Ladies and gentlemen, welcome to the 1989 World Series, brought to you by KNBR radio. I’m Ron Fairly, and we’re coming at you live from Candlestick Park for the third game between the San Francisco Giants and the Oakland A’s. This Bay Bridge series is the most exciting sporting event of the decade. Bill, why don’t you get us up to speed on the series thus far?”
“Well, Ron…” Static on our cheesy AM radio obscured Bill’s response. I glanced at the clock; it was only 4:50 p.m. My shift in the emergency room at Seton would be over at 5:30, and quitting time couldn’t come early enough. The day had been long and tedious, filled with surly patients and uncooperative families. I knew the department would be busy after the game, as alcohol-fueled baseball fans descended on the city. I was pleased to know I would not have to be involved in that hootenanny. I was scheduled the following day for a shift at CALSTAR and would be safely tucked into my own bed long before the drunks landed in the ER.
Since we had a lull, I wandered out through the ambulance doors into a spectacular October afternoon. As I sat down against the wall, turning my face to the warm sun, I wondered if I should try and brave the traffic to get to Vince’s World Series party in Berkeley that evening. It meant driving across the Bay Bridge during rush hour traffic. Vince Scott, one of the ER docs and a famed cook, was throwing a bash at his house. Inside, he was hustling to get his charts done quickly so he could zoom home before the rest of his guests arrived. His roommate had called several times during the afternoon with minor crises, the last of which was a spinach soufflé that refused to rise. “We’ll just call it a terrain,” an exasperated Vince had yelled into the phone. “Don’t worry about it. Worst comes to worst, we’ll go to 7-Eleven and get some chips and dip.” I glanced down at my watch. It was now 4:55, and I looked up to see Vince running out toward his rusty blue pickup truck.
As he threw his briefcase onto the passenger seat, he looked back at me basking in the sun. “So are you coming tonight?” he asked.
“Of course,” I said, “except the traffic is going to be a nightmare.”
“I know,” he said. “I’m on my way now. Maybe everybody in the greater Bay Area will be at the game, or at least watching it. I have a house full of guests, and my roommate is going nuts. Anyway, you have directions. Call if you get lost.”
“Thanks, Vince. I’m off at 5:30, so it’ll be after six when I get there. Is it OK if I wear my scrubs? I didn’t bring a change of clothes with me.”
“Janice, you’re welcome to wear anything you want.” He hopped into the truck and wheeled out of the parking lot, waving.
I wandered back inside and found Bob, the ER doc who had taken over from Vince, writing in a chart. “Oh, Janice,” he said, “I was just looking for you. Can you set up a suture tray with 4-0 nylon in 4B? The guy fell through a plate-glass window at work and has a pretty deep laceration in his thigh. Come to think of it, open two sutures for me, OK?”
“Bob, for you, the world,” I replied. “Hey, how did you manage to draw the short straw to be on tonight?” I asked.
“I missed the last staff meeting, and I got elected,” he said, grinning. “That’ll teach me, huh?”
I picked up the supplies and headed to room 4B, where I introduced myself to a young man sitting quietly and holding a very bloody dressing over his wound. I got the sutures ready and Bob wandered in a minute later. “You ready to get started, sport?” he asked the patient.
“Ready as I’ll ever be.” He turned his head away gritting his teeth as Bob began to infiltrate the wound with local anesthetic.
I wandered back to the nursing station, got a glass of water, and sat down next to Mary Janet, a fellow nurse. In the background, the pre-game radio show was still in progress. “So are you going to Vince’s party?” she asked as I made a note on a chart.
“I think so. It’s not every day the World Series features our own teams, and I’m sure the food is going to be fabulous.”
“Wish I could go,” M.J. said moodily. “But I’m here till ten o’clock. Just about the time all hell breaks loose.”
“Don’t worry, I’ll eat enough for two, OK?” She grinned and returned to her charting.
“Hey, what was that?” she asked suddenly. I looked down and noticed the water in my cup sloshing over the rim. Then everything around us began to rattle. We both looked up at the same time and then heard a loud growling rumble as the walls began to shake.
“I think we’re having an earthquake, that’s what,” I said, standing up unsteadily, as the floor was now beginning to pitch and sway. Realizing the nursing station was surrounded by glass walls, we both began moving toward the ambulance doors. As we were standing up, Bob came running down the hall, headed for the parking lot with his patient right behind him, the unfinished suture streaming from his thigh and dripping blood. As we reached the doorway, the shaking became more intense. I watched the asphalt move in a slow undulating wave, and nearby a forty-foot pine tree thrashed violently back and forth. The noise became a crescendo of booming thunder as the earth beneath us shifted. After what seemed like forever, the waves slowed and the rumble died out. We all stood uneasily for a moment and stared at one another, unsure if Mother Nature was really finished.
Bob broke the silence. “Well, that was a pretty good shaker. Must have been at least a four or five.” The emergency generator in the corner of the parking lot kicked in, spewing diesel fumes into the air.
We moved back into the ER, now joking and laughing. Edita, our unit clerk, set up a pool on the size of the earthquake. “Put me down for five bucks on a 5.3,” I said, handing over the cash.
“Aw, you’re crazy,” M.J. said, handing Edita another five dollars. “That was a 6.0 if I’ve ever seen one.” Everyone else crowded around, handing over their bets as Edita furiously scribbled down the various guesses. (We would learn later that the earthquake was in fact a 7.1.) In the nursing station, several books had been knocked off the shelf, but no other damage was apparent. In the background, KNBR continued its coverage of the baseball game, and the commentators were busy setting up their own betting pool.
“Well, everybody seems to be OK here at Candlestick,” the announcer said. “The players and fans are milling around. I don’t see any damage to the park, but they have the engineers out here to check on everything before we get into the game. Boy, oh, boy, this is an unprecedented addition to an already historic World Series. First we have the two Bay Area rivals playing, and now we have an earthquake to boot! Don’t worry, folks, looks like all’s well here.”
“Well, Ron, this sure is a historic moment—” Bill was abruptly cut off by the emergency broadcasting system’s attention signal: “Regular broadcasting has been interrupted because of an imminent or current disaster state. Please stand by for emergency information.”
Silence filled the airwaves. Everyone at the station looked up from what they were doing and stared at the radio. They must be overreacting, I thought. After all, we were all fine, weren’t we? Another voice came on the air, a roll call of the Bay Area county EMS dispatchers.
“This is a roll call for Bay Area EMS. San Francisco County?”
“San Francisco present. Communications partially intact. Unknown extent of damage.”
“Alameda County?”
“Alameda County present, communications mostly disrupted, initial report of a partial freeway collapse.”
“San Mateo County?”
“San Mateo County present, reports unclear. Initial report of multiple damaged structures, extent unknown. Communications partially disrupted.”
“Santa Clara County?”
Silence, followed by another query. “Santa Clara County, please respond.” Silence. “Santa Clara County, this is the Bay Area Emergency Network. Please respond.” In the background, we heard a terrified voice. “We can’t raise Santa Clara, we can’t raise Santa Clara!” The broadcast was abruptly cut off by ominous static.
At that moment, the medics ran in. Their previously jovial expressions were now replaced with deep concern. “We’ve been monitoring county dispatch. This one is bad. The Amfac hotel at the airport has collapsed, there’s a huge fire in the Marina district of San Francisco, and a portion of the Bay Bridge has collapsed. This thing is gonna get real bad, real fast. You guys better implement your disaster plan and get some people in here now.”
The enormity of this earthquake was only starting to sink in—this was no garden variety Bay Area shaker. Suddenly it didn’t seem like so much fun. Just then the double doors to the registration area burst open, and a man came rushing in carrying a woman with two broken femurs. “I need some help,” he screamed in panic. “A wall fell down on her and broke both her legs.” Susan, M.J. and I scrambled for a gurney, and they wheeled the patient back to the ortho room, which now had no lights. I glanced out of the ambulance doors and looked north toward San Francisco. Huge columns of black smoke billowed up from the Marina district, and the wailing of sirens was everywhere. Things were starting to happen quickly.
Susan, who had the unenviable job of charge nurse that night, returned from the ortho room and pulled out the disaster manual, frantically trying to locate the earthquake section. She pulled out policy after policy, all of which were absolutely useless. Only the emergency lights were available in the back room. M.J. had found several flashlights, and two of the techs were holding them for the orthopedists as they struggled in the gloom to treat the woman with the broken femurs. We might as well have been treating her in somebody’s basement. I stood for a few minutes watching the eerie scene.
Mark was working in the ICU that night and I decided that when I had a moment I would go over to check on him. But for now, we had to get the emergency triage center set up. I walked back to the nursing station and found Susan still desperately flipping through the policy and procedure manuals. Thankfully, David Goldschmid, our ER director, ran in through the doors. “What’s happening?” he asked as he pulled off his coat.
“The hospital seems to be OK, but we only have generator power,” Susan told him. “We have got one critical patient—a woman who broke both femurs. Ortho is with her right now with M.J. I can’t find the earthquake disaster policy. Do you know where it is?”
He shook his head. “We’ve been reworking that one. So this is how we’re going to start: Assign at least one nurse to each of the critical care rooms. I’m going to set up a rapid triage table outside in the waiting room, and get Bob and another nurse to man that. They can manage all the minors, and we’ll have them ship back anyone who’s serious. Janice, you get on the phone and try to find out the status of both CALSTAR and Stanford Life Flight in case we need to get anyone out. Then start calling all the staff, both doctors and nurses, and ask them to come in if they can. We need as many people as possible. Susan, call the nursing office and the OR to find out bed and staff availability. Then call the county and let them know how many casualties we can take. In the meantime, I’ll help Bob set up triage outside.”
Suddenly I remembered Vince’s party. “David, Vince just left here twenty minutes ago. He might have been on the Bay Bridge when it collapsed.”
David grew pale. “The Bay Bridge collapsed? I hadn’t heard that yet.” We all stopped and stared at one another until David spoke. “We can’t do anything about that right now. Janice, try the staff in the immediate area first, then try to call his house. Maybe he was already home. Let me know either way, OK?”
I headed for the phone, glad to have something to keep me busy. I grabbed the employee phone list and began, but with each call I was met with, “Please try your number later. All circuits are busy.” Methodically, I continued to dial each person on the list, and each time got the same frustrating message. I dialed Vince’s house three times and was unable to get through. My increasing panic was interrupted by Susan.
“Janice, we need you out here now,” she hollered as she pushed a man clutching his chest past the nursing station into one of the critical care rooms. He was gray, diaphoretic, and seemed to be having a hard time breathing. I dropped the phone and followed them into room 2, helping Susan undress our patient as she gave me his story.
“This is Mr. Flanagan. He had a sudden onset of severe crushing chest pain right after the earthquake,” she said as she hoisted him up to the bed. “I’ll help you get started, but the waiting room is starting to fill up.”
“Just go get me the twelve-lead EKG, then go ahead back out. But send David in here on your way out, OK?” I nodded reassuringly to our patient.
“So, Mr. Flanagan, having a little excitement here today,” I said as I hooked him up to the EKG. His EKG confirmed what we had already suspected: he was indeed having a very large, possibly lethal heart attack. The monitor displayed a pattern we call tombstones—a fitting name, because this is a grave clinical indicator. His blood pressure was quite low, and his oxygen saturation was on the downhill slide, indicating fluid was starting to back up into his lungs from his failing heart.
I placed him on high-flow oxygen, started an IV, and obtained the blood work we needed before starting TPA, the “clot-busting drug.” David had come in and was looking over my shoulder as the machine spit out the EKG results. I glanced at him as he picked it up, and he nodded. “TPA,” was all he said, and then returned to the station. While I was working, I picked up the phone and dialed the nursing supervisor, with my back to the patient so he couldn’t hear me. “Claudette, got a Mr. Flanagan here with a big anterior wall MI. We’re gonna need an ICU bed, and he might need to go to the cardiac cath lab. Nothing official yet, just wanted to give you a heads-up.”
“Thanks, Janice,” she said, “I’ll keep a bed open in the coronary care unit. Let me know when he’s officially admitted and whether we have to call the cath lab team in.”
“Will do,” I said, and stuck my head out of the room to get David’s attention. He was juggling two phones and trying to write at the same time. “Hey David, are we going to take him to the cath lab or do TPA here?”
“Dr. Brown is on his way up to see him now,” he said, “I think he wants to take him downstairs to the lab for intracoronary TPA. But get everything ready to go here.” I started to draw up the medication.
As I was working, Mark wandered in from the ICU. “What are you guys up to?” he said, giving me a peck on the cheek. He glanced at the monitor and softly whispered in my ear, “Jesus—that’s pretty impressive.” I nodded, relieved to see him and know he was all right.
“We’re a little busy here, getting ready to go down to the cath lab. Mr. Flanagan, this is Mark Hudson. He’s a nurse over in the ICU, and happens to be my husband.”
Mr. Flanagan held up a shaky hand to Mark. “Pleased to meet ya,” he said. “You’ll have to excuse me. I’m not feeling so good.”
I looked back at Mark. “Could you do me a favor? Go to the nursing station and get me ten milligrams of morphine. We have to try and get rid of some of his chest pain, and I’ve got to get a dopamine drip started for his blood pressure.” Mark nodded and trotted off to the station. I turned to Mr. Flanagan. “You sure picked quite a day to get sick. First the World Series, now an earthquake.”
Mark returned to the room with the morphine. I gestured for him to give it. “Start with two milligrams. He’s still hypotensive, and the dopamine hasn’t kicked in yet. So how did you all fare in the ICU?”
“It’s not too bad now,” he said. “Want a second IV?” I indicated yes, and he set up his equipment as we talked. “When everything started shaking, we all dove under the console desk, and when it was all over, every monitor in the joint had heart rates over 150. We ran around and gave everybody Valium and a couple of people Adenosine, and got everything settled down. One guy was really upset. He figured he had given up smoking, drinking, lost fifty pounds and had taken up jogging, and still landed in the OR for a coronary bypass. Then we have an earthquake, and he’s convinced we’re all gonna die. I had to assure him that the hospital was not going to come crashing down. Of course, a little Valium and some morphine helped.” He turned to Mr. Flanagan. “Is the chest pain any better?”
“A little,” Mr. Flanagan replied. “Ya know, I feel kind of the same way.”
Half an hour later, I had Mr. Flanagan down in the cardiac catheterization laboratory, where they run tests to see which coronary arteries are blocked, and possibly try to clear them. When I returned to the ER, I found the nursing station crawling with bodies—administrative suit-type bodies. The ER staff was busy trying to manage the hoards of mostly minor injuries that had flooded the department, but were having difficulty navigating through the crush of suits, who were making mysterious notes on clipboards. His Highness the CEO had arrived and was surrounded by nervous aides who scrambled after him as he moved from spot to spot, furiously taking notes as he spoke. I ran into Susan, who was running down the hallway carrying an armload of charts. “What’s going on here?” I asked. “I can’t even get into the station to get meds because of all the bodies. What are they doing here?”
“I know, I know. David keeps chasing them out, but they keep coming back.” She handed me a couple of charts.
Outside the doors, an ambulance pulled up with a screech. As they pulled the patient out of the rig, we could clearly hear him yelling. “God damn it! God damn it! I can’t believe this shit!” Susan looked at me, shrugged, and took the charts back.
“Room 12,” she said to the ambulance crew, and headed off.
As the medics wheeled our distraught patient into the room, they gave me a brief report. “This gentleman was in one of the luxury boxes at Candlestick. After the earthquake, he started having chest pain. So here he is. We have to get back there—lots of patients lining up at the first aid station. We’ll get the paperwork back to you later.”
“Fine,” I said as I turned my attention to our obviously distraught patient, who seemed to be close to tears. He clutched my arm, babbling as I tried to take off his shirt and hook him up to the monitors.
“All my life I’ve been waiting for this day,” he ranted. “My son, my oldest son, is playing in the World Series. I flew in from Miami this morning—had a huge party last night. And the day I get to see my own son playing in the World Series, there’s an earthquake! A goddamn earthquake! All my life I’ve been waiting for this, I tell you! And now I’m having a goddamn heart attack! It’s not fair. I mean I coached this kid from the time he was in diapers, always praying for this day. And now I’m never gonna see him play again, ’cause I’m gonna die from a frickin’ heart attack.” While he was raving, I pulled off his shirt and placed him on the cardiac monitor. Sure enough, he was having a large heart attack.
I tried to calm him down a bit. “We’re not going to let you die,” I said in my most reassuring tone. I asked him his son’s name but, being only a fair-weather baseball fan, I didn’t recognize it.
“I’ll be right back,” I said to him. “I’m going to get some medicine for your pain and have the doctor take a look at you. Your job right now is to try and relax. All of this screaming isn’t helping your heart.”
I hurried back to the station, pushing my way through the expanding crowd of suits. “I need one of the docs for another MI in 12,” I yelled over the din, to no one in particular. “Anybody around?” I scanned the crowd, looking for a doctor. To my delight, Vince came striding through the door, pulling on his lab coat.
“Oh my God, Vince,” I said, hugging him tightly. “Where were you? We were afraid that you were on the bridge when it collapsed. Are you all right?”
“I’m fine,” he said, hugging me back. “Little shook up, but OK. And yes, I was on the bridge. Mid-span right before Treasure Island. I was listening to the radio, when my truck started shaking. At first I thought all four tires blew out at the same time, then I realized everybody around me was having a problem, too. Then everything stopped. When we figured out what had happened, every car on that bridge was trying to turn around and get off as quick as they could. It was mayhem. I was afraid there was going to be an aftershock and the whole bridge would go. There was no way I was going to get home, so I came back here. Figured you all might need some help.” He glanced around at the chaos. “Looks like I made the right decision.”
“We were so worried about you. And yes, you did make the right decision,” I said, propelling him toward room 12. “I have a patient in need of your services at this very moment.” I pushed Vince into the room and introduced him to our patient. “He was watching his son play in the World Series when the earthquake started. Sitting in one of those fancy luxury boxes. Now he’s having a lot of chest pain.” I pushed the twelve-lead EKG under his nose.
“Yes, I believe he is having that heart attack,” he said. This was the fourth MI in our department within two hours.
Things in the rest of the department were starting to get under control. David had finally escorted the administrators to another command post, where they set up what they called “the nerve center,” whatever that was. Ten off-duty nurses showed up of their own accord, along with almost as many physicians. Every room was staffed with two nurses and one doctor, and a fast-track clinic was up and running to manage the flood of patients with minor bumps and bruises. With all the help we were catching up.
My thoughts turned to my family. I knew they would be watching the Series, and through the magic of television there probably wasn’t a human being in the developed world unaware of the events in San Francisco that night. Most of the television stations were beaming out live clips of the Marina burning, and of the Cypress Freeway in Oakland that had collapsed, killing most of the unlucky souls trapped on the lower deck. But despite the intense damage in isolated spots, the Bay Area had dodged the bullet again. This was not the Big One. Unfortunately, most of the country didn’t know that. From the horrific pictures, it appeared that San Francisco had fallen into the ocean or was at least going to burn to the ground.
I knew my family would be frantic. Repeatedly I dialed for an outside line, only to be met with that irritating message: “Please try your call again later. All circuits are busy.” Finally, after a half-hour of diligent dialing, I made it through. Of course, their phone was busy. “When are they going to get call waiting?” I thought angrily as I tried again and again. I was to learn later they were on the phone with my sister, who then lived in St. Louis. Together they were busy worrying about Mark and me, unaware I was trying to get through. Finally, I had an operator break through the line with an emergency call.
At nine o’clock, I was finally released to go home. I had no idea what would be waiting at our little condo in Brisbane. To my surprise, the power was on and the outside of the building didn’t appear to be damaged. I ran up the steps two at a time and stood uncertainly at the front door, afraid to open it. Taking a deep breath, I unlocked the door and it swung open. Roscoe flung himself into my arms, shaking and crying, but unhurt. I flipped on the lights. Aside from the artwork hanging a bit askew and a few books knocked off the bookcase, nothing was damaged. It was all very strange, and the strangeness persisted for days.
While we had been struggling in the Seton emergency department, another story was unfolding at CALSTAR.
Andy was in the hangar setting up chairs for a class that evening, while Rose and Tim were upstairs watching the pre-game blather. As the earthquake began, the hangar door began to shake, and as Andy ran outside, he saw the ground pitch, rocking his truck two or three feet back and forth. Beyond the parking lot, the airport runways appeared to be moving in waves.
When the shaking subsided, Tim and Rose ran downstairs to check for damage. The helicopter had been rocked, too, but not damaged. Because the phones and electricity were out, and therefore probably the pagers as well, they realized that dispatch had no way to contact them except by radio. Anyway, with the phones down, it would be impossible for county agencies to contact CALSTAR dispatch.
The crew piled into the helicopter and cranked up the radios. There was general bedlam on all of the county channels. At one point the Alameda County Emergency Channel (CMED) dispatched four ambulances to a “building collapse” on Cypress Street in Oakland. Andy asked if they wanted CALSTAR to respond, to which he received an enthusiastic affirmative.
As they approached the area where the building had reportedly collapsed, they could see smoke rising from the Cypress Freeway, a double-decker viaduct in downtown Oakland. The structure looked odd—it appeared to have melted into a ribbon of asphalt and concrete. As usual, the initial reports were inaccurate: It was not a building that had collapsed, but rather a long section of this freeway. The top section had caved in, crushing everything on the lower deck beneath tons of concrete and rubble.
The crew watched in horror as people swarmed out of their cars, trying to escape, while others below gestured wildly at the helicopter, asking them to land and render assistance. Only ten or twelve minutes had elapsed since the earthquake had rumbled through.
Andy relayed to CMED what they were witnessing, which was probably the first accurate description of the earthquake’s most lethal result. Tim began to orbit lower, considering landing on the partially collapsed structure. But when they were twenty or thirty feet from the surface, they all decided it was too dangerous. For all they knew, the additional weight of the helicopter might be enough to send the whole thing crashing to the ground. They veered back into the sky, trying to decide on a course of action.
The main problem was that they could not communicate with any of the firefighters below; no central radio frequency had been assigned. By this time the CHP helicopter had arrived, and both decided to set down at a secure helipad at the nearby Oakland Army Base until the fire department could establish a safe LZ. They spent twenty minutes at the base treating civilians for minor injuries, the most serious of which was a woman whose bookshelf had fallen on her head.
At last, both helicopters were assigned an LZ on West Grand Avenue, adjacent to the Cypress structure. The scene still was not under control. As CALSTAR was on short final, a car raced directly through the LZ, though once it was shooed off they landed uneventfully. A paramedic directed them to an extrication in progress down the street—a truck on the upper deck had been violently thrown off the structure, landing thirty feet below.
EMS personnel and firefighters were swarming over the freeway, looking for survivors. Neighbors came by with ladders and attempted to help anyone who might still be alive on the lower deck, or get people off the upper deck. The fire department was methodically moving down the freeway, peering into the lower deck, which now only afforded a foot or two of space, marking “DOA” in black spray paint whenever a body was discovered. Unfortunately, there were only a few survivors on that level. Almost everyone trapped in the collapse was fatally crushed.