I am sure that you can remember exactly where you were when you first heard that a jet had flown into the World Trade Center. There was great confusion and dismay. When the second jet hit the towers it was clear that the first crash was no accident. It was not long until we heard that the Pentagon was also a target. The  final surprise was to hear that another jet had gone down in rural Pennsylvania.

 

September 11, 2001 was a beautiful early fall day in Boston. I was seeing patients that morning in the medical specialties office at the West Roxbury Office of Harvard Vanguard Medical Associates. It must have been around 9:30 that my medical assistant knocked on the exam room door. She said, “Dr. Lindsey I am sorry to interrupt you, but may I speak with you in the break room?” When I opened the door I could see that she was obviously upset. I apologized to my patient for the unexpected interruption, and left her sitting alone in a johnny on the end of the exam table. My first concern was that something had happened to some member of my family. I had been interrupted before when my sister-in-law died unexpectedly, and when my mother had suffered complications from what should have been a routine medical procedure.

 

As I followed her into the break room she just said, “You have got to see this!” As I entered the room I could see several of our staff in tears. They were watching what seemed to be an endless loop of shots of the twin towers with their tops billowing smoke. Every now and then there were small images of people jumping to certain death. I walked out of the break room and into the waiting room where someone had commandeered a TV that we used for training videos. Several patients were gathered around the TV watching the same awful scenes. Some were quietly crying, and all appeared stunned.

 

I stood with them and watched the same recurrent scene of confusion and terror for a few minutes before I remembered my patient. I walked back to the exam room and explained to her what I had seen. We quickly finished our conversation. I must have written some prescription renewals. Perhaps I ordered some follow up blood work. We walked together back to the front desk. I did not know if there were other patients waiting to see me. It felt like I had responsibilities that I could not just drop. I was scheduled to see patients in our Kenmore Square office that afternoon. I remember going there, but I think that most of the patients had called and cancelled or we asked them to reschedule. There was a sense of uncertainty and concern. Would there be more attacks? What was going to happen next? Later that day I learned that one of my neighbors had been on one of the planes.

 

I can’t remember much of the rest of the day. I talked to my wife who learned of the events from a radio report she heard as she was driving to Worcester for the first day of her clinical office experience in her NP training program. We were both very worried about our son who was a freshman at Reed College in Portland, Oregon. It seemed that at a time like this we should all be together.

 

The plane that hit the Pentagon would have been a most remarkable event had it been the only Al Qaeda success, but that piece of the tragedy seemed forgotten in comparison to the massive devastation and loss of life in New York. There was even more focus on New York because of the valiant efforts of the first responders who were then trapped as victims themselves when the buildings began to crumble and collapse less than two hours after Mohammed Atta had flown the first plane, American Airlines Flight 11, into the North Tower.

 

It was all over in less than three hours. Flight 11 took off from Boston at 7:59. The North tower was hit at 8:46. By 10:28 both towers were down, part of the Pentagon had been hit and collapsed, and although the reports were sketchy we had learned that United flight 93 from Newark to San Francisco had left a deep scar in an open field in rural Pennsylvania. Between the three sites almost 3,000 people had died, and we would never be the same again.

 

There is much that divides us, but there are some events that unite most of us. My grandparents’ generation was challenged by the Great Depression. My parents’ generation was united by Pearl Harbor and the conflict that followed. In our times we have been stunned by assassinations, race riots, and a controversial war, but before 9/11 we had never been brought together by a tragedy that was so focused and associated with such a great sense of shared vulnerability.

 

The rubble in New York has now been replaced by a gleaming new World Trade building that is surrounded by a stunning memorial park. You may have peered into the waters of the beautiful pools and waterfalls that now mark the footprint of where the North and South Towers of the old World Trade center once stood. Perhaps you have walked around the pools and read the nearly 3000 names that are inscribed there as you tried to imagine the lives that were suddenly ended in less than three hours. Perhaps you just sat in the shade of the hundreds of trees that shield the pools from the noise and bustle of the city and turn the site into a sanctuary.

 

Before last Sunday morning my knowledge of what happened on the fourth flight, United Airlines flight 93, was limited compared to what I knew and had observed about ground zero in Manhattan, or American Airlines flight 77 that left Dulles Airport in Virginia before crashing into the Pentagon. I did not remember that there were only forty people on board a plane capable of carrying almost two hundred, or that it flew all the way to Ohio before it was turned around by the terrorists, or that it was less than a half hour away from Washington when it crashed in an open field near Shanksville, Pennsylvania. I did know that there was evidence that the passengers had caused the plane to crash, and that the possible target was the Capitol, but somehow the story of flight 93 had all seemed a little secondary to the events in New York and at the Pentagon.

 

Perhaps the story of flight 93 was lost in comparison to the horror captured by the TV cameras that recorded what happened at the World Trade Center, or the symbolism of an enemy successfully striking the command center of our military. Perhaps it was because there were really no pictures to inform us. Whatever the explanation, things changed for me last Sunday as I watched and listened as Jane Pauley introduced the story of flight 93 and the new memorial that is almost completed at the crash site.

 

Flight 93 was the last flight of the four hijacked flights to take off and to be taken over by terrorists. Perhaps you know that the terrorists moved all the passengers to the back of the plane. Perhaps you know that the passengers used cell phones and the airphones that we once saw on airplanes to contact their families to tell them of their plight. Through the calls they learned of the events at the World Trade Center and the Pentagon. Surely they knew what the terrorists’ plans would do to them. There is enough documentation to know that they took a vote and decided to fight back even though the outcome might cost them their lives. There is now a consensus opinion that the objective of the hijackers was the Capital building. Is there more that we need to know?

 

The memorial that has just been dedicated is not quite finished. It is a 93 foot tower. When completed there will be forty windchimes that will represent the forty voices and lives that were lost and that we must not forget. I was surprised to find myself choking up as the camera panned the beautiful countryside and the spot where the plane came to earth.

 

As the segment ended and the next vignette began, I was left thinking in a new and more focused way about the courage of the passengers. Hearing the recording of someone who never intended to be a heroine tell her husband to tell their children that she loves them knowing that she may soon die trying to prevent a larger disaster can put a lot things into clearer focus.

 

The passengers on flight 93 decided that they were not going to die without fight. Maybe the fact that the plane was less than a quarter full gave them the room to act. Maybe the knowledge that they acquired about what had already happened with the other three planes focused their choices for them. We know that they wanted to live, but it is also obvious that they knew that objective could not be accomplished without foiling the objective of their captors, the terrorists.

 

I was left wondering what those forty people would want to tell us if they could speak to us today. What would they say is really important? I wondered if from their perspective we are talking about the right things in our times. I will not put words in their mouths.

 

I do know that the world has changed dramatically since 2001. 9/11 gave us long lines and a new liturgy to follow when we travel. 9/11 made us fearful when we saw someone near us who might be from the Middle East. 9/11 has enabled politicians who would seek to gain more power for themselves by rhetoric that intensifies our natural tendencies toward xenophobia. 9/11 thrust us into over fifteen years of military action that has diverted trillions of dollars of resources from more worthwhile endeavors, cost thousands of our military personnel their lives, and left many more permanently scarred while turning much of Iraq and Afghanistan into rubble with death and injury to countless numbers of innocent people.

 

The heroes on flight 93 could not have imagined all that would follow their sacrifice any more than the soldiers who died on Omaha Beach on D-Day could imagine the world we now live in three quarters of a century later. I think it is possible that if we could talk to all of our heroes through history they would be distressed by the tone of our conversations today. I would like to think that they would say that their sacrifice was meant to enable us to continue the pursuit of a more perfect union with a more equitable distribution of the comforts and possibilities of opportunity, health, and happiness.

 

I do not know if the passengers on flight 93 would care if we preserve the ability the ACA offers to give everyone healthcare without penalty even if they have a preexisting condition. It may seem inappropriate to talk about healthcare in the context of their sacrifice, but I do believe that they died to preserve our ability to debate questions like the coverage of preexisting conditions. They, like all of the heroes that preceded them, died to preserve and improve our ability to debate the important questions that face us as a nation like the future of healthcare. Their sacrifice was for a future where the possibilities of ideas like the Triple Aim could be considered and balanced against the benefit of tax breaks, and perhaps pursued as a collective objective. It is up to us not to waste the sacrifices of the forty people on flight 93, or the lives of so many others given over the history of our nation to create possibilities that a liberal democracy offers. To honor them we should return to a more civil discourse to protect the ideals that they died to protect.