And depth of injury is critical to survival, residual function, and appearance. Depth of burns is categorized by degrees: First-degree burns are red, dry, moderately painful, and involve only minor damage to the epidermis; they may slough the next day, but heal quickly without scar. Anyone who has turned lobster-red after exposure to the summer sun has experienced a first-degree burn.
Second-degree burns are red, wet, and blistered; they are painful and vary both in their damage to the dermis and their ability to heal without thick scars. They can, however, heal in two to three weeks without skin grafting. Many a slipped pot-holder has resulted in a second-degree hand burn.
Third-degree burns are leathery, dry, lack sensation, and have a charred or waxy appearance. They involve complete destruction of the epidermis and dermis, along with the latter’s blood vessels, hair follicles, sweat glands, and nerves — a so-called “full thickness burn.” Unless a third-degree burn is small enough to heal by the skin’s contraction over the devitalized area (less than an inch in diameter), skin grafting is always necessary to resurface the wound. Fortunately, most of us will never experience a third-degree burn.
Fourth-degree burns involve not only full-thickness destruction of the skin and subcutaneous tissue, but also underlying structures like fascia, muscle, or bone. Difficult as it is to imagine burning bone, it can and does occur, particularly where bones are small and near the skin’s surface, as with fingers. Because devitalized bone (like devitalized soft tissue) must be surgically removed, fourth-degree hand burns may necessitate finger, or even entire hand, amputations. Several Station fire victims can attest to this.
Surprisingly, second-degree burns are far more painful in their initial presentation than are third-degree; this is because nerves remain intact in second-degree, but are completely destroyed in third-degree burns. For this reason, Station fire victims stumbling around the club’s parking lot with blistered faces and limbs were initially in greater pain than their more seriously burned counterparts. Third-degree burn victims would eventually, however, far surpass their less-seriously burned friends in lifetime scarring and disability.
Because different areas of the skin conduct heat differently, location of the body areas exposed to heat may determine whether full-thickness burns result. The outermost layer of epidermis is an excellent insulator from heat; therefore, where it is thickest, as on the soles and palms, full-thickness burns are rare. Backs of hands, by contrast, are much more susceptible to irreversible burn injury requiring skin grafts. Shake hands with several of the more seriously burned Station fire victims: you’ll often find their palms to be original equipment, and the backs of their hands, retreads.
The majority of Station fire fatalities did not succumb to their burns, however, but rather to inhalation injury. Inhalation injury is the most common cause of death in building fires. It occurs not only because of what is inhaled, but because of the temperature of what is inhaled. Either factor can kill, even in the absence of skin burns.
Reports of fire injuries commonly speak of “smoke inhalation.” What we call smoke is actually a suspension of visible particles in air and toxic gases. The types of toxic gases produced depend upon the fuel being burned and the completeness of its combustion. For example, combustion of the egg-crate polyurethane foam on the west walls of The Station produced hydrogen cyanide (the same efficiently lethal gas used in execution chambers). Hydrogen cyanide interferes with the body’s cellular utilization of oxygen.
The Station’s burning polyurethane foam also produced carbon monoxide. Carbon monoxide kills by competing with oxygen for a ride aboard our bodies’ red blood cells. And since carbon monoxide has over two hundred times the binding power of oxygen, it’s no wonder that it so efficiently displaces oxygen for that hemoglobin transport. Invisible and odorless, carbon monoxide emitted by something as mundane as an improperly vented home furnace can kill a family in its sleep.
Hydrogen cyanide and carbon monoxide together interact in a synergistic manner to depress the body’s central nervous system, preventing fire victims from escaping. Thought is slowed; perception altered; judgment impaired. Victims feel sleepy, and unconsciousness soon follows. When Station patrons like Stephanie Simpson and Katherine Randall speak of a “knockdown” or “pass-out” effect from inhaling smoke that night, they are describing their own rapid central nervous system depression.
Polyurethane foam was not the only plastic that burned in quantity during the Station fire. In 1996, then club owner Howard Julian screwed two-inch-thick blocks of white, closed-cell polyethylene foam to the walls of the drummer’s alcove — about 192 square feet of the stuff. The Derderian brothers later glued their egg-crate polyurethane foam on top of it. As soon as fire reached the polyethylene layer of the alcove walls, that burning foam produced acrolein, a potent chemical irritant of the eyes, nose, and lungs. Even if fleeing patrons wanted to keep their eyes open to find an escape route, their eyelids would have reflexively clamped shut in the face of this chemical onslaught.
The consumption of ambient oxygen by fire, even in the absence of toxic gases, can also injure or kill. Motor coordination is impaired when the ambient air oxygen concentration is about 17 percent; faulty judgment and fatigue occur at 10 to 14 percent; unconsciousness and death, at 6 to 10 percent. According to the NIST computer simulations of conditions within The Station, O2 concentrations in the club’s atrium dropped from a normal concentration of 21 percent to only 2 percent within ninety seconds. It is unsurprising that so many Great White fans died where they first fell.
The temperature of inhaled gases alone may eventually kill, even if not immediately. High temperatures can burn the trachea, resulting in swelling that narrows that airway ten to fourteen hours after injury. Unless stented open by intubation, that critically important air tube can swell shut, asphyxiating the victim.
With serious burns comes the possibility of fatal insult to circulation and respiration both from within and without. In a full-thickness burn, the skin forms a leathery outer layer called “eschar” (think overcooked meat). This eschar contracts as a result of the shrinking and hardening of collagen fibers within the skin that occurs with excessive heat. (Overcooking a pork chop under the broiler produces an eschar on its upper surface, curling the chop’s edges upward; on a grill, its underside contracts, causing the opposite effect.)
If a burn victim’s eschar is circumferential — as around a finger, arm, or leg — it can choke off blood supply to the extremity by trapping swelling tissues within its leathery case. Unless the pressure is relieved, the limb may be lost.
The situation is even worse if the circumferential eschar is on the neck or the torso. As tissues burned from the outside and inside (through inhalation injury) swell within the neck, a constricting eschar can cause the airway to be compressed, strangling the burn patient long after his escape from the fire. Even if the patient is intubated, however, breathing may still be impossible if burn eschar encircles her torso. As the charred skin contracts, it can prevent her from expanding her chest to draw a breath.
For this reason surgeons perform “escharotomies” — lengthwise incisions, down to the fat — of fingers, arms, legs, neck, or torso. This release from its leathery straitjacket is done in order to keep the body from literally choking itself to death. Several of the more seriously burned Station fire survivors were able to salvage limbs through this procedure. Most of these burn victims were among the crowd that headed for the front door when fire broke out. Unfortunately for them, however, they were not at the front of the pack.
CHAPTER 16
DOMINO THEORY
SOME SAY A GIRL WAS THE FIRST TO FALL.
With the flood of patrons streaming out the double front doors of The Station, there began an exodus that, allowed to continue, would have saved most in the club. Erin Pucino, the Derderians’ gas station clerk who had attended the concert on a free pass with her closest friend, Laurie Hussey, was part of this human tide. As long as people at the f
ront of the pack exited the front doors as fast as those in the rear needed to move, the system remained in tenuous balance. But when burning plastic began to rain down, toxic smoke filled lungs, and screams of “We’re burning!” pierced the air, instinct drove the scrum forward against those in the entrance corridor — the narrow area with the downward-sloping tile floor.
It was inevitable that someone in front would fall. As others behind that person tripped, they became additional obstacles. When a buzz-cut line-backer-size male threw himself over the top of the pile to escape, the die was cast. The narrow twenty-foot corridor to the front doors immediately filled with fallen club patrons, wedged diagonally like tipped dominoes, stacked floor to ceiling — and this occurred a mere ninety seconds after Great White’s pyro first ignited the club’s walls.
The only members of that unfortunate human pyramid who stood a chance were those, like Erin Pucino, trapped just short of escape with their head or arms extending out the front door. She and others lay within the isosceles triangle of temperature and oxygen tenability identified by the NIST researchers immediately inside the front doors. But even that location was no guarantee of survival.
In the seventeenth century, courts in the Massachusetts Bay Colony, fifty miles to The Station’s north, sentenced convicted witches to “pressing” by stones until they could no longer expand their diaphragms to breathe. An equally cruel fate befell Station Fire victims at the bottom of the front-door pileup. One young woman within the stack, untouched by fire or smoke, was found on autopsy to have simply asphyxiated from the weight of those trapped above her.
From outside the front doors, the situation did not immediately look so bleak. Patrolman Mark Knott radioed in his “Stampede” call and picked himself up from the club’s frozen parking lot. He watched as perhaps one hundred patrons streamed out the same doors through which he had been propelled moments earlier. His colleague, Anthony Bettencourt, popped out with the surging crowd, his radio microphone still attached to his uniform shirt’s epaulet, but its cord ripped from the radio. For a few moments, Knott thought that evacuation of the club would be successful, if not particularly orderly. Then he heard screams, and desperate people kicking at the atrium windows from the inside. When the first victims fell in the front doorway, Knott knew things would not go well.
Skott Greene, the genial proprietor of the Doors of Perception tattoo studio, and his buddy, Richard Cabral, were enjoying their status as personal guests of Jack Russell when Great White began its set. They both headed for the front doors as soon as it became clear that their free concert was over. Greene and Cabral soon found themselves in the immoveable crowd between the performance space and the club’s front doors. There they would spend the very brief remainder of their lives.
Among those near the front doorway when the crowd tipped “like dominoes” were John and Andrea Fairbairn. They were “an easy five steps from the door if they had been on their feet” — but they were not on their feet. John and Andrea were pinned to the floor, with John on top of his wife and another girl who lay motionless, spent from her struggle. Another man was yet below Andrea. The smoke was so thick that the only light came from the door opening. With the “sound of a freight train,” a flame front ignited flammable gases over their heads, raining burning roofing and ceiling tiles on them all, singeing their hair and backs.
When a flaming piece of building material fell on the face of the girl underneath Fairbairn, he swiped at it twice, causing her to begin moving again. That slight movement freed his trapped leg, allowing him to wiggle one foot from its sneaker. He finally broke completely free.
But now only one of the Fairbairns was free. John turned back to the densely packed mass of humanity. He grabbed his wife under her armpits, and wrestled her from the pileup. Fairbairn dragged her to the parking lot below, where they both collapsed, exhausted.
Outside the scrum, Patrolman Bettencourt struggled to untie the knots attaching the Budweiser banner to the railing in front of the main doors, enabling people to slip under it to the parking lot several feet below. Terrified victims in the front of the stack of bodies reached out, imploring someone — anyone — to grab their arms. Several people attempted to, but were driven back by the smoke and heat, as well as by their natural fear of being clutched and held within the killing zone. One would-be rescuer was Jason Nadeau, a twenty-seven-year-old Pawtucket resident, who had earlier exited the club with his girlfriend. As he peered through the smoke filling the entrance corridor, Nadeau could dimly see Andrea Mancini, calmly standing at her position behind the ticket counter. He was the last person to report seeing Andrea alive.
Robert Cripe, a truck driver from West Warwick, had come to The Station with his girlfriend. Cripe managed to spring free of the front door just in front of the pileup, but his girlfriend, Sharon Wilson, was trapped at the bottom of the pile, unable to move. Cripe removed his leather jacket and extended it to her. With each of them pulling as hard as humanly possible, Sharon managed to wriggle free of the bodies crushing her torso. She emerged alive and terrified, but without pants or shoes.
When Patrolman Knott heard kicking at the atrium windows, he extended his folding metal baton and smashed one of the few breakable low glass panels, clearing shards from its frame. Out tumbled three or four people. Knott pulled out several more, burned and unresponsive. He reached into the smoke, so thick and black that he worked by feel alone, pulling on anyone or thing within reach. He and a “heavy-set guy” pulled victims a dozen feet away from the club’s north wall; others dragged them farther toward Cowesett Avenue and safety. The last leg Knott pulled through the window was that of a bar stool. By then, the atrium was unsurvivable. It had been all of two minutes since Great White ignited its pyro.
Robert Riffe was in the crush of patrons forcing their way toward the front doors when he was stopped within inches of the outside doorframe. Riffe, twenty-two, had been an intern at WHJY a year earlier, but this night he and his close friend, Ryan Fleck, had come to The Station on their own to hear Great White. Riffe lost sight of Fleck in his rush to the doors. The narrow corridor to the front doors was fed from two sides — one from the performance space to the west and the other, from the horseshoe bar to the east. At their confluence all movement stopped.
Riffe managed to get his head and torso out the main door, so that he was breathing fresh air, but could move no farther. His legs were caught among the bodies wedged into the doorway. One man who had already escaped grabbed his arms, but quickly gave up. Somehow Riffe was able to turn onto his back, still in the middle of the stack. He reached desperately upward toward another man, Chris Scott, who pulled — and Riffe budged a little. Encouraged, Scott pulled harder, screaming, “Come on. You can do it! Get out! Pull, pull!” Even though Riffe’s legs were pinned within the pile, he was able to kick his shoes off. This gave him enough room to slip free.
Once free of the pileup, Riffe realized that his friend, Ryan, was still behind him, trapped and now burning. He stood frozen, screaming Ryan’s name and, “I’m sorry! I’m sorry!” Staggering in shock toward his car, Riffe was stunned to see Ryan waiting for him by the vehicle. He had somehow escaped ahead of Riffe. The two young men hugged, then turned in horror to see people tumbling, bloody and aflame, through the club’s windows.
Patrolman Knott saw that no further survivors would exit the atrium windows. The heat emanating from that area had begun to melt the plastic front bumper of a car parked nearby. He turned his attention to the front doors, where a scene from Dante’s Inferno was unfolding. Bodies were stacked such that only a foot or two remained between the top of the pile and the ceiling. As unburned gaseous fuel met oxygen-rich outside air, flames erupted from that small opening. Knott grabbed “one or two arms” sticking out from the middle of the pile, but none would budge. Then, he dragged a “thin guy with stringy black hair” over the top of the stack, his back afire. Turning again to the stack, he found the next person’s back already on fire. Everyone within the pile
was screaming to him for help. Knott removed his Gore-Tex jacket, afraid that it would melt onto him. In fact, roofing tar from The Station’s entranceway did just that, dripping onto both the trapped and those attempting rescue.
Elizabeth Arruda had come to The Station with her boyfriend, Derek Silva, and their friend, Tom Marion, a twenty-seven-year-old Wal-Mart furniture department manager. All three had been up front near the right corner of the stage when Great White set up their instruments. But Elizabeth had a headache, so the group moved back toward the main bar immediately before Great White began its abbreviated set. When the pyro went off, Arruda thought the special effects strange for such a has-been group and small venue. When flames appeared on the walls, Tom Marion said to her, “Oh, my God, I think the stage is on fire,” and immediately turned Elizabeth around to move her toward the front doors. She could not believe her ears when she heard some people saying, “Wow, this is so cool.”
Arruda held on to Derek Silva’s jacket, and Tom Marion clung to her side as the trio moved with the surging crowd. When they got as far as the front hallway, the smoke obscured all light. Elizabeth covered her face and held fast to Derek’s jacket. Tom told her, “Just hold your breath; we’re almost at the door.” Arruda was horrified to be stepping on fallen bodies — people who had been overcome by the smoke. Others around her screamed, “I can’t die like this.”
When they got near enough to see outside light, there was a stack of people in their way. Derek Silva climbed over the pile, but became wedged on top. He managed to grab an outside railing and free himself, but Elizabeth was left behind. Tom Marion picked her up and pushed Elizabeth over the top of the human stack, but her sneakers got stuck. Derek Silva pulled on her arms with such ferocity that she feared their dislocation, until finally she slipped out of her sneakers and popped free, arms and back seriously burned. Her friend Tom remained trapped behind the pileup.
Killer Show Page 14