The bus, the purse and the limb

Cardiff GP Andrew Dearden, who is a member of BMA council, recalls treating the injured

I had had meetings on the Wednesday with the BMA’s GP committee, and was speaking at a GP Registrar conference in Bristol on the Thursday afternoon so decided to stay in London on Wednesday night and catch a late morning train down to Bristol for the conference on Thursday morning.

I had woken up, got ready and so on and by about 9.30 a.m. was preparing to leave the BMA flat, which is situated about 50 yards down the road from BMA House. I had to return the key to the BMA front lodge before catching the train but decided to make a few phonecalls before leaving. As I was leaving my flat I heard a loud "whoomping" sound. I thought it may have been a crash but the sound was very loud, a "big" sound that resonated. I thought it might have been a crash between two big vehicles. Ironically I thought it could have been a crash between two buses at the T-junction in front of BMA house or perhaps opposite Euston train station.

As I reached the foyer of the block of flats I looked down the road towards BMA House. I saw the bus about 50 – 60 yards away. The first thing I noticed was the fact that the bus was missing its roof and that the back of the bus looked like someone had stepped on it and squashed it down. I could see the front seats of the top floor quite clearly and that they were still attached to the floor. I was a bit surprised that I could not see another vehicle near the bus capable of causing that amount of damage that high up the bus, for example one of these mobile cranes. I then noticed several things pretty much at the same time. One, there were other cars around the bus that had also stopped. Second, I noticed a large area of debris all around the bus, glass, metal etc. Lastly I noticed that people were rushing from BMA house and kneeling on the ground around the bus. It was then I realised that people must have been injured and may have needed medical help. I left my bags with the staff in the flats and ran across to the area at the front of BMA House.

As I ran I could begin to see a lot of glass and metal fragments all around. As I got closer to the bus area I began to see pieces of material and people’s possessions lying around, I saw a lady’s purse I think. Then I ran past a dismembered limb lying on the floor and began to see other parts of human bodies. It was then it hit me that this was not something "ordinary", that this was something bad. I know that sounds a bit simple, but it says exactly what I felt.

Three of my most vivid images of the day were the bus, the purse and the limb. Each seems to say something of the tragedy and suffering of the day.

As I ran upto the scene I could see doctors tending to people on the ground. Some I recognised as GP colleagues and others from various other committees of the BMA. A few I did not know but you could see they knew what they were doing. I let Sam Everington [deputy chairman of the BMA], who was in the midst of things, know that I was there and then began to help treat the people injured at the scene. I first helped move a person who seemed trapped under a car. We had to stabilise a badly broken ankle area before it was possible to move them into the BMA courtyard. Once they were moved I started helping someone with multiple fractures to limbs, one extremely serious to their lower leg. A younger doctor and I put lines into opposite sides. I do remember thinking that this guy was likely to lose his leg, so great was the injury to it.

During this time, though I cannot remember exactly how, we were told that the explosion was probably a bomb and that there maybe another bomb in the vicinity. I remember seeing police with dogs walking around, which I assumed were sniffer dogs. What I was aware of later, was that no one seemed to worry about any danger to those around the bus, just concentrated on the needs of those already injured. That said, we also knew the need to get those people off the road and into the BMA courtyard as soon as possible.

I don’t remember much screaming. Just those giving care shouting for the things they needed. The police and paramedics were great. It seemed that whenever I asked for something, scissors, tape, fluids, boards to splint fractures, it appeared within a few seconds, brought to me by those supporting us as we provided the direct care.

The scene both on the road and inside BMA House was one of "organised chaos." While we were treating patients or running around finding enough oxygen, fluids, venflons etc, there were also several people who were obviously keeping an overall view of things. Peter Holden [a Trent GP, member of BMA council and secretary of the British Association for Immediate Care] took the clinical prioritisation and organisation while Sam Everington took the practical organisation.

I have to say here that the BMA Staff were fantastic. As doctors I suppose all of us have seen some of these injuries as some time. Perhaps one at a time or at some time distance between each one but we’ve probably seen something to help us prepare for something like this. But the non-medical staff of the BMA had not. Yet they stood side by side with the doctors and did what had to be done. They took tables apart so we could have something to move patients on. They pulled the injured from the bus, carried them inside once we had stabilised them and kept finding things that we needed to provide immediate care to those people. As I look back now, I do become emotional with pride to remember what the BMA, as a whole, doctors and staff alike, did and were able to do. We often make the mistake of focusing on the medical care in these situations, but we need to remember that it is also those who take care of everything else that is needed that allows the medics to be free to provide the care. I am sure that people could have, and would have, died on Thursday morning without the staff of the BMA.

Once the patients I had been helping with were stabilised and had sufficient medical cover I began to help with distributing supplies like IV Fluids and oxygen. We nearly ran short a few times but it seemed that as soon as I thought we had run out of something, another ambulance turned up with further supplies that kept us going until we got things in larger quantities.

I then turned my attention to helping organising the ambulances at the rear of BMA house. We asked the police to move people back so we had clear roads in and out of the area. We got the ambulances as they arrived to get into a sort of "taxi rank," so that as patients were loaded on one and it left the next was able to pull up and receive patients as quickly as possible. I helped with this until one of the local ambulance officer types turned up and then took over. Peter [Holden] had, by this time, got support from other trained emergancy trained doctors who together prioritised the patients in the order that we moved them out.

It was around this time, when things had started to cool a little that we started to think about contacting our families. The mobiles systems were off; the reason, we were told, was to ensure that emergency calls would not be blocked. We found a few landlines working within BMA house and took turns trying to contact family and other loved ones. I managed to contact my wife who I thought would be beside herself with worry. She answered in her usual sunny voice "Hello darling, there’s nice of you to call, where are you then?" It turned out that she had not seen the news, and did not know anything about what was happening and was not worried at all. (She has reassured me since that if she had known what was going on, she would have been appropriately worried!) I asked her to call our kids in school, my mum and other members of our family to let them know that I was OK. I did say a prayer and thanked God that I was able to speak to her before she had heard of anything that was going on. I still feel grateful and get emotional when I think of how she was spared that worry.

Once we had got the severely injured onto ambulances and to hospitals, the walking wounded began to arrive at BMA house to be seen prior to being transported to the hospitals too.

Once all the injured had left BMA House we began to care for the carers. We raided the BMA kitchens, both the doctors and staff canteens for sandwiches, rolls, chocolates, fruit, crisps and drinks, which were then given to the staff, the paramedics, the police and doctors, in fact anyone who was there and hungry or thirsty. We began distributing it among those who were in the courtyard and building, and taking hot drinks out to the police who were keeping the area clear and secure in the surrounding area.

We arranged for all BMA staff to meet regularly each hour so we could begin to make arrangements for the staff that were then left in-house. Some of us scanned the radio, some watched the TV for information, and others worked on potential accommodation and transport needs. The fact that we gathered back each hour really made me feel that we were a group working together and felt that we "knew" what was going on. Slowly people began to leave BMA House and walk or drive for home, many taking other staff with them to stay the night.

I think it took us about 2-3 hours to move, treat and get all the seriously wounded to hospital. It took another hour or so to see the walking wounded and send them also onto the hospital service. (I did lose track of time I have to say so my timings could be a little off.)

At about 5 pm or so I decided to walk over to Paddington train station to see if I could get a train home. There were a lot of people walking home at that time. But I saw no panic, no terror, and no fear. I have to say that that impressed me no end.

I do remember thinking though as I walked towards Paddington that all these people who were walking past me, were at least walking, their lives would only be a little disrupted by the events of the day but the people whom we had treated, many of them would never walk in the same way again, that their lives had been altered. I did feel a little like I was walking in a bubble, separated from the other people on the street. It was an odd sensation.

It turned out that the trains to Cardiff were sporadic and delayed so I stayed overnight in a nearby hotel I was fortunate enough to be able to book. I finally got to my room and sat down at around 7.30 – 8.00 p.m. and suddenly felt more tired than I ever have in my life. It was as if, I literally had no energy in my body at all. I suppose we’d been running on adrenaline for hours and once we were able to stop, our whole bodies stopped, at least that is what it felt like to me. It was a full hour before I was able to get up and do anything at all.

I managed to travel back to Cardiff the next day, on the Friday morning at 10.15 am, nearly 24 hours later than I had planned to travel the day before. One of the headlines in the newspaper stated "What a difference a day makes"; what a difference indeed.

I have been asked what I think about those who carried out the bombing. Whether it has changed my outlook on life? Do I think we should seek revenge on those who perpetrated this vile act?

I do not think we can resist evil by becoming evil ourselves. We defend ourselves when attacked, we take sensible precautions to avoid attack when we can, but if we change our lives as these people wish, they win. We win by keeping our ideals, our lives, and our sense of self. I am incredibly proud / pleased / happy to be a doctor and to have been able to help, proud to be associated with friends that coped as well as they did, doing the things they did in the midst of the human trauma around us. I was awfully proud of those who live and work in London. As one born in Wales, brought up in Australia and having lived in New Zealand, I was also proud to be British.