For First Responders, 9/11 Struck Close to Home

ARLINGTON, Va. -- Arlington County Fire Department Battalion Chief James Bonzano was attending a leadership seminar about a mile from the Pentagon on Sept. 11, 2001, when he heard a blast and felt the ground tremble. It was 9:37 a.m. Monitors in the room carried news of planes striking the World Trade Center in New York. Now an American Airlines Boeing 757 carrying 64 people had slammed into the Pentagon. As fighter jets circled above, Bonzano soon boarded a bus filled with other firefighters and headed toward the crash scene.

As the bus crested the last hill, the Pentagon appeared on the horizon, black smoke pouring from a fiery gash that exposed the wreckage within. The firefighters fell silent, awed by the destruction and the challenge they faced. The Pentagon lies within Arlington County's jurisdiction. It was their responsibility to lead the response to a plane crash, building collapse and fire in the headquarters of the U.S. military -- a vast, secure installation with 23,000 employees and 17 miles of corridors.

"You could have heard a pin drop on that bus," Bonzano says.

Remarkably, the department had trained for just such a scenario. A year before the Sept. 11 attacks, Arlington firefighters, working with police, military and other public safety agencies, had staged a tabletop scenario envisioning a plane crash into the Pentagon's inner courtyard. They worked through every detail, from the arrival of the first fire truck until the moment control was restored. "We were there at the Pentagon with all the important folks," says Arlington Battalion Chief Robert Cornwell, now retired, who was an architect of the exercise. "We tried to make it as realistic as possible."

The effort paid off on 9/11, not least because the first responders knew each other and spoke the same language, says Bonzano, now the Arlington fire chief. "We had a great working relationship with [the folks at] the Pentagon, both military and civilian. We had trained with them and could put faces behind names."

For every first responder, 9/11 marks a watershed moment when the risks they face -- and the magnitude of their responsibility to the public -- became chillingly clear. Violent extremists and anyone else with access to a weapon and an inclination to kill are increasingly turning communal spaces in every corner of the world into battlefields, using whatever weapon lies close at hand.

On 9/11, no one was prepared for terrorists to hijack four passenger jets and turn them into winged missiles weighing as much as 270,000 pounds loaded with jet fuel and traveling at 400 miles per hour. Upon impact, the fuel exploded, transforming each jet's 600,000 rivets and airframe bolts into white hot shrapnel that bored through concrete and steel, according to the Arlington County Fire Department's after-action report. At the Pentagon, the shrapnel penetrated the building's five rings. The ground glittered with aluminum shards from the plane's fuselage.

The attacks killed approximately 3,000 people and injured 6,000 more. Nearly 350 New York firefighters lost their lives. At the Pentagon, 125 people died. The toll might have been much higher if the offices struck by the plane had not been under construction. Firefighters at the scene encountered chaos. "There was a tremendous amount of exterior fire, a lot of activity, confusion, people running," says Cornwell, who led the fight that day to put the fire out. "There were a lot of people with weapons, military personnel. It reminded me of Vietnam, to be honest with you."

The 9/11 attack drove home the reality that terrorists were clever enough, and resourceful enough, to dictate where battles would be fought.

"All of a sudden there was the realization that we lived in a much larger, more threatening world," says Timothy Manning, deputy administrator for Protection and National Preparedness at the Federal Emergency Management Agency.

This new world was one first responders were ill-prepared for. Before 9/11, firefighters and emergency medical personnel were trained to fight fires and respond to medical emergencies, jobs that are risky enough. Public safety professionals in fields from emergency medicine to law enforcement and public health also focused on sharpening their skills in their own realms. But they tended to work in their own silos rather than in teams trained to respond to all hazards.

"They didn't recognize the importance of working together," Manning says.

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The critical need for an all-hazards approach to public safety was reinforced by a new crisis a week after 9/11. With the nation still in mourning, a perpetrator later identified by the FBI as U.S. Army biologist Bruce Ivins unleashed a series of anthrax attacks. The perpetrator mailed millions of deadly anthrax spores to U.S. Senate offices and news organizations. The attacks killed five, infected 17 and kindled a new fear on the heels of 9/11: weapons of mass destruction.

The convergence of the 9/11 and anthrax attacks propelled the U.S. into wars in Afghanistan and Iraq. The onslaught in Iraq was framed by the Bush administration as necessary to protect the U.S. homeland from Iraqi President Saddam Hussein's rumored stockpiles of biological and chemical weapons, which were never found. They also plunged first responders in the U.S. into renewed soul-searching about their roles and how best to combat these threats.

The Arlington County Fire Department was ahead of the curve. Six years before 9/11, then-Fire Chief Ed Plaugher listened with deep concern to reports of a sarin nerve gas release by a cult then known as Aum Shinrikyo during rush hour in the Tokyo subway. The gas, estimated to be 26 times more lethal than cyanide, killed 12 people and injured many more. Plaugher believed that the nation's first responders were not trained or prepared to deal with such an event. At Plaugher's urging, county officials relayed his concerns in a letter to the White House.

Plaugher launched collaborations -- and joint training exercises, including the tabletop at the Pentagon -- with federal, state and local public safety agencies. "He always had his eye on the big picture, on all hazards," Bonzano says. "To the boots-on-the-ground fireman, me being one of those guys, I always found his thoughts esoteric, not very tangible. He turned out to be spot on."

In the wake of 9/11, with an infusion of homeland security funding, the department stepped up its efforts and developed new protocols for training and equipment, scrapping a battered ambulance used as a makeshift hazardous materials truck and replacing it with a state-of-the-art vehicle. Arlington fire trucks were stocked with antidotes to sarin and other chemical and biological agents.

The multi-agency approach that the Arlington County Fire Department and other officials before 9/11 rehearsed at the Pentagon has become the model followed nationwide. And first responders nationwide now train for myriad threats, from nuclear radiation to chemical and biological weapons.

"We are ready to deal with just about anything you've heard of that's being used, planned or thought of," New York City Fire Commissioner Daniel Nigro says.

Training is a constant. And, given the need for a coordinated response in a high threat environment, the focus is now on an integrated response, involving the police department, hospitals, even the FBI, which handles intelligence and carries out criminal investigations. The settings include malls, elementary schools, office buildings, hotels, movie theaters -- anywhere an attack may take place.

"The training we're doing is no longer reactive, it's preemptive," Bonzano says. "We have set and defined responsibilities, variables that are almost plug and play. We train to the point where it's almost second nature.

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"If you ask the boots on the ground, they'll say, 'We've done enough training, Chief.' But that's what we're doing."

These training scenarios incorporate lessons that cost lives in such places as London, Madrid, Mumbai, San Bernardino and Orlando. "Today, combined with other gruesome weapons, there's the use of fire. It was used in Mumbai. It was used in Benghazi. We're planning for when it's used here," New York's Nigro says.

Active shooters are among the current concerns. Perhaps the most tragic lessons for first responders come from places like the Columbine school shootings and the London transit bombings, where medics waited for the threats to be eliminated before they plunged in to save lives. The credo: Don't become a casualty.

That is beginning to change, says Dr. Reed Smith, medical director at the Arlington County Fire Department. First responders can no longer wait by the curb when people are dying. "The battlefield has changed for us," he says. "What we find is that it's much more like a combat environment."

Rather than hanging back, firefighters are increasingly practicing "warm-zone care" -- entering the danger zone escorted by police in active-shooter situations. The police establish a secure perimeter, within which medics can apply tourniquets and other battlefield techniques to sustain victims until they can be evacuated.

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"We're the experts at stopping the dying," Smith says. "Get me to the side of the patient as quickly as you can, as safely as you can, and I will stop the dying as quickly as I can."

Smith acknowledges that the approach puts firefighters at risk. "Of course, what we do is dangerous," he says. "We lose 50 to 80 firefighters a year fighting fires. But we've never had a hard time going into fires or earthquakes. Historically, we've had a hard time going into places where there are bullets and blasts."

That's no longer the case in Arlington County, he says, where police and fire have run scenarios like the shootings at Orlando's Pulse nightclub several times. And support for the warm-zone approach is growing, Smith says, endorsed by the International Association of Fire Fighters, the International Association of Fire Chiefs and other organizations. The federal government has poured $47 billion in grant money into public safety agencies to bolster their equipment and training. "You see it in the news and don't even realize that it's something we couldn't have done 16 years before," FEMA's Manning says.

The bomb robot used to stop the Dallas police shooter and the armored police unit used to penetrate Pulse were purchased with federal grant money, Manning says.

What is most heartening, Bonzano says, is that there are so many first responders who'll put themselves in harm's way to save lives.

"I just met with our rookies," he says. "We have 19 or 20 of them in school. They're just the best bunch of kids. They're going to see a lot of stuff, God forbid, but that's what they're here for."

Steve Sternberg is a senior writer for U.S. News and a data journalist covering health care performance, health policy, clinical medicine and public health. You can follow him on Twitter (@stevensternberg), connect with him on LinkedIn or email him at ssternberg@usnews.com.