The Downwind Walk: A USAR Paramedic’s Experiences on September 11, 2001


On the morning of Sept-ember 11, 2001, I was working as an EMS supervisor in the Bronx. I was the station supervisor, busy getting units in service, completing the log book and ordering supplies when the signal 10-40, which is a plane crash, was announced over the Bronx radio: “Signal 10-40 has been announced at Number 1 World Trade Center (WTC); I am dispatcher 5678, and the time is 9:02 hours.” I remember thinking that must not be real. How could a pilot not see the tower on such a clear day? Maybe it was a small tour plane that hit the tower. I went back to work, paying attention to station operations.

EMT Keith McGregor came in the office and turned on the TV. “Boss, we are under attack,” he said.

I replied, “What, Keith?”

He said, “We are under attack, Boss. There is a plane into the WTC, and another one crashed into the Pentagon in Washington.”

I looked at the TV in disbelief. For the first time, I saw the imprint of the plane on the side of the WTC. It was huge; this was no tour plane—this was a jetliner, and smoke was rising out of the building through the plane’s footprint. The group of EMTs gathered in my office started to go wild in disbelief. We watched the TV in amazement. I looked at the dispatch screen and saw some 60 ambulances assigned. “Wow, this is bad,” I thought to myself.

When the first tower collapsed, I could not believe it was gone. I thought we just lost 30 EMTs and medics. I wondered what it would be like with only one tower. Little did I imagine there would be hundreds of rescuers killed by the day’s end! Many of those killed or severely injured were coworkers, firefighters with whom we had done EMS jobs, and urban search and rescue (USAR) team members I had trained with at the fire academy.

One unit from my station was headed to Ground Zero. I helped them load their equipment in the ambulance; we loaded extra weapons of mass destruction (WMD) kits and oxygen bottles and closed the back door. I knocked on the side and gave the thumbs up in their rearview mirror. They acknowledged me with a wave and drove out the apparatus floor bay. I heard on the citywide radio a medic calling for help. The dispatcher advised him to go to the triage center. He replied, “I cannot see. I cannot breathe. I need help!” I wondered if they were using WMDs. The sun filled the empty apparatus bay as my basic life support (BLS) unit pulled away. I wondered if I would ever see those EMTs again. They were going into a war zone.

(1) Ground Zero from the World Trade Center North Tower site. (Photos by author.)
(1) Ground Zero from the World Trade Center North Tower site. (Photos by author.)

I responded down to Ground Zero with the USAR team. When I arrived, I found my way to the USAR team staging area and saw personnel waiting. I walked up and asked, “What are we waiting for?”



“We are waiting for word to come down about the plan, the operation.”

“What about Chief Downey?” I asked.

“He is gone,” a voice said.

“The rescue guys from USAR?” I asked.

“Steve, we lost all five rescue companies, the hazmat truck, and all Special Operations Command units.”

The enormity of the collapse was hitting me. There was no radio communication because the radio towers were on top of the WTC. There was no plan, no forward motion. The collapse had left the city decimated, and a vacuum in command existed. I had never been to any type of disaster where there was no forward motion—not the Happy Land Fire, not the 1993 WTC bombing.

A voice spoke out: “We should get to the pile.”

A clear voice spoke out: “Our brothers are digging on their hands and knees; they will last for another 10 or 12 hours, and we have to set up for a long-term operation. We are here until we get the job done.”

Next a voice shouted, “Run, Number 7 is going!”

We turned and looked up and began moving backward. A salient voice boomed: “Do not run; we are far enough away. We do not run; we are the FDNY (Fire Department of New York).”

Number 7 WTC fell in about three seconds. At the time, I thought it was a seven-story building. I later found out the building was a 47-story building. To see that building fall in three seconds was earth shattering.

The collapse of Number 7 WTC was like a pacing spike to an asystolic heart. The salient voice I had heard before directed us, “Unload the cache. Let’s get to work. Unload the Anvil boxes. Everybody wears gloves. We don’t need any more injuries.”

(2) A USAR medical specialist from NY-TF1 in full equipment.
(2) A USAR medical specialist from NY-TF1 in full equipment.

We set up the tents, and a new pattern arose out of the dust as we all started performing our jobs and checking equipment. Captain Jack Quigley ensured that the area we set up as the USAR base was washed down to clear it of dust. We used a boot wash and left our turnout coats outside the tents. We were fortunate to be issued masks with filters as we unloaded the cache of equipment. The masks fit nicely because we had been test-fitted as part of our training. Looking back at these actions, I am thankful we applied our training and used our masks.


When we finally suited up and began rotating down to the pile, we were awestruck by the devastation and number of fire department vehicles destroyed. The collapse of the Twin Towers left a disorganized pile of four-to-one I-beams that stood hundreds of feet high. We were chasing the shadows of hope as we searched the pile—hope that we would find pockets where rescuers had been trapped alive. As we climbed and searched, we asked, “Where is everybody?” We had team members who had found people in Oklahoma City; surely, we would find people here. Day after day, hope grew into frustration and exhaustion. Determined to find our lost brothers and sisters, we searched buildings and tunnels for access beneath the pile. As the “pile” turned into the “pit,” hope dissipated and reality set in.

Little details were very poignant. I can remember looking up and seeing the American flag on a fire truck that had been uncovered from the debris. Firefighters had started using the engine as a tool storage and rehab area. The bright colors of crimson red, white, and blue were a stark comparison to the grey and black, dust-filled background. I thought to myself, “In all the jobs I have been to, I have never seen an American flag flying.” I then realized we were no longer working for New York City but rather for our country.

Dr. Dario Gonzalez had trained us to take care of trapped patients, care for team members, and stay safe. He once told us, “The worst-case scenario planners think of is a small nuclear bomb being placed next to the WTC and both towers coming down over Manhattan. They estimate there would be 50,000 people trapped and all the USAR teams in the country would not be enough.” When he said that, I scoffed and thought, “That will never happen.” As I looked around the pile, I saw USAR teams from Florida, Massachusetts, Puerto Rico, and Texas. They were all here except Virginia (which was busy at the Pentagon). Our country’s worst nightmare had come true.


There were distinct times during the rescue effort at Ground Zero where hazards posed a threat to my well-being. I am grateful for the training I had, which kept me safe.

I teach students that my three best friends are time, distance, and shielding. By minimizing our time exposed to a hazard, maximizing our distance from the hazard, and using the right personal protective equipment (PPE), we were able to work safely at Ground Zero.

I am grateful for the training I had and the outstanding teammates with whom I worked. In a response of this magnitude, it is not training alone that gets you through the moment. The collective abilities and unique talents we each bring to the scene help us to establish a new system and to recover.


Day in and day out in EMS, the pressures of our job cause us to argue over trivial issues and alienate each other. Events like 9/11 draw us closer by the pressures of the day. I think it is important to see the big picture and respect your coworkers, knowing they are a dedicated breed that is also vulnerable. Why wait for a tragedy to honor and respect our coworkers? During the rescue efforts, it was amazing to see fire, police, and Port Authority personnel working hand-in-hand to achieve a common goal. The pressures of this disaster brought us all closer as we rose to meet the challenges. It is important to keep things in perspective during the relative safety of day-to-day work.


Looking back at the coworkers we lost (and continue to lose), it is difficult to find any good or lesson learned from September 11, 2001. After reliving the sights, sounds, and smells of Ground Zero, I realize that we are left only with the humanity and caring our fellow EMTs and paramedics exhibited on 9/11. As we commemorated the 10th anniversary of September 11, 2001, it was important to remember those we lost. Equally important is for us to share the lessons learned from 9/11 with new generations of EMTs and paramedics who will face the challenges of the future. Whether the next “big one” will be terrorism, an earthquake, or a hurricane, we don’t know. But the increasing lethality of terrorism is good reason alone to prepare for and hand down the experiences of 9/11.


Occasionally, a medic or an EMT would come into my office complaining about the job, their partner, or the stresses of life. I often remind them, “Hey, I know 343 guys who would trade places with you in a heartbeat,” as I look at the poster of the FDNY personnel who died on 9/11. “You’re right, Boss; every day you wake up is a great day, and this is a great job.”

How do we move forward from September 11, 2001? We move forward by honoring our coworkers we lost on 9/11, by appreciating those we work with each day, and by sharing the lessons we learn in EMS with the next generation of providers. I would ask you to reflect on each anniversary of September 11, 2001, and ask yourself, “Have I delivered patient care with the same caring as Carlos Lillo, Ricardo Quinn, and the other EMTs and paramedics demonstrated at Ground Zero? Am I living life to the fullest by improving and learning?”

We cannot forget September 11, 2001; Katrina; or any other disaster that affects our lives and weighs on our minds. However, we can take solace in the fact that during the worst moments of our country, we are not a collection of cities but one country united, working together.

STEVEN KANARIAN, MPH, EMT-P, is a retired lieutenant from Fire Department of New York*EMS and a former FEMA USAR NY-TF1 medical specialist who has published The Downwind Walk: A USAR Paramedic’s Experiences after the Terrorist Attacks of September 11, 2001. For additional information about his experiences on 9/11, visit

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