Masters of the Ordinary

By this past March, it had been 4½ grueling years since 9/11. Across America, emergency plans had long since been redrawn, training amped up, billions spent on equipment and gear, enough CO2 expended on need-to-be-ready rhetoric to burn a Texas-size hole in the ozone. And in New York City, where the events of that day so famously touched off this national scramble for preparedness, they held a simulation.

The exercise, called Trifecta, posited a bomb containing highly toxic arsenic trichloride exploding on a freight train in a Queens rail yard just as it passed a passenger train heading in the opposite direction. It involved more than two dozen agencies and around 1,500 responding personnel, whose priorities included freeing victims, triaging and treating the injured and evacuating unhurt passengers. For this they were to use the Big Apple's year-old Citywide Incident Management System (CIMS).

The fire department was the first to respond; police, as CIMS dictates, then took the lead and established a unified command. EMS was...where, exactly? Outside looking in. Try to control your surprise.

"We could have probably done a slightly better job in handling the persons who were injured," the city's commissioner of emergency management, Joseph Bruno, acknowledged afterward. "We saw a real lag in getting people out of the area. I was critical of how long people were having to wait for EMS to come in."

Part of the delay, the New York Times reported, was due to participants' reluctance to move victims without more information about what chemical threat they were facing and how bad it was. A possible solution, Bruno suggested, might be to create triage areas within the restricted zone, "so that EMS could work on these folks as quickly as possible."

Another problem was that arriving responders, particularly from the Department of Environmental Protection, created a logjam of hastily parked vehicles that-much as happened on 9/11-hindered coming and going from the scene. "If there were failings," Bruno noted, "that was one of them."

The New Ideal
The Trifecta exercise wasn't a disaster unto itself, and it didn't expose anything scandalous. But it did illustrate just how elusive a concept homeland security, as it applies to the emergency services-and particularly to EMS-can be, and just how difficult it really is to recreate (or, in some instances, create) a nation's entire emergency response framework in a few short years.

America's new ideal-a seamless battery of well-trained, well-equipped and well-integrated forces that can rely on well-tested plans to respond, promptly and properly, to any hazard, anytime, anywhere-is asking a lot. And that's worth remembering in September 2006, which represents the fifth anniversary of the attacks that started it all.

It's worth remembering when, as happened in Louisiana in May, a mock evacuation that's part of a hurricane preparedness drill is canceled because no one can determine who has jurisdiction over a FEMA trailer park full of Katrina refugees.

It's worth remembering when an audit scorches a major city's (San Francisco's) office of emergency services, as it did that same month, for failing to complete its disaster plans, including one as central as how to handle an earthquake (this coming, ironically, 100 years after the city's most famous temblor).

It's worth remembering when the Department of Homeland Security's National Asset Database-a listing of potential terrorist targets that helps federal officials determine how to disperse grant funds to the states-identifies more sites in Indiana (8,591) than in New York (5,687) or California (3,212).

And it's worth remembering when that now-familiar 4% figure is brought up (4% being the percentage of the $3.38 billion distributed by the Department of Homeland Security for emergency preparedness that went to EMS in 2002-03).