Reflections on the Impact of a National Tragedy

By now, the tragic terrorist-driven events in New York City and Washington, D.C., on Sept. 11, 2001, have been the subject of many discussions and reports. The live pictures and descriptions provided by television that day and in subsequent days will live on in the memory of not only those closely and tragically touched by the atrocity, but by all Americans old enough to understand the implications of this well-orchestrated inhumane act.

While the tragedy of the events was immediate, their larger impact, and the impact of emergency actions undertaken to prevent additional terrorist activity, will likely be to influence or change everything from the manner in which many daily human activities are carried out, to negative influences on the economics of individuals, institutions, and the U.S. government. As this is written, it is too early to forecast the impact of the enormity of the tragedy, or of subsequent actions or events, on our American way of life.

The immediate impact on dentistry in California probably depended upon several factors. If you were in your dental practice, the immediate impact might have ranged from minimal to significant, depending upon such factors as proximity of the dental office to governmental offices in a dense population area that might have been deemed a target for further terrorist acts. In such a case, you might have had to make a decision to close due to safety concerns. You might also have experienced a heavier than normal cancellation rate due to patient fears. If either instance occurred, you would have likely experienced immediate, but limited, economic impact for a few days.

The impact on the California Dental Association was immediate. CDA headquarters, being mere footsteps from the seat of California government, made the necessary decision to close for the day for safety precautions as there was a real, although uncertain (and fortunately unrealized), threat perceived to hover over government facilities and areas with densely populated high-rise facilities.

The most severe impact on the California Dental Association and many individual members was the cancellation of the Fall Scientific Session that was to be held later that week. Many of the details have been chronicled elsewhere. Despite the obvious tragedy of the early morning events on Sept. 11, late that morning West Coast time, there were still very mixed feelings about whether to move forward with or cancel the Session. Air travel had been suspended until noon the following day, and that might interrupt or cancel the travel plans of East Coast or other out-of-town exhibitors, speakers, and dentists planning to attend. Initially, that did not seem to be a formidable problem when compared with the enormous task of canceling the meeting, informing the many people planning to travel to the meeting, and dealing with the potential economic implications of lost revenues to exhibitors, CDA, and CDA vendors. Of the calls CDA initially received, the attendance plans of exhibitors and members were mixed, with many still wanting the show to go on.

It is reasonable to say that the decision by Executive Staff and the Executive Committee late that day, for many good reasons, was still risky. There was some fear that it might be difficult to communicate the cancellation to individuals planning to attend, causing inconvenience to those who were not reached. There was also some concern that some exhibitors would be offended because of the lost sales opportunity. Many members can attest to the many mail offers and incentives to visit booths that they had received from various exhibitors in the preceding several weeks that would not be fulfilled. The bottom line was there was a nagging human fear that there would be public relations fallout from such an action. In fairness, there had been the contrary fear that a meeting held during a national period of mourning would present a negative.

However, the one unknown that no one could predict was the impact that the magnitude of the human tragedy would have. No one in this lifetime had experienced the after effects of such a catastrophic event on American soil -- thus, in retrospect, it was really not possible to predict what the outcomes would be. It had not been logical to expect that suspension of air flights would extend two additional full days, and then resume at exceedingly reduced levels for some time to come. That had never happened before and hopefully will never happen again. However, the logistics of this event would be felt for some time.

As of this writing, many of the major airlines have reduced their schedules by up to 20 percent and have laid off thousands of personnel. At least in the short term, many people are much more reluctant to undertake air travel, which affects the economics of the airline industry, travel industry, and hotels, and most likely, the attendance at major meetings such as those that CDA and other professional organizations offer. CDA will likely experience less attendance at the next San Francisco meeting because, historically, when a meeting has not been held for a year (which happens periodically when ADA meetings are held in the city) attendance at the subsequent session shows a dip.

The negative economic impact of cancellation aside, a negative impact on public relations has not been experienced as of this writing. For many reasons, the most notable being the need for a period of mourning following an unexpected national tragedy, the initial results were rather positive. Most amazing to this observer was the information that fewer than a dozen individuals arrived on the Friday morning that the Sessions was scheduled to start. While others traveling shorter distances by car could have arrived later in the day or on the next two days, the very few that arrived at a time when the registration areas are normally overflowing was an indication that three good things had happened.

First, CDA’s significant efforts to inform members via Web, fax, e-mail, and news media had been very successful. Second, the shutdown of air travel had probably helped many who might have been continuing to plan to attend realize that it would not be possible to get to San Francisco. Finally, and possibly most importantly, the American people saw the need to reflect and to honor those who had perished in the tragedy of Sept. 11.

Suddenly, the many issues facing California dentistry that had seemed so crucial prior to Sept. 11 were temporarily furloughed from a position of priority in the minds of CDA leadership. Issues such as licensure by credential, the future of the Dental Board, and the amalgam and Proposition 65 legal matters took a few days off from active discussion. A few days after the tragedy, one association volunteer even remarked that in light of the events and their impact on family considerations, he was considering resigning as a delegate to the American Dental Association House of Delegates in Kansas City. This emotion at the time was understandable. While most Americans expect some modification in our future lifestyles as a result of terrorist threat, we believe that dentistry cannot allow such threats to divert our attention away from conducting the necessary business that will ensure our future ability to undertake our significant health care responsibility to the public. While most Americans seem to have some agreement that "things will never be the same" as they were before these attacks, we do believe that our routines will return to a state of normalcy, likely long before this column is read.

This terrible tragedy also provides us one more opportunity to recognize a segment of our profession that primarily only at times of mass fatality receives recognition for the outstanding continuing work it does for the public. We speak, of course, of those dentists who do forensic work. While it is unknown at this writing how many dentists from California ultimately might have participated, we know that at least three joined their colleagues from other regions of the country to undertake what would be expected to be an extremely difficult task of identifying victims, particularly at the New York site. Police and firefighters frequently are credited in the media for their contributions, largely because of the heroic rescue efforts they undertake in the early phases of a disaster. Having seen photos and descriptions of the work that forensic dentists do under the extremely trying circumstances of a crime or disaster scene, we believe that they should also be recognized for their valuable contributions to society and for the credit they bring to the dental profession.

Out of this tragedy, we have seen many expressions of patriotism and unity. Perhaps the unity demonstrated during this crisis will translate as a positive in many ways. For dentistry, the positive could be that it might help erase some of the hurdles that many believe have existed as the profession has sought to become more inclusive despite its increasing diversity.