It seemed that the hotel had moved all of its regular guests to other quarters so that DMORT could commandeer almost the entire facility. The hotel staff was basically serving only rescue workers, and they approached me with a subdued readiness to help that I think they saw as their contribution to the recovery effort.
I appreciated their concern as they directed me to my room and then showed me how to follow the arrows that had been taped inside elevator doors and at every landing, directing me to “DMORT-MST.” MST stood for “Management Support Team,” the administrative wing of DMORT. Whenever there's a disaster, MST is there, arranging for the living quarters, food, telephone lines, computers, faxes, photocopiers, and all the other necessities that nobody notices-unless they're not there. Now, MST staff helped me fill out all of the necessary paperwork and signed me up as a temporary employee of the U.S. Department of Health and Human Services (DHHS), part of their National Disaster Medical System. (In the summer of 2003, this division became part of the Department of Homeland Security.) As a member of their team, I'd be paid an hourly salary and receive a per diem allotment to cover food and incidentals. The hotel room was free, courtesy of my new employer.
Being in DMORT is a bit like being in the National Guard, although in our case response to an incident is strictly voluntary. We keep our regular jobs, but when the country needs us to serve somewhere, we work things out with our bosses and go. My superiors at home had agreed to bring in anthropologists from neighboring states to cover any routine cases that might arise, as long as I promised to come back if I were truly needed.
Over my three tours of duty in New York, I tried my best to keep up with my Kentucky commitments. When I was on the night shift, signing in at six p.m. and checking out at seven a.m., I made sure never to sleep past four p.m. so I could use that final hour of the normal workday to return calls to my home state. Then, sometime between two a.m. and four a.m., when there was usually a lull in activity at the morgue, I'd answer my office e-mail-courtesy of the library at nearby NYU Hospital, which had offered us their computer services. So even while I was serving DMORT in New York, I was still keeping up with my job in Kentucky: examining digital pictures of bones e-mailed to me by coroners (thankfully, all were nonhuman, or I might have had to go back); corresponding with detectives about active cases; and working with attorneys to arrange my scheduled testimony for upcoming trials. Because I was still working for the Commonwealth, I still had to fill out my time sheets, answer the many questions routinely called in by police and families, and otherwise provide the kind of ongoing presence required by my office.
All of us in DMORT had gone through a rigorous application process and, once we'd been accepted, we had to attend mandatory annual training sessions. Although I'd had plenty of experience working in emergency situations, this wasn't true for all the funeral directors, dentists, and other volunteers who'd come to DMORT from private practice, and it was important for us all to learn how to work together as one cohesive unit. For people used to being their own bosses, it was important to learn how to take orders, work under strict federal guidelines, follow protocol, and make the shift from dealing with individual patients to working on a virtual assembly line of people, living or dead. Those of us who dealt primarily in law enforcement had our own lessons to learn: how to develop working relationships with other types of professionals; finding ways of building trust and camaraderie and mutual respect. The last thing you want in an emergency situation is any kind of turf war.
Of course, people being what they are, there
At five forty-five the next morning, I walked into the hotel dining room that MST had reserved for our twice-daily meetings and immediately felt like part of the team. This kind of briefing was familiar from my days at Waco, though there were almost three times as many people at these meetings, and there was still more pressure to move quickly and cooperatively. It helped to be dressed like everyone else; all of us DMORT personnel were wearing standard-issue battle-dress uniforms: khaki shirts with button-down flap pockets, multi-pocketed pants, high-topped black combat boots- uniforms that made us instantly recognizable and helped us function as a unit amid the firefighters and police officers.
The businesslike briefing left little time for greetings and socializing. At six a.m. sharp, DMORT Region 4 commander Dale Downy started in with a quick report on the recovery efforts at the three terrorist target sites, relaying the latest words of encouragement from President Bush and DHHS Secretary Tommy Thompson. Then he gave us our assignments. I was going to the morgue to help with triage.
As I boarded the chartered bus that would take me down to the morgue, I couldn't quite picture what was in store. Despite my experience in multiple-fatality incidents, I'd never dealt with anything remotely like this-none of us had. In other cases, the scope of the disaster had seemed finite. We'd had some kind of list of who the victims were, records that enabled us to match remains to names. Here, the chaos seemed endless and so did the tragedy.
I was riding with a group of mortuary workers who had been in New York from early on. These old-timers leaned their heads against the windows and either stared into the dark or tried to nap, while a few of us newcomers talked quietly, trying to diffuse some of the nervous anticipation that became more intense the closer we got to Manhattan, our nerves keyed up by the flashing blue lights and whining siren of the police escort that led our way.
We arrived at the morgue just as the sun was coming up. The night-shift workers were anxious to board these same buses for the ride home and they'd gathered in the street behind the police barricade-groggy, dirty, with sightless, glazed-over eyes. They tried to greet us with encouraging smiles and handshakes, but I could tell they were exhausted.
I allowed my colleagues to sweep me along as we crossed the police barricade at First Avenue and funneled through the checkpoint set up by the New York State Police at the end of the block. The morgue was down 30th Street, half a block away.
Security was tight here, and each of us had to show our DMORT identification badge to two uniformed officers. Then I followed the other members of the team down this street toward the East River, into the tent city that had been set up within hours of the disaster to analyze and identify the remains of what was then assumed to be more than five thousand victims.
The OCME had commandeered the entire area, and I looked around quickly, trying to get the lay of the land. In the middle of the block was the garage-type entrance to New York City 's permanent morgue, on the ground floor of a six-story brick building that handled the “routine” violent and accidental deaths in this huge city. Within hours of the disaster, Chief Medical Examiner Dr. Charles Hirsch had realized that his regular autopsy suite would hardly be enough, and he initiated his agency's mass-fatality plan-turning his building's delivery garage into the disaster morgue and tacking on a three-sided tent, which extended our work space right down to the street. Heavy reinforced plastic flaps let us seal off the disaster morgue entrance tent from rain, wind, or cold, though the flaps were almost always left open to allow air to circulate and the typical morgue odors to dissipate. Despite the disaster, New York City 's regular forensic business had to continue, so the standard autopsy suite and the modified emergency morgue operated side by side as parallel worlds-one for routine violence, the other for disaster.
I came to think of the left side of the street as the medical section of Tent City. First came two refrigerated trailers, the kind normally pulled along the highway as the back part of a semi or tractor-trailer rig. These trailers, known as “reefers,” were attached to large diesel-powered refrigeration units that periodically roared to life as they tried to keep the trailer's contents cool. Here, workers stored the body bags as they were brought in from the disaster site so that we could process the remains in a steady stream, rather than allowing them to stack up and deteriorate in the heat of the day.
To the right was the “support side” of the street-another group of white tents whose yellow- and blue-striped roofs lent an incongruous circus air to the area. I noticed a chapel, complete with altar, flowers, and rows of benches-a private yet communal place where the rescue workers could share a moment of much-needed quiet. Then there was a tent stacked with mysterious-looking cardboard boxes, which I later found out contained such personal items as toothbrushes, soap, shaving supplies, even packages of underwear and socks-anything that displaced workers might need when they had to work here for days at a stretch, without time for a long commute back to the suburbs.
The next tent was filled with police officers. When I saw some of them standing around drinking coffee and smoking cigarettes, taking a brief break from the urgent pace of work, I felt the urge to smile. I was finally starting to feel at home.
Then there was the morgue, whose open tent flaps allowed a clear view all the way inside. I saw six stainless steel autopsy trays, each long enough to hold a human body, supported by a pair of sawhorses. Behind each tray was a stainless steel cart filled with latex gloves, marking pens, plastic bags of all sizes, scissors, knives, and a bone saw.
A team of medical specialists surrounded each tray, moving in the highly synchronized choreography that you see in an operating room, an ER-or a morgue. The noise was overwhelming as the workers shouted to one another over bone saws that whined like dentists' drills. Clerks wearing hospital scrubs stood by, passing labeled folders to the pathologists each time a new body bag was loaded onto their table. And over it all hung the heavy smell of death, along with diesel fuel from the nearby reefers.
I wanted to stop for a closer look, but my colleagues were making their way to the tent labeled DMORT. Inside, their twenty-by-twenty-foot nylon tent was crammed so full of people and supplies that there was barely room to move. The side walls were stacked with boxes of disposable surgical gloves and gowns, while along the back were paper towels, notebooks, and office supplies. I noticed some military-issue canvas cots where exhausted morgue workers might catch a catnap during breaks, and in the center of the tent were a half-dozen folding chairs surrounding a makeshift table-a large wooden spool normally used to hold a coil of steel cable. It remained me of something you'd have at a fishing camp.
This table held the sign-in sheet that each of us had to initial each day before we scattered to our various assignments. The DMORT supervisor on duty, Cliff Oldfield, knew that this was my first day, so he told me to stand by. In just a few minutes, he promised, he'd tell me everything I needed to know.
When Cliff brought me over to the morgue, Amy Zelson Mundorff, the forensic anthropologist who worked full-time for the city's chief medical examiner, was ready to greet me. I saw immediately how personal this tragedy was for her and her colleagues-although she was smiling brightly, large purple and green bruises ringed her eyes, and her forehead sprouted a lump large enough to cast a shadow. Cliff had told me that she, along with Dr. Hirsch and several other OCME staff members, had rushed to the Twin Towers shortly after the first plane hit. They were in the process of trying to establish a site for a temporary morgue when Tower 2 had come crashing down. The blast blew her headfirst into the marble pillar of a nearby building, while Dr. Hirsch escaped death by inches. One staff member suffered a massive concussion and fractured ribs, and another's leg was shattered, leaving bone and muscle exposed to the air.
However, Amy, just barely five feet tall and sporting a head full of curly black hair, was still very much alive and eager to get on with the business of victim identification. After she gave me a whirlwind tour of the medical examiner's office, we wound up at ground level in the morgue tent, where she took her place at the first autopsy table, the one designated for triage. As she worked, she quickly explained the overall recovery and identification protocol.
The protocol we were using was based on the emergency plans that the OCME had developed well in advance of September 11, with modifications that Dr. Hirsch had added when the scope of the disaster became clear. This protocol fascinated me: It was both different from and similar to the setup at the other incidents I had worked.
Most mass-fatality morgues are set up in sort of an assembly-line format. Rescue personnel bring in bodies or body parts to be photographed, x-rayed, and preliminarily identified by careful scrutiny of superficial characteristics such as hair color, skin color, clothing, and perhaps jewelry.
If the body is relatively intact, the forensic pathologist will conduct an exam that is not too different from normal autopsy protocol. He or she will photograph, weigh, measure, and describe the body in painstaking detail, including observations on its overall condition and any old scars or other evidence of surgery that the preliminary exam might have missed. The pathologist will also document the acute injuries that most likely caused the person's death-documentation that would eventually include photographs and a detailed written or dictated description.
In some cases, as in the Oklahoma City bombing, living perpetrators are involved who may eventually stand trial for murder. The medicolegal details of autopsies might well have ramifications for their criminal prosecution.
But the attack on the Twin Towers was a completely different situation. There was no reason to conduct traditional medicolegal autopsies: Millions of people had witnessed the events as they happened. We all knew that these were deaths by homicide and that none of the hijackers could have escaped alive. It would be virtually impossible to identify the specific causes of death for each victim. All that mattered was identifying the victims themselves-but that task was difficult enough.
Here, the first step in the identification process was triage, a French word that means “to separate.” The term is used primarily in battlefield or medical situations, where patients or victims are separated into categories based on how urgent it is to treat them. This triage process began with a forensic anthropologist who had to identify and separate every single bit of human tissue that came through the morgue door. If a bag came in filled with a twenty-pound mass of muscle, skin, and bone, we had to be able to tell either by feel or by sight if the tissues were connected. If a bone led to a tendon, and then to a muscle, and the other end of the same muscle was connected to yet another bone, then the entire specimen could stay together and be processed as a single set of remains, because the “connections” established the fact that these were the remains of one person. But if we determined that there was no physical connection between one part and another, then we'd
