Few people have any idea about how to rescue a disabled person during an emergency in a high-rise building, says today's writer, an Albuquerque woman who is disabled. But she aims to change this.

By Barbara J. McKee

Oct. 10, 2001 -- The elevator is stuck again. It's the sixth time since I began this job.

Until today, I would joke with the people passing me by on their way to the stairs, saying I was keeping watch to make sure no one ripped off a computer or two. To the women I knew, I would say this was the best way I knew to get a date with a cute fireman. This would bring the inevitable smiles and small talk, and then they would continue their descent to the ground, where freedom lay.

But today, I can't engage in such inane chatter.

As I look out to the parking lot and street beyond, I have an overwhelming urge to crawl out of my wheelchair and make my way down the stairs, no matter what the physical consequence. But I don't, reminding myself that the events of Sept. 11 aren't happening to me right here, right now.

It's just a broken elevator. No one is trying to kill me; no one knows that I wait in fear or even cares who I am. I want to pound on the huge glass windows, screaming, "Get me out of here!" But I do not. Instead, I lean over the safety railing and look below at the world moving along, oblivious to my predicament.

But the panic refuses to subside. I can't help but think of those who perished just days ago as a frightened throng of people, some of them friends of the disabled people in the World Trade Center, filed past in desperation to save themselves. Some might have given encouraging words of rescue; some might have averted their eyes, knowing that they were leaving a fellow human being behind who might possibly die.

I envision the panic of the disabled, knowing that their lives might end right now, in horrific destruction. It dawns on them how much the passing adults fear them, how quickly humans can disassociate themselves from someone who might keep them from their own salvation.

One brave soul took the chance and carried one of us on his back, telling the others he encountered that he would be back to get them. The relief of those who passed by was apparent, as this Good Samaritan lifted their burden of guilt.

I heard the story of the man whose wheelchair wouldn't fit through the doorway of the stairwell in the North Tower of the World Trade Center. He was left there with promises of rescue by unknown saviors. I imagined the pats on the shoulder, the murmurs of good luck and prayer. He had no choice but to trust them, unable to accept that the crumbling building surrounding him had already sealed his fate.

As I think of the horrifying scenarios that took place, I can't help but begin to cry, knowing that I, and others like me, might suffer that same fate one day - left behind with promises and lies, words of encouragement that mask the truth: There is no plan for ordinary people to save us. That task is left to the "professionals," the men and women of the firefighters and the police.

But what if they don't come? What if they can't? This is what happened inside the World Trade Center towers, and it will happen again - unless ordinary people overcome their fear of us.

People don't know that carrying a disabled person is much like carrying a child. For, in fact, we are reduced to the helplessness of an infant in times of crisis. Our bodies ignore the intelligence of our minds and starkly remind us of our vulnerability. A set of stairs brings us back to just who we are. A fire alarm announces to us that we are completely dependent on the altruism of humanity. We feel the fear begin in our gut, hoping that just one person will be our Good Samaritan today.

Recently, there was a fire in my building, two floors above me. As the staff members made their trek to safety, they passed by, asking how I was going to get out of the building. I had no answer for them. The department director had no plan; she was already down in the courtyard. Fearing for my safety, one of the employees remarked to her that I was still in the stairwell. Alarmed, she made her way back up the two flights of stairs to the landing, where I parked with my boss and her supervisor.

All of them were bewildered at the situation and asked, "How do you usually get rescued?" Again, I had no answer.

One of the brighter employees knew of "safe rooms" in the back of the building on each floor. They are surrounded in concrete, and I was supposed to go there and wait. She said I had better tell someone I would be there, or I'd be trapped, as there was no doorknob on the inside to let me out. The door would lock behind me to "protect" me as I began my vigil for the person with the magical key.

Naturally, I refused such imprisonment, preferring to meet death head-on, eyes wide open.

Luckily, the fire was a false alarm. But the conversation continued about what to do with me if a "real" emergency cropped up again. It became apparent that, even though I worked for a department for the disabled, none of the staff members knew or understood what being disabled really meant. They looked to me for strength, answers and direction.

I was astounded, because every person was there to improve the lives of severely disabled children and young adults. Give them a complicated disability, and they could rattle off the treatment plan and the local and federal resources available to the families. Ask them how to get me down to the ground floor if there was a fire, and they stared blankly, waiting for a manual to come out in print.

But there is no time for a disability safety manual to be written by the able-bodied. That is the job of the disabled. We must teach those around us how to save us, and we must teach ourselves.

Many of the disabled have no idea that it's our responsibility to case the building we are in to ensure our safety. How many of us ask for the disabled escape plan at our jobs? How many of us have one for our homes? I know hundreds of wheelchair-disabled people who have only one entrance to or exit from their house. This is unacceptable, but inevitable. Even the best-designed accessible homes have only one way out.

I had an apartment for a couple of years that boasted of being the most accessible and modern in the area. Each apartment had one entrance. The windows were the only other escape. You had to plan your bedroom layout to leave enough space to shimmy up next to the window, crank open the glass and punch out the screen. From there, you had to transfer out of your chair and fall to the ground, covered in pea gravel and decorative shrubs, then crawl away from the building - if you didn't break your arm, shoulder or hand in the fall.

Now I live in a house with two exits. One has a ramp, one does not. The door that is not ramped has low-enough steps that I can wheel over them backward, albeit very slowly. I can only hope the fire doesn't spread too quickly.

Both of these doorways are in the front of my house. If there is a fire in the front of the house and I'm home alone, I'm done for. I'm in the process of building a third exit, right off my bedroom. I'm punching out one of my windows that looks over my back yard and am putting in a doorway that opens to a large deck with a ramp that leads to the driveway. But this modification is months away from being completed. In the meantime, I'll have to hope my husband can bash out the old metal frame window and dump me out into the yard.

For those of us who live alone, there is even less hope. The fire department will have to save us - that is, if we have marked our windows with the appropriate stickers to show them where we are or have placed a big sign on the front door pronouncing where we sleep.

I wonder how many disabled people know that their local fire department should have a safety package with emblem stickers that you place on your front door, stating a disabled person lives in the house, with additional stickers to place on the bedroom windows. When I lived in Dearborn, Mich., the fire department even had emblem stickers to announce how many children and pets were also at risk.

I did a search on the Internet about fire safety procedures for the disabled. On the site safetyinfo.com, all I could find was a brief mention for businesses that have "special" employees. The paragraph stated that disabled individuals should have a partner to help them - provided the company has taken the time to work out such a plan.

The rescue plan for the disabled was mentioned as a sidebar, as if the disabled were an afterthought. Here's the complete text, much to my dismay:

"Determine the needs of disabled persons and non-English-speaking personnel. For example, a blind employee could be assigned a partner in case an evacuation is necessary.

"The Americans with Disabilities Act (ADA) defines a disabled person as anyone who has a physical or mental impairment that substantially limits one or more major life activities, such as seeing, hearing, walking, breathing, performing manual tasks, learning, caring for oneself or working.

"Your emergency planning priorities may be influenced by government regulation. To remain in compliance, you may be required to address specific emergency management functions that might otherwise be a lower priority activity for that given year."

OSHA has a Web site that is very thorough in telling companies how to set up a plan. But the decision to do so is still up to the company. People will e-mail me in protest, saying it's the law, and every employer must have one. But I can tell you from firsthand experience that most employers have no clue about what to do with a disabled employee - especially one in a wheelchair.

In buildings the size of the World Trade Center, or of any size, for that matter, disabled individuals truly put their lives in danger if there isn't a well-developed plan that is part of the employee orientation. There needs to be a way out besides the elevator or the precarious chance of help from a compassionate stranger.

But how to remedy such dangers?

Exclude the disabled from working anywhere but the first floor? That would surely place them at risk of being denied employment based on physical barriers. Landing a job in the disabled community is tough enough as it is. Throw in the current reality of their safety in a crisis, and it will be close to impossible to get a job in any company that is housed in a multistoried building.

Ideas are the cornerstones of change. I have one that I hope will begin some serious discussion. It is long overdue in the business world. How about one or more special stretchers on each floor that could be slid down the stairs by other employees? Trying to get a wheelchair down a flight of stairs when the people doing so have little to no experience is dangerous to all involved. But having a stretcher available gives the physically disabled a chance at life. Rescue teams have been using stretchers for rescues on hillsides, in avalanches and for other steep rescues for years.

Why can't this type of device be implemented for rescuing the disabled? Training for such rescues makes sense, just as training to administer cardiopulmonary resuscitation has proved to save thousands of lives.

My fellow Americans in New York had no chance for survival. Blessed are those who tried to save them. The many who died had no idea how to save themselves. Neither did those around them.

But that can change. It must change as the baby-boomer population grows older, thereby increasing the disabled community to proportions that have never been seen before.

We can't ignore this need, nor should we. It is our duty as humans to help one another, sometimes at the risk of our own lives. That is what separates us from lower life forms.

Leaving someone behind because the knowledge of how to save them is unknown leaves everyone feeling guilty and angry.

There is no need to exclude such information from ordinary citizens. CPR was once thought to be too dangerous to teach common people. That theory was proved wrong, and rightfully so.

People can learn how to rescue the disabled, just as they have learned other life-saving procedures. The ability to help those in times of crisis is the nobility of being human. We all want to live, and helping others to stay among the living takes knowledge.

It's time to give the disabled an equal chance at staying alive.

TODAY'S BYLINE

McKee, of Albuquerque, is a writer whose work has been published in the local poetry newsletters "Flaming Tongues" and "Herland," in several anthologies and in the national publications for the disabled, "New Mobility" and "New Vision." Her upcoming poetry book, "Trilogy of One," is an eclectic collection of her thoughts and experiences of life before and after her entrance into the disabled culture in 1975. In 1997, she became the first wheelchair-user to graduate summa cum laude from an accredited institution, with a degree in culinary arts. She has performed her poetry on several occasions and is part of a two-woman show called "No Shy Bones," performing at the South Broadway Cultural Center and at the University of New Mexico. She is working to expand and promote her production company, EclecticPankyland Productions, and to further examine myths about the disabled.

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Panic ensues when a crisis occurs and people don't know how to react.

I learned a great deal about crisis response in the past few weeks, as did all of us. We've all heard the stories of triumph and horror. To combat feelings of helplessness, I spent many hours doing research on how the disabled community is reacting to the recent tragedy.

Posted on the disability site http://disability.about.com is a survey to tally the feelings of the disabled in a crisis situation. There are five choices:

1: I hope public safety officers will help me.

2: I think people will try hard to help.

3: I don't want friends or family to sacrifice lives for me.

4: I don't expect to survive.

5: It's too dreadful to contemplate.

Guess which one is in the lead? If you guessed No. 4, you're right. At the bottom was No. 1. This is how the community of the disabled feels. This has to change.

To have change, there must be viable options.

In the case of a fire, people are taught to get "under" the smoke to avoid the deadly fumes. The timetable for the effects of smoke inhalation is extremely fast: Within 30 seconds, the mind becomes disoriented; in 2 minutes, the individual becomes unconscious; in 3 minutes - death.

Most of the plans I reviewed have the disabled person and their rescuers above the smoke. So what is a viable alternative?

One of my online friends who works at a large rehab hospital gave me information that is taught to the newly disabled. I wish I had such information back in 1975:

"We no longer recommend placing a disabled symbol on the door or window to indicate where you are to firefighters. Unfortunately, some sick people were using these to find vulnerable people to rob. Instead, we recommend placing the "child" stickers on your bedroom window. Firemen look for and go to these windows first. In our area, some fire departments have a computer system to indicate if a disabled person is at a certain address. Find out if yours does."

"If you have to evacuate from your home in a fire, sitting upright in a chair is not a desirable position, as you will have your head up in the smoke and fumes - which is what kills people, not the flames. An able-bodied person is taught to crawl out in these circumstances. We recommend that people in chairs consider getting a car-repair "creeper" and keep it stored under their beds. Depending on your level of disability, either you, or someone you live with who can assist, can roll you on to this and then push or pull your way out the exit to evacuate."

As I researched escape plans on the Internet for businesses, it became apparent that some plans are well thought out and others are the minimum required. To my surprise, it was colleges and universities that had the most comprehensive plans, with complete descriptions and illustrations to show the way out of an emergency. Whether it was for a fire, earthquake, or bomb threat, most had good plans in place.

Now is the time to put into place the proper procedures to save as many lives as possible. Changes need to be made - but how? Why should they change? Who will set these procedures for change in motion? Is change needed at all?

These questions require a team of people, including the disabled. In my research, it was apparent that some disaster plans had never been tested by a disabled person for validation.

One in particular suggested several ways a mobility-impaired person could be carried down flights of stairs. One suggestion was to keep wheelchair-users in their chairs and move them, similarly to moving a refrigerator. In my experience, this is the best way I could describe how to take me down a flight of stairs. But I learned that this practice is not the best choice in a disaster event.

One aspect was common to nearly every plan I researched: Ask the disabled individual what the rescuer should do to help them. Now that sounds odd, but if you're dealing with a person who has a severe disability, such as a quadriplegic on a ventilator, this is a most appropriate question.

You may try to move this person to an evacuation chair or other evacuation device and unhook his or her support systems.

When my supervisors asked me how I would like to be evacuated, they were asking the right questions. I had never been asked such questions before, because I assumed the "people in charge" would know what to do.

"Mercy at Will," a basket-type stretcher, appears to be the logical choice for a flexible option. The stretcher can address just about every mobility issue. It can be dragged along the floor below the smoke and fumes in a fire. It can be lifted around tight corners in stairwells. It can be equipped with Velcro straps for respirators. People who would have no idea how to use an evacuation chair can use this stretcher. Why isn't this device used, instead of the common "evac chair?"

Most of the evac chairs I found were nothing more than glorified lawn chairs, similar to the infamous "aisle chair" used by airlines to board nonambulatory people. When I fly, I have my husband carry me to my seat. I've had more injuries utilizing an aisle chair than I would if I could have crawled to my seat - which I've come close to doing.

Unfortunately, the devices commonly used are unsafe for most wheelchair-users, and are clumsy and awkward for the personnel designated to help. The standard evac chair for the disabled has two 5-inch wheels on the back, with two snap-up handles in the front, and two safety belts go across the chest and legs.

This chair is the most common. It's inexpensive, and most companies feel it will be used infrequently, so expense is the deciding factor. This notion has to change.

Several companies manufacture evacuation chairs for the disabled. A majority of these chairs have limited- to no-capacity to be used horizontally and are expensive. However, there is a good one from the company AOK Global Products Ltd. in Deer Park, N.Y., that meets the ADA requirements and is the best I've seen. It retails for around $990, and the price lowers if purchased in multiples.

The company PMX Medical in Salt Lake City has a stretcher that is closest to my suggestion. Its Model 71 Basket Stretcher retails for $509.85.

These are just two of many I've found in my search for a device that will save the disabled from being left behind in the most extreme dangers.

In a well-known rehabilitation center, stretchers and evac chairs are placed in the stairwells on every floor, and all personnel are trained to use them. They have practice sessions to keep their skills up. Granted, every office building will not be overflowing with wheelchair-users as is a rehab hospital, but the concept is the same: Have the device, and teach people how to use it. Simple.

Practicing fire drills is common. Adding the proper evacuation of the disabled should be part of the process.

Most emergencies will not warrant the use of stretchers. Fortunately, we can be rescued after simply going to an area far enough away, such as a smoke-free stairwell landing or a room with a window, to await help. But in extreme cases, waiting for professionals to show up is just not an option. Just as in the case of a person suffering a heart attack, seconds count. An evac chair that slides down the stairs, or a stretcher device, will make the difference between life and death.

For more information on these devices, visit these Web sites:

http://www.rescuechair.com/index.html

http://www.pmxmedical.com/index2.html

For ideas on developing an evacuation plan, visit these Web sites:

http://www.jik.com/disaster.html

http://admin-scb.ouhsc.edu/ems/Evacuation.html

http://www.unlv.edu/facilities/emergency/evacuation.html