Pres. George

appointment of Dr. John Howard, 175

opening of the Pentagon to workers on September 12 and, 115–116

visit to Walter Reed Army Medical Center, 85

visit to Washington Hospital Center Burn Center, 91

Butler, Chief Glen, medical response and rescue efforts, 27

C

Cahill, Michael, medical response and rescue efforts, 17

Capital Area Crisis Response Team, Mental Health Community Response Coalition and, 

151

Cardenus, Col. Steven, Tricare operations center and, 55

Carlton, Lt. Gen. Paul K., Jr., medical response and rescue efforts, 12–14, 16, 27, 28

CDC. See Centers for Disease Control and Prevention

Centers for Disease Control and Prevention

emergency preparedness planning and, 188, 197

medical response and rescue efforts in New York City and, 163

Chaplains

medical response and rescue efforts and, 22

mental health response, 130, 145, 152, 172

ChemPro 100 chemical agent detectors, 188

Cho, Lt. Col. John, transition to recovery period and, 39

CHPPM. See Army Center for Health Promotion and Preventive Medicine

CISDs. See Critical incident stress debriefings

CNN television, description of attacks on the World Trade Center, 4

Collins, Joseph, medical response planning and, 62

Collison, Maj. John, assistance to Birdwell after his injury, 87

Combs, Special Agent Chris, medical response and rescue efforts, 21, 46

Command and control issues

coordination with EMS, 100

environmental health and safety sampling and air monitoring, 122–123

hospitals and clinics and, 100

initial attack and rescue period, 43–47

Communications issues

continuation of the response and, 27, 28
xxiv Attack on the Pentagon: The Medical Response to 9/11

environmental health and safety sampling and air monitoring, 122–123

hospitals and clinics and, 81, 100–101

identification of remains, 72

initial response to the attack and, 9

lack of a regional coordinator, 101

lack of ambulances and, 28, 41

lack of two-way radios, 31

poor communication between DiLorenzo Tricare Health Clinic and Arlington County 

EMS teams, 44–45

regional disaster planning and, 101

summary of, 43–47

transition to recovery period, 36

use of runners, 32, 101

Compton, Dr. Alan, medical response planning and, 62

Connors, Col. Kevin, medical response and rescue efforts in New York City and, 156, 

158

Construction workers

medical response and rescue efforts, 32

removal of concrete barriers, 38

Continuation of the response

Army Center for Health Promotion and Preventive Medicine, 197–201

Army Medical Command, 187–190

Army Medical Department, 190–197

civilian hospitals, 183–184

hospital alliances, 184–187

mental health issues, 206–207

military hospitals, 181–183

Pentagon Post-Disaster Health Assessment Survey, 201–202

summary, 207

World Trade Center Support Health Assessment Survey, 202–205

Cook, Maj. David, chaplain role in New York City, 172

Cornwell, Battalion Chief Bob, medical response and rescue efforts, 19

Costco, provision of food and water for workers, 36

Cozza, Lt. Col. Steve, mental health response and, 131

Crandall, Lt. Col. Edward, mental health response and, 131

Critical incident stress debriefings, description, 147

Cruz-Santiago, Juan, treatment at Washington Hospital Center, 90

Cummings, Lt. Col. Laurie, environmental health and safety role, 116

D

Davison Army Airfield, VA, evacuation helicopters and, 42

Daxon, Col. Eric, medical response to the attack on the Pentagon and, 63

DeAtley, Craig, emergency response working group and, 184–185

Defense Protective Service

initial response role, 10

mass casualty planning and, 8

Delaney, Kevin, environmental health and safety role, 114, 123, 197

Deltuba, Maj. Janet, communication issues and, 36

DeWitt Army Community Hospital
Index xxv

behavioral health teams, 59

mental health response and, 67, 130, 135

number of survivors treated at, 85

post-9/11 revisions and improvements to preparedness, 182–183

response to the attack on the Pentagon, 3, 42, 54, 58–59, 76, 85–86

types of injuries treated, 85

DiLorenzo, Anthony, 3

DiLorenzo Tricare Health Clinic

Action Response Teams, 8

ambulatory patients and, 10

anthrax contamination incident and, 200

continuation of the response and, 27–29

effect of the crash on, 8

emergency teams, 3

environmental health and safety role, 110, 115, 123, 125

initial medical response, 8–16

lack of coordination with EMS units and, 28

location and description, 2–3, 8

mass casualty plan and exercise, 8, 46, 52, 103

mental health response and, 130, 132, 133

mission, 3

Occupational Medicine Department, 115

omnicel supplies and, 27

resumation of operations on September 12, 40

subclinics, 3

triage areas and parking zones (map), 11

District of Columbia Hospital Association

disaster preparedness and, 103

mass casualty exercise, 182

monthly meetings of EMS personnel, 184

Dorn, Capt. Alan, medical response and rescue efforts, 19, 21, 27

Dover Air Force Base, DE

authorization of teams to travel to, 57

data transmission problems, 73–74

identification of remains, 68–76

mental health response and, 147–148

movement of remains to, 65, 66–67

shortcomings in facilities, 73

DPS. See Defense Protective Service

Dunn, Col. Michael

biosurveillance and, 189

nuclear, biological, and chemical casualty care network and, 182

Walter Reed Army Medical Center’s response to the attack on the Pentagon and, 54, 

59, 182

Durm, Capt. William B., medical response and rescue efforts, 14, 27, 28

E

8th Medical Brigade, medical response and rescue efforts, 156

89th Medical Group, mental health response and, 148–149
xxvi Attack on the Pentagon: The Medical Response to 9/11

11th Medical Group Flight Medicine Clinic

initial medical response and, 15–16

staff and role, 3, 8

Environics, ChemPro 100 chemical agent detectors and, 188

Environmental health and safety

Army Center for Health Promotion and Preventive Medicine role, 109–121, 123–124, 

125, 197–201

background, 109–110

challenges for industrial health personnel, 117–118

chemical and biological warfare agent inspection, 121

coordination/command and control/communications issues, 122–123

decontamination efforts, 124, 187

drinking water concerns, 121

Environmental Protection Agency role, 118, 121–122, 123

Federal Bureau of Investigation role, 110, 116–117, 121, 122, 123

initial response, 114–116

New York City attack site and, 160–161, 163–171, 174–176, 177

numbers, types, and results of samples collected during Pentagon sampling after 9/11 

by the U.S. Army Center for Health Promotion and Preventive Medicine using 

direct reading instruments (table), 120

potential dangers of the damaged Pentagon, 109

protective equipment needs, 115, 125

radiation detection, 121

sampling analysis and results, 118–120

sampling efforts, 116–118

site safety and security issues, 124–125

summary of issues, 125–126

Walter Reed Army Medical Center role, 110, 115, 125

Washington Headquarters Services role, 109–121, 125

EPA. See U.S. Environmental Protection Agency

Erkenbrack, Lt. Col. Adrian

medical response and rescue efforts, 25–26

personal account of the attack and rescue efforts, 7

Evacuation issues

after the all-clear, 34

helicopters and, 41, 42

lack of ambulances and, 28, 41–42

relocation to the tunnel area, 23–24

rumors of further attacks and, 23

summary of, 41–42

“Expert Consensus on Mass Violence and Intervention,” 137

F

“Fact Sheet on Countering Terrorism of Water Supplies,” 197

Fairfax County, VA

fire and rescue department response to the attack, 21

urban search and rescue team, 37–38, 64

Fairfax County Emergency Medical Services, after the all-clear and, 33
Index xxvii

FBI. See Federal Bureau of Investigation

Federal Bureau of Investigation

Disaster Mortuary Operational Response Team, 76

environmental health and safety role, 110, 116–117, 121, 122, 123, 125

identification of remains and, 68, 71, 73, 76

incident command system and, 19–20

Joint Operations Command, 39, 40

mass casualty planning and, 8

medical response and rescue efforts in New York City and, 163

recovery operations and, 64–67

reports of further attacks and, 23

Federal Emergency Management Agency

assistance to civilians, 144

environmental health and safety role, 110

exit routes to remove victims, 38

incident command system and, 19–20

joint exercises with MEDCOM, 195

mass casualty planning and, 8

medical response and rescue efforts in New York City and, 156, 157, 163, 166, 

170–171, 174

Pentagon Family Assistance Center and, 139, 142, 144

recovery operations and, 64–67

Virginia Task Force I, 38

Federal Emergency Response Plan

agencies involved, 52

attack on the Pentagon and, 52, 63

incident command system, 181

Feerick, Capt. John P., medical response and rescue efforts, 25, 30, 33–34, 36–37, 38–40

Felicio, Lt. Col. John, medical response and rescue efforts, 10, 40, 44–45, 58

FEMA. See Federal Emergency Management Agency

Fierro, Dr. Marcella, recovery operations and, 65

54th Quartermaster Company, recovery operations and, 64, 67

53d Troop Command, 204th Engineer Battalion, 161

Flight Medicine Clinic. See 11th Medical Group Flight Medicine Clinic

Force Health Protection Conference, 191

Fort Belvoir, VA. See DeWitt Army Community Hospital

Fort Belvoir Mental Health Service, mental health response and, 132

Fort Lee, VA, Mortuary Affairs unit, recovery operations and, 65, 67

Fort McNair clinic, 3

Fort Monmouth, NJ

behavioral health staff, 56

medical response and rescue efforts, 156

Patterson Army Health Clinic, 58

Fort Myer, VA. See also Rader Army Health Clinic

Fire Department rescue efforts, 7–8, 19

Joint Operations Center, 110, 123

Fort Sam Houston, TX, response to the attack on the Pentagon and, 62, 64

42d Infantry Division

Aviation Brigade, 161
xxviii Attack on the Pentagon: The Medical Response to 9/11

Joint Task Force 42, 161

medical response and rescue efforts in New York City and, 161–162, 170

1st Battalion, 101st Cavalry, 161; 69th Infantry, 161

27th Infantry Brigade, 161

Frost, Navy Reserve Capt. Stephen, medical response and rescue efforts, 25, 30, 33

G

Ganci, Peter, death of, 156

Geiling, Col. James

emergency preparedness teams and, 3

mental health response and, 133

re-opening of DiLorenzo Tricare Health Clinic on September 12, 38

transition to recovery period and, 38–39

work at Walter Reed’s intensive care unit, 4

Geitz, Staff Sgt. Wayne, medical response and rescue efforts in New York City and, 158

George Washington University Hospital, treatment of casualties, 55, 96, 98

Georgetown University Hospital, treatment of Birdwell after the attack on the Pentagon, 

16, 29, 87–88

Gerber, Col. Fred

Directorate of Health Care Operations role, 60

Walter Reed Army Medical Center’s response to the attack on the Pentagon and, 58, 

64

Gibbs, Capt. Chuck, medical response and rescue efforts, 19, 23

Gilroy, Dennis, rescue efforts, 7–8

Glidewell, Capt. Jennifer, medical response and rescue efforts, 9, 10, 27, 28

Goran, Col. Tim, medical response planning and, 62

Graves Registration and Mortuary Affairs personnel, recovery operations and, 64

Gray, Randy, transition to recovery period and, 34

Gum, Col. Robert, medical response and rescue efforts in New York City and, 168–170, 

176–177

H

Hammer, Dr. Mike, medical response and rescue efforts, 22

Hanfling, Dr. Daniel

crisis response center coordination, 95

Northern Virginia Hospital Alliance and, 184–186

Virginia Task Force I role, 38, 96

Harrahill, Cdr. Mary, medical response and rescue efforts in New York City and, 158

Hatton, Ronald, coordination between installations and medical facilities and, 189

Hawkins, Staff Sgt. Charles, medical response and rescue efforts, 15–16, 28

Headquarters response and recovery operations

Armed Forces Institute of Pathology, 68–76

Army Medical Command, 60–64

Army Office of the Surgeon General, 60–64

background, 51–52

DeWitt Army Community Hospital, 58–59

North Atlantic Regional Medical Command, 52–58
Index xxix

Office of the Armed Forces Medical Examiner, 68–76

Rader Army Health Clinic, 59–60

recovery operations, 64–67

Somerset, PA, operations, 76

summary, 76–77

Walter Reed Army Medical Center, 52–58

Hebron, Lt. Col. Bernard, MEDCOM disaster preparedness and, 187

Henson, Jerry, rescue of, 13–14

Herr, David, medical response and rescue efforts, 27

Hook, Luticia, treatment at Washington Hospital Center, 90

Horoho, Lt. Col. Patricia

after the all-clear and, 30–33

background, 16–17

initial medical response and rescue efforts, 16–25

personal characteristics, 17

transition to recovery period and, 34–40, 65

Hospitals and clinics. See also specific institutions

Army hospital liaisons, 98–100

civilian medical facilities, 87–98, 183–184

command and control issues, 100, 181–182

communications issues, 100–101

disaster plans, preparedness, and training issues, 102–104, 181–187

disposition of 9/11 Pentagon patients (table), 82

emergency operations center activation and preparation to receive casualties, 81–82

hospital alliances, 184–187

inter-institution communication, 81

mental health liaisons with civilian hospitals, 144

military medical facilities, 83–87, 181–183, 186–187

number of DoD personnel and civilians killed in the attack on the Pentagon, 81

number of injured survivors who sought treatment, 81

personnel and staffing issues, 101–102

post-9/11 revisions and improvements, 181–187

security issues, 102

supply issues, 102

Howard, Dr. John, air mask lawsuit and, 175

Howard University Hospital, support role, 55

Huleatt, Col. William, mental health response and, 131, 139–144

I

Ibanaz, Capt. Joseph, medical response and rescue efforts, 10, 44

Inova Alexandria Hospital

disaster plan activation, 94–95

number of survivors treated, 95

treatment of casualties, 42, 55, 94–95

types of injuries, 95

Inova Fairfax Hospital

disaster procedure activation, 95

evacuation helicopters and, 42, 96
xxx Attack on the Pentagon: The Medical Response to 9/11

Northern Virginia Hospital Alliance and, 185–186

number of survivors treated, 95

provision of supplies and medical equipment, 41

treatment of casualties, 21, 42, 55, 95–96

types of injuries, 95

Inova HealthPlex Emergency Care Center, treatment of survivors, 96

Integra, supply of replacement skin for Washington Hospital Center and, 90

Intrepido, Maj. Anthony, environmental health and safety role, 114–115

J

Jackson, Maj. Gen. James T.

medical response and rescue efforts, 21, 34, 46

visit to the Pentagon during recovery efforts, 124

James, Lt. Col. Larry, mental health response and, 131

Jefferies, Maj. Harry, medical response and rescue efforts in New York City and, 158

Jeng, Dr. James, treatment of burn victims, 89–90, 92

Jester, John, transition to recovery period and, 34

Johns Hopkins University Hospital, support role, 55

Johnson, Technical Sgt. Michael E., medical response and rescue efforts, 15–16

Jordan, Dr. Marion H.

proposal for the distribution of burn casualties in mass casualty situations, 184

treatment of Birdwell after the attack on the Pentagon, 87–88

treatment of burn victims, 89–90, 92

K

Kaiser, Maj. Stephen, medical response and rescue efforts in New York City and, 158

Kaminski, Col. Michael

communications issues, 44–45, 46

medical response and rescue efforts, 10

Keesler Air Force Base, MS

environmental health and safety role, 110

mental health response and, 148–149

Keller Army Community Hospital, treatment concerns, 56–57

Kelley, Racquel, treatment at Washington Hospital Center, 90

King, Maj. David, treatment at Washington Hospital Center, 90

Kozloff, Kenneth, Inova Alexandria Hospital’s response to the attack on the Pentagon, 95

Kristo, Dr. David, hospital liaison role, 99

Kurtz, Louise, treatment at Washington Hospital Center, 90

L

Ladouceur, Col. Berthony, Walter Reed Army Medical Center’s response to the attack on 

the Pentagon and, 54

Lirette, MSgt. Paul, medical response and rescue efforts, 15–16

Lucci, Lt. Col. Edward

District of Columbia Hospital Association and, 182

evacuation and stabilization of patients and, 28, 55–56, 94
Index xxxi

views on a potential threat to the DC Metro system, 103

Lynch, Col. Mike, mental health response and, 131

M

Malcolm Grow Air Force Medical Center, treatment of casualties, 55

Mallon, Col. Tim

environmental health and safety role, 114, 116, 169

post-9/11 improvements in disaster preparedness and, 189

Malone, Col. Eileen

post-9/11 improvements in emergency preparedness and, 182–183

role in DeWitt Army Community Hospital’s response to the attack on the Pentagon, 

58–59, 85–86, 99

Martinez-Lopez, Maj. Gen. Lester, environmental health and safety role, 109–121, 169

Maryland National Guard, supplies from, 57

Mateczun, Rear Adm. John, medical response and rescue efforts, 14, 28, 39

Maude, Lt. Gen. Timothy J., death of, 136

McDonald’s, provision of food and water for workers, 36

McGill, Capt. Daniel, Walter Reed Army Medical Center’s response to the attack on the 

Pentagon and, 54, 58

McGovern, Lt. Col. Joanne, medical response planning and, 63

McKinney, Kelly R., Whitman’s public announcement about the safety of the air and 

drinking water near the World Trade Center and, 167–168

McKown, Dr. Douglas, medical response and rescue efforts in New York City and, 171

McVeigh, Lt. Col. Bruce, Health Care Operations role, 60–61

MEDCOM. See Army Medical Command

Medical Command Regulation 525-4, 187–188

Medical Emergency Management Planning (Pamphlet 525-1), 187, 194, 195

MedStar evacuation helicopters, 42

Mental Health Community Response Coalition, establishment and activities of, 151

Mental health response

Air Force mental health teams, 129, 148–149

“burnout” of mental health workers and, 136

challenges, 137

chaplains and, 130, 145

community mental health in the National Capital Region, 150–151

coping strategies, 148

critical incident stress debriefings, 147

execution of the response, 133–136

ground zero workers in New York City and, 171–172

group debriefings, 134

groups involved, 129–130

“hotline conference calls” and, 132

initial response and planning, 130–132

intervention techniques, 133–134

levels of treatment, 132

liaisons with civilian hospitals, 144

Mental Health Community Response Coalition, 151

mental health team deployment, 134–136

military chaplains, 130, 145
xxxii Attack on the Pentagon: The Medical Response to 9/11

Navy mental health teams, 129, 149–150

Office of the Deputy Chief of Staff of the Army for Personnel, 136–138

Operation Solace, 129, 131, 133, 149

Pentagon employees and, 135–136

Pentagon Family Assistance Center, 129, 133, 139–144

persons who handled human remains and, 145–148

Project Heartland effort after the Oklahoma City bombing response and, 132

recovery workers and, 135

special medical augmentation response team–stress management (SMART-SM), 129, 

130–132, 134–136

structured debriefings, 133–134

summary of efforts, 152

“therapy by walking around,” 134, 206–207

therapy dogs, 130, 142–144

workshop on mental health and mass violence, 206–207

Metropolitan Washington Airports Authority

incident command system and, 19–20

initial response to the attack, 21

Military District of Washington

activation of, 34

coordination with Walter Reed Army Medical Center on gate security, 55

incident command system and, 19–20

recovery operations and, 67, 77

updating of radio systems, 182

Milliken, Lt. Col. Chuck, mental health response and, 131–132

Mitchell, Col. Glenn, MEDCOM’s response to the attack on the Pentagon and, 61, 62–63

Molofsky, Sgt. Maj. Celia, hospital liaison role, 100

Monette, Ted, medical response and rescue efforts, 156

Montgomery County, MD, urban search and rescue team, 64

Moody, Sheila, personal account of the attack and rescue efforts, 5–7

Moore, Maj. Mike, medical response and rescue efforts, 23

Morrow, David, environmental health and safety role, 118

Mount Sinai Center for Occupational and Environmental Medicine, pulmonary illnesses 

of ground zero workers research, 175–176

N

Nance, Malcolm, medical response and rescue efforts, 17–18, 21–22

NARMC. See North Atlantic Regional Medical Command

National Guard

environmental health and safety role at the Pentagon attack site, 110

medical aid stations for, 171, 177

role in New York City, 156, 161–162, 168, 169–170, 174, 176

National Institute for Occupational Safety and Health

anthrax contamination incident and, 200

medical response and rescue efforts in New York City and, 163

National Mass Fatalities Institute, Mental Health Community Response Coalition and, 

151

National Medical Response Team, incident command system and, 19–20

National Naval Medical Center
Index xxxiii

environmental health and safety role, 110

mental health response and, 129, 132, 149–150

treatment of casualties, 55

Naval Medical Research Center, Biological Defense Research Directorate Operations, 

121

Navy dental clinic, description and role, 3, 8

Nelson-Firing, Lisa, therapy dogs and, 144

New York Army National Guard. See 42d Infantry Division; National Guard

New York City

Army medical liaison and, 158–163, 176

combat stress control teams and, 171–172

description of the attack on and the destruction of the World Trade Center, 155

environmental health and safety issues, 160–162, 163–171, 177

food safety issues, 164, 165

guidelines to help doctors diagnose illnesses related to 9/11 toxic substances, 175

immunizations for tetanus and hepatitis B for ground zero workers, 168

initial response, 155–158

lawsuit involving air mask usage at ground zero, 174–176

Medical Examiner’s Office and, 170–171

medical treatment issues, 171–174

summary of issues, 176–177

treatment of National Guard troops and volunteers at ground zero, 171–174

U.S. Air Force role, 174

USNS Comfort and, 157–158, 162–163, 173, 176

World Trade Center Support Health Assessment Survey, 202–205

New York City Fire Department, study of lung capacity loss among firefighters at ground 

zero, 175

New York City Health Department, briefing about hazardous conditions at ground zero, 

161

New York State Environmental Protection Department, medical response and rescue efforts in New York City and, 163

New York State Health Department, statistics on deaths of ground zero workers, 176

Newman, David M., air mask lawsuit and, 175

Nguyen, Col. (Ret.) Duong, medical response and rescue efforts, 22, 25, 30

Nigro, Daniel, medical response and rescue efforts, 156

9/11 Commission Report, 42

North Atlantic Regional Medical Command

description and role of, 51

hospital liaisons, 99

medical response and rescue efforts in New York City and, 172, 176

response to the attack on the Pentagon, 52–58

special medical augmentation response team–stress management (SMART-SM), 129, 

130–132, 134–136

Northern Virginia Community Hospital, treatment of survivors, 96

Northern Virginia Hospital Alliance, description and role of, 185–186

NVHA. See Northern Virginia Hospital Alliance

O

OAFME. See Office of the Armed Forces Medical Examiner
xxxiv Attack on the Pentagon: The Medical Response to 9/11

ODCSPER. See Office of the Deputy Chief of Staff for Personnel [US Army]

Office of the Armed Forces Medical Examiner

identification of remains and, 68–76, 77

recovery operations and, 65

Office of the Assistant Secretary of Defense for Health Affairs, mental health response 

and, 132, 133

Office of the Deputy Chief of Staff for Personnel [US Army]

challenges of mental health staff, 136–137

desensitizing tours for workers, 137–138

loss of colleagues, 136–137

mental health response and, 136–138

“psychological after-action reviews,” 137

types of mental health services offered to, 137

Office of the Surgeon General. See Army Office of the Surgeon General

Ogletree, Natalie, assistance to Birdwell after his injury, 87

Operation Solace, 129, 130, 133, 149

Opio, Col. (Ret.) Roger, MEDCOM’s response to the attack on the Pentagon and, 61

Orman, Col. David, mental health response and, 131

OSHA. See U.S. Occupational Safety and Health Administration

OTSG. See Army Office of the Surgeon General

P

PAARs. See Psychological after-action reviews

Pamphlet 525-1: Medical Emergency Management Planning, 187, 194, 195

Pataki, Gov. George, mobilization of National Guard units, 156

Patterson, Col. Virgil, mental health response and, 131

Peake, Lt. Gen. James B.

initial response to the terrorist attacks and, 51–52, 56, 58

memorandum concerning improvements to MEDCOM’s emergency preparedness, 

188

Office of the Surgeon General’s response to the attack on the Pentagon and, 60–64

official photograph, 53

Operation Solace and, 131

video teleconferences, 56, 60, 61

visit to the attack site, 38

visit to Washington Hospital Center Burn Center, 91–92, 98

Peetoom, Sue, therapy dogs and, 142

Pentagon. See also South side of the Pentagon; West side of the Pentagon

child care center and developmental school, 10

medical facilities serving occupants of, 2–3

modernization program, 2

original structure, 1

physical description, 1–2

resumation of operations on September 12, 40

Site R treatment of casualties, 56, 57, 58

Pentagon Family Assistance Center

assistance to children and adolescents, 140–141

assistance to civilians, 141–142

groups targeted for intervention, 140
Index xxxv

Mental Health Community Response Coalition and, 151

mental health response and, 129, 133, 139–144

Sheraton Hotel location, 139

staffing of, 139

therapy dogs and, 142–144

value of, 152

visits to the impact area for families, 142

Pentagon Officers’ Athletic Club, casualty collection point, 27–28

Pentagon Post-Disaster Health Assessment Survey, description and results, 162, 201–202

Pentagon Renovation Program Safety Office, role in environmental monitoring, 109

Peoples, Lt. Col. George, transition to recovery period and, 39

Personal protective equipment

air mask usage at ground zero in New York City, 160–162, 164–168, 174–176, 177

basic needs, 115, 125

difficulty of getting supplies, 169, 174

post-9/11 supplies of, 188

recovery operations at the Pentagon and, 66

Poropatich, Dr. Ronald, hospital liaison role, 99

Powell, Cdr. Craig, medical response and rescue efforts, 13–14

Powers, Army Chaplain Robert, mental health response and, 145

PPE. See Personal protective equipment

Psychological after-action reviews, description, 137

R

Rader Army Health Clinic

after-action report, 45

behavioral health teams, 60

location and description, 3, 59

number of survivors treated at, 86

response to the attack on the Pentagon, 22–23, 54, 59–60, 76, 86–87

support sent to the Pentagon, 87

Rafey, Dr. Ernie, medical response and rescue efforts, 22

Recovery operations

agencies involved, 64–65

anxiety of workers, 145–146

Armed Forces Institute of Pathology role, 68–76

body bags for, 64

body removal process, 66–67

cadaver identification methods, 69–70

command and control issues, 71–72

communications issues, 72

critical incident stress debriefings, 147

dental teams, 64

jurisdiction challenges, 65

media and, 76

mental health of workers handling remains and, 67

mental health services for persons handling human remains, 145–148

movement of remains planning, 65

Office of the Armed Forces Medical Examiner role, 68–76
xxxvi Attack on the Pentagon: The Medical Response to 9/11

physicians’ role, 145–146

protective clothing for, 66

3d Infantry Regiment (the Old Guard) and, 34, 60, 64–67

transition to recovery period, 34–40

Red Cross. See American Red Cross

Resource Coordinating Committee of Oklahoma City, Mental Health Community Response Coalition and, 151

Respirators. See Personal protective equipment

Reyes, Capt. Ricardo, environmental health and safety role, 121

Ritchie, Lt. Col. Elspeth, mental health response and, 132

Rivera, Col. Walter, medical response and rescue efforts in New York City and, 162, 168, 

169

Robichaux, Col. Rene, mental health response and, 131

Rolon, MSgt. Roberto, environmental health and safety role, 117

Ronald Reagan Washington National Airport Fire Department

incident command system and, 19–20

initial response to the attack, 21

Root, CWO4 William, Thurman’s attempt to rescue, 83

Rosenberg, Sgt. Matthew, medical response and rescue efforts, 9, 10, 12–14, 27, 28

Roser, Col. John Frederick, Jr.

medical response and rescue efforts, 22

Rader Army Health Clinic’s response to the attack on the Pentagon and, 59, 60, 101

Rumsfeld, Defense Secretary Donald

medical response and rescue efforts, 17

opening of the Pentagon to workers on September 12 and, 109, 115–116

Ruzek, Josef I., mental health response and, 141

S

Safety. See Environmental health and safety; Personal protective equipment

Salvation Army

mental health response, 130

provision of food for rescue workers at ground zero in New York City, 165

role in the transition to recovery period, 36

San Antonio, TX, MEDCOM, response to the attack on the Pentagon and, 61–64, 77

Schaeffer, Lt. Kevin

treatment at Walter Reed Army Medical Center, 84

treatment at Washington Hospital Center, 90

Schiek, Maj. William, Health Care Operations role, 60–61

Schwartz, Asst. Fire Chief James

medical response and rescue efforts, 19, 21, 23, 25, 34, 37, 39, 100–101

opening of the Pentagon to workers on September 12 and, 115–116

Security issues

environmental sampling and, 117, 124–125

hospitals and clinics, 102

Sepulveda, MSgt. Noel

medical response and rescue efforts, 24–25, 34, 35, 36–37, 65

personal account of the attack on the Pentagon, 4–5

Sherman, Antoinette, death of from burn injuries, 90

Sinclair, Wayne, treatment at Washington Hospital Center, 90
Index xxxvii

Skipper, Mark, rescue efforts, 7–8

Skummer, Lawrence, medical response and rescue efforts, 15–16

Sledzik, Paul, Disaster Mortuary Operational Response Team role, 76

SMART. See Special medical augmentation response teams

SMART-SM. See Special medical augmentation response team–stress management

Smith, Battalion Fire Chief Jerome, medical response and rescue efforts, 9, 19

Smith, Col. Paul, environmental health and safety role, 114, 116, 169, 189

Smith & Nephew Corp., supply of replacement skin for Washington Hospital Center and, 

90

Smithsonian Institution, identification of remains and, 68, 72

Social Security Administration, Pentagon Family Assistance Center and, 139

Somerset, PA

crash of United Airlines Flight 93, 23

identification of remains and, 68, 76

Sorenson, Pfc. Kristopher, medical response and rescue efforts, 12

South side of the Pentagon

after the all-clear, 29–34

initial medical response and rescue efforts, 16–27

Special medical augmentation response (SMART) teams, environmental health and safety 

role, 110, 114, 116, 121, 187, 188

Special medical augmentation response team–stress management (SMART-SM), mental 

health role, 129, 130–132, 134–136

Spruell, Evandra, medical response and rescue efforts, 15–16

Staffing issues, hospitals and clinics, 101–102

State Defense Emergency Act, 175

Stokes, Col. James, mental health response and, 131, 132

Strickland, Sgt. Maj. Larry L., death of, 136

Supply issues

DiLorenzo Tricare Health Clinic omnicels and, 27

hospitals and clinics and, 102

morphine shortage, 27, 40

personal protective equipment, 169, 174, 188

shortage of two-way radios, 31, 40, 43

summary of, 40–41

tunnel triage area and, 25

T

Therapy dogs, mental health response and, 130, 142–144

Therapy Dogs International, Pentagon Family Assistance Center and, 142–144

Thomas, Katherine A., condition updates on patients, 99

3d Infantry Regiment (the Old Guard)

mental health efforts targeting, 135

observation of for possible health threats, 117

recovery operations and, 34, 60, 64–67, 77

3M Corporation, provision of protective equipment for ground zero workers, 169

344th Combat Support Hospital Medical Brigade, medical response and rescue efforts, 

156

Thurman, Maj. John Lewis, personal account of the attack on the Pentagon and rescue 

efforts, 83–84
xxxviiiAttack on the Pentagon: The Medical Response to 9/11 Attack on the Pentagon: The Medical Response to 9/11

Tilly, MSgt. Jack, recovery operations and, 64

Timboe, Maj. Gen. Harold

Col. Wallace’s recommendations for improvements in emergency preparedness and, 

190

hospital liaisons and, 99

initial response to the terrorist attacks and, 51–52

medical response teams for New York City, 155–156

official photograph, 53

SMART-SM team activation, 130

visit to the attack site, 38

visit to Washington Hospital Center Burn Center, 91

Walter Reed Army Medical Center’s response to the attack on the Pentagon and, 

52–58, 76

Trainor, Gloria J., mental health needs of recovery workers in New York City and, 172

Tricare Northeast Region One, hospital liaisons, 99

Tubb, Col. Richard, call to Walter Reed Army Medical Center about Pres. Bush’s visit, 85

249th Engineer Battalion, medical response and rescue efforts in New York City and, 161

U

Uniformed Services University of the Health Sciences

Department of Preventive Medicine and Biometrics, 118

environmental health and safety role, 110, 118

Urbana, Col. Craig, medical response and rescue efforts, 34

U.S. Air Force

89th Medical Group, 148–149

11th Medical Group Flight Medicine Clinic, 3

mental health response, 129, 134–136, 148–149

Pentagon Family Assistance Center and, 139

support for the medical response and rescue efforts in New York City, 174

U.S. Army. See also specific entities

Institute of Chemical Defense Research, 188

mental health outreach efforts, 131, 136

Operation Solace, 129, 130, 133, 149

U.S. Army Central Identification Laboratory, identification of remains and, 68

U.S. Army Corps of Engineers, 249th Engineer Battalion, 161

U.S. Army Reserve 8th Medical Brigade, activation of, 57

U.S. Department of Defense. See also Washington Headquarters Services

Deployment Health Clinical Center, 134

Federal Response Plan and, 52

instructions on coordination between military installations and medical facilities and, 

189–190

MEDCOM’s response and, 61

medical response and rescue efforts in New York City and, 156

Pentagon Family Assistance Center opening, 139

Pentagon modernization program, 2

Site R activation, 56

workshop on mental health and mass violence and, 206–207

U.S. Department of Health and Human Services

decontamination efforts and, 124
Index xxxix

national medical response team task forces, 65

Substance Abuse and Mental Health Agency, 142

workshop on mental health and mass violence and, 206–207

U.S. Department of Housing and Urban Development, mold standards, 120

U.S. Department of Justice

Pentagon Family Assistance Center and, 139

workshop on mental health and mass violence and, 206–207

U.S. Department of the Army, hospital liaisons, 99

U.S. Department of Veterans Affairs

brief education and support model, 141

mental health response, 130

National Center for Post-Traumatic Stress Disorder, 132, 141

Pentagon Family Assistance Center and, 139

screening of ground zero workers exposed to human remains, 168

workshop on mental health and mass violence and, 206–207

U.S. Environmental Protection Agency

anthrax contamination incident and, 200

Chemical Emergency Planning and Preparedness Office, 200

environmental health and safety role at the Pentagon attack site, 110, 118, 121–122, 

125

medical response and rescue efforts in New York City and, 163, 164

U.S. Navy

Casualty Assistance/Prisoner of War and Missing in Action/Retired Activities Branch, 

150

mental health response, 129, 134–136, 149–150

U.S. Occupational Safety and Health Administration

anthrax contamination incident and, 200

environmental health and safety role at the Pentagon attack site, 110

medical response and rescue efforts in New York City and, 163, 170

U.S. Park Police, medical evacuation helicopters and, 41, 42

U.S. Postal Service, anthrax contamination incident, 200

U.S. Public Health Service

Federal Response Plan and, 52

medical response and rescue efforts in New York City and, 157, 159, 163, 164

USNS Comfort

New York City medical response and rescue efforts and, 157–158, 162–163, 173, 176

role in recovery efforts at the Pentagon, 58, 64

V

VA. See U.S. Department of Veterans Affairs

Vafier, Dr. Jim, medical response and rescue efforts, 23–25, 27, 30–40, 43, 46, 47, 65

Van Alstyne, Lt. Gen. John

medical response and rescue efforts, 18, 34

Pentagon Family Assistance Center leadership, 139–144

Viera, Lt. Col. Steven, mental health response and, 133

Virginia Beach, VA, urban search and rescue team, 64

Virginia Department of Emergency Management

environmental health and safety role, 110

incident command system and, 19–20
xl Attack on the Pentagon: The Medical Response to 9/11

Virginia Department of Environmental Quality, environmental health and safety role, 110, 

122

Virginia Hospital Center–Arlington

hospital liaisons and, 99

number of survivors treated, 94

post-9/11 improvements in emergency preparedness, 183–184

provision of supplies and medical equipment and, 41

treatment of casualties, 21, 29, 42, 55, 92–94

types of injuries treated, 94

Virginia State Police, incident command system and, 19–20

Volunteers. See also specific organizations

environmental health and safety role, 114–115

initial response and, 10–12, 14, 17–19, 21–22, 25, 46

mental health response, 130, 141, 152

Pentagon Family Assistance Center and, 139

W

Wagner, Capt. Glenn N., identification of remains and, 68, 71–72, 75

Wagner, Lt. Col. Karen, Thurman’s attempt to rescue, 83

Waldrep, Lt. Col. Douglas, medical response and, 137

Wallace, Alan, rescue efforts, 7–8

Wallace, Col. Stephen C.

appointment by Timboe as the Army’s official medical liaison in New York City, 156

career and service of, 158

environmental health and safety issues at ground zero and, 163–170, 176

first impressions of the destruction of the World Trade Center, 159–160

health briefings to National Guard troops, 156

initial medical response in New York City and, 158–163, 176

Medical Examiner’s Office and, 170–171

recommendations for improvements in emergency preparedness, 190–197

Walter Reed Army Medical Center

anthrax contamination incident in Washington, DC, investigation and, 200

Center for Health Promotion and Preventive Medicine, 57, 109–121, 123–125

chaplains assigned to the stress management team, 145

chemical-biological augmentation team, 56

chemical decontamination program, 182

civilian survivors treated at, 84

command issues, 181–182

communications issues, 81, 100

coordination with the Military District of Washington, 55

emergency planning, 52, 54

environmental health and safety role, 110, 115, 125

Federal Response Plan and, 181–182

“The Management of Chemical and Biological Casualties” course, 103

mass casualty exercise, 182

Mental Health Department, 99

mental health efforts, 57, 67, 129, 130–132, 134–136

multiple phone line availability, 54

number of survivors treated at, 84
Index xli

on-site care for firefighters and recovery and morgue personnel, 57

Patient Administration Department, 55

Pentagon Family Assistance Center and, 139

post-9/11 revisions and improvements to preparedness, 181–182

Psychiatric Consultation Liaison Service, 144

readiness training for military and civilian healthcare workers, 182

“Red Book” emergency management procedures handbook, 182

response to the attack on the Pentagon, 52–58, 76, 83–85

Social Work Department, 144

support center for families of patients, 85

trauma support teams, 57

types of injuries, 84–85

visit from Pres. George Bush and First Lady Laura Bush, 85

Washington, DC, and Virginia Disaster Response Network, Mental Health Community 

Response Coalition and, 151

Washington, DC, fire and police departments

adoption of emergency codes from, 182

incident command system and, 19–20

initial response to the attack, 21

Washington Headquarters Services

environmental health and safety role, 109–121, 123, 125

mass casualty planning and, 8

responsibilities, 109

Safety and Environmental Management Branch, 109

Washington Hospital Center

Burn Center, 89–91, 99, 184

hospital liaisons and, 99

Mrs. Birdwell’s experience at, 98–99

number of survivors treated at, 88

post-9/11 improvements in emergency preparedness, 184

replacement skin supplies and, 90, 102

treatment of casualties, 21, 55

types of injuries treated, 88

visit from Gen. Peake, 91, 98

visit from Gen. Timboe, 91

visit from Pres. George Bush and First Lady Laura Bush, 91

Weathers, Maj. Kent, medical response and rescue efforts, 22

Webster, Brig. Gen. William G., medical response and rescue efforts, 17

Weese, Dr. Coleen, medical response and rescue efforts in New York City and, 169–170

West side of the Pentagon

after the all-clear, 29–34

initial medical response and rescue efforts, 16–27

Wheldon, Maj. Gen. George, medical response and rescue efforts, 21, 32, 34

White, Arlington County Assistant Chief for Technical Support John, medical response 

and rescue efforts, 21, 24, 26–27, 31, 35, 37

Whitman, Christine, public announcement about the safety of the air and drinking water 

near the World Trade Center, 167, 175

WHS. See Washington Headquarters Services

Williams, Dr. Michael, treatment of Birdwell after the attack on the Pentagon, 87–88

Williams, Kenneth, environmental health and safety role, 118
xlii Attack on the Pentagon: The Medical Response to 9/11

Wilson, Col. Patrick, comments on the Directorate of Health Care Operations role, 60

World Trade Center Support Health Assessment Survey

description and results, 202–205

number of individuals at high risk for mental health concerns (table), 205

respondents’ estimated intensity of exposure (table), 203

respondents’ exposure to dust, chemicals/fumes, and smoke (table), 203

respondents’ health problems or concerns (table), 204

respondents’ identification of new or worsened health problems or concerns (table), 

205

respondents’ pulmonary symptoms (table), 204

WRAMC. See Walter Reed Army Medical Center

Wright-Patterson Air Force Base, OH, supply of replacement skin for Washington Hospital Center and, 90

Wyrick, Maj. Gen. (Ret.) Michael, Northern Virginia Hospital Alliance and, 185–186

Y

Yates, John, treatment at Washington Hospital Center, 90

Z

Zadroga, James, death of, 175