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Chicago Emergency Center Designed for Mass Casualties

CHICAGO -- Open one of the little hatches secreted within 10 of the 12 gray pillars in the Edward A. Brennan Entry Pavilion -- aka the lobby -- of the Tower, opening Monday at Rush University Medical Center, and you peer into a world of future horror that most Chicagoans never consider but a team here has been thinking about for years.

What you see looks ordinary enough -- a red electrical outlet marked "Critical." One port labeled "Oxygen" and another labeled "Vacuum."

"In a disaster, this becomes forward triage," said Dr. Dino Rumoro, chairman of emergency medicine at Rush. "We have hundreds of people coming in; this would be the place you see them first."

That the lobby of the $654 million, 304-bed Tower can transform into a field hospital is just one way the adjacent Center for Advanced Emergency Response -- aka the ER -- can ramp up for mass casualty events. The center, 1653 W. Congress, opens before the Tower, at 6 a.m. Friday, and bristles with hidden design elements waiting for disaster.

The floor of the extra-large ambulance bay, which can unload five full-sized ambulances at once, slopes to a drain, so water that is contaminated by washing down patients can flow into a 10,000-gallon holding tank under the floor and not into the city sewer system.

"Post 9/11, the United States was hit with the reality that bad things can happen on our soil and it can be to a large magnitude," said Rumoro. "A biological attack is scary. Chemical attacks are scary, too."

If you think dirty bombs and weaponized plagues are the stuff of Michael Crichton novels, you haven't been following the headlines. Researchers at the University of Wisconsin-Madison and elsewhere developed an airborne version of the bird flu considered so dangerous that the U.S. government has sought to limit publication of their findings in scientific journals to reduce the likelihood of genetic techniques falling into the hands of terrorists. But the likelihood is there.

Add that to dirty nukes. And anthrax. "We said, if we are going to build a new facility, let's think about the worst case scenario that can happen in the city," Rumoro said.

Thus a ventilation system that can seal off any or all three pods of the center and create negative air flow, to keep pathogens from escaping, and allows use of charcoal filters. A special room with deluge showers right off the ambulance bay. Cameras everywhere. A VIP room, designed with input from the White House medical staff, to deal with patients who must be both treated and protected. Each room in the center has a pair of medical outlets - for situations where patients are forced to double up.

Of course, the center will spend the bulk of its efforts, one hopes, on typical emergencies: broken legs, heart attacks. But even then, it's state-of-the-art. The center has two enormous $2 million dual energy CT scanners. The door handles in the psychiatric unit rooms point downward, to reduce the opportunity for suicide by hanging.

And yes, there is PR in the ER. Signs read "Family Lounge," not "Waiting Room."

"We don't like the word 'Waiting,'' said Rumoro.

It's odd to walk through a brand new hospital, to see never-used, red, plastic biohazard bins and pristine blue mattresses, to squint your eyes and try to imagine all the ordinary pain and suffering that will pass through these halls in years to come, then try to imagine the unimaginable. Unimaginable to most; Rush spent seven years planning this facility, contemplating what calamities might someday befall Chicago.

Readiness is expensive. Rush used grants from the departments of Defense and Energy as well as private sources. The white, butterfly-shaped Tower, prominently visible from the Eisenhower Expressway, is itself part of a decade-long, $1 billion redevelopment, the largest in Rush's 174-year history.

If the threat never becomes real, some might see this as wasteful. Some gripe about airport security, forgetting how 19 terrorists breezed by on 9/11. I thought of Shakespeare.

"If it be now, 'tis not to come," Hamlet says. "If it be not to come, it will be now. If it be not now, yet it will come, the readiness is all." Readiness is good whether used or not.

"I prefer it never be used, to be honest with you," Rumoro said.



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