Attack on the Pentagon

The Medical Response to 9/11

Attack on the Pentagon

The Medical Response to 9/11

Mary Ellen Condon-Rall, PhD

Borden Institute

Fort Detrick, Maryland

Office of The Surgeon General

United States Army

Falls Church, Virginia

US Army Medical Department Center & School

Fort Sam Houston, Texas

2011
Editorial Staff: Joan Redding Douglas Wise

Martha K. Lenhart, MD, PhD Senior Production Editor Layout Editor

Colonel, MC, US Army

Director and Editor in Chief, Borden Institute Bruce Maston Linette Sparacino

Illustrator Technical Editor

The opinions or assertions contained herein are the personal views of the authors 

and are not to be construed as doctrine of the Department of the Army or the 

Department of Defense.

Use of trade or brand names in this publication does not imply endorsement by 

the Department of Defense

CERTAIN PARTS OF THIS PUBLICATION PERTAIN TO COPYRIGHT 

RESTRICTIONS. ALL RIGHTS RESERVED.

NO COPYRIGHTED PARTS OF THIS PUBLICATION MAY BE REPRODUCED 

OR TRANSMITTED IN ANY FORM OR BY ANY MEANS, ELECTRONIC OR 

MECHANICAL (INCLUDING PHOTOCOPY, RECORDING, OR ANY INFORMATION STORAGE AND RETRIEVAL SYSTEM), WITHOUT PERMISSION IN 

WRITING FROM THE PUBLISHER OR COPYRIGHT OWNER.

Published by the Office of The Surgeon General

Borden Institute

Fort Detrick, Maryland, and Fort Sam Houston, Texas

Library of Congress Cataloging-in-Publication Data

Condon-Rall, Mary Ellen, 1938-

 Attack on the Pentagon : the medical response to 9/11 / Mary Ellen Condon-Rall.

 p. ; cm.

 Includes bibliographical references and index.

 1. Emergency medicine--Virginia--Arlington--Evaluation. 2. Emergency management-

-Virginia--Arlington--Evaluation. 3. September 11 Terrorist Attacks, 2001. I. Borden 

Institute (U.S.) II. Title.

 [DNLM: 1. September 11 Terrorist Attacks--history--Virginia--Autobiography. 

2. Emergency Medical Services--history--Virginia--Autobiography. 3. History, 

21st Century--Virginia--Autobiography. 4. Military Medicine--history--Virginia--

Autobiography. 5. Rescue Work--history--Virginia--Autobiography. WA 295]

 RA975.5.E5C66 2011

 616.02’50922755295--dc23

 2011028958

PRINTED IN THE UNITED STATES OF AMERICA

18, 17, 16, 15, 14, 13, 12, 11 5 4 3 2 1
Contents

Foreword vii

Preface ix

Chapter One

The Attack and Rescue 1

Chapter Two

Headquarters Response and Recovery Operations 51

Chapter Three

Hospitals and Clinics 81

Chapter Four

Environmental Health and Safety Issues 109

Chapter Five

The Mental Health Response 129

Chapter Six

New York City 155

Chapter Seven

The Continuing Response 181

Bibliographical Note xiii

Acronyms and Abbreviations xv

Index xix

Foreword 

“9/11”—a day that changed our lives and the world. The course of those several 

hours on the 11th of September 2001 affected individuals, institutions, and nations. 

Mary Ellen Condon-Rall tells the story of the medical response to the Pentagon as 

ground zero through the eyes of many of those individuals and, in so doing, paints 

a picture that no single view can capture. The quiet professionalism demonstrated 

that day, and so well described in this book, captures the values the Army, and 

all of our military services, have espoused: loyalty, duty, selfless service, honor, 

integrity, personal courage. Amid the chaos there was self-motivation; to the 

ever changing circumstances there was rapid adaptation and readaptation. As the 

immediate consequences were addressed, the longer-term response and recovery 

was being considered and steps taken to address future needs. This was the visible 

response—men and women of all ranks, military and civilian, caring for their 

coworkers shoulder to shoulder. 

At the same time the work of the Pentagon moved from a peacetime to a 

war footing. From the determined workforce that reported back the next day, 

appreciating the importance of their roles in a dramatically changed world, to 

the most senior leaders of the Army who led recovery efforts with sensitivity 

and compassion while at the same time planning our military response to the 

heinous acts of that day, this is a story of great Americans galvanized to action 

and service to the nation. It is a tribute to personal intrepidity, to institutional 

resilience, and to the preparation and training that led not only to needed medical 

and organizational skills but also to the culture of service-above-self demonstrated 

in the instinctive behavior captured in this recounting. That infamous day began 

a decade of medical advances on the battlefield, across the evacuation chain, and 

in the recovery and rehabilitation of our wounded warriors. Many of those whose 
actions are cataloged in this book have been an integral part of that remarkable 

story and many continue to make that history today.

James B. Peake, MD

Lieutenant General (Ret), U.S. Army

6th Secretary of Veterans Affairs

Senior Vice President, CGI Federal

June 2011

viii Foreword
Preface

No one medical service could have handled the response to 9/11 on its own. 

Therefore, I have placed the story in the context of the Army Medical Department’s interaction with other medical responders: the US Navy, Air Force, and 

civilian medical facilities and organizations. Also, I did not limit the account to 

9/11/2001, but continued it through the months and, in the case of the concluding 

chapter, years that followed. The narrative first focuses on the immediate medical 

response at the Pentagon, and the medical transition to recovery on the first day. 

The story then moves to Army Medical Department headquarters in Falls Church, 

Virginia, and San Antonio, Texas, where Army Medical Command (MEDCOM) 

personnel monitored the response. Accounts of the Army’s involvement in the 

recovery of deceased attack victims at the Pentagon and the work of the Armed 

Forces Institute of Pathology in identifying human remains at Dover Air Force 

Base follow. The roles of military and civilian hospital staffs and of military environmental health and mental health specialists in taking care of attack victims and 

their families are also examined. Late in the volume I include a chapter on New 

York City because military medical forces also responded to ground zero. The 

telling of this story, mainly through the eyes of two MEDCOM officers detailed 

to New York to support National Guard troops guarding ground zero’s perimeter, 

may provide valuable insights on how to respond to similar events in the future. 

A theme that stands out in the telling of this story is that preparation and training paid off. When these attributes were weak or absent, responders encountered 

problems. In Washington, DC, and New York City, MEDCOM put into effect 

existing disaster response plans. As a result, military medical response needs, including supplies, were with few exceptions already in place. However, responders 

needed to learn how to use volunteers effectively and how to improve control of 

medical personnel, equipment, and supplies. 

It would be impractical to list all of the people who have generously helped in 

producing this volume. However, I must give recognition and special thanks to 

the following. I am indebted to four historians who gave unstintingly of their time, 

skill, and energy to reviewing the manuscript: Major Lew Barger of the Office of 
the Surgeon General’s Office of Medical History; Robert JT Joy, MD, of the Uniformed Services University of the Health Sciences; William B Hammond, PhD, 

of the US Army Center of Military History; and John T Greenwood, PhD, Director, Office of Medical History. My understanding of the events benefited greatly 

from their perceptive comments and constructive suggestions.

Talented colleagues at the Office of Medical History were ready to lend a hand. 

Office director John T Greenwood and acting director (after John retired) Major 

Richard Prior provided me with counsel and encouragement. Archivists Debbie 

Gerlock and Lisa Wagner helped in finding materials, and administrative assistant 

Annita Ferencz in producing supportive graphics.

Many others are deserving of praise. Jan Herman, of the US Navy’s Bureau of 

Medicine and Surgery, and Stephen Lofgren and Frank Shirer of the US Army 

Center of Military History helped me find relevant sources and answers to my 

many questions. The after-action reports, as well as countless e-mails, of Lieutenant Colonel Stephen Wallace and Colonel Robert M Gum, Army MEDCOM envoys to ground zero, made the New York City chapter possible. I must also thank 

then Lieutenant Colonel Patricia Horoho (today Lieutenant General and incoming 

US Army Surgeon General) and Malcolm Nance for their invaluable personal tour 

of the Pentagon crash site, including descriptions of medical responders’ actions 

on 9/11.

This book would not have been possible without having at my disposal more 

than 200 interviews of medical responders and victims of the 9/11 attack. I am 

indebted to the oral history teams of the OTSG Office of Medical History (Major 

Debora R Cox, Major Robert Glisson, and John Greenwood); the US Navy Bureau 

of Medicine and Surgery (Lara Bronstein, Jan Herman, and Janice M Hores); the 

US Army’s Center of Military History (Leo Hirrel, Specialist First Class Dennis 

Lapic, Master Sergeant Donna Majors, Lieutenant Colonel Robert Russo, Austin 

Shellenberger, and Frank Shirer); the US Air Force History Support Office (Perry 

Jamieson); and the Office of the Air Force Surgeon General (James S Nanney). 

I gleaned insights and observations from a great many e-mail exchanges with 

medical responders to 9/11. Some outstandingly helpful e-mails came from Lieutenant Colonel Wallace; Colonel Gum; Lieutenant Colonel Horoho; Malcolm 

Nance; Major Lorrie A Brown; Lieutenant Colonel Edward B Lucci; Joe E Collins; Colonel Steven L Cardenas; Navy Captain Glenn Wagner; Marion H Jordan, 

MD; John J Resta; Colonel Elspeth C Ritchie; Bernard F Hebron; David Fallert; 

Daniel Hanfling, MD; Lieutenant Colonel Floyd Burgher; and Colonel Walter 

Rivera.

A number of organizations and individuals donated photographs, for which I 

am grateful. Among the organizations are US Army Center for Health Promotion 

and Preventive Medicine; DiLorenzo Tricare Health Clinic; Armed Forces Institute of Pathology; New York Army National Guard; Federal Emergency Management Agency; Walter Reed Army Medical Center; DeWitt Army Community 

Hospital; Georgetown University Hospital; Washington Hospital Center; Virginia 

Hospital Center, Arlington; Inova HealthPlex Emergency Care Center; Arlington 

x Preface
Urgent Care; and George Washington University Hospital. Individuals who donated photographs include Lieutenant Colonel Wallace, Colonel Gum, and Lisa 

Nelson-Firing (of Therapy Dogs).

Finally, Joan Redding of the Borden Institute edited the volume. Her meticulousness, literary skill, hard work, and attention to detail improved the flow of the 

narrative and the accuracy of the references. Her unflagging spirit and endless 

enthusiasm successfully steered the book through the publication process. 

Many people gave willingly of their time, knowledge, and materials to support me in telling this amazing and poignant story. The book is a better product 

because of their kindness and generosity. For the conclusions, interpretations, and 

any errors of fact in the volume, I alone am responsible.

Mary Ellen Condon-Rall

June 2011

Preface xi