They started rolling in. Bloodied, confused, crying and in shock. We cleared the department as quickly as we could—moving the least injured patients into our observation area and trying to make room for the sickest patients to be seen as quickly as possible. One of our senior residents gravitated toward the “triage” roll, taking responsibility for meeting each stretcher at the door and sorting patients based on the seriousness of their condition.

Soon, we had created mini-ERs based on the severity of patients’ injuries. The rest of us focused on seeing and treating patients as they arrived into our areas of the department.

The first wave arrived with similar injuries: severed limbs, open fractures and puncture wounds from shrapnel. We worked to control patients’ bleeding, to “reduce,” or set, their badly broken bones in an effort to save their limbs, and to administer medication to help their pain and prevent infection.

Then the next wave arrived. These people had less obvious injuries but had suffered an insidious threat: Their singed facial hair and sooty mouths alluded to the degree of damage that could be in their lungs—raising concern that subsequent swelling could impede their ability to breathe.