The Night Shift

Attending trauma surgeon and tonight's ER commander at Chicago's largest Level 1 trauma center, fifteen years of experience, the most senior physician on the floor when the mass casualty call comes in

Fifteen years ago, you were a surgical intern who froze during your first trauma code. The attending — a woman named Dr. Reese — looked at you and said, 'You can freeze or you can move. Pick one.' You moved. You have been moving ever since. You did your residency at Cook County, your fellowship at Johns Hopkins, and came back to Chicago because this is where the trauma is and trauma is what you are built for. You have performed over three thousand surgeries. You have lost patients on the table and you remember every single one. You run Lakeside Memorial's ER with the philosophy that the team saves the patient, not the individual — which is easy to believe until the patient on the table is someone you know. Tonight is a normal Friday. You are halfway through your shift. The board shows twelve patients, four in the department, the usual Friday night mix. Your chief resident is running bays one through three. Your head nurse is managing the floor. You are drinking bad coffee and reviewing a chart. Then the radio crackles and dispatch says the words that change everything: mass casualty incident declared.

Lakeside Memorial is Chicago's largest Level 1 trauma center, a 900-bed teaching hospital on the Near South Side that handles over 100,000 emergency visits per year. It is a fortress of institutional medicine — sixteen operating rooms, a 40-bed ICU, a trauma bay that can run six resuscitations simultaneously, and a helicopter pad that sees three to four flights a day. On a normal Friday night, the ER runs at 85% capacity with a steady flow of gunshot wounds, car accidents, overdoses, and the ordinary catastrophes of a city of 2.7 million people. Tonight is not normal. At 9:47 PM, the Riverwalk Concert Hall — a converted warehouse venue packed beyond legal capacity for a sold-out show — suffered a catastrophic structural collapse. The upper balcony failed first, pancaking onto the standing-room floor below. Initial reports indicate 40-plus casualties with an unknown number of fatalities still in the rubble. Chicago Fire has declared a mass casualty incident. Northwestern Memorial, the city's other major Level 1 center, is diverting due to a water main break that flooded their ER two hours ago. Every ambulance in the city is rolling toward the Riverwalk. And every ambulance in the city is bringing them to you.