Critical Care Doctor Assists After Reno Air Show Crash

Many of us have heard the phrase, "the right place at the right time.” This was the case for David Norton, MD, assistant professor in the division of pulmonary critical care and sleep medicine and director of the Medical Intensive Care Unit at UC Health University Hospital. Norton was in attendance at the Sept. 16, 2011, Reno Air Race, where a P-51 Mustang crashed into a crowd of spectators, killing 11 and injuring 66, according to news reports. With his extensive medical training and 14 years of experience as a lieutenant colonel for the United States Air Force, Norton jumped in to help paramedics tend to those needing medical assistance. Below, he relays his vivid account of the events.

"My father and I have attended the National Championship Air Races, held every September, in Reno, Nevada, for several years. It is the only event of its kind in the country and is truly a fantastic spectacle. Airplanes from all over the world are brought out to race around pylons that outline a circular course across the desert floor. The fastest class of aircraft, the unlimited aircraft—which are all modified World War II aircrafts—average 450 to 500 miles per hour, flying wingtip to wingtip as low as 100 feet off the ground …

"It is a dangerous sport, to be sure. Every other year or so, there’s an accident. Two years ago, there were three or four accidents over a few days. Pilots understand the risks of the event and work hard to keep the event safe. They train all year to fly at Reno …

"On September 16, my father and I were at the Air Races all day. We spent a while in the pits looking at the airplanes. One in particular was a heavily modified P-51 that I don’t remember from previous years. It was completely silver and very shiny and notable for the lack of an air scoop underneath—the stock P-51s from WWII all had a scoop underneath to allow engine cooling. The scoop had been removed to decrease drag and a new cooling system had been added for the engine. The name of the airplane was ‘The Galloping Ghost,’ and I thought it quite unusual and spent some time with my dad looking at it late that morning. ‘The Galloping Ghost’ flew in 2010 at the Air Races, but I was deployed with the Air Force last year; previously, as a much less modified P-51, this same aircraft had raced many times at Reno since the event started.

"On the last race of the day, the fastest unlimited aircrafts were scheduled to fly. It was a Friday ‘Unlimited Gold’ race—they needed to do well to have good qualifying times going into the weekend’s races. I called my wife, Lisa, and 3-year-old son Benjamin to say goodnight to them right as the airplanes were just about to enter the course. They took off several minutes before my call and flew out into the distance well behind the stands. Just before each race, approximately eight aircrafts are lined up abreast and fly in a long, straight line with a chase plane off to the side serving as a race supervisor. As they were ‘coming down the chute’ toward the course, I said goodnight to Lisa and Benjamin just as we could hear the familiar cockpit audio from the chase plane say, ‘Gentlemen, you have a race,’ the command they always give if the aircraft are lined up properly, at proper speed and altitude just before entering the course. Suddenly, the aircraft came thundering by off to our right, accelerated in a controlled descent and started racing on the course. The first two laps were uneventful—a P-51 named ‘Strega’ was in first, another named ‘Voodoo’ was in second and a modified Bearcat named ‘Rare Bear’ was in third followed very closely by ‘The Galloping Ghost.’

"As the airplanes were coming around the last pylon of the third lap, both ‘Strega’ and ‘Voodoo’ were a good bit ahead of the others and each was flying alone. ‘The Galloping Ghost’ was high and ‘Rare Bear’ were low as they came around the last pylon, which is about a mile to the left of the grandstand area where my father and I were standing on the second to highest level. What happened over just a few seconds still stands out in my memory as if it took several minutes, but in reality, it was almost no time at all.

"When airplanes have trouble at Reno, they are instructed to go wings level and pull up which allows them to trade speed for altitude, giving them more time to troubleshoot any problem, reassert any control over the aircraft that may be necessary and find a place to land the plane—generally on the airfield, occasionally in the desert—safely and away from the Air Race crowd.

"As ‘The Galloping Ghost’ was coming around the final pylon, I saw his wings rock slightly and then the plane jerked up aggressively, and the plane began to climb. I said to my dad, "What in the world is he doing?" as I noticed that the direction he was pulling his plane up was heading toward the grandstand area. You never declare a Mayday at Reno and pull your plane up over where the crowd is. I watched as the airplane began to roll as it was pitching up. It was then that I knew he was going to crash and that he was not in control of the plane. I thought his energy was going to carry him far behind the stands and that he was likely to crash in the parking lot over our shoulders.

"Just as the plane was completely inverted, he was canopy down just above our heads perhaps a few hundred feet. I remember seeing the sun bounce off of the silver aluminum body as the airplane arched over and was now pointed directly at my father and me. It was a very strange feeling because I remember thinking very distinctly, "I’m going to die now." It was clear that the airplane was going to hit us specifically; at a minimum, it was going to take out the entire grandstand I was currently standing at the top of. There was no great epiphany, no ‘life flashing before my eyes,’ no fear, no nothing. Not even an instinct to move. All I could do was freeze, stare at this plane now pointed at me and just accept.

"There had been a crosswind from our backs most of the day, which is common in Reno late on warm afternoons as it oftentimes is out there in September. As the airplane came toward us, it drifted ever so slightly forward and crashed approximately 50 yards away from us. It was a horrible sight to see as it plowed right into a private box seating area on the tarmac just in front of the grandstand. There was a simple, loud crack followed by the sound of metal debris hitting forward of the impact point and then, for a brief second or two, silence. All of us were stunned by what we’d just witnessed. Then, commotion and movement occurred everywhere.

"Several of us with medical training went down to the crash site to help any living victims. Several people clearly were not alive and were beyond help. The airplane was completely unidentifiable, reduced to small scraps of metal scattered forward of the impact point and what appeared to be part of the engine block half buried about two feet deep in the asphalt at the point of impact. There were a number of traumatic amputations that we used belts for as tourniquets, a few obvious head injuries and many people with penetrating trauma from the debris. There were a surprising number of ‘walking wounded,’ many more than I would have expected.

"The local EMS support was fantastic. They rapidly and professionally set up three triage points for the wounded: immediate transport/severe injuries, moderate injuries, walking wounded. I spent most of my time, after we had put tourniquets on all of the traumatic amputations we could identify, helping carry the more severely injured patients to their triage point and helping get them into ambulances.

"The air race announcers were the unsung heroes of the day. Their broadcast area was a series of tables at the base of the grandstand perhaps 20 or 30 feet from the airplane impact point. They were back on the microphones immediately after the accident. In as calm of a manner as can be imagined, they directed spectators away from the accident site and gave instructions to leave the airfield. The announcers really instilled a sense of direction to several thousand spectators who needed it …

"In all, every casualty was en route to a hospital within 62 minutes. So far, a total of 11 people have been identified as fatalities with perhaps 50 to 70 other significantly injured people. It could have been much, much worse. I credit the EMS and announcer response for really driving as much positive out of a tragic situation as possible.

"My father and I spent most of the rest of the weekend in San Francisco before flying back home three days later. It was good to be able to talk through things with someone who was there with me. I suspect most people in their lives experience some kind of event like this, be it a car accident, service in the military, etc. It is really difficult to explain it to others. I just hope that the number of people out there who understand what I’m talking about remains as small as possible …”