Mary Jos knew the week of September 10, 2001, would be eventful: She and her newly retired husband, David, were selling their house and moving into an apartment in Manhattan's Battery Park, a short 7-minute walk to her job at the World Trade Center. Moving day was set for September 13.
They did not quite make it.
On September 11-the only day that week she was scheduled to be in the office-Ms Jos was at work in Two World Trade Center when hijackers deliberately slammed a commercial jetliner into the building.
Ms Jos is one of only 17 people working on floors 78 and above who survived. She was seriously injured, with the left side of her body taking the brunt of the injury. She sustained superficial, partial-thickness, and full-thickness burns to 20% of her body, as well as deep shrapnel wounds to her left arm, leg, and scalp from flying debris.
On September 21, 2002, little more than a year after the attack, Ms Jos shared the details of her experience with attendees of the 17th Annual Clinical Symposium on Advances in Skin & Wound Care, September 21-24, 2002, in Dallas, TX. Her lecture was supported by an educational grant from ConvaTec.
Displaying the warmth, humor, and determination that have served her well this past year, she gave a moving account of what happened to her that day and how those events have changed her life. She also left little doubt of her affection for her numerous caregivers, calling them "my angels." She included in that group her husband, "who didn't know he was going to get a new job" as her caregiver shortly after he retired.
Stronger than an Earthquake
Ms Jos was standing outside her office on the 86th floor of Two World Trade Center when One World Trade Center was hit by the first hijacked airplane. She said that she had been in Mexico City during an earthquake, but that "couldn't compare with the shaking from this explosion."
After advising staff to leave the building, Ms Jos took the local elevator to the 78th floor of Two World Trade Center-the Sky Lobby-where she would transfer to the main elevator that would take her to the ground floor. When she got off the elevator on the 78th floor, though, she stopped to talk with a colleague and missed the elevator to the ground floor. She was in the north end of the lobby when the second plane hit Two World Trade Center.
FIGURE
She acknowledges that her memory is sketchy after the impact, which knocked her unconscious, but she has been able to piece together what happened next from what she remembers and from conversations with others.
77 Floors to Safety
Ms Jos regained consciousness and removed the debris that was covering her. She felt heat and thought she was on fire. She rolled around to extinguish the flames, only to realize that she wasn't on fire; the heat generated by the explosion caused by the airplane's impact with the building was burning her skin.
She crawled to the stairwell in an eerie silence, then yelled for others to follow her when she was able to open the stairwell door. Unfortunately, no one followed.
Ms Jos was met at the landing at the 77th floor by Eric Thompson, another employee at Two World Trade Center and the first of her angels. He had seen her on the landing at the 78th floor and waited for her to crawl over debris in the stairwell to the 77th floor landing. He then helped her walk the 77 stories down to the ground floor. They stopped only twice-once for her to accept a drink of water and once for Allan, one of Mr Thompson's coworkers, to cover her burned left arm, "so that people wouldn't stare at it," she said.
On the ground floor, Mr Thompson turned her over to Ms Jos's second angel, Mitch Wallace, a court employee who also had emergency medical training. He triaged her, then put her in an ambulance headed for The Burn Center at NewYork Weill Cornell Medical Center, part of the NewYork-Presbyterian Healthcare System. Ms Jos later found out that Mr Wallace went back into Two World Trade Center to treat a burn patient and died when the building collapsed-which she saw through the ambulance's window.
The First of 24 Days
When she arrived at the hospital, Ms Jos was immediately surrounded by physicians and nurses. After she was evaluated in the emergency department, she was transported to the operating room for surgery. Her husband, who couldn't get into the city, was kept apprised of her treatment and status by the staff.
After 2 days in the intensive care unit, Ms Jos was transferred to a step-down unit, where she began physical therapy. Once she was mobile, she began her daily trips to "the tank," where her wounds were debrided. She can joke about the experience now, but she admits that the procedure was extremely painful and that the "love and caring of the staff" helped her get through it.
Following a second surgery for skin grafts on her upper left arm and left leg, she developed a full-blown allergic reaction-although the staff could not determine what she was allergic to. All dressings, topical ointments, and medications (including pain medications) were discontinued until the reaction subsided. Her blistering skin eventually sloughed off-she laughingly referred to it as her "free facial peel"-but the aftereffect of the reaction was a fear of being alone, especially at night. The staff understood and arranged for her husband to stay with her.
After a third surgery a few days later to graft the fullthickness burns on her back, she was introduced to pressure garments. She initially balked at the idea of wearing them 23 hours a day for a year or two, until she talked with other former burn patients and saw photos of burn scars that had not been treated with pressure garments. She is now faithfully wearing them.
On October 4, 24 days after entering the hospital and nervous about leaving the security of the hospital, Ms Jos was discharged. A home health care nurse treated her graft sites and helped ease her fears. Therapists continue to help her build her physical and emotional strength.
Raising Funds for Charity
Before the lecture by Ms Jos, a video montage of September 11 and its aftermath was shown. The video was produced by ABC television and set to music by Tracy McCord, a regional manager for Hollister, Inc. McCord then sang his song, "Stronger Now America," live. A compact disc containing the song was sold for $5 at the Hollister exhibit hall booth, raising $1500 for the New York Fire Department's Benevolent Fund.
In addition, Smith & Nephew provided a Twin Towers pin for attendees as they entered the lecture hall to hear Ms Jos. The company also offered the pin in its exhibit hall booth for a donation. On-site sale of the pin raised $4000 for St. Vincent's Manhattan, part of the Saint Vincent Catholic Medical Centers health system. The hospital is near the World Trade Center, and its staff treated approximately 1400 victims of the terrorist attack.
Award-Winning People
Two awards are given annually at the Clinical Symposium on Advances in Skin & Wound Care: the Sharon Baranoski Founder's Award and the ConvaTec Research Scholarship. This year's winners are Nancy Stotts, EdD, RN, FAAN, for the Founder's Award and a group led by Consuelo "Connie" Kelly, MS, RN, APN, CWOCN, for the ConvaTec scholarship.
Sharon Baranoski Founder's Award
Nancy Stotts, EdD, RN, FAAN, is the 6th winner of the Sharon Baranoski Founder's Award, which is given annually to honor overall pursuit of excellence in the field of skin and wound care.
Dr Stotts is a professor of nursing at the University of California San Francisco, San Francisco, CA. She has been a faculty member at the University of California for 30 years, where she has taught baccalaureate, master's, and doctoral students. She says that one of her loves is translating theory into practice, and she has done this over the years at the university through the programs that she has developed. One of her first training grants, written in 1977, included master's-level coursework on wound healing, quite an innovation at the time.
Dr Stotts has focused her research on wound healing and the assessment and management of pressure ulcers. An overall theme in her work is to elucidate factors that interfere with normal wound healing, with particular emphasis on nutritional factors and oxygenation. Her current research explores perfusion in nursing home residents with pressure ulcers. The work is funded by the American Nurses Foundation and the John A. Hartford Foundation.
A prolific author, Dr Stotts has published more than 75 journal articles and 30 book chapters. She is a member of the editorial advisory board of Advances in Skin & Wound Care.
The Sharon Baranoski Founder's Award is given by Lippincott Williams & Wilkins, publisher of Advances in Skin & Wound Care and sponsor of the Clinical Symposium on Advances in Skin & Wound Care, in honor of Sharon Baranoski, MSN, RN, CWOCN, founder and symposium director. Past winners include Barbara Bates-Jensen, PhD, RN, CWOCN; Rita Frantz, PhD, RN, FAAN, CWCN; Janet Cuddigan, PhD, RN, CWCN; Luther Kloth, MS, PT, CWS, FAPTA; and Laura Bolton, PhD.
The Sharon Baranoski Founder's Award was supported by an educational grant from 3M Health Care.
For more information about submitting a nominee for next year's award, call 1-800-346-7844, ext 7750, or E-mail [email protected].
ConvaTec Research Scholarship
A group led by Consuelo "Connie" Kelly, MS, RN, APN, CWOCN, is this year's winner of the ConvaTec Research Scholarship for their research proposal, "The Effects of DuoDerm Hydroactive Sterile Gel and Morphone Admixture for Painful Pressure Ulcers."
Kelly will work with Lisa Boudreau, BS, RN, CWOCN, and Judith Paice, PhD, RN, to enroll inpatients from the oncology and palliative care units at Northwestern Memorial Hospital, Chicago, IL, into a randomized, controlled clinical study that will evaluate pain relief resulting from topical application of DuoDerm Hydroactive Sterile Gel mixed with morphine versus DuoDerm without morphine. All patients will have Stage II or III pressure ulcers that are 10 cm x 10 cm or less, with at least 50% granulation tissue.
The ConvaTec Research Scholarship is designed to support research (prospective or retrospective studies or literature reviews) in the area of wound and skin care. Health care professionals are invited to submit proposals for research projects investigating any aspect of epidemiology, prevention, or treatment of skin and wound care problems in any patient care setting. Two awards are given each year.
For a copy of the ConvaTec Research Scholarship application, write to: Linda Pruitt, MS, RN, ET, ConvaTec, 100 Headquarters Park Dr, Skillman, NJ 08558.