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When the devastation wrought by unbridled expressions of human hatred is so extensive, it blinds us for a time from even acknowledging the potential for good that humanity possesses. Somehow the noise and chaos from the worst expressions of human behavior overshadow all else in our consciousness. But even before all the events in this tragedy had unfolded, even before we could fully understand or link the disconnected snippets of "news" conveyed by the media, shreds of features from the best in humanity slowly surfaced:
Calming Countless people, whose only preparation in disaster management was their sense of humanity, left the safety of their homes and places of business to assuage some of the panic worn on faces of the victims and to reassure them that they had survived. Others soothed by helping to locate and reunite loved ones for terrified family or friends. Composure in the midst of calamity afforded hope when there seemed to be so little of it nearby.
Caring Realizing that their lives would soon end, numerous victims called their loved ones to convey messages of encouragement, affirmations of their love, and even heart-breaking wishes that they "have a good life." A fortunate few actually spoke with those they cared most about; many needed to leave their caring words recorded on voice mail.
Ceaseless Regardless of how long it took to find and identify victims of this tragedy, fire personnel, police, emergency service workers, military, civilians, and others who had just been passersby searched through rubble for endless hours and days. "Whatever it takes" represented the minimal expectation.
Cheering Up and down the streets of New York City, once stereotyped as populated by the rudest crowds in the country, spontaneous clapping, ovations, banners, tears, and "Thank You’s" appeared daily as fire trucks, ambulances, and police vehicles drove through local neighborhoods.
Cleansing Both healthcare workers and passers-by recognized an immediate need for cleansing the eyes of victims or rescuers so that they could see through the soot and smoke to confirm their survival, reorient themselves, and continue their lives as best they could.
Collaborative When disaster struck—in rural Pennsylvania, at the Pentagon, and in urban New York City—individuals and groups who never would have noticed or interacted with one another in the normal course of life events came together as best they could to help each other with the realities at hand. Neither victims nor their rescuers or supporters belonged to distinct races, ethnicities, religions, cultures, languages, or socioeconomic classes in those hours and days. Although victims of this treachery came from some 40 different countries, they and we were all members of a single, grieving American family.
Comforting, Consoling Despite the dangers inherent in doing so, the chaplain of the New York City fire department instinctively proceeded to where his firefighters would most need him to comfort their souls, bless their lives, and console them in their loss. His body was one of the first solemnly carried from the scene.
Compassionate Strangers opened their hearts to those most directly affected by this tragedy. Restaurants provided free meals; places of business converted into shelters of refuge; private corporations across the United States deluged millions of dollars of donated and requested goods, medical supplies, clothing, and equipment into the support effort; lawyers provided free legal services; local utilities reconstructed lines of communication; and social service agencies flooded the areas.
Competent Tales of firefighters carrying their fellow man down 57 flights of blackened stairs and carrying little old ladies, children, and their buddies from one precarious site to another sounded nearly redundant as the days went by. The phrase, "It’s my job," never quite explained how a wife or husband with 3 or 4 children of their own could regularly and knowingly head directly into harm’s way to help some unidentified stranger.
Concerned The manifestations of selflessness during this tragedy were truly awesome to behold. Fully mobile and injury-free workers refused to leave the side of a coworker who was confined to a wheelchair. One man telephoned that he would remain in the upper floor of the World Trade Center with a long ago paralyzed employee because, "The man is my best friend."
Courageous Heroes came in all shapes and sizes and circumstances throughout this episode. Surely one of the distinctive forms of genuine courage was manifested by the passengers on Flight 93, who recognized the nature and likely outcomes of their predicament, and—rather than cower or freeze at their own imminent demise—rushed the cockpit to ensure that the terrorists never reached their intended target. Their rallying cry of, "Let’s roll!," was a testament to their bravery.
Curing Here and there, one heard stories of medical miracles, disaster management, and healthcare staff providing definitive cures for ills and injuries related to these events. Despite thousands of health-care professionals volunteering and overcoming enormous traffic, time, logistical, and family issues, however, relatively few were able to use their curative capabilities because of the small number of survivors.
As I reflect on the anniversary of the horrific events of September 2001 and search for some modicum of solace in the good that followed in the aftermath of that day, I can summarize the attributes that made a difference at that time of intense national need: calming, caring, ceaseless, cheering, cleansing, collaborative, comforting, consoling, compassionate, competent, concerned, courageous, and curing. Somehow it is easy to recognize in that list so many attributes of a good nurse. One might also conclude that what our nation most needed then was good critical care nursing.
GUIDELINES FOR LASTING LEGACIES IN CRITICAL CARE NURSING
Your legacy to future generations of critical care nurses may include pearls salient to any aspect or role in critical care nursing. Pearls not available in any published medium are especially welcome and may be characterized in any of the following forms:
Wisdom
Lessons you have learned (eg, look at all the data, but when discrepancies arise, go with your gut) Traditional words of wisdom (I don’t know that there is a precise way to describe this shiny, bluish-gray, tinged with yellow skin color, but remember it because it’s always a precursor of bad news) Truisms your mama never taught you (some folks have no support system; not all parents love their children and vice versa) Insights not visible to all (if all of our patients are critically ill, how do we recognize when a "problem" exists? Isn’t being critically ill a problem?) New commandments you have discovered (eg, Thou shalt not turn a stopcock while an emotionally charged family is visiting until thou hast learned to operate it correctly) Universal laws that have been personally verified (As the weight of an object approaches my body weight, there is an inverse probability that I can relocate it from where it is presently situated) Guaranteed guidelines for getting along (Never leave for the next shift the unfinished and unpleasant residue generated during your shift)
Wit
Lessons learned from a wide range of humorous or whimsical happening (eg, the dumbest and/or funniest and/or most embarrassing thing I’ve ever said to a patient, a family, a physician, pharmacologist, chaplain, peer, supervisor, or subordinate and the dumbest thing I’ve ever done, seen, heard, charted, etc to any of the above.
Reminiscence
Your finest hour or proudest moment in critical care nursing The memory you return to for confirmation or inspiration The high point of your career as a critical care nurse
Whatever
Things I’ve learned that defy classification.
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