"It's gonna be a big one," one of the nurses said in a dry, blasé voice, as she walked down the clinic hall. "Plane just hit one of the twin towers. They'll be coming in droves." Her tone was the nearly bored resignation of someone who's worked in a city hospital for years and who's seen it all: Bellevue Hospital, after all, is the quintessential municipal hospital—huge emergency room, Level 1 trauma center, recipient of New York City's urban fallout for 275 years. Another plane crash, or train wreck, or gunfight, typically elicits not much more than a "Here we go again." It took exactly 17 minutes for that attitude to crumble. As soon as the second tower was hit, even the crustiest of old-timers was shaken. From the upper floors of the hospital, the smoking towers were visible 60 blocks downtown. And then the hospital shifted gears like I'd never seen in my 25 years working there. The staff was reacting based on the memory of the nearly 1,000 people Bellevue treated from the World Trade Center bombing in 1993. They knew that the ER would need to be expanded, and then there would be an acute need for hospital beds, especially intensive care unit beds. Our medical clinic was quickly transformed into an additional ER, with triage stations and equipment for first aid, burns and smoke inhalation. Other clinics were converted into ICUs, with cardiac monitors and ventilators wheeled in from storage.