Feb. 4th, 2017

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Before Firecracker Day, there were about eight hundred critical burn beds on the West Coast of the United States. Three days ago they were full, but mostly occupied by unlucky adults.

Today the remaining six hundred beds are full and to overflowing, and every single one is occupied by a child.

They are the lucky ones. Too many children, thousand and thousands, more than can be borne to think about, were killed instantly in and around San Francisco and Millbrae. Others took painful hours to die, of blast or burns or radiation, or all three. Best not to think of them.

The survivors have been triaged - sorted - three times. Children who were expectant, a grisly euphemism for 'expected to die shortly' - were left with their parents, who would care for them as best they could and at least be there for their passing.

Children who were lightly injured, or suffering from unknown radiation injuries, were also left with their parents, or evacuated to makeshift orphanages. One of these is the CalExpo center in Sacramento, and a venue more accustomed to car and RV shows is instead just as full of orphans.

Time will tell. Radiation sickness is a game of numbers: how many days to onset of symptoms? How many days of function before the second decline? How many transplant teams (few) and how much bone marrow (not enough)? Then for the survivors, the second game, the cancer lottery, and the third, immune system collapse. These would be later, months and years.

Where are the adults who were in those scattered beds, burned in peacetime by accident before Firecracker Day? A lucky few were whisked away to more remote hospitals, where this would not interfere with rescue operations. Some will survive in conventional hospital beds, although in great pain and horribly scarred. But most will die within days, dead that others who need a greater chance might have it. They weren't asked. They were just... moved.

Children heal well. Children need more care but use less consumables, especially medications and plasma.

Children are a higher ratio of lives per pound.

The 'Air Bridge' of medical evacuation helicopters is fed from Stanford, Childrens at Oakland, Santa Rosa and Walnut Creek. Civilian medevacs and crews have been flown in from across the continent. They feed into Fairfield.

There, the military medical evacuation system takes over. At least that was the plan.

Instead, both military and civil airlift has been retasked to the far more important task of preventing the next San Francisco, the next Millbrae. They are flying troops into airheads in China, where American forces are outnumbered hundreds to one yet killing dozens for each soldier they lose.

So instead, UC Davis has stopped being a college campus and has become a medical city, a barracks of broken bodies. Sophomore biology students are ICU nurses now. Anyone with hands can change a dressing or empty a bedpan.

There is one last desperate sorting. Not by paramedics, not by overworked doctors, but by experts in pediatrics and trauma and radiation medicine.

The children who will survive anyway are diverted to Sacramento hospitals. There the long work of rehabilitation can begin. (Next year, America supplants Cambodia as the largest consumer of child prosthetic limbs in the world.)

The children who will die anyway are sent to the State Hospital at Vacaville. The psychiatric nurses are accustomed to giving painkillers and psychotropic medications. (The former adult patients were given a swift, stark choice: volunteer for Army Shock Troops - penal battalions - for immediate China deployment, or be shot.)

The middle range, the children who might survive with adequate care, are sorted again. The superb military burn center at San Antonio, Texas is a painful three days by improvised hospital bus away.

The others are cared for at UC Davis, until they are well enough to survive the bus trip or sick enough to send to Vacaville.

There are still thousands of them.

But there are tens of thousands to care for them.

Many children cannot be saved. But no more will have to die alone.

###

Approved for distribution, Pritchard.

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