staten island advance.

hospitals put post-9/11 drills to test with jill gardiner.
staffers react to surge of horrendous injuries suffered by dozens in ferry disaster .
10.17.2003

The emergency staffs at Staten Island's hospitals have seen horrific injuries like those from Wednesday's ferry crash.

They've just never seen so many at one time.

"We see all of this stuff, but more in drips and drabs," said Dr. Edward Adrian, director of the emergency department at St. Vincent's Hospital in West Brighton.

"You may get gunshot wounds, severed extremities. None of this is new," he said. "It's just that you don't usually get it all at once."

The crash killed 10 people and injured 72.

When the injured started to come in to the Level 1 trauma centers on Staten Island, staff members of all ranks found themselves in the thick of the type of disaster they've trained and drilled for extensively since Sept. 11, 2001.

While hospital staffs were more prepared now than before the terrorist attacks, this was the most thorough test of the system.

Suddenly, stripping a bed meant more than fresh linens. The faster trauma areas were sterilized and outfitted, the quicker medical team could stabilize the next serious patient.

Attending-level physicians, including department heads, scurried between hospital wings to bring X-rays into emergency rooms for immediate analysis, cutting up to a half-hour from the usual diagnosis time.

"In the heat of the battle, it's 'Let's get these people taken care of.' It's 'Do what we're trained to do, and let's give these people who didn't ask to be hurt the best chance of survival,'" said Dr. Jeffrey Nicastro, director of trauma and surgical critical care at Staten Island University Hospital.

The injured, including three patients with double leg amputations and another whose torso was nearly sheared in two, disturbed even the most highly trained professionals.

no yielding to emotions.

But yielding to emotions when critical decisions must be made on the spot isn't an option.

"You just go on autopilot until it's over," said Jean Gordon, clinical nurse specialist and trauma coordinator at St. Vincent's. "In that golden hour we were trying to take care of business."

Throughout the night, hospitals fielded phone calls from those who feared their relatives might have been victims.

Patient lists were faxed between St. Vincent's and University Hospital, a cooperation that helped each institution provide accurate information to concerned callers.

Hospital workers, most of whom live on Staten Island, squeezed in phone calls to track down their own loved ones. One employee in the communications department of St. Vincent's lost her husband in the crash.

"We are not immune - this is our community," Ms. Gordon said, during a news conference yesterday afternoon outside the emergency room. "A lot of our families ride the ferry. I have 10 brothers and sisters. I didn't know who was on the ferry."

The chaos at the trauma centers quieted by 9:30 Wednesday night, but doctors and administrators are still dealing with critical patients.

All the patients at St. Vincent's are breathing without assistance, but five are still critical and four are recovering from serious surgery. That includes Assistant Capt. Richard J. Smith, who attempted to commit suicide in his home after the crash.

The woman whose stomach was torn open lost her entire left leg and half of her right, though a source at University Hospital said she was progressing slightly faster than doctors had anticipated and may survive.

Two patients, one at each hospital, had both legs amputated below the knee. At University Hospital, a man with a spinal fracture has lost the use of his legs and may never regain mobility.

Both hospitals have become media magnets, attracting reporters from dozens of news organizations, seeking constant updates on patient conditions.

They have held press conferences on hospital grounds and played host to politicians like Mayor Michael Bloomberg and Gov. George Pataki, who have come to visit patients and their families.

Some at the hospital are finding the media spotlight on what is usually their everyday work somewhat unsettling.

"There are a few more (patients) today than there were several days ago," Dr. Nicastro said. "A lot of attention is now focused on what we do. It's not a position that we're used to being in. I find that a little disquieting."

Yesterday, only 24 hours after the crash, the hospitals shifted focus from acute trauma care to continued support for the patients and their families. St. Vincent's had stress management services, including massage, for employees, patients and family members.

Special units have also been mobilized to provide counseling for the post-traumatic stress that often follows such a tragedy.

The city Department of Health and Mental Hygiene and the American Red Cross now have counselors at the St. George ferry terminal during afternoon commutes. They've committed to collaborating with organizations on Staten Island to provide appropriate counseling for as long as it's needed.

The medical staffs at the hospitals are currently monitoring patients for additional illnesses that tend to manifest days after trauma, such as pneumonia or complications from the use of artificial resuscitation equipment.

And though conditions have eased, hospital officials say they will continue to prepare for the unexpected.

"The Marine Corps has a motto that says in a crisis you don't rise to the occasion - you fall to your level of training. That's why we have to stay vigilant and train ourselves and rehearse," Dr. Nicastro said.