The hospital’s administrators, concerned with getting established, had neglected to develop a disaster preparedness plan. They’d been aware of the necessity for such a plan, because it was a requirement for certification of the hospital, but the appropriate time for implementing a disaster program simply had not arisen, although within the previous year Beckman General had dealt with a pile-up of automobiles on the freeway during a heavily fogged morning. At that time, the hospital lobby had served as the triage station—the large space that was immediately set aside for the prompt, brief examinations of the accident victims prior to assignment of emergency attention. The need for a workable disaster plan was recognized then; however, administrative accomplishments evolved slowly.
In these dawn hours, less than a day after the destruction of the White Water Plant, the victims still littered the grounds outside the emergency entrance. Inside, medical personnel heatedly debated the advisability of admitting the radiation victims. The probability of contamination unnerved them.
Dr. Bernard Parsons, a surgeon, was the first to openly criticize the hospital’s failure to admit the victims.
The policy made no sense whatsoever to him. They’d gone over this again and again, and still they were unable to reach a decision. Couldn’t they see that everything the medical profession stood for was placed on the line this morning?
All staffers had been requested to remain within the building, and most had willingly stayed on, assuming many hours of endless work was before them. It turned out, however, that not only would the staff not be permitted to leave the hospital until acceptable levels of radiation were recorded, but due to radiation hazards no new patients would be accepted. For the whole of the night the staff had been deadlocked on this issue of admitting radiation victims.
The indecisiveness was frustrating almost to the point of causing rage in Parsons. Feeling his neck growing hot under his collar, the surgeon ripped his white jacket off and threw it aside. Unveiling his upper torso revealed an enormously thick chest and broad spanning shoulders. Taller than average, with a shock of brown hair atop a rugged face, Bernard Parsons, stripped to a tight undershirt and white trousers, looked for all the world like a lumberjack. In fact, in the fall of the past year he had taken his vacation in the great woods upstate. To get as far removed from the cares of surgery and medicine as possible, he’d deliberately sought out a small logging town for a rest. It had come as a distinct surprise to the men and women of the village that the barrel chested man with the smooth purposeful stride was not a logger at all, but a surgeon. Someone had humorously nicknamed him Jack—a name Parsons had fondly accepted, even preferring it to Bernard.
Sensing his ire growing, Parsons mentally gave himself a brief reminder that he’d gain nothing with his colleagues, indeed, he’d lose whatever persuasive edge he had, if he gave vent to his anger. He forced himself to assume a tone of reasonableness. “All right, all right! We haven’t solved a thing, but we simply cannot ignore those people out there. In my opinion it’s a damned sad state of affairs that we’ve never prepared for this sort of crisis; however, we’re still obligated to treat them.”
Dr. Cash Archer from obstetrics interjected, “So you want to treat them, Bern? Is that what you’re saying?”
“Yes, it is. I’ll treat their wounds, Archie, but I need help.”
“Where do you propose to keep the patients?” asked the Chief of Staff, Dr. Karl Kranz. He was a great public relations man, but he wasn’t convinced the hospital should admit irradiated people, even if someone volunteered to treat them.
“How about the isolation unit?” Parsons suggested.
“Well, I don’t know. That’s pretty small. There must be twelve or fifteen outside now, and that number will grow,” replied Krantz.
“They’d be better inside and cramped than left outside in their condition. Besides, they’ll absorb even larger doses the longer we leave them there,” reminded Parsons.
Shaking his head worriedly, the Chief of Staff replied, “I’m not sure of this, Bernard. You realize that if we decide to treat those people, part of the hospital will have to be condemned to future use by the rest of the staff and regular patients. And not only will we lose part of our great facility, but you and anyone who chooses to work with you will become contaminated. You will have to be confined to that area we set apart for you. It wouldn’t look good.”
Jesus, murmured Parsons to himself. This do-nothing kraut should have stayed in medical school. He had no interest in people... .unless they were some group of socialites wanting to be wined and dined out of their contributions. That was Kranz, always the silver tongued administrator....great rapport with the moneyed people. “Dr. Kranz,” said Parsons firmly, “as physicians we are compelled to offer treatment to those people!”
Dr. Archer cleared his throat and replied. “Bern, we also have an obligation to the patients already under our care. We can’t jeopardize their health simply because there are others needing us.’’
Parsons leveled a look at Archer. “You’re right, Archie... .for once. So I’ll tell you what we must do. Some of us will continue with the hospital proper, and some of us will set up an isolation unit for those people outside. That way we can cover all the bases. How about that?”
There were murmurings among the staff, but Parsons knew that none would argue with the logic of his suggestion. He had won his point. The next hurdle would be finding personnel willing to risk treating the patients. “Look,” he said, “I have no way—nor desire—to force anybody into risking their personal well-being. But I’m telling you to try to put yourselves in the places of those folks outside. After you’ve done that, if you feel you still can’t help, I promise there’ll be no hard feelings. Think about it. What does your conscience tell you?” As he talked, he scrutinized each of the staff seated before him. His gaze fell on Archer who leveled a cool stare back without flinching a muscle. “You have all dedicated your lives to humanitarian labors—well, this is no time to quit,” he said, ending his brief speech. The staff sat quietly for a moment, not speaking.
Finally Dr. Kranz spoke. “Bernard, I don’t believe any of us can dispute what you say but what you’re asking of your colleagues....well, we do need some time to think.”
“To think, Doctor?” Or to make excuses, Parsons wondered silently.
“Yes, we need some time to decide. Perhaps if you’d just wait in the lounge for a few minutes....”
Parsons turned and walked out. Time....we need time.....Dammit, there wasn’t time! Yet, how often had that frustrating phrase rung through his brain? He remembered the first occasion very distinctly... .it was during his internship at Johns Hopkins. He’d been revved up, bright and eager to start his career, to act. To heal. Then on his third day a good-looking, strapping young man was put on his case load. Tim was a picture of health, the all-American image of youth. His wide smile was infectious; his laugh deep and sincere. “Hi Doc,” he’d said. “You’re going to fix me up, huh?”
Parsons had liked Tim instantly. He’d sat with the youth and they’d talked about baseball. The Orioles were having a bad season, their worst season in many years, but Tim was sure the team would snap back for the coming year—they had to. He was going off to the Oriole training camp the following summer. The team was going to be his life, his whole purpose.
At that meeting Parsons had listened to Tim and shared in his excitement. And only once did he make any effort to examine the body. For a few seconds he’d palpated the cervical nodes. The one at the angle of the neck was textbook descriptive. It was a firm, rubbery mass, enlarged greatly over neighboring nodes. As soon as Tim left, Parsons had hastened down to the pathologist. It never hurt to check. Maybe the lab report had gotten mixed up, maybe someone else’s report had got into Tim’s file by mistake. Maybe the node would go down.
“But are you positive, Doctor?” he’d asked the pathologist.
The pathologist had sighed, a flicker of exasperation in the sound. “It�
��s Hodgkins. No doubt about that.”
Parsons, perplexed, had had to protest. “He seems so healthy....so vigorous.”
“The boy is in remission. In another year he won’t be around.” His voice grew kinder. “If we’d caught it earlier....if we had more time....we need time to do anything with Hodgkins disease, Doctor.”
Parsons had suddenly felt as if he’d had the wind kicked out of him. Later he’d learned that time was crucial—the important factor with most diseases. With most everything, for that matter. Even with Amy. If he’d not been so busy at the hospital he could have spent more time with his wife. And she wouldn’t have been so bored. But he hadn’t had the time.
He snorted at the idea of comparing his ex-wife with a disease. Well, she had been as devastating to him as a disease. The recollection of unexpectedly coming home that afternoon, and finding Amy and her lover locked in passion, flitted through his memory. The divorce had at least been amicable. No threats, no accusations—just amicable.
Coming back to reality, Parsons pulled out his note pad and dropped to a chair at the table. Time the doctors needed. Well, he’d give them time. He began compiling a list of equipment, drugs, and supplies that would be required in isolation. As the list grew, his attention skipped away only once—once while he wondered how he’d feel if nobody chose to volunteer for the isolation unit. Would he really be able to forgive them for that? He returned to the list. It was growing longer. Would he be able to requisition everything outlined? He had no wish to deprive the patients already within Beckman General, but just how important could a gall bladder removal be in light of the horrendous damage to those people waiting outside?
He’d lost track of the time when a young, feminine arm reached out and removed one of the sheets. “Shall I begin getting this stuff together, Doctor?”
Nurse Sharon Henry was holding the paper. Behind her stood Dr. Max Feldman from Urology, next to him the new intern, Evans, and two aides.
Five. It was a small crew that had come forward—not as many as he had dared to hope for. But five would do. Counting himself, there would be six personnel who would be completely sectioned off from the functioning of the rest of Beckman General. They wouldn’t be allowed to enter any other part of the hospital after they’d become contaminated. They’d also be subjecting themselves to hazards that could possibly claim their lives.
Dr. Parsons was at once gratified and saddened by their courage. “Are you positive?” he asked. “Remember, once we step out that door we’re committed. There’ll be no turning back then.”
Their faces were almost stoic. It was too bad Cash Archer couldn’t bring himself to join them, Parsons thought. Maybe he should have flung the challenge directly at the obstetrician. But Archie would have let it pass. “Well, what do you say? Any of you can get out now by just walking away.” He didn’t want any of them to leave, but he needed to know each was certain of his own commitment.
“Shall I get started, Doctor?” Sharon Henry asked as she waved the list at him, answering his question.
He patted her on the shoulder, “By all means, nurse.”
“Tell me what I can do, Bern,” said the urologist. “It’s been a long time since I’ve treated anything interesting.”
The group met together again after the supplies were assembled and deposited in the make-shift isolation unit. Arrangements were made with the regular staff whereby additional materials could be left in a neutral zone to be claimed by members of the isolation staff when necessary. Everything was finally ready.
“Bern, how long will the hospital’s auxiliary power system last?” Max Feldman asked.
The question made Parsons hesitate. He knew this was a concern of everyone. Utility-supplied electricity had been cut off during the night but the center’s stand-by power source had immediately started functioning. He finally answered. “It’s hard to say, Max. The generators will only operate as long as we have fuel.”
“Assuming the fuel tanks are full, Bern, how long do we have power?”
“I’m not sure. But I vaguely remember hearing something about three days.”
“Only seventy-two hours,” murmured Max Feldman. “Doesn’t give us much leeway. A hospital without power....” He let the subject drop. The seventy-two hours had already begun.
“There’s one other thing,” remarked Parsons. “The civil defense bulletins warn against water usage. Since the water is contaminated, even in the pipes, diets will obviously be limited to milk and juices for as long as they last—ours as well as the patients. We’re fortunate—one of the best-stocked departments in the hospital is the kitchen. However,” he added, “we’ll begin immediately with a strict rationing schedule for our personnel and patients. Serious patients will be exempt from food rationing for as long as possible.” Bern could only speculate what Krantz would do for the rest of the hospital.
He was aware that none of them knew exactly what to expect in their patients. Never having experienced a disaster of this magnitude or scope, and having had no training in treating excessive radiation exposure, it would be anyone’s guess as to what would develop with the patients. They all assumed that the number of persons grouped in the parking lot would grow. Little did they realize that before another day elapsed, survivors in the dozens would begin amassing outside the lone, rear entrance.
With Dr. Parsons leading, all six walked out to the ambulance area, to their patients. At a glance it was obvious that three of the injured had died during the night. Others, the most disabled first, were supported or placed on stretchers and carried inside the building for the first attention they’d received since the devastation some twenty-four hours earlier.
Acute, intense doses of radiation produced both immediate and delayed effects. After-effects, and the wide variety of their manifestation, could be a long time in developing; immediate reactions were pronounced and horrible. Of the several who had not been near the reactor and had not received the initial blast of radioactive heat, their symptoms—nausea, vomiting, and diarrhea— were indistinguishable from gastric upsets caused by a large number of rather ordinary illnesses. The knowledge that these symptoms were reactions to radiation poisoning caused Parsons and his staff to approach treatment with new awareness. Medication for treating this aspect of radiation poisoning was the same medication prescribed for upset stomachs and influenza. Vomiting and diarrhea, when uncontrolled, were as debilitating as any disease. When compounded by radiation poisoning, control became all the more urgent.
They were a stinking, malodorous assemblage, these victims of White Water. Liquid antidiarrheals and antinauseants were used freely, but with only limited success. Sharon Henry, a highly skilled, compassionate nurse, had rarely encountered such massive resistance by stomachs to the chalky fluid she poured. Methodically she’d tip the head back and the patient would swallow. Then with equal precision the stomach rejected the fluid, spewing it convulsively out the mouth and nose.
“Dr. Parsons, they just can’t seem to hold this down,” she shouted.
“Send more in right after they regurgitate,” he advised. “They’re going to need every ounce of energy they can get, and this constant loss of body fluid is sapping them.”
The doctors lent their attention to the most severe cases. Deep lacerations received during the wreckage of automobiles had become swollen with infection. The immediate cleansing of these wounds was attended to. For the victims of radiation burns, there was little that could be done beyond dressing the seared flesh.
Antibiotics were given in any case that remotely suggested need; but the need was great. There seemed no end to open, festering wounds. Shot after shot was injected by the staff until the changing of syringes became automatic. Pain killers and fever reducers were as frequently administered as antibiotics, for without a single exception, every patient had a body temperature that was in or nearing critical range—a boiling fever that resulted from massive infections and inflammation. Superficially, excluding the hideous burns co
vering only one side of their faces, the victims were much like the typical survivors of a freeway crash—abrasions, bruises, broken bones, and always the vomiting and diarrhea.
A chest wound was open to the critical eye of Dr. Feldman. As a urologist he’d not dealt with this kind of task since his intern days. He was sharpening old skills quickly. “Bern, would you take a look at this?” The huge gaping slit was full of seeping pus.
Dr. Parsons glanced briefly and wrinkled his nose. “That’ll take a lot of cleaning, Max. Better start him on a double dose of penicillin.”
The small staff worked hurriedly, their actions almost mechanical. They gave minimal thought to anything other than their labors, but they all carried in their minds the fact that the radiation had already begun its devastation on the patients. Some of the victims had greater natural resistance to the damage of the invisible rays and would fare better than others. But in some, the radiation had already attacked the body’s cells, tearing apart the cells’ structures, and killing the cells outright. Evidence of this fatal destruction lay in three human forms out on the parking lot.
In other patients, passively sitting, taking their medication, the rays had struck their cells, distorting the cell structures, breaking chromosomes and ionizing chemical molecules within the cells. From some of these invasions the cells would recover. From others, cells would begin to divide abnormally, perhaps over years, and the final result would be the long-term after-effect—a malignant tumor.
Eventually Parsons and the staff had all the patients in various stages of treatment. For the first time since the small, select medical group had walked out into the compound to lay claim to the victims there was an opportunity to take stock of the scene.
Bernard Parsons was a man of excellent physical condition. Robust, his strong hands were laced with straps of muscles that allowed him to perform arduous, lengthy operations that often spanned the greater portion of a day. And yet, despite their strength, his hands had begun to shake with fatigue. Catching Max’s attention, he motioned and they went into an alcove.
The Nuclear Catastrophe (a fiction novel of survival) Page 10
