Plan D for Disaster

Tuesday morning, Sept. 11, 2001, a scene of horror and confusion was unfolding across the Hudson River, but for the moment, everything was normal at—what was then named—St. Mary’s Hospital on Willow Avenue in Hoboken.

Mary DeAngelo, head nurse of the emergency room at the time, was on the fifth floor doing her rounds when she caught a glimpse of the news on television. A commercial airliner had crashed into the north tower of the World Trade Center, and people on the ground below were running for their lives.

“It was just a shock,” she said. After 17 years on the job, she had never seen anything like it, but minutes later, she got a phone call that a response team was gathering at the bus terminal downtown, and she was on her way.

Dr. Angelo Caprio, a general surgeon at the hospital, was at home getting ready for work when he heard from his bathroom someone on TV say a plane had hit the World Trade Center. He thought of the B-25 bomber that had crashed into the Empire State Building nearly half a century earlier and said he wondered how such an accident could ever happen again. As he stopped in front of his TV, he saw the second plane hit. “We’re under attack,” Caprio thought to himself. And he picked up the phone to call the hospital and declare a Plan D for disaster. As St. Mary’s designated disaster physician, Caprio had handled what he called “minor disasters,” mostly power outages and nothing with casualties in the thousands.

City officials and members of the local police and fire departments as well as the ambulance corps started gathering where Hoboken Bus Terminal meets Erie Lackawanna Ferry Terminal. , where DeAngelo’s husband John later called in supply requests to St. Mary’s emergency room.

After arriving on the scene, Caprio and DeAngelo phoned the hospital to ask for more manpower, and after a short while, dozens of workers from St. Mary’s and other hospitals in the county showed up. Doctors and nurses who arrived at the bus terminal to take a ferry or PATH train to their jobs in New York City could no longer get to their regular jobs.

“Everybody stayed,” Caprio said. Together, they raised a hospital.

“This doesn’t look like much,” Caprio said recently, clicking through a slideshow of 9/11 photos on his office computer, “but it’s actually a field hospital.” And it wasn’t the first time he’d helped set one up. Caprio is a commander in the Navy Reserve and had built his share of medical facilities while serving in the Gulf War. “Every time we go out in the field,” said Caprio, “we put up a field hospital, just in case.” But the field hospital at the bus terminal that day was not for practice. It was ready with several rows of folding chairs for people in triage and about 30 beds for patients.

It was still morning when the first patients came over on the ferry from lower Manhattan. They arrived 15 to 25 people at a time and were escorted through “decon,” short for decontamination, where firefighters use hoses to wash them, clothes and all, from the dust and debris that had fallen on them.

“No matter what they had on, everybody had the same grayish-white coloration,” Caprio said. “They were all covered with dust.” The later it got, the thicker the dust became.

Caprio said he had called a friend who’d done construction work at the World Trade Center to ask him if the building still contained asbestos. “He said, ‘Every bit of it,’” said Caprio, who then required medical personnel to wear protective white suits that covered them from head to toe. Caprio also used a marker to write “MD” for doctor or “RN” for nurse on the backs of the suits, so patients would know who was who.

Caprio wore a vest that distinguished him from the others and stood at the edge of the pier to wait to direct passengers on where to go. And at one point while the crowd funneled past him, a woman, frantic and crying, walked right to him. “I can’t find my baby,” she told him. “I was pushing my stroller, and I can’t find my baby.” She had been separated from her child by a mob of people pushing onto the ferry to escape lower Manhattan. Caprio said he tried to calm her down, but the woman was understandably hysterical.

About 20 minutes later, a man, also panicked, approached Caprio. “Can you help me?” He asked Caprio. “I have this stroller with this kid in it.” The stroller and the baby were covered with the same gray dust as everyone else, but the woman was elated. “You had to see her go crazy,” said Caprio, who couldn’t help but tear up himself when he talked about the reunion. “It was one of the good stories that day,” he said.

Hoboken’s response team decontaminated 6,831 people. At triage, doctors and nurses checked vision and breathing, since burning eyes and lungs were common complaints. Two thousand people became patients, and they were loaded into ambulances that lined up next to the bus terminal on Hudson Place. Three hundred of them were sent to the local hospital.

Back at St. Mary’s, DeAngelo’s staff was manning phone calls from friends and family members searching for loved ones. “It was very, very crazy,” DeAngelo said.

The hospital received about 5,000 calls, some from as far as China. More came in the following days. A couple of people were reunited that way, but not too many.

Caprio said he thought about the casualties when he saw all the empty chairs at triage. They reminded him that there were a lot of patients his team would not be seeing that day, since so many victims never made it out of the towers.

“Anybody who was left in there died,” Caprio said. “They never found anyone.” Hoboken eventually transferred 134 casualties from ferries and tugboats to nearby hospitals.

Caprio and DeAngelo spent the better part of three days at the bus terminal and other sites around the county. At the hospital, meetings were organized for staff to debrief and talk about their experiences. “We had to deal with the aftermath of it,” DeAngelo said. She added that her staff became stronger because of it, though the day has affected her. “It does leave a mark,” she said.

Caprio, who is now the chief medical officer and head of the hospital’s office of emergency management, said that soon after 9/11, the hospital, now the Hoboken University Medical Center, intensified emergency response training for its staff and purchased more equipment, including triage and decon tents.

In short, ten years later, Caprio and his team are ready, should they ever have to build their makeshift hospital again.