"Beaumont Devastated"

Outside a furniture warehouse that was being used as a sorting station for casualties in Beaumont, Texas, the "wounded" were lying on litters in the street. There was row upon row of forms splattered with red paint, wearing torn and dirty old clothes. Word came that the disaster hospital, set up in an elementary school ten blocks away, was ready. Volunteer bearers lifted a litter. "Hey, what you got?" asked one of the cases. "Both legs blown off!" was the grinning reply.

Beaumont (pop. 60,000) and Houston (pop. 385,000) were giving the biggest practical test to date of an idea which so far has flourished in the U.S. only in civil-defense manuals--the plan for mutual aid between communities. Several U.S. cities have had major "disaster" workouts (Chicago in 1952 assumed 100,000 casualties, 20,000 dead), but have counted on their own medical facilities. In the Beaumont test, the presumption was that a refinery blast had caused 250 casualties* and knocked out local medical aid. It was up to Houston, 90 miles away, to give succor.

One to Be Boss. It was at 6:33 p.m. on Friday, when many people would normally be starting a weekend trip, that Baylor University's Dean Stanley Olson was called to the phone in the Doctors' Club dining room of Texas Medical Center and got the flash: Beaumont was devastated. All he had known in advance was that the test would be within a week of an agreed date. He at once ordered the Baylor switchboard to send out the alert. But here came the first snag. The Houston Surgical Society was having a meeting in an inn near by, and the phone was busy. One doctor had to hoof it over to the inn to get the surgeons moving.

In 45 minutes, 168 professional men and women (including 50 doctors) and 150 medical students gathered in an auditorium and 116 vehicles massed in the parking lot. Next snag: when the first convoy was ready to roll at 7:30, the one man authorized to order it out could not be found. He, in turn, was hunting for the one doctor qualified to say that it was set to go. That cost 33 precious minutes. Said Dr. James Schofield: "We made a basic error trying to spare people's feelings. There's got to be just one boss."

One to Close the Door. Since this was only a rehearsal, the convoys jostled regular traffic on the highway to Beaumont, made generally good time. With emergency generators and police floodlights, the first surgical unit in Beaumont was at its operating table with scalpels poised by 11:45. Not until then had Dr. Don Butler allowed a case to leave the sorting center. Confusion, he figured, should not be allowed to spread to the emergency surgeries. As he summed it up: "If they're dying out there and you're not ready to begin operating, you just have to close the door."

This kind of cold but necessary practicality, common to the battlefield but startling to civilians, shows up in what civil-defense men are calling "triage" (pronounced try-idge).* Explained Dr. Grant Taylor, who directed the Hiroshima damage survey and served as a judge of the Houston-Beaumont test: "You need somebody out front to say 'No--not you, but you.' He'd probably have to carry a revolver on his hip. If a man is 80% burned, he's almost sure to die, no matter what you do for him. If he's 10% burned, he's almost sure to live, whether you treat him or not. So you do not treat either of these extremes. It's in the area between 20% and 40% that burn treatment is most profitable."

When doctors and civil-defense men pored over reports last week, the Houston-Beaumont test was rated a great and instructive success. Said Baylor's Dean Olson: "It taught our students more about the fundamental philosophy of handling mass casualties than they could have gotten from any other way I know of ... I haven't the faintest idea of how to handle the mass of casualties that could face us in the hydrogen age. But after this test, I know better now how to deal with 250 casualties in six hours. I'm perfectly willing to talk later about large problems."

* Seemingly a modest number, but considerably more than the 1942 Cocoanut Grove fire, which taxed Bostons' medical facilities to the utmost with 181 cases. * Originally, according to Webster: "The process of grading marketable produce."

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