Eight Years Ago

I remember 9/11/01 very well.

I was underemployed at the time, and actually liking it pretty well. The main hospital our radiology group covered had been bought out by its cross-town rival, and not wishing to be an employee for the other radiology group, another radiologist and I were covering our secondary hospital on a per-diem basis. Tuesday was my day off, so I played some Counter-Strike until the late evening the night before, slipped into bed and slept the sleep of the innocent.

About 8:05 am I woke up with the sounds of early morning domesticity wafting in from the kitchen. I walked over to the computer, fired up Drudge Report and was confronted with the headline 'PLANE HITS WTC'. Just a few months earlier someone had run a Cessna into a building in Florida, and a couple of years earlier John F. Kennedy Junior had crashed into the Atlantic. I figured another light plane had struck the WTC, bad for the pilot, passengers and anyone in the office it hit, but not horrific, right?

I switched on "Fox & Friends" to see both towers ablaze, like Godzilla had come to town. Within a few seconds they replayed the video of the second plane hitting the WTC at high speed. The first might have been a badly off-course jetliner with control problems that happened to hit the tallest thing in Manhattan. The second was clearly no accident, with the high-speed bank into the corner of the building. Seeing something so bizarre, so unexpected, I half-anticipated more plane strikes in Manhattan in short order. Within half an hour, word came that the Pentagon had been hit, and I knew that something big was going on. My first thought was, "Someone has been reading Tom Clancy." The climactic scene in "Debt of Honor" is a JAL 747 slamming into the Capitol Building, and this was pretty much the same thing.

After seeing the towers collapse, one after the other, I was sure that I had just witnessed the most significant event of my generation. I also knew that someone, somewhere in the world was laughing and pleased about this, and that the person who planned this was absolutely messing with the wrong people.

Later I found out that someone I had met had been a passenger on Flight 77, the jet that crashed into the Pentagon. Paul Ambrose had been an officer in the American Medical Student Association, a competitor organization to my own AMA Resident Physician Section. I had a couple of chances to meet him at AMA events, he was really an exceptional guy. He did his residency at Dartmouth, was appointed the resident representative on the ACGME (the most important body for resident and fellowship programs), and went on to get a Master's in Public Health at Harvard. At the time of his death, he was a Senior Clinical Advisor to the Surgeon General. Paul was headed for a bright career in public health, and I'm sure he would have had plenty to say about our current health care debate. The Association for Prevention and Treatment Research has an annual conference and scholarship program named for Paul Ambrose. It says something about someone that, even at the tender age of 32, his life's mission and passion were so evident that he's still remembered and honored today.

The first time I met him, he was introducing a presentation from Doctors Without Borders. In retrospect, it's ironic that participation in an overseas mission with DWB seems dangerous and exciting, while getting on a plane from DC to California seems pedestrian. You worry the most about the confinement in your seat, about comfort, not the clean-shaven men in first class who are going to make a political point with your life and that of everyone in your plane, and anyone they can get on the ground.

People critical of our response after 9/11 often begin their criticism by asserting that "You think American lives are more valuable than the lives of people from other countries", and to be honest I don't. Americans of all walks of life are my countrymen and I feel a closer kinship to them than I do to others, I'll be honest. The big reason that another 9/11 needs to not happen is that Americans demand a response from their government, and the American government has the tools to get a response. Often, the tools are blunt and/or explosive, and come whistling down out of the sky to leave a mess on the ground. Avoiding another 9/11 is important because ultimately, it saves lives all around the world. It's hard to imagine a world without 9/11. We would not have put boots on the ground in Afghanistan on a dare. We might have eventually gotten around to getting rid of Saddam Hussein. The events of 9/11/2001 did change the variables in terms of what was 'acceptable risk', if you believe Ron Susskind's book The One Percent Doctrine, anything with a 1% risk of occurring had to be eliminated as a possibility. When you get down to that level of risk reduction, the US military gets very busy.

I'm thankful that my kids have no direct memory of 9/11. I'm glad I didn't have to try to explain it to them so they could understand. The idea that the world contains people so angry and nihilistic that using passenger jets as cruise missiles seems like a good idea is something I'd rather my kids not dwell on. On 9/11, I remember Paul and other people like Barbara Olson, an author whose books I have read, and Rick Rescorla, a British-born US Army officer and genuine hero of the Vietnam war who died at the World Trade Center. I remember the passengers on Flight 93, who showed what is defined by 'the Militia': not goofballs in camouflage crawling around Michigan, but average Americans who, finding themselves in the most dangerous circumstances imaginable, self-organized and probably saved thousands of lives at the cost of their own. The American response to 9/11 started on Flight 93, within minutes of their notification that the WTC had been hit by hijacked planes (through nominally illegal cell phone calls, I might add). Those people didn't wait for someone to tell them what to do. That's Americans in a crisis -- a brief moment of "Oh $%#*", then back to work on solving the problem.

That's what I want my kids to remember about 9/11.