Responding (continued)

nurses and other health professionals did put their own lives in jeopardy in order to treat and save the World Trade Center victims. I don’t know of a single person who was not riveted to the television during the aftermath of the Tuesday attack. We all saw scrubs-clad volunteers treating the injured at ground zero. We saw countless interviews with exhausted hospital personnel who refused to go home for a nap, a shower or a shave talk about their experiences in the immediate aftermath of the initial blasts and the buildings’ collapse. We, as fellow doctors, felt their pain, their feelings of impotence, and yet their determination.

I know we all wish we had been there to help. Unfortunately, most volunteer medical professionals—including ours—were turned away when they arrived in New York. What made this tragedy even more unspeakably tragic was the scarcity of survivors: There just wasn’t anything more for anyone to do.

I am extremely proud of our faculty and graduates who did respond and who were able to help:

*Darren Feldman, ’01, a first year resident at St. Vincent’s, was treating patients at the triage unit at ground zero when he ran into Tom Ashar, ’01. Darren and Tom worked together on the front lines of this tragedy at the MASH unit at Chelsea Piers. In an e-mail Darren said, “Unfortunately we saw only rescue workers treated for smoke inhalation, asthma or dehydration. We saw no victims.”

*Michael Nelson, one of our former ER residents, is an attending physician at St. Vincent’s Hospital in Manhattan, the closest hospital to the World Trade Centers. He was the primary ER physician on duty at the time of the attack and treated the first and most seriously wounded victims.

*Four ER physicians drove to New York to provide medical assistance and relief to staff at St. Vincent’s. When they arrived at Chelsea Piers, they were told that there was simply nothing for them to do. Michael Rolnick, assistant professor of surgery and an expert in disaster management, said they called other hospitals to offer assistance, but there were simply no patients. They returned to Baltimore the same day.

*In addition, Shock Trauma was asked by the Pentagon to be on stand-by to receive victims from that attack, but Washington hospitals were able to tend to the few survivors. There are countless other faculty and staff who offered their services and who helped in meaningful ways, by donating blood, supplies, or money, and they, too, are to be commended. Since September 11, the School of Medicine has been on the front lines of the war on bioterrorism, and I will highlight several of our activities.

Smallpox Vaccine Research
At the request of U.S. health officials, the University of Maryland School of Medicine is participating in a multi-center study to measure the effectiveness of the existing smallpox vaccine, and determine whether the current vaccine supply can be effectively diluted in order to make more available doses. The study involving 680 adults is being conducted at the University of Maryland Center for Vaccine Development (CVD), and at three other academic medical centers.

“This study is now our highest priority,” says Carol O. Tacket, MD, professor of medicine and leader of the study in Maryland. Study volunteers have received either undiluted vaccine, a dose one-fifth the strength of existing vaccine, or one that is one-tenth as strong.

As you know, smallpox has a high rate of serious illness and death. It is the only human infection to be eradicated worldwide—the last known case of smallpox occurred in 1977 in Somalia, and routine immunization has not been done in the U.S. for more than two decades.

“In the wake of the attacks of September 11, we must be prepared for anything, and that includes the threat of bioterrorism,” says Robert Edelman, MD, professor of medicine and associate director for clinical research at the CVD. The U.S. government has 15.4 million doses of smallpox vaccine and has ordered 40 million more for delivery by the end of 2004. “If the current vaccine can be diluted and still provide adequate protection, it may be possible to increase the number of doses of existing vaccine,” says Dr. Edelman.

Anthrax Research
Researchers at the CVD have also been tapped by the National Institutes of Health (NIH) to evaluate a new anthrax vaccine. Unlike the current vaccine, which uses a weakened form of the anthrax bacterium to produce an immune response, the new vaccine uses part of a specific gene to create protective antigens.

“The result is a pure protein that we believe is safer than the current vaccine,” says James D. Campbell, MD, assistant professor of pediatrics and the lead investigator. Because the antigens are produced genetically, there is no contact with the anthrax toxin.

If effective, the new vaccine could provide protection with fewer doses and fewer side effects, while helping to ease concerns about the production and the supply of the current vaccine. The phase I trial is expected to begin later this year.

Air Force Physicians Training
at Shock Trauma
Military physicians will receive special training at the R Adams Cowley Shock Trauma Center under an agreement between the University of Maryland School of Medicine, the University of Maryland Medical Center and the U.S. Air Force.

Beginning last November, eight to ten Air Force doctors, nurses and medical technicians rotate through Shock Trauma on a 30-day rotation to refresh their skills in treating severe injuries. In January, groups of two Air Force personnel began to rotate through Shock Trauma on a monthly basis. In addition, four or five Air Force doctors will become full-time School of Medicine faculty for a three- to four-year period.

Working side by side with School of Medicine trauma surgeons, Air Force physicians will learn the latest techniques for treating the kind of injuries likely to occur in warfare, such as gunshot or stab wounds and blunt force injuries related to explosions.

Air Force doctors and nurses will also practice the art of triage, a skill military doctors rarely use during peacetime. “The Air Force realized there were issues of preparedness,” says Frank M. Calia, MD, MACP, vice dean. “They have superb surgeons, but they don’t see the volume of clinical cases that we do.”

Working with the Army to
Improve Trauma Care
America’s war on terrorism has also brought new urgency to the need for technologically advanced trauma care on the battlefield, on the street, and in military and civilian hospitals. That need brought together researchers, clinicians, information technology experts, educators and policymakers for a special symposium at the University of Maryland School of Medicine.

The conference, “Medicine, Technology and Human Factors in Trauma Care: A Civilian/Military Perspective,” was held last November at the medical school. The symposium was jointly sponsored by the Charles McC. Mathias, Jr. National Study Center for Trauma and Emergency Medical Systems (NSC) and the U.S. Army Medical Research and Materiel Command.

Participants examined the impact of emerging technology, including telemedicine, and clinical advances in trauma management. “It is essential that we use civilian expertise in trauma care to support military research and training, and to save lives,” says Colin F. Mackenzie, MD, professor of anesthesiology and director of the NSC.

This is but a sampling of activities ongoing at the School of Medicine. While I am deeply saddened by the terrible events of last September, my faith in our profession has been reaffirmed. I hope yours has as well. I have always known physicians to be altruistic in their commitment and dedication to their fellow human beings, and I am extremely proud to be counted among you.

Be good to each other. And may God bless America.