On my way to Al Asad, I had a few “layover” days in Kuwait. There, I spent an inordinate amount of time in a tent, ducking the sand and the heat. My roommates included a few other medical types, among them COL Robert Vigersky whom I had known from my days at Walter Reed Army Medical Center (WRAMC). One day, as we were reminiscing about life in the DC area, it occurred to both of us that we had simultaneously come full-circle: we were both at WRAMC on 9/11, and now here we were on the Middle East on the five-year anniversary of the commencement of Operation Iraqi Freedom.

September 11 has always been a special day for members of the Rupard family, as it marks the birthday of one Rebecca Ann Rupard (who later became Rebecca Ann Anundson). Becky is the girl of a thousand nicknames: she was a tiny little thing as an elementary school kid, and so her nickname became “Speck-y” which evolved into just plain “Speck.” For much of her teen years, she was (for reasons unclear to me) “Beckles” and eventually “Beckles the Clown.” In fact, I’m pretty sure that there was a time when just pain old “clown” sufficed. Everyone loved Becky, and we all love her still. She possesses the enviable characteristic of being a truly happy person—not in some cheesy, depression-masking sort of way, and not in the way that a drooling chocolate labrador is “happy” as he licks your face. Becky is genuinely glad to be alive, and has been in all of the days that I have known her. One of my colleagues here recently described a particular medic, admiringly, as someone who “cannot be broken.” That is Beckles the Clown to a tee, and that is one of the many reasons why we all love her.

Unfortunately, Becky’s birthday was befouled by the terrible events and evil deeds of 9/11/2001, which has now become for all of the Rupards the birthday that will live in infamy. 9/11 is also notable for me, as my birthday is just two days later, on the 13th. This initially fortunate proximity resulted in no relatives forgetting either of our birthdays the way that big brother Barry’s is occasionally overlooked, being way out there in May all by itself. Now, though, Becky’s special day is remembered by nationwide half-masts and moments of silence.

On September 11th, 2001, at the time the first plane hit (around 8:45 AM), I was in morning report at Walter Reed Army Medical Center. In most Internal Medicine residencies, one of the graduating third-year residents is chosen to stick around for a fourth year, during which he is dubbed the “Chief of Medical Residents” or Chief Resident for short. This is a staff position in most hospitals (meaning that the Chief is considered, on paper at least, to be a full-fledged faculty member). The duties of the Chief Resident at WRAMC are many and varied, ranging from the planning of the schedules of every non-surgical intern, to the administration, teaching, and general herding of the Internal Medicine residents. For the academic year 2001 to 2002, I was the Chief of Medical Residents at WRAMC.

Being Chief is a fun job, but a challenging one, especially at an institution like Walter Reed, where every resident is brilliantly smart, and many are inevitably smarter, on some or all subjects, than I. On that sunny morning, we were reviewing cases in morning report, and when the meeting let out, I remained behind to speak with one of my colleagues in the hallway. Sometime around 9:05, a medical student came up to us and explained that a plane had just hit one of the World Trade Center buildings. I nodded “okay” to him, and continued my conversation, not thinking much about it. A few minutes later, as I walked the long cement hallway back to my office, I heard about the second plane. I can’t remember exactly who told me that bit of news, but I recall that we both wondered aloud whether terrorists were somehow involved.

I walked briskly down to the second floor, to the office of my direct supervisor, LTC Gregory Argyros. LTC Argyros had a television in his office, ostensibly for teaching purposes, but I had never seen it turned on until that moment. The picture on the screen was of the Pentagon, with smoke billowing out of one of its sides.

“What happened?”

“They don’t really know” he offered very calmly and deliberately, like always. I had seen Greg in normal moments, as well as in moments of anger and crisis (i.e., a suddenly arrhythmic patient), and he always had this same calm demeanor: everything was workable, all crises could and would be handled. Exactly as he was at that moment. “They think a bomb may have gone off inside the Pentagon.”

“What would you like me to do?”

“The hospital command is going to meet in a few minutes, and we’ll make an emergency response plan. I think it will require every set of hands that we can find. Call all of the residents into the hospital.”

“Including the doctors who are post-call?” I asked.

He thought for a few seconds. “Yeah, I think everyone should come in.”

I walked back to the elevator, mentally making a plan for mobilizing all of our people. When I stepped back onto the seventh floor, I walked past the morning report room, and noted a group of people standing at the large windows, looking towards the southeast. It took me a minute to see what they were seeing, but then became clear: a stream of smoke was floating up into the sky, from somewhere far behind the parking garage. It looked blackand noxious and evil, and it looked much, much too close to myself, my work, my patients, my home, and my family.