Даниэла Стил: Turning Point

“They’ll send them to SF General and Saint Francis’s burn center first,” the anesthesiologist responded, as they continued to watch the fire burning out of control on the news.

Several more doctors and some nurses wandered in to watch, as Tom tossed his paper cup into the wastebasket and went to check his young patient again. The boy was still heavily sedated but doing well, and Tom was pleased. He was back five minutes later. He looked at the fire again, and saw a line of ambulances arrive, paramedics rushing toward the scene to confer with the police.

“That’s some hell of a fire,” Tom said somberly as the announcer said it was believed that lights on some of the Christmas trees may have caused it, but arson had not been ruled out yet. Two floors of the enormous hotel were in flames. You could hear the explosions in the background, as the windows continued to blow out and the fire moved to other floors. The hotel had been evacuated immediately, and several additional units of firefighters were now on the scene.

The doctors from the ER were conferring, trying to guess if some of the injured would be sent to the East Bay, and the consensus was they’d be sending people to the city hospitals first, but it was a reasonable possibility that Alta Bates might get some victims of the blaze that night. Tom went to speak to the head nurse in the ER to have her check their burn supplies. He wanted everything ready to receive critically injured burn victims, who might even be sent over by helicopter. Anything was possible and he needed to be sure they were prepared. There was no joking around now.

It was five P.M., and the streets were already dark. Floodlights had been set up on Market Street, and they were shooting water from high-powered hoses into the hotel, with no effect on the blaze so far.

—

At San Francisco General, Bill Browning and his team were watching the same broadcast, and he dispatched everyone to check supplies, and had the nurses at the desk start texting all the physicians on call that night. He wanted their full complement of staff on-site to deal with all the injured and burn victims the police sent them. SF General was in the front lines, and in less than an hour, they were at full staff, and all the supplies were ready as the ER staff crowded around the TVs. The fire had gotten worse and six floors were involved now, ladders were set up all along the front of the hotel. Firefighters had come from Marin and the East Bay to join the forces in the city. All of Market Street had been closed off, the smoke from the fire hung heavily in the air, and the stunned hotel guests had been moved back a block. The reporter said you could feel the intense heat in the street.

“How many do you think we can handle?” Bill asked one of the doctors who had come in. They had two hundred and eighty-four beds with the new facility, and they weren’t at capacity that night.

“Sixty easily. Close to a hundred if we have to.” They had recently had training for terrorist attacks, which would serve them well in dealing with large numbers of victims. Bill went to call their contact at the police department, to give him an idea of how many people they could handle comfortably, and at what point to start sending them to UCSF.

“We’re sending you twenty now, mostly older hotel guests suffering from smoke inhalation. We’re treating minor injuries at an EMT station we set up. The Department of Emergency Management guys are here, they’re doing triage right now. Get ready. We’re going to have a busy night. They just sent a dozen firefighters to Saint Francis.” Saint Francis had the best burn unit in the city, and Bill was sure they were prepared too.

Stephanie had just arrived at UCSF when the fire started, and after she saw the three patients they had called her in for, she joined the others at the TV. At five-thirty, they saw the first ambulances leave the scene.

The ambulances arrived at SF General ten minutes later, with the first smoke inhalation cases, and a pregnant woman Bill sent up to labor and delivery. She was having a panic attack and worried about her baby.

More ambulances showed up after the first ones, with minor injuries, including a broken leg that had happened when a hotel guest fell down the stairs during the evacuation. Eight badly burned firemen came in next, as Bill did triage at the ambulance entrance to the ER, and paramedics brought the injured in on gurneys, victims with soot on their faces and some of them still gasping from the smoke. They reached their limit faster than Bill had expected, and he called his police contact again, asking him to send the next group to UCSF, to give SF General a chance to organize their teams, and deal with the burn victims.

The ambulances went to UCSF after that, and Stephanie did triage along with two other trauma doctors. They had two heart attacks, more injured firemen, a number of children with their parents, and the fire hadn’t been stopped yet. The damage was being estimated on TV at a hundred million dollars, including structural damage, and by then two of the firefighters had died on the scene, one of them a twenty-four-year-old rookie and the other a veteran fireman who had gotten trapped in the building. It was a scene of major carnage, and at the same time the victims were arriving at UCSF, the authorities started sending ambulances to Alta Bates, and another dozen victims to the Stanford trauma unit by helicopter. Wendy was waiting for them at Stanford, and their entire ER and trauma staff had been called in.

The news broadcasts said it was the worst fire in the history of the city since the 1906 earthquake, and by eight o’clock that night, the uninjured guests, who were now homeless, had been sent to other hotels in the city. Those who took them in were using their ballrooms and conference centers to set up food and cots for them, once they ran out of rooms. Everyone was rallying to help and do what they could. And the Emergency Operations Center, directed by the Department of Emergency Management, were working closely with the police and fire department.

It was two in the morning when the fire stopped growing, and was considered contained within the hotel, although it wasn’t under full control yet. Every hospital had patients on gurneys in the halls, and additional nursing staff had been brought in to help. It was a disaster of major proportions. The mayor and governor were surveying the scene together, and planned to visit victims in the hospitals later that day.

By eight A.M., thirty-seven hotel guests had died from burns and smoke inhalation, as well as nine firemen who had been trapped. Another forty firemen and more than a hundred hotel guests had been injured. The evacuation had been properly handled, but panic had taken a heavy toll. Market Street looked like a bomb had hit it, and the fire had spread to a department store next door before it was brought under control.

Stephanie didn’t make it home until two P.M. the day after the fire. Her white coat was black with ash and soot, and she looked exhausted when Andy saw her. He had watched the progress of the fire on TV all night, and Stephanie had sent him a text at two A.M. that their ER was being overrun. Every hospital in the city had been receiving victims of the fire, and even doctors not on call and from other departments had gone to help.

“How bad is it at UCSF?” Andy asked with interest, as she sat bone-tired in a chair, grateful that the boys were down for their naps. She was filthy and drained and hadn’t slept all night.

“It’s like a war.” The hotel had virtually been destroyed, gutted by the fire. “It was like the terrorist drills they’ve been describing to us, only worse. The firefighters took the hardest hit.” Firefighters had battled the blaze for fifteen hours, and many more would be on the scene in the coming days, making sure it was out, and they still didn’t know if it had been arson or not. Stephanie hoped it wasn’t, knowing that someone had set the fire intentionally would have been infinitely worse. She went to take a bath a few minutes later, and crawled into bed afterward, as Andy walked into their room and sat down on the bed. It reminded her of the dinner the night before. “How was your mom? With the fire, I would have had to go in anyway.”