West, Texas, fertilizer explosion: DO first responder reflects on recovery, 5 years later

Last month, the residents of West, Texas, gathered to mark the anniversary of the fertilizer plant explosion that killed 15 people, wounded over 200 and destroyed many homes and businesses in the town. People in the roughly 2,800-member municipality have gotten together every April since the blast in 2013. But this year’s commemoration felt different, says George N. Smith, DO, West’s EMS director, who coordinated the emergency response to the explosion.

“It was our five-year anniversary—it’s time to move on,” he says. “The other anniversaries have been about honoring the people who died, and we will never forget the dead. But this anniversary was about recognizing that it’s time to move forward.”

The residents of West are moving forward in a newly built town, complete with a new high school and new baseball and softball fields. West has been injected with a fresh sense of hope and optimism and has seen over 75% of its residents who left after the explosion return, Dr. Smith notes. In this edited Q-and-A, he discusses the explosion’s aftermath, recovery efforts and how he himself has fared.

The cause of the explosion was a fire at the fertilizer plant, but the cause of the fire remains a mystery. However, the Federal Bureau of Alcohol, Tobacco, Firearms and Explosives eventually ruled that an arsonist started the fire. What do you think?

All I’d like to say is that the majority of West residents do not think the fire was caused by arson.

Your family medicine practice and home were both badly damaged after the explosion. How did you get them restored?

My house was essentially destroyed—all the builders kept from it was the slab, so it was completely rebuilt. My practice was reconstructed in October 2015, mostly with insurance money. But it cost a lot more to rebuild than my insurance would cover. I was involved in a lawsuit against the fertilizer manufacturer, and I was able to use some of that money to cover the excess. The Texas Osteopathic Medical Association also set up a practice recovery fund for me, and I received around $50,000 from that. I also received around $3,000 from the American Osteopathic Foundation (AOF).

How has practicing medicine changed for you since the explosion? So many of your patients were injured in the explosion.

Physically, most of my patients have recovered. Mentally, there’s still a lot of post-traumatic stress disorder. I advise people to talk about it, not to keep it in. When you hold it in is when you get into trouble.

We’ve had a psychologist come to town and meet with people, to make sure anybody who needed help could get it.

I’m still the EMS medical director for West. I was also on a committee of community leaders who were helping organize long-term recovery efforts. We held several general town meetings where we talked about how to deal with stress and where to go if you needed help.

What about your personal recovery?

I was in the nursing home when the explosion happened, and it collapsed. The roof of the building landed on my head and neck. I’ve had two neck surgeries since. There’s no proof that the explosion caused my neck issues, but I never had neck problems before.

I’m 70 years old, and I’m feeling my age. But overall, I feel optimistic about the community. My patients have been wonderful. They don’t want me to retire. And I plan to keep working as long as I can.

Have you developed any coping mechanisms to deal with the trauma of what you went through?

I’ve done a lot of speaking nationwide about the explosion and disaster response. I feel better knowing that because of what happened in West, I can teach physicians and other first responders how to handle these situations.

I’ve spoken at OMED, other osteopathic medical association meetings, and other emergency management meetings, including the Minnesota Governor’s Homeland Security and Emergency Management Conference, where I was the keynote speaker.

In Minnesota, a lot of people said to me, “The pictures of your town could be my town, and the things you told me to do to be prepared, I’d never thought about.”

I tell first responders to make sure they know where to get tires and who can change tires in the middle of the night. After the explosion, we had eight people up all night changing flat tires on our fire trucks. They kept getting flats because of all the debris on the roads.

Also, people need to have a disaster plan in place that they’ve rehearsed. In West, we basically took our tornado plan and used it. Because it was like a tornado had torn through half of the town.

How have your efforts following the explosion been recognized?

I was named the EMS Medical Director of the Year for the state of Texas for 2014. I was named Family Physician of the Year by the American College of Osteopathic Family Physicians last year. My school, the Kansas City University College of Osteopathic Medicine, named me Alumnus of the Year in 2013.

What advice would you give to DOs and osteopathic medical students?

I would advise everybody to get some disaster training, especially if you are in a small town. If you are a doctor in a small town and there’s a disaster and outside help can’t get there right away, you are going to have to do disaster management and help people, because you’ll be the best-trained person in town to help people medically.

More stories on disaster response:

‘This could happen to you’: Lessons learned from explosion in West, Texas

DO at center of West, Texas, explosion recounts night of horror

Responding to tragedy: Physician subspecializes in tactical medicine

Disaster Response 101: 5 top tips on being ready for the unthinkable