Doctors and Nurses Waited for Crunch That Never Came

Doctors, nurses and hospital technicians marveled here Wednesday at how well their emergency medical system worked in the face of probably the deadliest earthquake in U.S. history.

Although they had to work long stretches over more than 24 hours at times without telephones or electricity, occasionally even having to pump air into patients’ lungs manually, medical personnel said the emergency response was carried off largely without hitch.

Off-duty medical personnel came to work. Backup power generators began operating. Patients not in critical condition were sent home, as hospital beds were readied for an onslaught of thousands of earthquake victims.

But the crush of patients never came. Doctors and nurses in emergency rooms throughout San Francisco, Alameda and neighboring counties found themselves tending to a lot of bruises and broken bones but relatively few serious injuries.

Such efficiency, they acknowledged, came at a terrible cost.

“It’s more of (a case) for the coroner than for the medical community,” Dr. David Kears said of Tuesday’s quake.

“The real tragedy was at the site,” said Kears, interim chief of Oakland’s Highland General Hospital, one of Oakland’s largest hospitals and a county trauma center, located near the stretch of Interstate 880, called the Nimitz Freeway, that collapsed in Tuesday’s quake, killing dozens of commuters and other highway travelers.

“No amount of medical preparedness can address the problem of collapsed concrete,” Kears said.

Most people either walked away from the Nimitz unscathed or were killed by it, explained Pat Connell, acting chief of Highland’s emergency room, who was working the day after the quake, his 40th birthday.

Like many physicians and nurses throughout the Bay Area, Connell came to work voluntarily on his day off. Wearing street clothes--flip-flop sandals, khaki pants, a leather vest and an Army fatigue hat--Connell said he visited the site of the highway collapse Tuesday evening and found many ambulances, many people who wanted to help, but very few people who needed help.

“It was a case of the quick and the dead. You either walked away or you were dead,” Connell said.

Some hospital administrators were almost embarrassed at how little there was for them to do during the emergency.

Only two youngsters were referred Tuesday night to Children’s Hospital Medical Center of Northern California in Oakland. There weren’t even “the usual bumps and bruises” that the hospital emergency room normally sees, commented a hospital spokesman.

Doctors at Alta Bates Hospital, one of the area’s best hospitals in Berkeley only five miles from the freeway collapse, saw 37 patients and admitted only three of them.

In all, according to estimates by the Hospital Council of Northern and Central California, 2,750 people have been treated at 112 Bay Area hospitals, but only 250 remain hospitalized.

Throughout the disaster, most hospitals in the area have remained “fully operational” and no patients or workers were injured at any hospital in the region, although some facilities sustained damage, said C. Duane Dauner, president of the California Assn. of Hospitals and Health Systems.

The association, which is monitoring and assessing the situation, said the latest status report on the hospitals in the area showed that only five appeared to have sustained enough damage sufficient to affect operations.

The most severely damaged hospitals are Watsonville Community Hospital and Peralta Hospital in Oakland, both of which were closed down, and Herrick Hospital in Oakland, which closed its upper three stories.

Even though they had far fewer victims than they anticipated and even though emergency systems seemed to run smoothly, hospital workers said they had to work through the night under some dicey conditions.

At Highland General, Judy Ricci, assistant director of nursing, described the hospital’s brief power failure as the “longest 30 seconds” of her life. Suction machines, life support systems--everything--failed for a moment. Medical personnel had to manually pump air into patients who were on resuscitation devices. Even though lifesaving equipment almost instantly resumed operation, lights did not come back on for many hours.

Nurses and doctors found themselves working with patients by flashlight, if they could find one. “Who keeps 200 flashlights handy?” Ricci quipped. For a while, there was no phone, no radio. It was impossible to communicate with ambulances to know the magnitude of what was happening, Connell said.

But the period of crisis has not entirely passed. According to studies of earthquakes in other parts of the world, there tend to be a higher than normal incidence of heart attacks and an unusually large number of births in the 48 to 72 hours after a disaster.

As a result, a team of mental health workers is being organized at Alta Bates to accept calls.

At Eaden Hospital Medical Center in Castro Valley, a series of two-hour sessions with social workers and psychologists is being organized to allow people to talk through their earthquake fears.

Scott reported from Oakland; Roark reported from Los Angeles.