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The moment Gregory Ciottone '87, commander of the Disaster Medical Assistance Team (DMAT) Massachusetts-2, saw the first World Trade Center tower collapse on television on September 11, he knew his unit was headed for what would come to be known as "Ground Zero." Within minutes his beeper went off and he was bound for what he described as "pretty much hell."
Ciottone, an emergency room physician at Boston's Beth Israel Deaconess Medical Center and a faculty member at Harvard Medical School, has worked on the Central Massachusetts level-one DMAT unit (one of 25 nationwide) since 1994 and has been its commander since 1998. His 56-member unit was the first of four to arrive at Ground Zero and set up three of the four medical stations within the area's inner perimeter.
Ciottone's previous deployments as DMAT commander included the northeastern ice storms, the Egypt Air crash of 1998, Hurricane Mitch and the arrival of Kosovar refugees at Fort Dix in 1999. In February Ciottone was scheduled to leave for Salt Lake City for the 2002 Winter Olympic Games.
The World Trade Center disaster defied any comparison.
"The situation was just horrible," Ciottone said. His DMAT unit was used to treating the casualties of a disaster, but in New York there weren't any to treat. They waited, wanting to help the victims, but nobody was pulled out alive. "It took an emotional and physical toll," said Ciottone. "You always wanted people to come out of the pile."
The scene still was extremely dangerous, and search and rescue workers and firefighters at Ground Zero were injured on a regular basis. Ciottone's unit treated 300 to 400 patients daily. While most ailments were minor, like respiratory problems and sprained ankles, they also included strokes, heart attacks and third-degree burns.
And many of the ailments weren't physical. Mental health professionals were necessary for both patients and workers on the site to handle the stress. Members of Ciottone's unit, meanwhile, had to keep in mind that in order to be effective practitioners of disaster and emergency medicine they had to keep their own emotions in check. "We were working like crazy," he said.
That from someone whose usual pace is full speed.
Ciottone is also founder and CEO of the nonprofit Emergency Medicine Visions International (EMVI), which improves emergency medical care delivery and disaster response worldwide through education and training.
He became involved in international medicine in the early 1990s during his residency at the University of Massachusetts Medical Center. The school was initiating a project to administer training courses in pre-hospital medicine in the former Soviet Union and Eastern Europe. Ciottone was asked to participate and took his first trip to Armenia.
"The tremendous hardship witnessed, the need for Western medical care and training and the genuine kindness of the people hooked me," said Ciottone.
After completing his residency he became the director of UMass's Institute of Disaster and Emergency Medicine (IDEM), which later evolved into the Division of International Disaster and Emergency Medicine (DIDEM). With IDEM Ciottone helped develop an emergency and disaster-medicine training center to better train Eastern European and former Soviet Union medical trainers with faculty from their own country. There are now 16 centers, which have educated more than 35,000 medical practitioners.
In 1999 Ciottone formed EMVI to continue his international medicine work outside of the medical school, and in 2001 he moved the DIDEM to Harvard, where he now directs the Division of International Disaster and Emergency Medicine at Beth Israel.
Ciottone practices international medicine without compensation, taking three-week trips to lecture in Europe, the Middle East, Latin America, the Caribbean and Japan.
"A little effort goes a long way," Ciottone realized during his initial trip to Armenia, many trips ago. And a great effort can make a world of difference.
--Alicia Nemiccolo MacLeay '97
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