On Sept. 11, 2001, a hijacked passenger airliner crashed into the Pentagon, resulting in hundreds of casualties and many wounded. (Photo courtesy of Merwynn Pagdanganan)

For Kiyokawa, being involved in the military medical response at the Pentagon began with the realization of the gravity of the event. He had only been in the role for a month and a half, and was still getting used to the job and its pace.

“The most amazing events on the days that followed included participating in standing up the Army Operations Center and the twice daily ‘balcony briefs,’” he said. “It was amazing how the Army staff quickly hit a battle rhythm of updates to senior leaders on all actions in response to the 9/11 attacks, and the Army Office of the Surgeon General/Medical Command fed into those briefs with updates on wounded every morning.”

The experience influenced his life and career in military medicine markedly.

“It forever changed my perspective of what terrorism can bring to any society,” he said.

This, despite “having lived through the 70s and 80s, when plane hijacking was common, through a Cold War that saw the wall come down in 1989, and the first Gulf War in 1991, which resulted in a 100-day ground war,” he said. Yet “ongoing individual acts of terrorism in the 1990s did not prepare us for 2001.”

“It completely changed the course of the United States, the Department of Defense, and foreign policy,” he said. “In 20 years, we have focused on countries harboring terrorists and the warfare we have fought was based on counterinsurgencies and not force on force.”

In turn, he says, medicine fell into asymmetric warfare, where there is no distinguishable front line. 

“The last 20 years have helped to further define what medical readiness means and the recent pandemic further emphasizes disease and non-battle injury threats and public health as a key defensive weapon in future warfare.”

The historic nature of the event, the impact on the nation, the military and a whole generation really sunk in as the weeks followed, he said. But one of the most moving moments he recalls took place during the memorial service for Army Lt. Col. Karen Wagner, a medical service corps officer who was killed when the plane hit the Pentagon. 

“Army Gen. Eric Shinseki, then the Army’s chief of staff, walked out of the chapel with the family in tears,” he recalled. “It hit me that this wasn’t just about Karen Wagner, but about the Army, the DOD, and the nation.”

Kiyokawa said it’s important that younger generations learn and remember these events. They can “benefit from history only if they can improve how our country reacts to world events.” But it’s also important to remember, “we are all at risk for terrorist acts foreign or domestic,” he said.

“We have a choice to determine the direction of our country,” he said. “And it is no longer warfare only seen on television.”

For Air Force Lt. Col. Lola Osawe, branch chief of performance improvement at the Air Education and Training Command’s surgeon general’s office at Joint Base San Antonio, Texas, the most important aspect she thinks people should remember from that day is that “terror is real, and we must continue to protect our country from all that seek to destroy her.”

The events of that day also influenced her military career.

“It changed my life,” she said. “So many people died that day, and we saw it happen live on TV.”

At the time, she was a captain assigned as an action officer to the headquarters of the Air Combat Command’s Aerospace Expeditionary Force Center at Langley Air Force Base in Virginia. She was also in the process of applying for a transfer into the Medical Service Corp, which resulted in her participation in the overseas operations that resulted from the events of 9/11.

“As a young officer in her 20s, seeing a terrifying attack on American soil shook me to my core,” she recalled. “When I finally transferred into Air Force Medical Service, I took my work taking care of our military members and their families seriously in all my medical leadership roles since then, both on active duty and the reserves.”

She also participated in Operation Enduring Freedom, helping to plan and deploy personnel and air assets to support operations in Afghanistan.

She said it’s important to remember “how vulnerable we are and to never take our freedom for granted,” she said.

“Death seemed so cruel,” she said. “It was humbling to see how helpless we all felt watching those planes slam into the Pentagon and the Twin Towers.”