San Andreas. Loma Prieta. 1906.
The terms alone conjure catastrophe in the minds of many San Franciscans.
But we’ve learned much since those bygone earthquakes. When a disaster of any sort hits, officials have deemed that we may need to call in the (medical) calvary: The United States Navy.
Navy doctors and Navy resources, according to city officials, could make the difference in saving lives.
So as San Francisco prepares for Fleet Week’s swooping jets, a trauma crew from Zuckerberg San Francisco General Hospital flew to the USS San Diego (LDP-22) to cross-train with Navy medical professionals. The exercise may be the first of its kind, according to Aram Bronston, a prehospital coordinator at the San Francisco Department of Emergency Management.
“No one ever figured out how our medical teams can work together,” Bronston excitedly told a crew of trauma personnel Sunday morning.
To practice the use of a Navy ship as a medical base of operations, Bronston assembled a crew: Rachael Callcut, a trauma surgeon at ZSFGH; Malina Singh, vice chief of emergency medicine at ZSFGH; Benn Lancman, an anesthesiologist at ZSFGH; and Craig Johnston, chief of California’s Disaster Medical Services Division.
After the briefing, we boarded a helicopter bound for the USS San Diego in San Francisco Bay.
1145 hours — Time to fly
“I’m deathly afraid of flying,” Dr. Singh told me just before the crew drove to San Francisco International Airport.
Two hours later, we were set to board an MH-60S Sea Hawk helicopter.
USS San Diego hospital corpsman Mark Barranda was the crews’ faux “patient,” all the way down to his makeup-laden gut wound as he laid in an ambulance on the tarmac at SFO.
Callcut, Singh and Lancman got to work.
Barranda’s gurney was rolled out of the ambulance, and the crew chanted “One! Two! Three!” as they lifted him onto a stretcher. Each professional attended him with practiced precision and then placed him in the helicopter.
Most of the crew flew to the ship together, save for Singh, myself and a cameraman. We donned helmets, which drowned out the chop-chop-chop of the whirring blades, as the Sea Hawk returned to get us.
1559 hours — Navy medics shine
Flying past the skyscrapers of South of Market was peaceful, until a gust of wind knocked the Sea Hawk’s nose straight up with a jolt. Singh smiled.
So much for fear of flying.
We banked a hard left toward the USS San Diego. At 684 feet long and roughly 25,000 tons, the large grey lady looked like a longshot target.
The landing gear touched down with a soft thud. Crewmen ran out to retrieve us, and together we dashed into the ship past metal bulkheads to the USS San Diego’s operating room.
The Navy crew treated their “patient.”
“Can I get my shears?” a Navy surgeon in blue scrubs barked.
“Where’s my blood?” shouted another. “He’s got major abdominal bleeding.”
Callcut, who played a key role treating victims of the 2013 Asiana crash, said the Navy’s mock surgery would’ve played out nearly identically at the hospital. She noted the hospital personnel could benefit from lessons in logistics and hierarchy.
In a nearby room filled with gurneys, Lt. Commander Brian Guzman explained hazards of mid-air medical care. All medical actions are “visual for us … we can’t hear in flight,” he said.
The USS San Diego’s stairs are too tight for patients on gurneys, he added. Instead, patients strapped into a specialized body-length sleeve that was developed in Iraq, according to Marine Medical Corps Captain William C. Brunner.
Patients are pulled up by cables through a seven-deck-tall gaping hole.
“It’s like a mountain rescue,” said Brunner, “only the mountain is at sea, and you’re moving.”
1813 hours — Enter ‘The Chapel’
Ducking into a small porthole to a room dubbed “The Chapel,” the ZSFGH and naval crews aired concerns.
“Think of a large-scale earthquake,” Calcutt said. “You have 20 trauma surgeons” in the Bay Area, she estimated. “That’s the challenge we face.”
That staffing level is fine now, she said, but once trauma surgeons are burned out from several days of disaster care, they’ll need rest. At that point, the Navy could provide key replacement surgeons.
Medical Corps Third Fleet Capt. Jose Acosta added after a lengthy discussion, “At the end of the day, we have a common bond, but we have different capabilities.”
Bronston told those gathered, “this shows us the gaps where we really need to start training.” And, he said, it’s only the start of the conversation.
2100 hours — Talkin’ ship
Lt. Mark Steve Crider, an operating room nurse, doubled as our guide aboard the USS San Diego. Replete with easy charm and a south-Texan accent, he filled in the gaps in our knowledge — less medical, more personal.
“Deck is a bulkhead,” he said. “It’s not a bathroom. It’s a head.” Where you get chips and soda is a “geedunk,” and people chattin’, well, that’s skylarking — ”that’s not very good,” he added with a grimace.
Crider pointed out every crew member and every position we saw, and why they matter to the survival of his beloved ship. He took us down staircase after staircase to the “well,” the vast loading dock at ships bottom. Ocean water pours into the well when amphibious vehicles board the ship, which is one of the USS San Diego’s main functions.
As the night wore on, the ship coasted four miles toward the ocean, away from San Francisco’s light pollution. Crider took us topside to see the Milky Way, scattered across the inky black, to reflect.
The youngest of four children, Crider served as a Navy nuclear welder for years before jumping ship to become an OR nurse. His full-throated love of the Navy is palpable.
Inside The Chapel earlier in the day, one commander suggested the hospital personnel join Navy medics in real-world surgery, to which Crider replied:
“Don’t just bring a team together” to observe the Navy’s different ways, he said, “bring an open-minded team.”
The day’s learning done, we slept in the belly of the USS San Diego to its gentle rocking.