Cover Story

A flatbed truck piled high with coffins waits outside a city morgue following the Cocoanut Grove fire.

NFPA Journal®, Nov/Dec 2007

By Casey C. Grant, P.E.

IT WAS 1942 and the United States was at war. On the weekend before the Cocoanut Grove fire, a mock disaster of a supposed German Luftwaffe "blitz" tested the response of some thirty thousand of metropolitan Boston’s Civil Defense workers. All activity throughoutthe city came to a halt as close to 200 simulated explosions and fires produced approximately 300 phantom casualties. Authorities were pleased with the outcome of the drill, but nobody would have guessed that even before the passing of a single week the value of this drill would be put to its ultimate test.

PHOTOS  PHOTO GALLERY:   View photos from the Cocoanut Grove AUDIO CLIPS   NFPA program director for the Fire Protection Research Foundation Casey Grant on the Cocoanut Grove Fire:  A description of the Cocoanut Grove nightclub  Why was the fire so deadly?  Why did the fire spread so rapidly?  What was the response by the Boston fire department?   Cocoanut Grove survivor Dr. Saul Davis recounts the night of the fire:  His initial reaction to the fire  Fighting the mob  Looking for an escape  More audio clips FROM THIS ISSUE Last dance at the Cocoanut Grove The deadliest nightclub fire in U.S. history is still confounding and frightening 65 years later. Emergency disaster preparedness Boston hospitals faced a variety of challenges following the Cocoanut Grove fire. Medical advances Threatment of victims of the Cocoanut Grove fire helped advance medical knowledge on a variety of fronts. Fire Safety Regulations The tragedy brought about very positive changes in regulations concerning life safety. First Word - The Cocoanut Grove That fire created the opportunity for NFPA to lead the way to major reforms. RELATED NFPA FEATURES  The legacy of nightclub fires (May/June 2007)  Nightclub safety for students (May/June 2007)  NIST report on The Station nightclub fire (May/June 2005)  NFPA Makes sweeping changes following The Station nighclub fire (Jan/Feb 2004)  Safe exit: Nightclub safety equals life safety (July/Aug 2003)  Searching for answers to the Cocoanut Grove Fire of 1942 (May/June 2000) (PDF 2.5MB) NFPA FIRE STATISTICS  Nightclub/assembly occupancy fire fact sheets  10 Deadliest public assembly & nightclub fires in U.S. history  Download NFPA's fire investigation report  (PDF 6.3MB)

By tremendous good fortune the Boston Fire Department happened upon the Cocoanut Grove scene after responding to and extinguishing a nearby car fire. This providential circumstance was credited by one estimate as saving upwards of 100 of the building’s occupants. In all, the five alarms sounded for this fire brought twenty-five engine companies, five ladder companies, one water tower, one rescue company, and a variety of other emergency apparatus. The Police Department provided ambulance service, maintained law and order in the vicinity, roped off streets, and provided routes for emergency vehicles to transport the casualties. Many other agencies responded to the scene or shifted into operation, including members of the United States Army, Navy, Coast Guard, Civil Defense, Red Cross, and Salvation Army.

At times, a question existed as to who had authority over who at the fire scene, this being compounded by the presence of the Fire Commissioner, Police Commissioner, Mayor, State Fire Marshall, Commissioner of Public Safety, Civil Defense Director, and a variety of United States Military Officials. But this problem was academic, since attacking and extinguishing the fire was relatively straight-forward and accomplished effectively by the Fire Department. The primary focus of the event was rescue, and this was more an instinctive operation that proceeded urgently with minimal needed direction.

Today, the topic of disaster preparedness is directly addressed several documents but perhaps most notably NFPA 1600, Disaster/Emergency Management and Business Continuity Programs. Many of the details of the Cocoanut Grove Fire, and in particular the overall response to the disaster, relate to the concepts addressed by NFPA 1600.

For this disaster, the greatest challenge was the disposition of the human wreckage. The numbers of injured, dying, and dead were staggering beyond anyone’s comprehension. People, both living and dead, were transported to the hospitals in all available vehicles that included ambulances, police cars, taxi cabs, private cars, and even newspaper delivery trucks.

The only lack of coordination evident in hindsight was the failure to more evenly disperse the victims among the area’s hospitals. The customary hospital serving this area is Boston City Hospital, and this single medical facility received the lions-share of victims. Boston City Hospital became so overwhelmed that while victims, living and dead, lined the corridors of the admitting area, vehicles of every kind were outside lined up out of sight, waiting to unload their macabre cargo. Finally, word of this situation reached the fire scene and the overflow was diverted to Massachusetts General Hospital, this being the other of the two medical institutions to receive most of the victims.

In summary, the following hospital statistics highlight the challenges that faced the medical community following the Cocoanut Grove fire:

General Hospital Statistics

• Mass General received 114 casualties by 12:45 a.m. Sunday morning, second only to Boston City Hospital which received over 300. Numerous other civilian hospitals and military installation received only a few patients each. This includes about 30 other victims distributed among the following hospitals: Peter Bent Brigham, Beth Israel, Cambridge City, Kenmore, Faulkner, St. Elizabeth’s, Malden City, Massachusetts Memorial, Carney, and St. Margaret’s.
• The total casualty list, of both surviving and dead, included persons from twenty-five of the forty-eight states and the District of Columbia, plus one from Brazil.
• Fifty-one servicemen and two WACS were killed, and 26 others were hospitalized. The fatally injured servicemen, some of whom had ironically returned safely from battle overseas, included 17 from the Army, 26 Navy, 3 Marines, and five from the Coast Guard.
• Anticipated injury to death ratio for a disaster is typically 3 to 5 injured for every death. This disaster had those numbers reversed.
• In two separate reports, 54% of Grove survivors from Boston City Hospital interviewed were afflicted with "posttraumatic neuroses"; this was about 44% at Mass General. It was observed that a surprising number of relatives and friends had an "emotional upset that attained proportions of a major psychiatric condition and needed trained intervention."
• Recognizing that this was a community misfortune, the hospitals rendering service never charged any of the patients from this fire. The Red Cross provided considerable relief in the form of financial aid to both the public and private hospitals. This was especially helpful to Boston City Hospital, receiving generous volunteer medical assistance to offset its enormous influx of patients.

Profile of Boston City Hospital

• In little more than one hour after the first Grove victim was received at Boston City Hospital, over 300 had been received. This calculates to one Grove victim being received at Boston City Hospital every 11 seconds over a time period of approximately 1 hour and 15 minutes. This is one of the all-time highest admittance rates anywhere in the world.
• Within 2 hours of the fire, Boston City Hospital had admitted 132 injured victims, with over 200 dead and still counting.
• By the end of December, 1942, Boston City Hospital’s mortality rate was close to 30% (36 out of 132), with a number of these wholly or partially attributable to "full thickness" or third-degree burns.
• By February 1943, the official death toll was 488 and only 3 survivors remained critical, all at Boston City Hospital.
• In May, 1943, the last Grove casualty, a woman from Dorchester, MA died at Boston City Hospital after five months of withstanding both grave burns and compounded internal injuries.

Profile of Massachusetts General Hospital

• Of the 114 Grove victims delivered to Mass General within two hours after the fire, only 39 were still alive to be treated. Seventy-five were dead on arrival or before treatment could be given. (Many of the dead were not burned). Three married couples were among the survivors, but 17 were among the dead, and a number of other survivors had relatives who succumbed.
• Ten of the 39 living admitted to Mass General had significant burn injuries. The other 29 had slight or no external burns, but some of these suffered gravely from severe lung damage and anoxia (restricted oxygen supply to body tissues). All 39 patients at Mass General were bedded down by 3 a.m. Sunday morning. This included 21 males and 18 females. Thirty-two were in stable or good condition, 7 were critical, including movie star Buck Jones.
• Mass General lost 7 of its original 39 surviving patients in the first 3 days. Buck Jones was the fi fth among these.
• By the end of December, 1942, Mass General’s mortality rate was about 18% (7 our of 39). None of these were directly attributable to burn deaths.
• By the end of January, 1943, nine of the original Grove survivors remained at Mass General Hospital.
• In April, 1943, the last survivor from Mass General was discharged, four and a half month after admittance.