On September 11, 2001, thousands perished when terrorists hijacked commercial airliners and crashed them into the World Trade Center in New York City and the Pentagon in Washington, DC. The following month, anthrax was disseminated through the U.S. mail to the Capitol in Washington, and a news studio in New York, resulting in 11 cases each of cutaneous and inhalational anthrax, with 6 of the latter fatal. This paper will address the lessons learned from the aftermath of these incidents, so that we may be better prepared for future terrorist acts. Among the most salient lessons from 9/11 is that it is critical to establish clear lines of communication (since phone service may be unreliable), avenues of evacuation to medical facilities (since gridlock rapidly ensues), and command structure (since jurisdiction may be ambiguous). The many lessons from the anthrax attacks include the clinical signs distinguishing anthrax from influenza and other viral illnesses, and the survival benefits from prompt treatment with multiple antibiotics. Most notable of all, the psychological effects of each incident proved to be more durable and widespread than the immediate physical consequences. In addition to delineating lessons learned from the immediate aftermath of the incidents, we also address the most significant ways to enhance the education of health care providers so they can more effectively diagnose and treat patients exposed to terrorist attacks.
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