SIOUX CITY | Two factors combined to help ensure that survivors outnumbered victims in the United Airlines Flight 232 crash at Sioux Gateway Airport, a doctor who helped save lives that day said.
David Greco, the Sioux City doctor who headed the triage unit and determined who got sent first to the hospital after the July 19, 1989, crash, said it was "incredible luck" that 300 members of the 185th Air National Guard unit headquartered nearby were participating in drills that day. Additionally, the crash occurred in daylight, which helped emergency responders find survivors in a half-mile stretch of wreckage in a cornfield.
That aided the response during what Greco called "the Golden Hour," the first 60 minutes when people who suffer traumatic injuries typically live or die.
"The debris was incredible. It looked like a war zone," Greco said.
Although 112 people on the plane died, 184 survived, a statistic at which Greco still marvels 25 years after the crash that drew international attention.
More than 400 agencies responded when the DC-10 aircraft flying from Denver to Chicago had mechanical problems and crash-landed at Sioux Gateway. About 100 medical professionals showed up at what was then Marian Health Center, now Mercy Medical Center-Sioux City.
Greco, now 58 and retired in Huntington Beach, Calif., was the hospital's emergency room director. He had come to Sioux City in 1982 and in 1987 founded the Mercy Air Care service, which flies patients by helicopter to the emergency room.
The chaos of Flight 232 started around 3 p.m. when the jet was over Alta, Iowa. An explosion sliced hydraulic lines, making steering almost impossible.
Greco was at home packing for a flight to California to attend a baptism. He got a call about a plane with an engine out, something that happened periodically.
"That's probably nothing," Greco recalled telling his wife. "Keep packing, I'll be back in a little bit." The next hours were a rush like he'd never experienced.
Greco went to the airport, where he heard a flight controller speaking with Capt. Al Haynes, the plane's pilot. Greco recalled Haynes' steady tone in describing the crippled plane's circumstances.
The helicopter crew soon hovered over the airport, waiting for Flight 232. That made Greco one of few to see the horrific crash in real time from a bird's eye view.
"We saw (the plane) hit the runway; we thought he was going to make it," Greco said. But when he saw the plane in flames, cartwheeling and breaking apart, Greco assumed there would be no survivors.
After landing in the helicopter, Greco ran around the wreck's mile-long perimeter to assess the situation. "I saw bodies left, right," he said. Then a flight attendant emerged from the plane.
"I thought, 'My God, somebody is alive.' She just slid out of the tail, other people came down," Greco said.
Assessing the people on the ground, Greco had to quickly decide who would be whisked off to the hospital at once and who would have to wait. Having 40 ambulances from local municipalities lined up helped relieve the pressure.
"It was a big relief off me, because I'm not good at playing God," Greco said.
In addition, emergency officials, 185th soldiers and others were working fast to get help where it was needed.
"Everybody was working on adrenaline. Everybody's ears were open," Greco said.
The helicopter made two runs with two people each to the hospital, with Greco piloting the second of those. Another 36 patients went by ambulance.
At Marian Health Center, Verna Welte and her staff were ready.
"I don't think it could have gone any better. I think the patients would say the same thing, that they were well taken care of," said Welte, who was vice president of patient care services.
"Not to sound haughty -- because it wasn't me, it was the staff -- but the impression was that we did it right," said Welte, now 80 and retired from a 42-year nursing career.
Welte had been in a meeting when the call about the disabled plane came in. The hospital's disaster plan went into effect immediately, and a command center was set up in the physician's lounge of the emergency room.
The daytime staff who typically left at 3:30 p.m. were told to stay. Nurses were told to free up beds by discharging any patients who could go home earlier than they might have.
One of Welte's most lasting memories is of when the first patients arrived.
"I will never forget this. The hallways were fully occupied by doctors who have left their practices and brought their nursing staffs with them," she said.
They worked through the night, administering critical care for head and chest wounds, burns, broken limbs and concussions.
"You saw a lot of blood. Their appearance was such that you knew that they had been through a lot," said Welte, whose role was to oversee staffing. She didn't personally administer treatment.
The injured kept arriving in waves, but Welte said the hospital had enough materials, medicines and personnel to treat them all.
"(Nurses) did what needed to be done. They didn't go through the bureaucracy of questioning. They stepped up. They saw what had to be done and they did it," Welte said.
Outside the hospital, area residents lined up to donate blood, and others sent food for nurses working extended shifts.
The ranks of those needing attention soon swelled with the arrival of patients' relatives and national news media members.
The last patient was discharged from Marian after eight weeks.
Meanwhile, a receptionist for the former Terra Industries in Sioux City was helping process information about the deceased. She didn't have a medical background, but she had a keen eye for detail.
"I worked the morgue for two and a half days," recalled Patricia Collins, now 73, of Sioux City. "It was a phenomenal experience."
She said the work was "emotionally heavy" but also rewarding. Each evening she would talk about it with her husband, Dick Collins, a member of the 185th who was at the crash scene.
"I am a very strong person. I am a strong Christian and a strong Catholic. I was stone when I was there. I didn't shed a tear," she said.
One case still tugs at her heart, though. It involved a girl of about age 9 with painted fingernails and wearing friendship bracelets.
"That little girl, I think about her today. I just wish her parents know what good care we took of her, as we did with them all," Collins said.
For Welte, too, the emotion came not in the midst of the all-consuming response to the crisis but later, when survivors and family members gathered for a 1990 crash memorial at the hospital, attended by survivors and family members of those who died.
"That was more of a tear-jerker than the day it happened. That was emotional, very emotional."