Tending triage at 'Ground Zero'

Dr. Jose de la Cruz watched black smoke billow from the World Trade Center from the fourth floor of St. Vincent's Hospital in Staten Island, N.Y., last week.\nJust two months ago, the IU alumnus began his first year as a resident physician in New York.\n"Everybody was looking out and I saw just as we were looking at the tower ... we saw the second plane hit the tower and I didn't know what it was," he said. "By noon they got all their residents together and we were placed on emergency alert."\nThe day of the attacks, de la Cruz worked at the hospital in Staten Island, seeing patients who were brought in by ferry, mostly suffering from smoke inhalation. But by 3 p.m. Wednesday, he was needed in Manhattan. Doctors were needed at what has come to be known as "Ground Zero."\nPolice escorted him and two other doctors to the South side of the World Trade Center wreckage, only getting through with medical identification. They were assigned to do triage in the middle of the devastation of two planes crashing into the World Trade Center -- the worst Terrorist attack in United States history.\nDe la Cruz said the main triage station is now located at nearby Stuyvesant High School, but last Wednesday night they were set up in the entrance to the World Financial Center across the street from where the towers stood. The surrounding buildings were unstable, he said.\n"It was kind of scary because before we got there they told us we needed a hard hat and glasses," he said. "It was a very strange environment. You're surrounded by so much squalor and death." \nDe la Cruz, who is training to be an opthamologist, treated rescue workers with dust and debris in their eyes until about 5 a.m. Thursday. He wore two masks to shield his lungs from both the steaming dust still rising from the rubble and the smell.\n"If you're in an operation ... and you burn fat, that's how it smelled," he said. "It sounds very gruesome but that's the way it smelled."\nWith nearly 6,000 people missing or dead in New York, the tragedy forced one of de la Cruz's friends at a New York hospital to categorize patients with burn injuries coming into the emergency room. When de la Cruz called him, his friend said they were sending "medium-well" burn victims to Bellevue Hospital, with "medium rare" going to St. Vincent's Staten Island.\nWhen he saw the second plane hit, de la Cruz focused himself. Besides witnessing hurricanes in San Juan, Puerto Rico, his hometown, he had never seen such a tragedy. Then last week he was called on to help the injured. He locked all emotions away and prepared to do his job.\n"My first reaction, I didn't even think of anything at all," he said. "I need to go where I'm needed." \nBut as the days followed, the emotional burden was beginning to peek through. He and his girlfriend, Sylvia Villares, a resident physician studying pediatrics at St. Vincent's Manhattan, stopped watching television and tried to cheer each other up.\nPhysically, he was tired, although the weekend allowed him to rest. \n"There's still going to be ups and downs as far as emotion," de la Cruz said. "I still don't know how I feel. I can't describe the way I feel right (now)."\nBut he doesn't give up on the chance for survivors.\n"My gut instinct is that we needed to keep hope," he said. "I know it (seems like) too far a stretch, but you have to think about the magnitude. Everything became dust."\nHe said he was surprised about how few patients were brought to the hospital immediately following the attack.\n"I tried to stay away from the logic. The reality is that while we were there, we saw a lot of body parts instead of bodies. You're going to see more body parts than bodies. I kind of prepared myself for that," he said. "Once I left that area, everything just (began) to find its place inside of me."\nAnd in the week after the attacks, the focus of much discussion is how to bring those who committed the attacks to justice. De la Cruz is among those missing someone -- one of the resident physicians is still missing at the World Trade Center site. He said nothing the country does will bring the missing home or erase the memories he has.\n"Your first reaction is to totally obliterate whoever did (it)," he said. "... but I don't want to make people (feel) how I feel right now."\nIn the end, he said the terrorists should be "brought to justice."\n"As health professionals you're taught to not do any damage and treat the ill, but someone has to pay."\nDe la Cruz earned his bachelor's degree in exercise science from IU in 1991, and his master's in 1993, later attending medical school at Ponce School of Medicine in Puerto Rico. At the time he was an avid bicyclist of national caliber, said Associate Professor of Kinesiology Joel Stager, his graduate advisor who has kept in contact with him over the years.\nWith a desire to ride in the Little 500, he came to Bloomington, and raced for the Cinzano team in 1990. He attended IU for six years.\nWalking through New York, he said every small park is crowded with people together, remembering the dead and missing with vigils and gatherings. Union Square, near the New York University campus, sparked memories of de la Cruz's college experience during the anti-war gatherings in Dunn Meadow in the early 1990s.\n"It reminded me a lot of IU," he said. "Those are the same feelings I felt when I was at IU. Even though I was very far from the action, there was a lot of tension." \nThe magnetic way Americans and New Yorkers are coming together has been something impressive to de la Cruz. Villares, his girlfriend, said food was pouring into St. Vincent's Manhattan long after patients were coming in. She said she was given a turkey sandwich.\n"There was a note that said, 'Thank you.' I was very touched by that," she said.\nThe events of last week will change everyone's lives, he said. And through his first months in his three-year residency, de la Cruz said the terrorist attack taught him the hardship of medical school was more than worth it.\n"You have the satisfaction that you helped somebody even if it was just one person"