Friday, September 16, 2011

Mass Casualty

The first I knew of the horrific crash at the Reno Air Races today was when my friend Arthur Chenin called me a little before 6:00 and said, "You should go back to the hospital." I'd only gotten back from my afternoon volunteer shift a few hours earlier.

I tried calling the ED to see if I was needed, but of course couldn't get through, so I threw my scrubs and ID badge back on and just drove down there. The ED itself was like something out of Breugel: More staff than I've ever seen in the department, because everyone had been called in, and much, much more seriously injured patients than I've ever seen in the department. As I commented later to Gary, the place made ER look like Sesame Street. I've never seen that much blood. The doctors all already had thousand-yard stares. One of them spotted me, plucked at my sleeve, and pulled me into a room where a patient was surrounded by at least five staff members, and somebody was saying "the CT looked really bad, we should go on to the next person," and I left that room and spotted a staff chaplain and asked him what to do and he told me just to go around letting people know we were there, but I couldn't get into any of the rooms because the beds were circled by so many medical people, and anyway those patients weren't conscious or in any shape to ask for chaplaincy services. I did speak briefly to a fellow in one of the minor-injury rooms -- he had a cut finger -- who, with a buddy, was watching the disaster coverage on the news, both of them wide-eyed, and I introduced myself but they didn't need anything, and I warned them that they'd probably have to wait much longer than usual to be seen, and they said, "Of course, of course, don't worry about it. Thank you for talking to us."

So I left again, spotted another staff chaplain, and followed her into the waiting room, thinking to find family members there, and indeed there were dazed and bruised and bloodied people, and other people frowning down at cell phones, but the staff chaplain and the nurses had it covered, so I went back into the ED and asked what I should do and someone said, "Go downstairs. They're setting up waiting areas for the victims' families in the auditoriums."

I went down there. I helped move tables and chairs around. Dietary was bringing in beverages and snacks, so I ate some myself, thinking I might need my strength. Various other chaplains wandered in: hospital chaplains, hospice chaplains, law-enforcement chaplains. I think every chaplain in Northern Nevada had converged on the place. We stood around chatting, and a few family members and other bystanders showed up, and we chatted with them, but at any one time, there were more chaplains in the room than chaplainees, and that was before a phalanx of smartly uniformed Trauma Intervention Program volunteers marched through the door.

To be sure, I heard my share of horrors. Several people said, "Body parts were everywhere." Someone said, "I had to step around brains." Someone said, "I saw a shoe with only a foot in it." Lots of survivors' guilt: "I heard a voice in my head telling me to get out of there, and I did, but now four of my friends are in the hospital." "I got up to go to the bathroom, and when I came back, my box wasn't there anymore." I talked to someone who saw the pilot as the plane crashed: "You could tell he was trying really hard to wrestle that plane away from the grandstand and back towards the tarmac." I talked to two people who said, "We were on either side of our buddy, and a piece of metal came flying towards us, and he got hit and we didn't." I talked to someone who knew one friend was dead and didn't know about other friends; I talked to several people who had loved ones in surgery ("Oh, he got off really lightly, he only lost a finger, he'll be fine"); I talked to people who didn't actually know if their loved ones had been brought to this hospital and were desperately trying to get information.

Most surreal moments: 1) The snippets of Brahms' lullaby that came over the PA twice, alerting us that babies had just been born in the midst of the carnage. 2) The Code Blue that came over the PA for a room in the ED. Every emergency responder in the hospital's already there: you need to call a Code to summon them?

I told the people who came to the auditorium to take good care of themselves, told them to watch out for signs of PTSD (repetitive thoughts, nightmares, etc.), told them that clergy and therapists and journaling can help. I listened a lot. But, for the most part, there was nothing for me to do that fifty other people in the building couldn't do as well or better, so after three hours, I left.

As selfish as it may sound to put it this way, here's what I learned from this experience:

1. I've always wondered if I could handle trauma. After tonight, I think I could.

2. I must really like being a chaplain, because I wanted to do more tonight, not less (not, God knows, that I don't mourn and grieve the occasion).

3. In a mass disaster, every helping resource in the area shows up, and I trust those resources will continue to be available to everyone touched by this horror -- and the psychological toll alone will be huge -- in the coming months. So, weird as it sounds, the work I did during my much quieter afternoon shift today seems more important, because those folks weren't on the news. Nobody else was rushing to their side. The suicidal patient who sobbed and hugged me and was so grateful for prayer didn't have every chaplain in northern Nevada showing up to offer help. My weekly conversations with ordinary ED patients are (usually) much less dramatic than the ones I had tonight, but they're also less redundant.

Which is all a way of saying that my quiet little niche is fine with me, thanks.

And now I'm going to have a very delayed dinner. Rice Krispie Treats and peanuts just don't count as a meal.


  1. What a horrific event. Sounds like the hospital was organized and prepared. This was a case of "too many chaplains spoils the broth" I guess. Enough is enough. No doubt in the days to follow you will be needed by all the new patients.

  2. Thank you so much for sharing your experiences, for being there, and for knowing when it was time to leave.

    The level of organization and responsiveness reminds me of the time my house was broken into. The locksmith who came out that night to change the locks was utterly brilliant in dealing with not just the mechanical task at hand but also far more important one of restoring a sense of well-being and comfort in my home. Soon after, I learned the local stereo shop had special, lower pricing for equipment being replaced through insurance claims even though we were all done with the claims process itself and had the cash in our pockets. There were resources I'd never been aware of, there as soon as I needed them.

    Kudos to the hospital, and to all who helped yesterday. Kudos to you for your chaplaincy through all the "ordinary" days. And kudos for writing what you learned from last night's experience. As my father always said, "learn from everything." Learning and sharing what we've learned doesn't strike me as selfish in any way.

  3. Love your posts
    Love the colors of your weavings.

    Thank God for your caring and helping people in their time of desperation.

    I'm a nurse. We appreciate having chaplains to help us.

  4. Anonymous9:01 PM

    Oh, Susan. Prayers.

    My words are inadequate. I should be less elliptical and say who I'm praying for, but you know, everybody. Thank you for your gift of words in writing about this tragedy. Thank you for being a chaplain.



  5. Janet and Sharon -- Thank you!

  6. Anonymous4:42 AM

    Bless you, Susan,


  7. Susan, I've been a bit out of touch lately, but I think this is valuable. I've pointed folks to it from my blog.


  8. Susan, I came over from Marshall's blog. As a long time Emergency-Critical Care-Emergency Services Chaplain, I appreciate what you went through and am so glad you shared it. My prayers are with you. I hope you all have been able to do your work in walking through the emotional and spiritual aftermath of this horrific event. Thank you for your service.

    Andrew Gerns


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