In July 2001, I began my pathology residency at North Shore University Hospital in New York.
On September 11, I was completing my first rotation in surgical pathology. At around 9:30am, during a busy morning grossing surgical specimens, we heard that hijacked planes had struck the World Trade Center. We gathered in the conference room to watch the news unfold. When the towers collapsed, many of us were moved to tears, struggling to comprehend the scale and horror of what had happened.
After my shift, I went straight to our department’s blood bank, hoping to donate. I expected an urgent need for blood, plasma, platelets, and other supplies, but a long line had already formed outside of people of all ages.
The department asked those who had travelled from farther away to donate first so they could return home sooner. Hospital and department staff were asked to come back later, and I was not able to donate until the following week.
I remember the morning I finally walked into the donation room. The nurse explained that I would be donating plasma and platelets, which were urgently needed. I told her I would give whatever was required. After completing the forms, answering a long list of questions, and registering, I lay down for my first donation.
Everything went smoothly at first. However, after 10-20 minutes, I developed tingling and numbness around my mouth, face, tongue, fingers, and toes. I felt cold and began to shiver, and a bitter, metallic taste filled my mouth. Initially, I dismissed the symptoms, assuming they were caused by skipping breakfast.
Soon, the muscles in my hands, arms, and legs began to twitch, tremble, and cramp. I became nauseated, and my heartbeat seemed to slow. I tried to tell the nurse what was happening, but my voice was trembling so badly that I could barely speak. I was worried I was having a heart attack.
She responded immediately, slowing the machine, giving me a cup of milk, asking me to breathe slowly into a paper bag, and covering me with a blanket. Within minutes, the symptoms disappeared, and I felt as well as I had when I arrived.
When I asked what had happened, she explained that first-time plasma and platelet donors sometimes experience a citrate reaction, also known as citrate toxicity.
“I had the same problem the first time I donated,” said the large man in the bed beside me, grinning. “A cup of milk fixed the problem, and you’re fine!”
Later that day, I consulted a textbook and learned what had happened. During component donation, sodium citrate is added as an anticoagulant. Some of the citrate returns to the donor’s circulation with the red blood cells, where it temporarily binds calcium and lowers ionized calcium levels. This explained the symptoms I had experienced.
Several weeks later, I returned to the blood bank and donated again, this time without a reaction. It was my first personal lesson in clinical pathology – learned through my own body two years before my clinical pathology rotation in postgraduate year 3. My first two years of residency had been devoted entirely to anatomic pathology.
Smoke from the burning towers drifted over Manhattan and Long Island and did not fully dissipate for a month.
In the immediate aftermath, reports emerged of letters containing anthrax spores being sent through the mail to news organizations and government offices. I stayed up at night researching and quickly wrote six articles about the history and current state of bioterrorism. The series examined seven pathogens and biological agents associated with such attacks, including their diagnosis, prevention, and treatment.
Soon afterward, two bombing attacks struck McDonald's restaurants in Xi'an, China – one in December 2001, killing two and injuring 28, and another in 2003. I submitted my articles on biological attacks to mainland Chinese media and social platforms, so that readers in China would understand that we all face the dangers and consequences of such violence and terrorism. I also presented a special report during our department’s Grand Rounds, which was well received by the department chair and director of surgical pathology.
Many readers in China and elsewhere contacted me to say that the articles had helped them understand what is at stake in such attacks. We all share the same world – a global village. We need love, not hate.
9/11 – a historical event to be remembered forever.
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