Podcast Summary: This Is Actually Happening

Episode 346: What if you ran the ER five blocks away? [Rebroadcast #202]

Original Air Date: December 31, 2024
Guest: Dr. Tony Daher
Host: Wit Misseldine
Theme: First-person account of running the ER at New York Downtown Hospital, just five blocks from the World Trade Center, during the September 11, 2001 attacks.

Overview

This episode delivers an intimate, first-person account from Dr. Tony Daher, an ER doctor in lower Manhattan during the 9/11 attacks. Drawing on personal memories and professional insights, Dr. Daher recounts his upbringing, his path to emergency medicine, and the harrowing experience of leading a small ER at the closest hospital to Ground Zero as the catastrophe unfolded. Through his narrative, listeners glean a visceral sense of chaos, professional duty, emotional trauma, and human resilience—both in the ER and in the aftermath.

Key Discussion Points & Insights

1. Early Life and Path to Medicine (02:57–14:00)

• Multicultural Upbringing: Tony Daher was born in NYC to a Nicaraguan father and a New Yorker mother with Nicaraguan roots, growing up between New York and Puerto Rico.
• Influence of Family: Both parental influences and the Jesuit education instilled a strong sense of compassion and social commitment.
  • "Part of the central reality was protecting my mother...I was her emotional support, the only son. So it was a pretty powerful gravitational pull..." (04:30)
• Drive to Serve: Inspired by familial expectations and social justice ideals, he was drawn to medicine, specifically to places of greatest need like Bellevue Hospital (NYC) and fieldwork in Nicaragua.
• First Experiences with Failure: Recounts a case in Nicaragua where a young man died of injuries from a landmine, which profoundly shaped his views on medical error, regret, and resilience.
  • "You realize...if you do enough medicine, you will eventually have this happen to you. It’s like barnacles on your hull...but you just have to live with the barnacles and the ship will keep sailing.” (13:40)

2. Finding a Home in ER Medicine (14:00–19:47)

• Transition to Emergency Medicine in NYC: After working in family medicine, Tony’s natural affinity for the fast pace and unpredictability of the ER became clear.
• Leadership and International Life: Quickly became ER chief at a Manhattan hospital; balanced work between New York and France.
• The Real Test:
  • “Being with two little kids all day long is so much more stressful and difficult than being an ER doc.” (16:20)
• Purpose of the ER: "You get to do something useful on people's worst day, that when all hell is breaking loose, you get to be the one that puts it back together." (17:00)
• Profound Patient Impact: Recalls a patient in deadly arrhythmia who felt safest simply because the doctor stayed by his side.
  • “He wrote me a lovely letter saying...he felt I was with him in the life raft and would accompany him down these rapids no matter what.” (17:57)

3. The 9/11 Attacks – Inside the ER (19:47–37:59)

Setting the Stage

• Disaster Drills: Just two months before 9/11, his hospital ran an unannounced disaster drill, unknowingly preparing for what was to come.
• Morning of 9/11: Tony was the only attending ER physician on site.
• Initial Impact: Sudden influx of trauma patients after the first plane; immediate shift into triage and crisis management.
  • "It was like something out of one of those movies where a crowd is running away from something and barreled to the ER.” (21:05)
• Patient Stories:
  • Severely burned young woman hit by airplane landing gear;
  • Numerous traumatic injuries, mostly young and healthy individuals;
  • Patients burned by jet fuel cascading through elevator shafts.
• Organizational Chaos and Response: Staff and available providers rose remarkably to the occasion, improvising triage, treatment, and even engineering an airlock to keep smoke out.
  • "The way people rose to the occasion is something I'll never forget." (24:54)

Surreal Catastrophe as the Towers Collapsed

• Describing the Collapse: The terrifying arrival of the dust cloud, uncertainty over safety, and a new wave of respiratory cases.
  • “You get almost fatalistic at that point, thinking, all right, this is never going to end.” (33:15)
• Endless Patient Influx: Despite no power, dwindling resources, and unsafe air, the staff continued treating a relentless stream of injured.

4. Aftermath, Emotional Fallout, and Community (39:23–52:07)

• Night of 9/11: Tony and colleagues venture into Ground Zero to aid a trapped transit officer, feeling both fear and awe at rescue workers’ bravery.
• The Pain of Invisibility: The hospital’s efforts largely went unacknowledged in media and public records, leaving staff feeling invisible.
  • “After going through all that and to be literally invisible...That invisibility factor had kind of traumatized the staff.” (44:55)
• Moments of Shared Humanity: Community gestures (Philly cheesesteaks from a medical school, teddy bears from Oklahoma City) offered powerful, if simple, healing recognition.
• Profound Gratitude: A survivor’s wife thanks Tony, showing unexpected grace in the midst of tragedy.
  • “She was radiant with gratitude and love and...what you guys must have gone through on 9/11. And thank you for saving my husband.” (51:38)
• Sense of Loss & Global Solidarity: Tony laments the fleeting unity the world experienced after 9/11 and what was lost in the years that followed.
  • “One of the big tragedies of 9/11 is that feeling that the world was with us...That moment was squandered.” (48:10)
• Enduring Bonds Among Caregivers: The trust and camaraderie forged during the crisis provided a glimpse into what combat veterans feel.

Notable Quotes and Memorable Moments

• On the overwhelming scale of 9/11:
  “When you see the human wave coming at you, first instinct is to feel helpless, of, how on earth am I going to take care of all these people all at once?” (24:36)

• On failure and forgiveness in medicine:
  “The reason I can sleep at night is that we did everything that could have been done for every patient that came through the doors.” (36:40)

• On grace in the midst of loss:
  “Even in the depths of her grief, her love for him spilled over to us...I have never seen another human being so represent what Grace means.” (51:30)

• On the city’s transformation and shared mourning:
  “New York City became a tender place...you could sense that there was a caring and a tenderness about the city, that everybody was in mourning, everybody was grieving, but everybody was looking out for each other.” (47:30)

Timestamps for Important Segments

• 02:57–14:00 — Tony’s family, upbringing, early medical career
• 14:00–19:47 — Realization: ER medicine as a calling, important lessons
• 19:47–24:54 — 9/11 strikes; switch from routine to mass trauma
• 25:00–33:15 — The chaos, the triage, coping with unexpected scale and loss
• 33:15–36:40 — The terror, collapse of the towers, suffocating debris, impact on ER
• 39:23–44:55 — Ground Zero at night, rescue, dealing with invisibility and lack of recognition
• 44:55–48:10 — Community support, international outpouring, emotional reckoning
• 48:10–52:07 — Aftermath, survivor family, enduring relationships, meaning of grace

Final Reflections

Through Dr. Tony Daher’s vivid storytelling and reflective analysis, this episode offers a unique, ground-level view into the chaos, courage, and heartbreak of 9/11 for medical professionals. Touched by moments of grace, haunted by the weight of both victories and losses, and grounded in a profound commitment to human connection, his story transcends the medical field—speaking universally to the resilience of people faced with unimaginable tragedy.