After two days of heavy rain, the evening of March 11 has turned dry and, for the season, lovely: warmish, with a waxing quarter moon. Arriving for her shift at 8 p.m., Christine Cassidy, the senior attending physician in the emergency department at Jacobi Medical Center, suspects this will mean a busy twelve hours: The nicer the weather, the greater the trauma. And this being a Friday—a harbinger of mayhem in the North Bronx neighborhoods Jacobi serves—she is not surprised, as the night wears on, to find the three trauma bays steadily stocked with stabbings and gunshot wounds, while the rest of the emergency room deals with the heart attacks and strokes and mystery fevers that fall within its domain. Even on ordinary weekends, the Jacobi trauma center, often the busiest of the seventeen Level 1 centers in New York City, is something of a war zone: ambulances, police, bodies, blood. And this is no ordinary weekend.
At about 3:45 a.m., a World Wide Tours charter bus leaves the Mohegan Sun casino in Connecticut, a bit more than two hours from the Bronx. Many of the 32 passengers are Chinese-Americans heading back to Chinatown, where the trip originated on Friday evening. They have spent the interim gambling, eating, and generally enjoying themselves. The round-trip, including vouchers for food and slot machines, cost $15. A Chinatown sign advertising the tours says, “Go with the wind, be prosperous.”
Whether Ophadell Williams, the driver, is speeding or has perhaps fallen asleep at the wheel will surely be argued in the lawsuits being brought against him and World Wide Tours. Williams maintains that while crossing into the Bronx on I-95, he is clipped by an improperly passing tractor-trailer. In any case, witnesses, including some surviving passengers, say the bus swerves repeatedly onto the shoulder, rattling the rumble strips at the edge of the pavement, in the moments before it flips onto its side near exit 14 for the Hutchinson River Parkway. Once on its side, it hurtles forward another 480 feet and plows into a stanchion supporting the exit sign. The stanchion slices through the top of the bus from the front almost all the way to the back, at mid-window height—head level—peeling the roof back like the lid of an anchovy tin and carving through whatever it encounters on the way.
It is now 5:35 a.m. When EMS workers arrive moments later, they find a sickening scene, with a severed head and severed limbs, people hanging upside down, screaming, darkness, glass, and blood. Amazingly, they manage to pry bodies from the twisted metal and from each other; sort the thirteen dead from the twenty living, if barely so; and dispatch the first ambulances before 6 a.m.
The squat red phone with no dial or buttons rings at the nursing station. All Cassidy is told is that two patients, victims of a bus accident, are on their way. Based on this scrap of information, she puts out a Level 2 trauma call. But when the ambulances roar up minutes later—the accident was a mile away—she takes one look at the patients and begins to reconsider. “How many more?” she asks the EMS worker.
“A lot. The bus was destroyed.”
Awaiting the trauma team, she and the junior attending physician try to stabilize the first two patients. Cassidy also starts planning for a much larger disaster. Regular emergency patients will have to be cleared out, trauma equipment rushed in. She ups the call to Level 1 as victims keep arriving. Before an hour is up, there are fifteen.
Sheldon Teperman, head of Jacobi’s trauma service, is compulsive, “like Batman,” about being reachable. When his cell phone rings at 6:30 a.m., he’s in bed at home in Hoboken, New Jersey. Briefed on the situation, he throws on his jeans and “levitates” to the hospital, making a trip that can take an hour in 23 minutes. He tells himself: Do not get into an accident. He slows down on curves.
Teperman is 50 but looks younger, with blondish hair and blue eyes. In his peacock-blue scrubs he projects the swagger of a person who was accepted to medical school at age 17. This confidence is desirable in a traumatologist. Though the team has trained relentlessly, including mock incidents with euthanized pigs standing in for humans, the residents have never dealt with a disaster on this scale and have delayed most major decisions until Teperman can weigh in. When he arrives, Cassidy says to herself, Thank God.
By now the fifteen patients are situated in bays with a team assigned to each. Seven have injuries that can wait a bit. But eight are wildly unstable; there are blunt chest traumas, multiple fractures, head injuries, ruptured organs, massive internal bleeding, missing limbs, and a patient whose severe criticality cannot immediately be explained. Several desperately need surgery, but the only operating room typically available on the late shift still has a gunshot victim in it.