Autumn is in the air, and it was a typical fall day in Washington DC, the last day of an international meeting.  This meeting introduced many new medical and surgical therapies to lower mortality in patients with heart failure. The Willard Hotel was 50 yards from the back gate of the white house. While packing to leave for Regan Airport, I turned on the news and watched a replay of a commercial airline flying into the south tower of the world trade center. Quite frankly, I thought it was a trailer for a Steven Spielberg movie. As the news continued, a second commercial airline struck the north tower of the world trade center. Is this real? Am I in an alternate reality?

As I sat on the edge of the bed in my birthday suit, a heaviness fell over my heart. The intercom system of the hotel summoned all guests to the lobby. My survival instincts kicked in. I dumped all contents of my backpack on the bed and proceeded to fill it with all health bars and bottled water. What would motivate me to do something like this? As we all gathered in the hotel’s atrium, the doors open, and many tall men dressed in black suits and white shirts with black ties start to file in patterns speaking into their sleeves? Patrons rushed to the front of the hotel under the canopy. As we stand at attention, still not sure what is happening, a sudden dark smoke emanates from the distance, the Pentagon? The smell of Kerosene is in the air, ( our fighter jets are fueled by kerosene) jet fighters were scrambled, but it is too late. To our right, the back gates of the White House are open, and the white house staff is being evacuated. All guests are corralled in the hotel basement. Tuesday morning, kerosene-filled air was the last time I would be outside until Friday afternoon.

When we arrived in the basement, I found a payphone and called my eldest sister and the hospital. Cell phones were not that ordinary in 2001. “I am ok,” as we talked, several large screen TV showed the news and burning north and south towers of the World Trade Center. Shortly after, cell phones are no longer functional, and the system is overwhelmed.  We were allowed to go back to our rooms if we left the hotel, we could not come back. So this will be home until US intelligence can figure out the next steps. While walking back to my room, I looked out the lobby window; yes, it was a war zone. Humvees had hijacked the DC political streets, and military personnel was walking the streets with AR rifles. The hum of life in DC became a void, the absence of a joggers footsteps, no dogs barking, the void of clanking of dishes in restaurants, all were gone. The only sound in the background was the sound of change in lights at intersections. The president had grounded all flights in the US . While looking toward the White House, the presidents’ helicopter had descended out of the clouds, and I watched as President Bush rushed to the oval office; he will be speaking to us this evening.

Life had never been as uncertain as it was this moment in time, no flights home, streets were militarized, and after the first plane struck the world trade center, America had just joined the war on terror. Being sequestered and secluded for nearly one week makes one wonder about life and loss of life. The over 3000 people who died a violent death was disturbing. As a physician, I have been in a room with the grim reaper far too many times. As much as I travel, I could have easily been on one of those planes. My attention was about those who perished, the families they left behind. My raw emotions were darkness, sadness, and anger. What little innocence I had in 2001 was ripped from my soul.

We finally were given the news that there would be limited travel on that Friday. I booked my flight to head back to Texas. The flight home was quite sad; every time the plane banked, we could not help but wonder, “who is in the cockpit” I also made a significant change in my life. I would always take an aisle seat when I travel, always. I don’t have a hero complex. I want one shot at any asshole that attempts to take the cockpit.

The downstream results of 911 were my emersion into the study of terrorism. I read all books and CIA reports released and looked at documentaries on terrorism, including the 911 commission report, twice. I studied with the same ferocity I did medicine. The most important lesson from the book?  From the mouth of the mastermind of 911 regarding terrorism? ” our will to die is greater than Americans will live.” This quote resonated as to how you can win a war when you love the comforts of the US and the hatred of terrorists in the comfort of death. Osama Bin Laden had been on the radar of CIA intelligence for quite some time. His first exposure was during the Afghan/ Soviet war, and he was a leader in helping to get the Soviets out of Afghanistan. He built his brand as a warrior. Despite his heroics, he was not welcomed in Iraq, kicked out of Saudi, and eventually ended up in Afghanistan, where we nearly had him in Tora Bora. He settled in Abbottabad, Pakistan, until his death. CIA had been on the hunt, and he evaded every time. CIA operatives captured Khalid Shaik Mohammed (KSM). He was the mastermind that presented the initial idea to Bin Laden that since they could not fund a war, they could turn a hijacked plane into a missile to destroy the financial infrastructure of the US. Terrorists reasoned that if they could cripple our infrastructure, they could bring down the US. Bin Laden did not immediately agree to the plan and argued that it was dangerous and would never work. The American culture and CIA intelligence did not see this bearded man from the middle east as a threat to our national security. They even argued how he could run a global terrorist organization from a cave? KSM capture was vital. That was the first time CIA analysts concluded that they were looking in the wrong places. Since Bin Laden was not on the internet and was off the grid, he used a series of couriers who sent messages, financing, and plans to cell networks. CIA identified a courier in Abbottabad, Pakistan and the intelligence race was on. Bin Laden’s compound was only one mile from Pakistan naval School (our Westpoint). Admiral McCraven, whom I have had the honor to meet on several occasions, crafted a plan to send in Navy Seals to kill Bin Laden on a dark starry night; there was no capture. The movie zero dark thirty is a depiction of the actual mission. Yes, I have seen it at least a dozen times.

I have friends in Washington that this is a reasonably close representation of what happened in the events leading up to that fateful evening.

My mood the last several days has been somber. My darkness returned for the lives and families lost on that painful day in American history. Life was never the same for me, nor my innocence.

Our country is at a crossroads of domestic terrorists. How did we get here? When the national anthem is a point of questionable patriotism, are we no longer Americans? Why is it when I hear the national anthem, I am  brought to tears each time?