"How incredible it was to witness a post located in one state and a post located in another state literally come together and take care of an immediate need."
On 23 March, when disaster struck at Pope Air Force Base, Brig. Gen. Robert G. Claypool, MC, the commander of Brooke Army Medical Center, was attending a video teleconference at the U.S. Army Health Services Command at Fort Sam Houston. Also present in San Antonio were Brig. Gen. John J. Cuddy, MC, the deputy commander of the Health Services Command and the commander of the U.S. Army Medical Department Center and School; Maj. Gen. Edgar Anderson, Jr., MC, the commander of Wilford Hall Air Force Medical Center and the chairman of the San Antonio Health Care Coordinating Council; and Brig. Gen. Paul K. Carlton, MC, the director of medical servicesand training at the U.S. Air Force Education and Training Command. At the opposite end of the video teleconference, in Alexandria, Virginia, were Lt. Gen. Alcide M. LaNoue, MC, surgeon general of the Army; Lt. Gen. Alexander M. Sloan, MC, surgeon general of the Air Force; and members of their staffs.
Following interruption of the conference with news of the crash, General Carlton alerted the U.S. Army Institute of Surgical Research (USAISR) at Fort Sam Houston of the masses of severely burned soldiers and then contacted General Ronald R. Fogelman, the air mobility commander at Scott Air Force Base in Illinois, who arranged for air transport of Air Force ventilators directly to Fort Bragg and of USAISR burn teams to Womack Army Medical Center. Carlton also made sure that airframes were available for patient transport. According to General Claypool, General Carlton's actions "probably saved five or six hours of flying time.... And that was just one of the ad hoc things that I think made this a more efficient and more effective exercise." Claypool began to organize Brooke's response and Lt. Gen. Marc A. Cisneros, the commander of Fort Sam Houston and the Fifth U.S. Army, the garrison's response.
As chairman of the San Antonio Health Care Coordinating Council, General Anderson decided not to activate the San Antonio area casualty reception plan, whereby local facilities received incoming pat~ents. Instead, the USAISR burn unit expanded sufficiently to rece~ve casualties arriving at Fort Sam Houston from Fort Bragg.
The U.S. Army Institute of Surgical Research, originally known as the Surgical Research Unit, was formed in 1943 at the Halloran General Hospital, on Staten Island, New York, to evaluate the role of antibiotics in the treatment of war wounds. In 1947 the unit was moved to Fort Sam Houston, taking up quarters in what was then Brooke General Hospital, and, two years later, was tasked with the additional mission of studying thermal injuries, a concern of increasing importance during the nuclear age. In May 1953 it was officially organized as an activity of the Office of the Surgeon General and in October 1958, as the previously redesignated U.S. Army Surgical Research Umt, assigned to the U.S. Army Medical Research and Development Command, in Washington, D.C., but attached to the then Brooke Army Hospital. In 1970 the unit received its present name, reflecting the concept "that the burn patient is the universal trauma model with the multisystem effects of thermal injury representing an exaggerated form of the stereotyped response to all forms of trauma."
In 1994 the Institute of Surgical Research was divided into three divisions. The Clinical Division operated the burn wards, located in two wings of the mam hospital's fourth floor, and was directly involved in burn care and clinical studies. The Laboratory Division, composed of research scientists and physicians, conducted laboratory research on burn care and the support of the burn patient. This division was located on post, about 1 mile away from the main hospital. The Support Division provided administrative and logistical support to the other two divisions. At the time of the accident Col. Basil A. Pruitt. Jr., MC, was the USAISR commander and director.
Besides being the only military burn unit in the United States, the Institute of Surgical Research had become a role model for other burn centers both here and abroad. It treated annually between 250 and 400 patients. The typical patient had life-threatening second- and third degree burns on 35-40 percent of his or her body surface. Innovative concepts and techniques about burn care originated at the institute, which became known and recognized for excellence in the field of burn management.
Once notified of the accident, Col. William F. McManus, MC, the Clinical Division chief, diverted a USAISR burn team, already in North Carolina, to Fort Bragg for triage and assessment of casualties. After consulting with Maj. David Lawlor, MC, a general surgeon on the burn team, McManus decided to send three more teams and additional ventilators to Womack. Burn teams, each consisting of a physician, nurse, respiratory therapist, and a 91C licensed practical nurse, were to assess the degree of care required by the accident victims and their ability to survive the flight to San Antonio. The institute followed up with the Global Patient Movement Requirements Center at Scott Air Force Base, which General Carlton had already alerted, on the aeromedical evacuation of the patients and the attending burn teams.
Before the three burn teams could leave San Antonio, the Institute of Surgical Research had to obtain supplies and equipment for the in-flight treatment of forty to sixty casualties. "There was a mad flurry of scrounging around trying to get sufficient quantities and specific types to meet Air Force requirements," recalled Col. Elisabeth Greenfield, the USAISR chief nurse. Fortunately, Lt. Col. Charles Stetz, a clinical nurse specialist at the institute who had experienced a number of mass casualty situations, had some "institutional memory, understood what was going to be needed, [and] knew some of the resources that were available...." For the next twenty-four hours Stetz worked with the flight teams to determine their requirements for fluids, medications, equipment, and other necessities, and, together with Sfc. David C. Loresch, the Clinical Division's noncommissioned officer in charge, assembled suppliesto include "23 cardiac monitors, 60 intravenous infusion pumps, 8 cases of central venous catheters, 120 liters of lactated Ringer's solution, 15 bed rolls with 36 insulated space blankets, 26 [Bird] pressure-controlled transport ventilators, and 20 standard Bear ventilators"and obtained airframes to ferry patients. It was a tribute to their ingenuity and efficiency that they were able to do so much in so short a time.
Several hours passed while USAISR personnel located a pump that was compatible with Air Force flight regulations, rented additional ventilators, and procured bottles of human serum Albumin, the chief protein of human blood plasma, to be used intravenously in the treatment of shock. Some 1,300 bottles of Albumin were requested, but Brooke's pharmacy was unable to obtain that many, even through the Health Care Coalition, an organization of local health care providers in San Antonio. It seemed, according to Lt. Col. Gerald Nolan, Brooke's Plans, Training, Mobilization, and Security Division chief, that "industry [did not] stock sufficient quantities of Albumin to meet MASCAL conditions." The USAISR burn teams were able to cope with insufficient amounts of Albumin during this tragedy without any adverse affect on the patients, although the pharmacy remained concerned about future mass casualty situations. To transport the large quantity of supplies and equipment, they traveled to the airport by truck, rather than van, their normal conveyance. The first USAISR burn team departed Randolph Air Force Base, near San Antonio, for Fort Bragg at 1925 central standard time, or six hours after the accident.
With the burn teams en route to North Carolina, the Institute of Surgical Research prepared to receive the Fort Bragg casualties. The USAISR burn unit, which expected more than forty from North Carolina already had a patient census of twenty-six. Following emergency preparedness planning, Maj. David J. Barillo, MC, a general surgeon on the USAISR staff, coordinated the transfer of all but eleven patients from the institute to regional medical facilities and a veterans hospital. Colonels McManus and Greenfield expanded the burn unit's Wards 14A and 14B onto Ward 15A, located one floor above; extended shifts to twelve hours; and obtained additional nurses from the staffing agency under contract with Brooke, from the Air Force medical community, and from other Fort Sam Houston organizations. Colonels Greenfield and Stetz used their personal contacts to find former USAISR employees who could assist during the crisis; they also asked USAISR alumni, practicing in the San Antonio area, to register with the staffing agency. Those professionals were on board within seventy-two hours. To augment the USAISR staff, anesthesiologists, respiratory therapists, physical and occupational therapists, psychiatric nurse specialists, and social workers came from various facilitiesother Brooke departments, the Army Medical Department Center and School; the Joint Military Medical Readiness Command, also at Fort Sam Houston; and Wilford Hall Air Force Medical Center. Three Brooke residents in general surgery, who had rotated through the burn unit, temporarily joined the surgical team.
The USAISR staff was grateful for the additional help. "God knows, at a time like this, with the numbers of showers and dressing changes, just extra pairs of hands and legs to fetch and to do" were welcome, recalled Colonel Greenfield. The institute readily understood the cost to the patients should the staff become emotionally and physically drained. The temporary workers stayed about thirty days.
On 24 March the twenty Fort Bragg soldier patients selected for burn treatment arrived at Brooke. Eleven came on the first medevac flight in the morning, and nine landed in the afternoon. The burn victims were wrapped in aluminum-lined blankets to keep their bodies warm. Nine of the eleven and four of the nine casualties were on ventilators.
Because of a miscommunication with Scott Air Force Base, the twenty Bear ventilators sent directly to Fort Bragg proved to be incompatible with the electrical system of the C-9. Fortunately, the twenty six Bird ventilators, which had been obtained in San Antonio for ground transport of patients to the aircraft, were hand driven and did not require electricity. The employment of mechanical ventilators, however, demanded a greater supply of oxygen than conventional breathing apparatus The relatively short duration of the flight to San Antonio permitted the mechanical ventilation of the patients on board without depleting the oxygen supply.
During the flight the burn teams, many of whom had treated burn wounds in Vietnam before acquiring additional expertise at the USAISR burn unit, managed the Green Ramp victims as if they were in an intensive care unit. The teams maintained airways, used ventilators to facilitate breathing, and provided intravenous resuscitation during the journey. Major Lawlor, who was on the first C-9, reported that the Fort Bragg soldier patients remained stable, with no bleeding problems during the less than three-hour flight. The transfer from Womack and the aeromedical evacuation went smoothly because of the burn training Army professionals had received at the Institute of Surgical Research. According to Lawlor, burn teams "learned how to transport patients by aircraft and, in particular, patients with burns who had special needs." Maj. David Mozingo, MC, a general surgeon with the USAISR burn unit, credited "the continuity of [a] staff . . . [that] knew exactly what to do." During DESERT SHIELD/DESERT STORM the USAISR burn unit had put together concepts of how to send out burn teams and return them, and that experience paid off during the aftermath of the Pope Air Force Base disaster. Buses, escorted by San Antonio police, took the Fort Bragg casualties from Kelley Air Force Base in San Antonio to the institute.
The USAISR burn unit was ready, even though eleven institute patients, six of whom were children, were still undergoing treatment. Ward 14A was divided into two intensive care units, each with eight beds and two assigned physicians; Ward 14B became an acute care unit, with twenty-four beds; and Ward 15A was for the more stable patients. As the first Green Ramp casualties arrived on the ward, everybody teamednurses, medics, respiratory therapists, surgeons, and so forth. Their adrenalin was high, a usual occurrence during a mass casualty. "People were pumped," recalled Colonel Stetz. "They had their adrenalin rushing. There was teamwork . . . but some degree of fear. [They wondered:] Am I going to be able to get through this? Am I not going to hurt anybody?" Stetz believed that the physicians and nurses were very coordinated. "It looked like a well-choreographed dance. There was no panic. There was no confusion," he said. The USAISR staff had rehearsed mass casualty exercises regularly. "Intensive training . . . [and] teamwork," according to Colonel Greenfield, helped the staff to handle the twenty patients that came in on two flights only two hours apart. Everybody had a job to do and did it. Colonel Stetz confessed that his adrenalin "pumped non-stop for about a week."
The soldier patients were admitted, cultured, bathed, and dressed; had labs drawn and vital statistics taken; and were in their beds in less than five hours. Between nineteen and twenty-nine years old, they had second- and third-degree burns on 6-88 percent of their total body surface. The team of USAISR doctors, nurses, and technicians treated the patients, checked their status constantly, and evaluated their condition every eight hours.
Besides the psychological stress of dealing with a mass casualty, the USAISR staff had to endure the physical stress of working in an environment of high heat (85-87 degrees Fahrenheit) and high humidity, which was necessary to keep the burn patients warm since their own natural mechanism to regulate body temperature had been destroyed. In this uncomfortable heat and humidity staff members had to wear sterile gowns, masks, and glovessafeguards against infection. They also worked overtime, including long periods without rest, to care for the overload of badly injured soldiers.
For the USAISR staff, dehydration and emotional exhaustion were constant concerns. During the first four days of the mass casualty Colonel Greenfield arranged for box lunches to be delivered. She also ensured that liquid refreshments were provided three times a day. Later, a five-gallon vat of lemonade was brought to the USAISR burn unit, and personnel were ordered to take thirty-minute breaks.
On 28 March a USAISR burn team returned to the Univers~ty of North Carolina's Jaycee Burn Center to evacuate three more ~nJured soldiers and the marine who was originally scheduled for transfer on the morning of the tragic accident. The team also v~s~ted Womack Army Medical Center to evaluate an additional fifty soldiers with "funct~onally significant burns," to include those on outpatient status. Twenty of the fifty patients required specialty care at the USAISR burn umt and were transferred on two medevac aircraft two days later.
When the USAISR burn unit census peaked at fifty-three patients on 4 Apr~l, every conceivable spaceeven rooms in the inner cube which had limited visibility and, therefore, were normally used for storagecontained a bed and a patient. The staff relocated those in the mner cube as soon as it was medically feasible. 
Two weeks after the Green Ramp disaster Colonel Stetz stated that he found h~s work dunng the mass casualty to have been remarkably satisfying. "It is [as ifl we are doing what we are supposed to do, and I thmk that was the most rewarding part of it," he said. "From [the] start to the present (April 8, 1994), it is going very very smoothly. I have been incredibly impressed with the way everyone has reacted." Stetz gave credit for the success of the mass casualty to Colonel McManus, who d~rected everything and "knew instinctively what to do."
Surgical treatment of the Green Ramp victims began about three days after their arrival at the Institute of Surgical Research. "Every burned soldier can expect about 2 hours of surgery for every 10 percent of his body burned," said Colonel McManus. Following resuscitation of patients, burns were incised and skin grafts performed "to achieve timely and definitive closure of the wounds." Orthopedic and soft tissue injuries were treated as necessary. The institute's one operating room and Brooke's two operating rooms were in continuous use for the first two weeks; thereafter, two of them functioned for another ten days. By 7 June surgeons had performed ninety-three operations to treat the injuries sustained by the Fort Bragg soldiers. In support of those surgical procedures, USAISR occupational therapists made "187 splints, 72 positioning devices, and 40 compression devices required for post operative antideformity positioning and rehabilitation." Sufficient supplies of whole blood were on hand for transfusions because of the blood donor program at Fort Sam Houston and other installations.
The cost of the medical items needed to treat the injured soldiers during the first two weeks following the accident totaled over $200,000. The Health Services Command "quickly and with a minimum of processing time" transferred the capital from a catastrophic fund, which facilitated the ability of the Institute of Surgical Research to obtain the additional equipment and supplies. Funding could not be made directly to the institute "because ISR allocations are designated for research
Although preparations to receive the Green Ramp casualties went well, the Institute of Surgical Research lacked a "formal [written] plan to manage an influx of burn patients that exceed[ed] the ISR bed capacity and/or ability of the staff to manage patient care requirements." Duplication of effort and cumbersome procedures to obtain additional staff resulted from this lack of planning. Identifying supplemental staff for the institute to use during future mass casualty situations was paramount. Colonel Nolan later recommended that "an annual review should be made of ISR trained personnel registered with local agencies, other area volunteers, and Individual Mobilization Augmentees.... Resources would normally be needed over a 2-month period. MEDCOM [U.S. Army Medical Command] tracking could also identify trained personnel who could be brought into the region after the local lists are exhausted."
The burn management of the forty-three Fort Bragg soldiers represented the largest mass casualty response in the history of the Institute of Surgical Research. Its unparalleled ability to safely transport large numbers of critically ill patients was fully validated. Only through the constant state of readiness, ensured by the day-to-day clinical and aeromedical transfer activities of the burn center and its correlative laboratory activities dedicated to further improvement in burn care by the conduct of military relevant research, can the low morbidity no mortality results achieved in these patients be achieved in the future.
These results notwithstanding, Colonel Nolan, not content to rest on the successes, called for "a review of current casualty reception plans m light of lessons learned." In his opinion, having to prepare reports and to answer incoming phone calls meant that the USAISR staff had less time to spend with patients. To improve operations in the future, Nolan recommended that the regular daily patient report be accepted by all commandsor, as an alternative, tasking an administrative branch with reformatting the reportsand that the post operator and administrative officer refer inquiries about mass casualties to the public affairs office.
One of the first casualties from the 2d Battalion, 505th Infantry, to be airlifted to San Antonio on 24 March was Sgt. Christopher "Chris" J. Burson. Burson remembered nothing that had happened to him on Green Ramp, in the emergency room at Womack, or on the flight to San Antonio. With burns on his feet, legs, hips, and hands and with part of his left ear missing, he woke up delirious in the USAISR burn unit. He experienced more mental anguish than physical pain because, in his words, "all the nerve endings in my legs were burned and dead." He endured painful scrubs and underwent three skin grafts and six surgeries. Three weeks after the accident his spirit soared on the day he took his first few steps; "it was like being a baby again learning to walk." To his delight, Burson discovered that he enjoyed occupational therapy. He practiced stepping on and offa 4-inch block and p~ck~ng marbles out of playdough with his stiffleft hand. Before the accident Burson had aspired to a career as a sergeant major, a lifelong dream; but now, as soon as he was sufficiently recovered, he wanted to become an occupational therapist. "God makes things happen for a reason," the young soldier said.
On the same plane as Burson were Sergeant Kelley and Private Fletcher. Kelley, with burns on 70 percent of his body, and Fletcher, with burns on over 35 percent of his body, underwent many surgeries and skin grafts. Kelley found the burn treatment painful, "but the staff is right there beside you to help you." Fletcher had nothing but praise for the family support system, which "treated my family and friends exceptionally well," providing the support and perspective they needed to deal emotionally with his injuries; he also found great comfort in the handmade get-well cards that he received from schoolchildren around the country, especially the one that enclosed Band-Aids for his speedy recovery. Both soldiers appreciated the visits from unit members of their respective battalions, which raised their spirits and was a tribute to unit cohesiveness.
Four days later, on the twentyeighth, a USAISR burn team picked up Sergeant Naeyaert from the Jaycee Burn Center at Chapel Hill and evacuated him, as well as two other paratroopers and a marine, to San Antonio. Naeyaert's broken ankle and abdominal wound, where his spleen had been removed, were beginning to heal; however, the burns on his legs, back, and hands needed skin grafts. Family visits lifted his morale, he recalled, as he was on the critical list for about two months. He was indebted to the Red Cross for paying for his family's travel expenses. While recuperating, Naeyaert had the distinction of marrying his girlfriend, Amy, a member of the XVIII Airborne Corps' Headquarters and Headquarters Company, in the hospital chapel. Everything for the reception, held at the Fisher House on post, was donated, including the food and wedding cake.
One of the battalion's unit commanders, Captain Mingus, reached Brooke on 30 March, together with nineteen other evacuees. Before going up to the burn ward, they were showered and scrubbed to eliminate any bacteria they might have picked up on the flight from North Carolina. Medication eased some of their pain.
Mingus suffered burns on his hands and face. He had already received some stabilizing burn care and physical therapy at Womack. His subsequent treatment included surgery to incise the wounds, as swelling from burned tissue impedes blood flow to arms and legs, and skin grafts on his hands. During his ordeal the captain bonded with his fellow patients, especially the eleven soldiers from his company, with whom he developed a tighter and warmer friendship than before. He also became closer to his family, whom the Army flew to San Antonio so that they could be with him. For Mingus, tragedy produced the personal good of closer relationships with family and friends. 
Captain Walters, Mingus' counterpart in the 1st Battalion, 504th Infantry, arrived at Brooke at the same time. Walters was impressed with the way the competent USAISR staff explained every burn treatment to him and the reason for it. His witnessing the staff's compassion and commitment, working twelve-hour shifts, made him "appreciate the medical side of the Army a lot more...." He went into surgery on 4 Apri1 to treat the second-degree burns on his hands and ears.
Soldier and family morale was bolstered by the many distinguished visitors who called on the injured paratroopers at the USAISR burn unit. Between 25 March and 20 May more than twenty dignitaries, including the Army chief l f staff, Fort Bragg commanders, l ongressman Frank Tejeda of Texas, and philanthropist Yale King, journeyed to San Antonio to see the Fort Bragg soldier patients. General Steele made the trip three times to be with his troops, and General Frederick M. Franks, Jr., the commander of the U.S. Army Training and Doctrine Command, visited twice. The visits of notable persons to the Green Ramp casualties demonstrated, more than anything else, an appreciation of the sacrifices soldiers make for their country.
General Steele's first visit was on 26 March. To boost morale, he brought soldiers from the units that suffered the most casualties and also some of his subordinates Sergeant Major Slocum; Colonels Schmader, Abizaid' and McChrystal; the division chaplain, Lt. Col. Jerome Haberek; and the division surgeon, Maj. Jeffrey B. Clark, MC. They all wore their battle dress uniforms and maroon berets. Pam Steele, Kathy Abizaid, and Anne McChrystal also accompanied the group. The commanding general felt that "it was important to take the ladies with us," since women have the facility to comfort and console. During the visit General Steele showed how much he cared about his troops: He cried with them, he held their hands, and he prayed with them. Later, he would say that he "learned from the whole process that there is nothing wrong with showing your emotions." He and his entourage were on the ground at Fort Sam Houston for about four hours before returning to Fort Bragg on an Army C-20 aircraft, which the secretary of the Army had provided for their journey.
The following day Army Chief of Staff General Gordon R. Sullivan called on the twenty burn victims. He was accompanied by Generals LaNoue and Cisneros. Sullivan greeted the soldiers with "Hoo-ahs!," an expression that shows camaraderie. After speaking to every soldier, except one whose medical situation made it impossible, the chief of staff visited with family members. He praised the efforts of the Fort Sam Houston Family Assistance Center in helping the families of the burned paratroopers and thanked the San Antonio community for the donations of food and other assistance.
The visits of General Franks on 29 March and 11 May "increased everyone's optimism" and had a "mercurial and superb" impact, according to General Steele. Franks had lost a leg in Vietnam and remained in the Army. Burson, Fletcher, and Naeyaert recalled that General Franks' visit had inspired them to move beyond the tragedy and get on with their lives.
The USAISR staff members were impressed by the Army commanders"'extreme concern and devotion" for the soldiers and their families. They worried, however, about the increased infection risks "posed by multiple visitors" and the interference those visits made "with the necessary activities of patient care." Distinguished visitors were not restricted to normal visiting hours. Colonel Greenfield, the sharp no-nonsense chief nurse, wondered why their visits were not coordinated so that they could have come "at the same time." Colonel Nolan later recommended restricting VIP visits "to general officers directly in the patients' chain of command. If such a policy were established' it would promote patient morale while effecting infection control."
Although aspects of visitor traffic should be addressed in mass casualty planning, the overwhelming advantages of VIP visits on soldier morale could not be denied. For some soldiers, for example, Captain Walters, "the entire chain of command coming out really made a difference." While recovering from his burns, Walters had to cope with the loss of his good friend and jumping buddy in the accident. He found that the VIP visits bolstered his morale during his time of grief. Even that of his wife, Lt. Stephanie Walters, improved. She learned from the accident "how wonderful the Army community is, especially the medics' "willingness to go an extra shift, or an extra day, or another case...." Lieutenant Walters saw firsthand how committed the Army is in taking care of its own. For her, the experience "really reinforced [the notion] that people are the most precious commodity in the Army."
At 1600 on the day of the disaster General Claypool established an emergency operations center (EOC) at Brooke and placed Colonel Nolan in charge. The EOC staff provided information to the Health Serv~ces Command, exchanged data with Fort Bragg during the emergency, and sent three soldiers to meet the arriving casualties at the airport. General Claypool also provided personnel from Brooke's Patient Administration Division (PAD) to work with the USAISR burn unit and with the families. During the initial stages of the mass casualty PAD representat~ves staffed the Fort Sam Houston Family Assistance Center acted with the 82d Airborne Division liaison team in helping family members receive accurate and timely information, and facilitated the assuance of invitational orders to next of kin.
Despite best efforts, some problems became apparent during the mass casualty response. At first the information on when and how many patients were coming into the burn unit was not always reliable a problem that lasted until about 0630 on 24 March. Colonel Nolan subsequently recommended that a PAD representative be sent with the forward team to provide accurate information about numbers of victims and times of flight arrivals and to expedite the admission process Another weak area was that activities often were not properly coordinated through the Brooke EOC, which was supposed to be the source of all information. Although "communications exceeded expectations," the radios being used by support personnel were incompatible with those at the operations center. The EOC staff sometimes could not respond or lacked the appropriate details.
Nevertheless, information flowed more smoothly during the mass casualty response at Fort Sam Houston, with its one emergency operations center, than at Fort Bragg, with its multiple emergency operations centers providing conflicting material.
While General Claypool established a Brooke EOC to deal with the mass casualty, General Steele organized an effort to ensure that his injured paratroopers and their families would be well taken care of at Fort Sam Houston. At 0300, on the twenty-fourth, Steele sent a nineman liaison team to San Antonio to assess the situation and provide the 82d Airborne Division with information about the soldier pahents at the USAISR burn unit and the handling and care of their family members. He placed Capt. Michael Scudder, an Adjutant General Corps officer known to be intense and mission oriented, in charge of eight menone each from the 1st and 3d Brigades, three for administrative functions, two for tactical communications, and a chaplain. Captain Scudder's previous deployment for disaster relief during Hurricane Andrew, on only seven hours' notice, helped prepare him for his new assignment.
During the flight to San Antonio Scudder and his team developed a list of eighty things they needed "to accomplish to make business happen for us." Like other well-trained soldiers, who go to combat and figure out how to make the mission a success, the liaison team "just converted what we normally do every day in the Army to this particular situation," said the young captain. To maximize efficiency, Scudder divided responsibilities into eight or nine tasks per individual. Arriving at Fort Sam Houston at 1400, the team members agreed on a time and place to meet and then went their separate ways to perform their individual assignments.
The liaison team received working space at the Fort Sam Houston Family Assistance Center, where Scudder and his team actually lived until other accommodations could be found for them. There was little time to enjoy comfortable quarters, however, for they worked twentyfour hours a day supporting patients and families. By the fourth day Scudder had enlarged his team to fourteen to assist what eventually would be 43 patients and 120 family members.
Captain Scudder coordinated with Colonel Nolan at the Brooke EOC. He also met with key installation officialsEdward K Miller, director of the Plans, Training, Mobilization, and Security Division, who was Nolan's counterpart, and with James "Jim" R. Evetts, director of Fort Sam Houston's personnel and community activities. They and representatives of the five different commands at Fort Sam Houston attended daily emergency operations meetings involving the post commander, which gave Scudder a direct link to the post leadership. This leadership put their enaployees to work to solve problems for Scudder.
Problems included securing l guest rooms and transportation I for family mtembers; working out financial arrangements for stepparents and girlfriends, who did not meet the standard requirements for assistance; making certain that donation and foundation monies were directed toward financial support of families, once the brigades' normal family support money had run out; and protecting families from media scrutiny by keeping reporters outside the family assistance center and the hospital. "There is no need the families have that we cannot provide them," Scudder said.
The liaison team ensured that mothers and fathers rested enough and ate regular meals. Israel Tamez and his wife, Ramona, of Victoria, Texas, stayed at a guesthouse about 150 feet from the hospital. They visited their son, Pvt. Willy Leos of the 2d Battalion, 504th Infantry, as often as possible, which usually meant two daily visits, each limited to a little over two hoursa precautionary measure due to the concern about infection. Sleepless nights made the parents tired, but they were thankffil that their son's hospital stay would be only about three weeks.
Importantly, the liaison team boosted the morale of the families. Capt. Michael Guthrie, a team member, realized immediately how it helped them "to see a beret like their son's and recognize the shoulder patch. They see a beret and they feel more comfortable," he said. "It's like we're their second family."
On 30 March Brig. Gen. Michael Canavan, the 82d Airborne Division's assistant commander for operations, delivered maroon berets in sterile plastic bags--another precautionary measure against infection--to the injured paratroopers at the USAISR burn unit. The berets, donated by the U.S. Cavalry store in Fayetteville, were reminders of the support that came "from hundreds of miles away."
A member of the liaison team was always at the hospital, either in the family assistance room or on the burn ward. "These patients are still my soldiers, and I have responsibilities to them," said Captain Scudder. The extra support from the liaison team in taking care of the Green Ramp casualties and their families "made our job easier," reported Major Lawlor. Colonel Stetz echoed Major Lawlor's sentiments: "I have to take my hat off to the 82d.... I think Captain Scudder and the liaison team here have done an extraordinary job, not only in supporting the family members that are there . . . [but] coming up to help support the soldiers...." The presence of "their own people," added Stetz, meant more to the burned paratroopers than anyone else's.
The liaison team helped the burn unit staff to explain the operation of the hospital to the families. Colonels Greenfield and Stetz met with the families as a group to interpret the restrictive visiting hours and the concern about infection. Despite their explanations, about 10 percent of families compla~ned about being kept from visiting their loved ones. "Dealing with the families is a big issue," Stetz said, so Scudder's group "ran interference." Lieutenant Walters remembered that the liaison team explained "what the staff. . . [members were] like and how they worked." Colonel Greenfield believed that the team was "probably the single biggest godsend in this entire operation.... We have a total of fourteen people over there that are basically dealing with the families," she said. Colonel Stetz remarked: "The success of this whole operation has to lie equally with the 82d Airborne Division, not only the Institute of Surgical Research." The presence of Scudder's liaison team at Fort Sam Houston proved to be a mass casualty strategy boon.
Unlike Fort Bragg, Fort Sam Houston had a plan for managing large numbers of casualties. Following that plan, devised initially for DESERT SHIELD/DESERT STORM, the garrison's permanent Army Community Services office, which was housed in the Road Runner Community Center, an old recreational building on post that had out lived its usefulness, would become the Fort Sam Houston Family Assistance Center. The Army Community Services staff already knew how to tap into local community resources to benefit the Army, having stablished a committee for that purpose. 
At 1830, on the day of the accident, the garrison Commander, General Cisneros, instructed Jim Evetts to activate the family assistance center to handle the influx of casualties and families anti to provide support. Evetts immediately established his office at the Road Runner Community Center. Also to help the families of victims, Cisneros opened a military travel assistance section at the San Antonio airport.
Evetts relied upon Rita Dalton, the Army Community Services chief, and her staff. Army Community Services normally optrated on an eight-hour basis, Monday to Friday, and provided a vanety of assistance, to include relocation, family advocacy, emergency relief, and volunteer support. During an emergency the office was manned twenty-four hours a day. Once notified of the accident, Wilson Apkarian, the director for community and family activities at Fort Sam Hokston, and Kathleen Curd, his assistant, joined Evetts, and they worked through the night getting the assistance center ready to receive the families of the injured soldiers.
Following a well-planned and well-rehearsed guide, used whenever the USAISR burn unit received an influx of burn casualties, Evetts Apkarian, and Curd hooked up extra phone lines for the use of the famihes and, in the Road Runner auditorium, set up workstations for the various services. They placed signposts, with directions for family members, at strategic locations and had an 800 line installed for relatives to use to inquire about patients. They also initiated a flow of information from the Womack EOC, compiled phone lists, and began bringing in extra staff.
Staffing the family assistance center was a team effort. The garrison commander provided a duty officer, two paid civilians, chaplains, family advocates, and Army Emergency Relief and PAD personnel. The American Red Cross sent its representatives, and space was set aside for the 82d Airborne Division liaison team. Civilian and military volunteers manned every shift at the center. "So we were all co-located. It really expedited communication," remembered Kathleen Curd.
Volunteers offered their services from day one. Jim Evetts remembered "over 100 phone calls" the first night from people donating lodging, transportation, and time. The family assistance center staff kept a master list of those individuals who offered assistance "so that we could call on them when we needed their help," recalled Linda Thomas, installation volunteer coordinator and community programs manager for Army Community Services. Volunteering was on a rotational basis so anyone who offered support was "given the opportunity to do so," she said. Volunteers arranged transportation, manned telephones offered child care, brought in food, and assisted in the center's kitchen They even provided a listening ear. "We . . . [were] very careful to match our volunteers' experiences and skills to specific needs of the families so that we best use[d] the volunteer support to meet the famihes' needs," said Thomas. More than 200 volunteers, many of them Army wives or retired military (San Antonio's retired military population is the second largest, next to San Diego, in the United States) worked at the center during the emergency.
The Road Runner auditorium also became a home away from home for the families. They gathered for tea, shared emotions only they could understand, received Red Cross comfort packages, and brought m children for day care. They marked their names and hometowns on a map on the wall; two families discovered they lived only 15 miles apart. They picked up free passes to Sea World' the Alamo, and other ventures offered by businesses in town, as well as signed up for the activities they wished to undertake. Easter dinner was also held in the auditorium: "The most incredible thing to see is how the families in the auditorium have come from being individual families to one collective family. They're truly a family unit. And that's what the auditorium was designed to be," said Linda Thomas.
General Claypool took additional steps to help the families of the Fort Bragg soldier patients. He authorized a thirty-day exemption from the surcharge for eating at Brooke's dining facilities, and he provided free supplies of prescription medicines until other arrangements could be made. According to General Steele, Claypool "bent the rules" in the interest of the burn victims and the next of kin.
Helping the families was a San Antonio community effort as well. As the families started arriving, local and area businesses and volunteer agencies provided food and other supplies to the Fort Sam Houston Family Assistance Center. Coca-Cola Bottling Company of the Southwest contributed beverages; Pace Foods, salsa; Frito-Lay, chips; Albertson's, cookies, as well as more drinks and chips; Dunkin Donuts, a variety of donuts; and the United Services Organization, luncheon meat. H-E-B Grocery offered gift certificates for food, and Texas Copy donated a fax machine. The family assistance center received from the garrison exchange overnight guest packets and from the library over three boxes of books plus more than $300 worth of books-of-choice coupons, redeemable at a local bookstore. Finally, the San Antonio Military Family Service Board, which was instrumental in getting the Chamber of Commerce involved, helped the San Antonio retired military community rally around the accident victims.
By 25 March the Fort Sam Houston Family Assistance Center was assisting nineteen families. Lisa Kelley, who had joined her husband, Sergeant Kelley, on the evening of the twenty-fourth, was in a state of shock after learning about the severity of her husband's condition. She was surprised at how well the Army took care of her, but most thankful. As she later recalled, "I've had everything provided for me that I've needed, down to toothpaste.... There was always someone there willing to helpthe people at the community center, the Red Cross volunteers, the chaplains, the ACS [Army Community Services] volunteers, . . . the Army liaison team." Linda Thomas remarked on "how incredible it was to witness a post located in one state and a post located in another state literally come together and take care of an immediate need." Fort Bragg also was pleased with the way in which Fort Sam Houston took care of the paratroopers' families.
Once alerted, the public affairs offices (PAO) of Brooke Army Medical Center, Health Services Command, and Fort Sam Houston Jomed forces in executing the public affairs annex to the Fort Sam Houston mass casualty plan. They shared information with their operations centers and maintained contact with the public affairs offices of the Department of Defense, Department of the Army, Womack Army Medical Center, the 82d Airborne Division, and the XVIII Airborne Corps. The Fort Sam Houston public affairs officers met at 0430 on 24 March to coordinate assignments and responsibilities in preparation for the arrival of the burn patients. Their goal was to contain the press while providing ample opportunity for coverage.
According to policy, photographs of the patients' arrival were permitted; however, zooming in on their faces was prohibited, to protect their privacy and that of their families. By and large, the news media cooperated, and the public affairs officers disseminated timely mformation' in the form of patient updates and press releases, and arranged additional photo opportunities. The different public affairs offices coordinated all news activities. The reporters were allowed to talk to volunteers from the families, interview physicians and operations officers, attend press conferences in one of Brooke's waiting rooms, and cover the visits of dignitaries.
In general, the military got along well with the reporters, who were mainly from the San Antonio area. Because San Antonio was a m~l~tary town, most understood the soldier mentality and accepted the ground rules and restrictions involved in public affairs. They also knew that patients came first and news came second. As a result, the military and the press worked as a team on the coverage of the mass casualty at Fort Sam Houston.
Despite the positive relationship, some difficulties were evident. The Brooke PAO was understaffed, considering the volume of public interest in the disaster. Clerical and office support were needed, yet unavailable. Public affairs officers not employed by Brooke occasonally spoke for the hospital, but without the knowledge of the Brooke PAO. Finally, reporters had a tendency to gather outside the family assistance center, which caused traffic jams. Because of the traffic problem, Colonel Nolan later recommended that a media center be established "at the Officer's Club or some other area that would permit more controlled access and alleviate the need for extra military police for traffic control."
After learning of the accident, Brooke's chief of ministry and pastoral care, Col. Paul W. Dodd, placed all chaplains on alert anticipation of an influx of burn casualties from Fort Bragg. To oversee Brooke's ministry and pastoral response, Dodd appointed Maj. Michael T. Curd, the senior chaplain clinician, as Team Alpha leader. Curd, who was married to Kathleen Curd of the family assistance center, reviewed the chaplains annex to the hospital's emergency preparedness plan and worked out individual assignments and responsibilities. Each chaplain was to support four or five casualties and their families, as well as be on hand at assigned locations to comfort not only the soldier patients as they arrived but also the staff. Chaplains were to perform informal debriefings and spiritual healing whenever and wherever possible.
The ten chaplains of Team Alpha received their assignments from Major Curd at a meeting held at 0745 on 24 March in the Brooke EOC. At 1830 they attended a family support conference in the Fort Sam Houston Family Assistance Center. At the session Lt. Col. Anne Schwartz, the USAISR psychiatric nurse clinician, discussed how to prepare family members for what they were going to see and how to provide them with emotional support.
Fifteen minutes before the arrival of the first C-9, Team Alpha members went to their assigned locationstwo in the emergency room and eight in the USAISR burn unit. The casualties were brought to the main hospital, where a chaplain greeted and talked to each injured soldier and the accompanying medical staff. As soon as the patients were littered upstairs, another chaplain debriefed the litterbearers, who had never seen people so injured, so burned before," and as each casualty entered a room on the burn ward, another chaplain was there to reassure him and the medics with him. Within one hour every patient had been visited by a chaplain, and the Catholic patients had received the sacrament of the sick. The chaplains continued to visit their assigned patients until they were settled and their arrival procedures were completed. The same strategy was followed for the casualties that arrived in the following days.
A chaplain always talked with family members first and then accompanied them to the patient's side. Family members, who wore gowns, masks, and shower caps, were told to touch the casualty and to act normally and positively, if possible, for burn patients "feel ugly, . .feel totally alone." "They're alienated from the world as they knew it," said Chaplain Curd. Family members were advised not to show their emotions until they had left the patient's room. Once outside, they experienced a considerable emotional release, and the chaplains were there I to help them. Curd and other Team Alpha chaplains had been trained to deal with the special problems of burn victims and their families. Military chaplains remained available to family members on return visits to the USAISR burn unit.
Brooke's chaplains attempted to debrief the Fort Bragg soldier patients as soon as possible and attended family debriefings held at the main hospital. Garrison and unit chaplains staffed the Fort Sam Houston Family Assistance Center around the clock on a rotating basis. Also helping were twenty-eight chaplains temporarily at Fort Sam Houston for the trauma and crisis response team training course, which Chaplain Curd was teaching. Ultimately, a network of coordinated pastoral care took place at Fort Sam Houston, with chaplains from the Fifth U.S. Army, the garrison, the Army Medical Department, Fort Bragg, and the 82d Airborne Division participating.
Initial evaluations of the Fort Bragg soldier patients were made difficult by a lack of psychiatric support. The USAISR burn unit had only "one psychiatric nurse," Colonel Schwartz, who "could not handle it all," according to the outspoken Colonel Greenfield. As chief nurse, she made arrangements to have two psychiatric nurses from the Army Medical Department Center and School to help Schwartz in the afternoons and relied on the staffing agency under contract with Brooke to find a third nurse to come in for a few hours in the evenings. Greenfield believed that a mechanism for handling psychiatric evaluations of patients needed to be written into the hospital's emergency preparedness plan.
The combined response of the U.S. Army Institute of Surgical Research, Brooke Army Medical Center, and Fort Sam Houston demonstrated the effectiveness of training, experience, and planning. The highly capable USAISR burn teams and staff members successfully managed the Green Ramp casualties during their medevac flights and during their stay in the burn unit. Although the increased risk of infection due to multiple visitors was a matter of concern, the visits of dignitaries and the presence of the 82d Airborne Division liaison team boosted the morale of both the burn victims and their families. Mass casualty planning guided Brooke's departments and Fort Sam Houston's agencies in responding effectively to the crisis. Chaplains and medical and family support staffs dispensed essential services to the Fort Bragg soldier patients and their families, and public affairs officers afforded opportunities for coverage by the press. Brooke's emergency operations center provided not only accurate and timely information but also coordinated activities with garrison agencies. The survivors benefited from the teamwork in San Antonio, and this kind of dedication marked the sustained treatment ongoing at Fort Bragg and Womack Army Medical Center.
 Interv, Col Mary T. Sarnecly with Brig Gen Robert G. Claypool, 8 Apr 94 (hereafter cited as Claypool Interv).
 Quotation from ibid. See also Memo, Lt Col Gerald Nolan, Chief, Plans, Training, Mobilization, and Security Division, BAMC, to Chairman, Emergency Preparedness Committee, 25 May 94, sub: After-Action Review for BAMC Mass Casualty (MASCAL), 23 March 1994 (hereafter cited as Nolan Memo).
 Nolan Memo, 25 May 94.
 U.S. Army Institute of Surgical Research Fact Sheet, p. 1.
 Ibid, pp. 1-2.
 Ibid, pp, 2-4, Phil Reidinger, "Injured Bragg Soldiers Arrive Here," Fort Sam Houston News Leader, 25 Mar 94, p. 1.
 Memo, Lt Col Gerald Nolan, Chief, Plans, Training, Mobilization, and Security Division, BAMC, to CG, 82d Airborne Division, 18 Apr 94, sub. After-Action Review of Support for 82d Airborne Division Soldiers (hereafter cited as Nolan Memo); Interv, Lt Col Iris J. West with Maj David Lawlor, 26 May 94 (hereafter cited as Lawlor Interv).
 First quotation from Nolan Memo, 25 May 94, second quotation from Interv, Col Mary T. Sarnecky with Col Elisabeth Greenfield, 8 Apr 94 (hereafter cited as Greenfield Interv); third quotation from Interv, Col Mary T. Sarnecky with Lt Col Charles Stetz, 8 Apr 94 (hereafter cited as Stetz Interv); fourth quotation from AfterAction Report, U.S. Army Institute of Surgical Research, n.d., sub: Response to Pope Air Force Base Accident, p. 2 (hereafter cited as USAISR AAR).
 Nolan Memo, 25 May 94.
 Ibid.; Claypool Interv, 8 Apr 94; USAISR AAR, pp. 6-8; Greenfield Interv, 8 Apr 94.
 Greenfield Interv, 8 Apr 94.
 USAISR AAR, pp. 5-6.
 Lawlor Interv, 26 May 94; USAISR AAR7 pp. 5-6.
 First quotation from Lawlor Interv, 26 May 94; second quotation from Interv, Col Mary T. Sarnecky with Maj David Mozingo, 8 Apr 94. see also Nolan Memo, 25 May 94.
 First, second, third, and fifth quotations from Stetz Interv, 8 Apr 94, fourth quotation from Greenfield Interv, 8 Apr 94.
 Greenfield Interv, 8 Apr 94; "Accident at Pope Has San Antonio Connection," Fort Sarn Houston News Leader, 1 Apr 94, p. 5.
 Greenfield Interv, 8 Apr 94.
 Greenfield Interv, 8 Apr 94
 Stetz Interv, Apr 94.
 First quotation as given in ``Accident at Pope," p. 5; second and third quotations from USAISR AAR, p. 10. see also Nolan Memo, 25 May 94.
 Quotations from Nolan Memo, 18 Apr 94. See also USAISR AAR, p. 9. 24
 Nolan Memo, 18 Apr 94.
 First quotation from USAISR AAR, pp. 11-12; second quotation from Nolan Memo, 18 Apr 94.
 As quoted in Larry Bingham and Kim Oriole, "A Battle To Survive," Fayetteville Observer-Tzmes, 29 Jan 95, p. 7A. See also Interv, Mary Ellen Condon-Rall with Sgt Chr~stopher J. Burson, Sgt Jacob T. Naeyaert, Jr., and Spc Michael P Fletcher, 2 Aug 95 (hereafler cited as Burson, Naeyaert, and Fletcher Interv).
 First quotation from Interv, Lt Col Iris J. West with S Sgt Michael T. Kelley and Mrs. Lisa Kelley, 25 May 94; second quotation from Burson, Naeyaert, and Fletcher Interv, 2 Aug 95.
 Interv, Lt Col Iris J. West with Sgt Jacob T. Naeyaert, Jr., 25 May 94.
 Interv, Col Mary T. Sarnecky with Capt James Mingus, 8 Apr 94. The risk of infection in burn patients is high because broken skin allows bacteria to enter the body.
 Interv, Lt Col Iris J. West with Capt M. Lee Walters and Lt Stephanie Walters, 13 Apr 94 (hereafter cited as Walters Interv).
 Tab L (Brooke Army Medical Center VIP Visits) in Capt Michael Scudder, 82d Airborne Division (FOOD) Liaison Team Smart Book (hereafter cited as Scudder Smart Book).
 Quotations from Interv, Lt Col Iris J. West with Maj Gen William M. Steele, 20 Apr 94. See also Tab L in Scudder Smart Book.
 "Army Chief of Staff Visits Burned Paratroopers," San Antonio Express News 28 Mar 94, p. 6A. One patient was medically incapable of exchanging Hoo-ahs! recalled Phil Reidinger, a Fort Sam Houston public affairs officer who was present during the visit.
 Quotations from Steele Interv, 20 Apr 94. See also Tab L in Scudder Smart Book; Burson, Naeyaert, and Fletcher interv, 2 Aug 95.
 First three quotations from USAISR AAR, p. 11; fourth quotation from Greenfield Interv, 8 Apr 94; fifth quotation from Nolan Memo, 18 Apr 94.
 Walters Interv, 13 Apr 94.
 Nolan Memo, 25 May 94; Claypool Interv, 8 Apr 94.
 Nolan Memo, 25 May 94.
 Interv, Col Mary T. Sarnecky with Capt Michael Scudder, 7 Apr 94 (hereafter cited as Scudder Interv).
 Quotations from Scudder Interv, 7 Apr 94. See also Nolan Memo, 25 May 94.
 Nolan Memo, 18 Apr 94.
 Scudder Interv, 7 Apr 94.
 Larry Bingham, "Burned Soldier, Father Relish Life," Fayetteville ObserverTimes, 28 Mar 94, p. IA; "Army Liaison Team Helps Families of Burn Victims," News & Observer (Raleigh, N.C.), 29 Mar 94, p. 3A.
46 As quoted in Larry Bingham, "Pope Families Comforted," Fayetteville ObserverTimes, 28 Mar 94, p. 7B.
 As quoted in ibid
 First quotation from Scudder Interv, 7 Apr 94; second quotation from Lawlor Interv, 26 May 94; third quotation from Stetz Interv, 8 Apr 94.
 First, second, and fiflh quotations from Stetz Interv, 8 Apr 94; third quotation from Walters Interv, 13 Apr 94; fourth quotation from Greenfield Interv, 8 Apr 94.
 Nolan Memo, 18 Apr 94.
 Interv, Col Mary T. Sarnecky with Jim Evetts, 7 Apr 94 (hereafter ciled as Evetts Interv); Nolan Memo, 18 Apr 94.
 Evetts Interv, 7 Apr 94; Interv, Col Mary T. Sarnecky with Rita Dalton, 7 Apr 94 (hereafter cited as Dalton Interv); Interv, Col Mary T. Sarnecky with Kathleen Curd, 7 Apr 94 (hereafter cited as K. Curd Interv).
 Nolan Memo, 25 May 94; Evetts Interv, 7 Apr 94
 Quotation from K. Curd Interv, 7 Apr 94. See also Tab K ("Fort Sam Houston and San Antomo Open Arms to Injured Soldiers and Their Families," Fort Sam Houston News Release, 25 Mar 94) in Scudder Smart Book; Evetts Interv, 7 Apr 94.
 First quotation from Evetts Interv, 7 Apr 94; remaining quotations from Interv, Col Mary T. Sarnecky with Linda Thomas, 8 Apr 94 (hereafter cited as Thomas Interv). See also Larry Bingham, "They Are Family," Fayetteville Observer-Times, 30 Mar 94,p. 1B.
 Thomas Interv, 8 Apr 94 n Memo 18 A r 94; 57 Quotation from W. Steele Interv, 20 Apr 94. See also Nolan Memo, 18 Apr 94; Claypool Interv, 8 Apr 94.
 Tab K and Tab V (Update for 82d Airborne Division From BAMC82d Liason Team, 4 Apr 94) in Scudder Smart Book; Dalton Interv, 7 Apr 94; K. Curd Interv, 7 Apr 94.
 First quotation from Kelley Interv, 25 May 94; second quotation from Thomas Interv, 8 Apr 94.
 Nolan Memo, 18 Apr 94; Interv, Col Mary T. Sarnecky with Cindy Vaughan, 7 Apr 94 (hereafter cited las Vaughan Interv). Vaughan was the chief of media relations in the U.S. Army Medical Command Public Affairs Office.
 Vaughan Interv, 7 Apr 94.
 Quotation from Nolan Memo, 18 Apr 94. See also ibid., 25 May 94.
 Nolan Memo, 25 May 94; Interv, Lt Col Iris J. West with Maj Michael T Curd, 26 May 94 (hereafter cited as M. Curd Interv); After-Action Review, Maj Michael T. Curd, Department of Mlnistry and Pastoral Care, n.d., sub: Institute of Surgical Research Mass Casualty Operation, 23-31 March 1994, p. 1 (hereafter cited as Curd AAR).
 Curd AAR, pp. 1-2.
 Quotation from M. Curd Interv, 26 May 94. See also Curd AAR, pp; 1-2.
 As quoted in Larry gingham, "Chaplain Aids Victims and Families, Fayettteville Observer-Times, 31 Mar 94, p. 3A. See also M. Curd Interv, 26 May 94.
 Nolan Memo, 25 May 94; M. Curd Interv, 26 May 94; Curd AAR, p. 2.
 Greenfield Interv, 8 Apr 94.