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January 17, 23


There were bodies everywhere. Both platforms at the London underground station were littered with injured people, screaming, bleeding, pleading for help. Some had scrambled out of the wreckage crying, dazed, in shock, disorientated. Doctors, police, firefighters, and emergency crews were engaged in dealing with the largest disaster to ever occur on the underground system.

Several fires were spewing out acrid black smoke. Fumes and debris filled the air; the heat was suffocating.

In the deep lines underground lines, ventilation is produced by the piston effect, created by the trains forcing air through the tubes. With services now stopped, no fresh air was reaching platforms 9 and 10, and temperatures quickly rose to over 120 °F. The cutting gear used by the firefighters added to it causing oxygen levels to drop. It was almost unbearable.

Someone had placed a giant electric fan at the top of the escalators to remedy the situation, but all it did was shake lose years of soot and dirt.

In the enclosed space of the narrow platform the noise was deafening as firemen worked with acetylene torches and sledgehammers trying to free people trapped in the tangled metal. The screeching of high-powered metal cutters and saws made conversation almost impossible.

Alice’s eyes smarted and began to water from the acrid smoke, but she needed to ascertain what medical resources were needed.

After receiving the first phone call, she knew it was serious, but to what extent? Minutes later, when the second one came in, she knew she was facing a unique situation, something London hadn’t experienced since the ‘blitz’ years of the Second World War.

After placing all nine London hospitals on the highest alert, she knew she had to see and assess the situation for herself. Now she was there, she realized she might have to call on resources outside of her area. Only twenty minutes had passed since the accident, and nobody had any idea of what really had happened. The situation was chaotic.

Two fire chiefs had quickly deployed crews who were working feverishly but systematically on the front coaches, which were crumpled beyond recognition, but they had been hampered by the difficulty of access. Platform 9 was seventy feet underground, and fire and ambulance crews had to carry all their equipment through the station and down the now stationary escalators. The depth at which they were working, and the shielding effect of the soil and concrete, also meant that radios were ineffective. The only one working adequately belonged to an inspector of police.

‘We’ve got to get drinking water down here, lots of it and fast,’ a fire chief was saying. ‘These men will die of heat wearing their heavy uniforms. We also need it for the casualties.’

‘Agreed,’ the other replied, ‘and we’ve got to get a generator blowing cold air into the system.’ He paused as the radio attached to his jacket crackled and came to life. All he could hear was static and walked away to get a better signal. Several minutes later, he returned. ‘They’re bringing two portable units from Bermondsy and Pimlico, which should be here within twenty minutes or so. The Red Cross is taking care of the drinking water issue.’

‘All that we know is the train failed to stop at the end of the line,’ the second chief was explaining, ‘we have no idea why. It should have approached slowly at fifteen miles an hour, but it looks like it just kept going, plowed through the buffers and into the concrete wall. The carriages shot up into the air and then piled up on each other. The front coach with the driver was fifty feet long, but now it’s been compressed to about fifteen. It will take hours to get the bodies out.’

‘I have to ask,’ she interjected, ‘my name is Matron Alice Casey London Regional Director of Nursing. Do we have any idea how many passengers were on the train? Have you any idea of the number of casualties or injured?’

The chief lifted his helmet and wiped his brow with the back of his hand. ‘We really don’t know,’ he replied. ‘It’s commute time, so it was probably crowded, but at a guess between one hundred and fifty and two hundred.’

‘Oh, my God,’ she replied, ‘I need to go and access more resources.’ The noise suddenly increased as additional cutting machines started up. Cupping her ear and turning her back to the noise, she asked, ‘What do you have so far?’

‘I believe twelve critical cases have already been taken to hospital. It's going to be slow getting people out of here. We have no electricity, so nothing is working right now. Neither the escalators nor the small elevator can be used. There are about forty people waiting to be triaged, and some are very seriously injured. Casualties are arriving every second. We’re keeping the dead bodies over there,’ he pointed toward the men’s restroom; “so far there are nineteen. ‘We're focusing on trying to save lives, to get the wounded out as fast as we can. We need more help.’

‘Leave it to me,’ she said. Then turning to the police inspector asked, ‘Will you please radio to your dispatch and make emergency calls to these hospitals.’ Taking out a small notebook from her purse, she scribbled down the name of four hospitals and her name. ‘Tell them that this if of the highest priority. An emergency triage team from each one should report here as fast as possible.’

‘It's not a problem, madam,’ he responded and immediately spoke into the radio hanging on his lapel.

‘There’s a nineteen-year-old young woman trapped over there,’ a firefighter came to report, and if we don't get her out, she'll die. Her foot is caught up in the twisted metal, and we can’t get it out. It doesn’t look good. She’s lost a lot of blood.’

‘Have the doc over there take a look and see what he says,’ the chief replied tersely. Alice, herself a surgical nurse, sprang into action. ‘We need your opinion right away,’ she said in a commanding tone. Without saying a word, the doc looked at her, then both followed the firefighter into the wreck. The doctor looked briefly at Alice, ‘Are you a nurse?’ he asked.

‘Yes,’ she replied, ‘I’m a surgical specialist.’

‘Then you know that emergency surgery is needed, and we don’t have the necessary equipment. We need to amputate as soon as possible.’

‘I’ve already called for disaster medical teams,’ she replied, ‘they should be here shortly, and will have what is needed.’

Alice rushed upstairs to find a telephone. None were working. She wanted to call her husband, Charles before he went into surgery, to let him know where she was and needing to hear his calming voice. St. Bartholomew’s Hospital, where he was the head of a surgical team, was also the closest hospital to the underground.

Outside the station, she ran into a convenience store and asked to use their phone. As she spoke to her boss, the Minister of Health, her description of the scene was chilling in its description and brevity. “The front carriages an indescribable tangle of twisted metal; living and dead crushed together; impossible to estimate number of casualties; many dead; everything covered with thick layer of chocking black dust; no electricity; incredible heat and lack of oxygen; victims writhing in agony, screaming; emergency meds needed; major issue of suffocation; all of disaster services notified.”

Her husband failed to answer. The central nursing station informed her he had left the hospital, with an emergency team that included a surgical nurse and an anesthetist.

On arrival, without lights and the air filled with dust, it was difficult to see anything; a reliable assessment was impossible. People were stumbling about in the inky, dirty darkness. Firefighters stripped to the waist, their sweaty bodies covered in black dust, were working, hacking, sawing, cutting through twisted metal, trying to reach wounded passengers. The heat was so intense that they had started to use the fire hoses on themselves to keep cool. It was so exhausting the chiefs had started a rotation restricting each fire team to only twenty minutes of work.

‘Are you a surgeon?’ a voice called out to him. It was a fire chief with his helmet light piercing the obscurity who, seeing the equipment they were carrying, guessed they were a disaster team.

‘Yes, I am,’ answered Charles, unable to make out clearly whom he was talking to.

‘Then you're needed over there, and it's urgent. Follow me.’

It took just minutes, using what little light he had, for Charles to make a surgical determination. ‘Let’s get to it,’ he said to his team, keeping his voice as calm as he could, ‘I will need as much light as you can give me.’

A burly firefighter was holding a pretty, young twenty-year-old woman in his arms, one leg trapped at a grotesque angle under a pile of twisted steel. Talking non-stop with her, ‘Everything will be fine,’ he said reassuringly. ‘When you are recovered, I’ll take you dancing.’

The anesthetist explained very quickly what he was about to do, that he would put her to sleep, and she would feel no pain. The young woman joked, ‘I have no feeling in my foot anyway, but who will carry me out?’

The firefighter holding her, gave her a gentle squeeze. ‘You don't have to worry about that, darling,’ he whispered, ‘I won't let go of you,’ the light from his helmet catching her last smile before she slept.

Even during the war, Charles had never had to operate under such terrible conditions. With five firefighters holding flashlights he worked clinically and quickly. In just under half an hour, it was over. He had removed her foot, at the ankle. The firefighter who had held her throughout the procedure, with tears streaming down his blackened face, gently carried her inert body to a waiting stretcher. Against his huge, sweaty, shirtless body, she looked like a little, fragile rag doll. Even before it left the station the ambulance bell began to sound.


Eliza awoke startled, disoriented, and frightened, the sharp ringing of her alarm clock seemed deafening. It was pitch black. A smell of burning filled her bedroom not knowing it was the toast as her house mate prepared breakfast. Beginning to panic, she realized she couldn’t feel her left foot.

Slowly realizing where she was, ‘You need to get off me,’ she chided her Fox terrier, Max, lying across her feet. He immediately reassured her by coming to lick her face. ‘It’s time to get up,’ she said trying to forget the terrors of her night. As she opened her curtains, a feeling of gratitude and peace came over her; it was good to be alive.

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