BMJ  2005;331:167 (16 July), doi:10.1136/bmj.331.7509.167

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PERSONAL VIEWS

"Are there any doctors here?"

As soon as I heard the bang, I knew it was a bomb. Thunder doesn't sound that brutal or shake the building like that. At the time I was in a meeting room in BMA House with a visitor to the BMJ. "That's a bomb," I said, as my visitor and I leapt from our seats and ran out into the main editorial office. Everyone was rushing to the balcony to see what had happened. Even before I got close to the edge I knew from the contorted expressions etched into the faces of my friends and colleagues looking down on to the street two floors below that it was something horrific. Some of them were wailing. I peered over the edge for an aerial view of a most sickening scene. The roof of the crippled bus—the number 30 that was destroyed in a terrorist attack in Tavistock Square last week, right outside BMA House—had been ripped off like the lid of a sardine tin. Debris, bodies, and body parts were strewn across the road. In the eerie, smoky silence, a few people wandered in the street, dazed and bloodied. Our ordinary, leafy London square had become a battle-field. None of us could bear more than the briefest of glimpses.

My 12 year old memories of accident and emergency came flooding back

We didn't need a fire alarm to tell us to get out fast. The first instinct was to get away from any danger. Afraid and nauseous, heart pounding, I escorted my visitor down the fire exits to the back of BMA House. Among the relative safety of the crowd now gathering at the rear of the building, it dawned on me that as well as being a frightened editor and family man I was also a doctor. Of sorts. A former general practitioner to be precise, several years out of practice and not registered with the General Medical Council. Shouldn't I be helping? Could I really help?

Before I could make the decision to roll up my sleeves, it was made for me. "Are there any doctors here?" yelled a woman with a walkie-talkie and a fluorescent yellow jacket. "Yes, here," I barked back automatically. Somehow three injured women had staggered from the scene of the blast to the back of the building. A colleague (another former doctor), my visitor (a junior hospital doctor), and I set to work.

I made straight for a young woman soaked in blood from a head injury. Someone handed me a first aid box. In an instant, my 12 year old memories of accident and emergency came flooding back. It was the metallic smell of blood and the whiff of my latex gloves that hit me hardest, but the trauma basics and roadside manner seemed almost as hard wired. I'm still rubbish at bandages. After my best attempt at a systems check without any equipment, we escorted our walking wounded back into BMA House and helped to clear a large lounge (the Hastings Room) into a makeshift receiving room. With our patients shocked but stable, we turned our attention to the courtyard of BMA House and the mayhem in the street beyond.

Small clusters of doctors and paramedics were crouched over several serious casualties who had been carried into the courtyard on improvised stretchers. Many already had intravenous drips and stabilised cervical spines. Some were writhing in pain. Others looked ominously still. Doctors of all pedigrees were there—a group of GP trainers here for a meeting, BMA committee doctors, doctors on the staff of the BMA and BMJ Publishing Group, and some others I didn't recognise, who I think were from nearby hospitals. Many had been working bravely on the front line in Upper Woburn Place, the street that runs between Euston Station and Tavistock Square along which the bombed bus had been travelling.

It seemed clear who was in charge round each casualty, and although there were many weary looking faces, there was a wartime spirit, determined and supportive. My role now was as human drip stand, bag changer, stretcher bearer, patient comforter, log roller, and wound dresser. In the Hastings Room patients were prioritised efficiently and shipped out as soon as the ambulances were ready.

It seemed like an age, but it was only about two hours since the cruel blast and it was time to clear up. We couldn't use our mobile phones in the early stages; now, finally, was the time to be a family man again and phone loved ones at home to tell them that I was safe. Not everyone was so lucky.

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BMJ geaston{at}bmj.com

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Another personal view relating to the bus bombing outside BMA House is available on bmj.com

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