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Medical Response to 9/11 - Patricia Horoho and Malcolm Nance

Photo of the National 9/11 Pentagon Memorial. The Pentagon Memorial was created to remember and honor those family members and friends who are no longer with us because of the events of September 11, 2001 at the Pentagon. (Courtesy photo by Kevin Dwyer) Photo of the National 9/11 Pentagon Memorial. The Pentagon Memorial was created to remember and honor those family members and friends who are no longer with us because of the events of September 11, 2001 at the Pentagon. (Courtesy photo by Kevin Dwyer)

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Near where the airliner would enter the Pentagon, Lieutenant Colonel Patricia Horoho, an assistant deputy for personnel and health management affairs in the Office of the Assistant Secretary of the Army for Manpower and Reserve Affairs, and an Army nurse, had been at work in her office, in the E-ring, on the second floor, at the 5th corridor, when someone in the hallway announced that a plane had hit the World Trade Center. She walked across the hall into the Strategic Planning Cell, where there was a television, and saw the second jetliner hit the towers. Colonel Horoho said, “We’re going to be next.” Certain that the Pentagon would be attacked, she remained calm. She walked back to her office, and as she entered the doorway, she heard a loud boom and felt the building shake. She began following others evacuating the Pentagon by exiting through the mall entrance between corridors 6 and 7, but realized she needed to be near the crash site to provide help.

After letting a colleague know she was unhurt, Colonel Horoho moved to the front of the Pentagon to help care for patients. “This is where . . . I think Green Ramp came into play,” she recalled.

Colonel Horoho was born and raised at Fort Bragg, North Carolina, where her father was a member of the 82d Airborne Division. She joined the Army as a nurse in 1983. She was serving as chief emergency room nurse at Fort Bragg’s Womack Army Hospital in March 1994, when a collision between two military aircraft at adjacent Pope Air Force Base resulted in 24 deaths and approximately 130 injuries, mostly burns, to 82d Airborne troops practicing pre-jump exercises on an area of the base known as Green Ramp.

On the morning of 9/11, she was the right person, in the right place, at the right time. By experience and training – burn care and critical incident stress debriefings were her specialties – she was well suited for the job. Personal characteristics of confidence, strength, bravery, spirituality, hard work, and the ability to command contributed to her success.

When Colonel Horoho reached the west side of the Pentagon, she saw the huge gap that had been blown out of the middle section of the building. She did not see a fireball, just a lot of smoke and lots of debris, including aircraft parts strewn over the area. She went up to the building to go in, and saw the walking wounded, who were dazed, injured, burned, cut, or suffering smoke inhalation, coming down the steps. She pointed them in the direction of a grassy area with a tree for shade near the guardrail in front of the crash site, which she knew would work for a triage area. She received help from an off-duty paramedic from Alexandria, Virginia, Michael Cahill, who was near the Pentagon at the time of the attack, and from Pentagon employees who had just brought people out of the building, and who now were instructing the injured to go to the triage sector. Once the system was set for proceeding to the treatment zone, Colonel Horoho left the impact area and went to the guardrail to assess injuries.*

Retired Navy anti-terrorist specialist Malcolm Nance, who had been on the road near the Pentagon when the attack occurred, rushed to the building to help. He encountered Horoho, whom he described as “directing people and moving about decisively, with a purpose that commanded my full attention.” In shorts and shirt, he volunteered his services and spent the rest of the day under her command. Nance, who had seen action in Beirut, Somalia, and Kuwait, compared the Pentagon that morning to a battlefield. “Troops were assembling [firemen had just arrived from Arlington; there were military and civilian Pentagon employees and policemen], equipment was being mobilized, and people were dying.”

I ran up to her and the row of victims lining a guard rail. Victims were still stumbling out of the building’s north door on the West ring. Some people were being carried out and laid in front of the tree next to the only two ambulances that had just arrived. I forgot I was retired and shouted to her “I’m a Senior Chief. What do you need?” I asked. “OK! Great! This is the provisional triage until we can get an evacuation point up!” she responded. “I need to move my victims out of here! Get some people moving to act as stretcher bearers now! There are more victims inside! We’ve got to get to them too!” In 20 years of military service I had only seen the level of confidence and cool she exuded from Delta troopers and SEALs. At the Battle of the Pentagon, this woman was the commanding officer. It was plain to see that she had badly lost a round to the enemy, but was determined to win the battle.**

*  From an interview with then Lt. Col. Patricia D. Horoho, Assistant Deputy, Personnel and Health Management Policy Office of the Assistant Secretary of the Army for Manpower and Reserve affairs, the Pentagon, regarding Sept. 11, 2001.  Horoho was serving in an administrative, rather than patient care, setting. Lt. Gen. (ret.) Horoho served as Surgeon General of the Army from 2011 to 2015.

The complete account is in the book:  Attack on the Pentagon: The Medical Response to 9/11.

By Mary Ellen Condon-Rall, PhD, Borden Institute Fort Detrick, Maryland
Office of The Surgeon General United States Army Falls Church, Virginia
U.S. Army Medical Department Center & School Fort Sam Houston, Texas 2011

** Condensed from an E-mail from Malcolm Nance to Mary Ellen Condon-Rall, subject: “The Story”

The complete account is in the book:  Attack on the Pentagon: The Medical Response to 9/11.

By Mary Ellen Condon-Rall, PhD, Borden Institute Fort Detrick, Maryland
Office of The Surgeon General United States Army Falls Church, Virginia
U.S. Army Medical Department Center & School Fort Sam Houston, Texas 2011

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