Dr. Bruce Logan, President: NY Downtown Hospital
Although he is proud of his new $25 million center for disaster preparedness and emergency response which opened on September 7, Dr. Bruce Logan, President and CEO of New York Downtown Hospital—whose emergency room was the first-line responder after the bombing of the twin towers, reportedly seeing 175 patients an hour (as opposed to 80-100 a day)—looks to a “mindset” change in the wider community about how better to deal with catastrophes like 9/11 and Katrina. Even a state-of-the-art emergency room that boasts the largest decontamination unit in the city will mean little if the powers that be don’t invest more resources to improve communications among first responders and ensure that medical emergency response to terrorist attacks is seen for what it really is: action on the front line of national defense. Dr. Logan is surprised that the Lower Manhattan Development Corporation and the Department of Homeland Security do not appear to regard emergency health care as part of national need. “We need an imaging center, an MRI,” Dr. Logan says, but “the totality of what the hospital received was less than 15 percent of costs.”
There need not be competition for monies between local hospitals and police and fire departments, however, Dr. Logan says, if all first-response units—health and civil services —were put under a “federal” funding umbrella. Indeed, in the case of Downtown Hospital, just six blocks from WTC, history, alone, might argue for greater support. Downtown’s predecessor, Beekman Street Hospital, was “the” emergency room treating people in the aftermath of a terrorist bombing at J.P. Morgan in the ’20s. Even before 9/11 Downtown Hospital had in place a training program for paramedics and had instituted an “incident command system,” an administrative and communications color-coded logistics plan for those involved in responding to disasters, including blackouts and floods. And Downtown had been planning before 9/11 for a major renovation of its then 1960s-style emergency room. What the terrorist attack did—and Dr. Logan was right there, up-close, organizing, acting—was increase the funding “magnitude.”
Dr. Logan, a graduate of Colby College in Maine and Columbia University Medical School is one of the rare few doctors who have become hospital CEOs. His affable, easy-going manner should help him advance his arguments and ideas. A continuing series of international symposia on disaster preparedness and emergency response has already identified the need for a formal academic discipline, a curricular interdisciplinary program that would involve not just training but post-disaster analysis. Dr. Logan is now in discussions with CUNY and particularly with administration and faculty at John Jay College of Criminal Justice to implement such a program, which would include psychological as well as medical training. He notes that Katrina left in its wake some truly unfortunate incidents, such as emergency room staff at a local nursing home abandoning their patients, and the failure of various organizations to communicate with one another, resulting in chaos and death.
Israel, of course, has become an important place for medical administrators to learn about handling terrorism, but, as Dr. Logan notes, some differences are great between Israeli society and our own. In Israel the army and the police control everything until doctors take over. No ambulance gets into an Israeli hospital without thorough examination. Other Israeli policies, however, serve as models, particularly ways in which cafeterias and other hospital units can be equipped and used for emergency care, including the installation of redundant systems for monitoring oxygen and effecting decontamination. Today, five years after WTC, emergency response extends beyond concerns over bombings and involves as well the “scary” scenarios of biological, chemical and nuclear threats, including the “nightmare” of dirty bombs imbedded with low-grade nuclear material. Communication remains central, especially in regard to evacuation plans and transportation needs. In conversation with Representative Jerrold Nadler, Dr. Logan learned, for example, that the George Washington Bridge carries 80-90 percent of foodstuffs into the city.
Despite horrors past and possible, Dr. Logan remains hopeful that New Yorkers would once again show compassion and resilience as they did on that fateful fall day five years ago. As with the atom, for every negative charge, there is a positive one, and we are all composed of atoms.#
[The Elizabeth Blackwell Award was named for the first woman in the United States to get a medical degree in 1849. The predecessor of NY Downtown Hospital, the NY Infirmary for Women and Children, was founded by Elizabeth Blackwell.]