we start to dr. patty in new york. dr. i would think by now, you you have seen the images of the car shredded bite concrete train flat form. what are your thoughts that there is only one fatality. and three people critically injured. >> we want the least number of fatalities. looking to the damage and ceiling makes me concerned about the type of injuries. we have been involved in more of these we car. >> and many times people are trapped and it needs to be secured so the first responders can remove the patients. >> for you in the fold. you have to shake snap decision and there are pranan ium; >> we have a tream we look at the voilths sees and we have it died wo gets immediate treatment until they get to the hospital. depending on the number of casulties, sometimeses we will treat at the scene and others we will scoop and run and get them to trauma center. like mine or jersey central. >> and this being a crowded area, hospitalses are not that far away. but the roads are crowded that time of the morning of trying to get time