Three Medical Breakthroughs That Can Be Traced Back to a Tragic Nightclub Fire

Four hundred ninety-two people died as a result of the horrifying fire, an unprecedented death toll that led physicians to make unprecedented innovations

The interior of the Cocoanut Grove nightclub after the fire. Flickr

When fire swept across the dance floors and bars of the Cocoanut Grove nightclub, the emergency exits were locked (according to some accounts, to prevent patrons from ducking out on the bill) and the main entrance, a revolving door, quickly became jammed. It was a recipe for disaster.

The Cocoanut Grove nightclub was a well-known Boston nightclub in the 1930s and 1940s. Its demise, this day in 1942, remains the deadliest nightclub fire in American history. Speaking recently at the 75th anniversary commemoration of the fire in Boston, survivor Marshall Cole, 91, told the crowd that the tragedy has never left him. "From there on out, whenever I go to a place, I look for an exit," he said, according to Jordan Graham in the Boston Herald.

"Although the cause of the fire is officially unknown, it is believed to have been sparked by a busboy who didn't full extinguish a match he was using to change a lightbulb," Graham writes. "Faulty wiring, a club that was at twice its allowed capacity and side exits that were either blocked or bolted shut are thought to have made the catastrophe exponentially worse."

Any event that large was bound to have ramifications, and it is true that a number of legal changes can be traced back to the fire, like requiring emergency exits to stay unlocked. But a number of less-predictable medical advances also came in its wake. These three medical breakthroughs still have impacts today.

Advances in burn treatment

At the time of the fire, Cocoanut Grove nightclub was packed well beyond beyond its 600-person capacity, writes Amanda Hoover for About 1,000 people were inside at the time of the fire. “The dance floor teemed with couples and all of the chairs were claimed, witnesses said, as patrons weaved their way through thick crowds among artificial palm trees, leather walls, and ceilings covered in cloth,” she writes. “Then, before many even saw the beginning sparks, the nightclub was engulfed in flames.”

Besides the 492 deaths associated with the fire (not all of which took place at the scene), more than 150 people were injured. The Boston Fire Historical Association writes that the Boston City Hospital received 300 victims in one hour and more than 100 others went to Massachusetts General Hospital.

At Mass General, writes Caroline Richmond in the British Medical Journal, plastic surgeon Bradford Cannon devised a new way to treat their burns. “He discarded the accepted approach of using dyes and tannic acid as the primary treatment for burned tissues, having shown it to be harmful,” she writes. “Instead, he and colleagues used gauze containing boric acid and coated with petroleum jelly.” They also removed the most severely burned flesh and used skin grafts to cover the areas. Cannon took this new treatment with him to Valley Forge General Hospital in Philadelphia, where he used his Cocoanut Grove experience to treat thousands of U.S. servicemen.

"The physiological lessons we've learned from these 500 people have not been forgotten, and we've used them every day, all over the world," Peter Burke of Boston Medical Center told the assembled crowds this weekend, according to Graham.

Some of the earliest research into grief

Survivors of the Cocoanut Grove fire, along with relatives of soldiers who had fought in the war, were interviewed by psychiatrist Erich Lindemann for the first-ever systematic study of grief, writes Meghan O’Rourke for The New Yorker. In that paper, he discussed the feelings of guilt felt by survivors of the fire. “A central topic of discussion for a young married woman was the fact that her husband died after he left her following a quarrel, and of a young man whose wife died, that he fainted too soon to save her,” Lindemann wrote. His research laid the groundwork for new psychiatric understandings of grief.

A new understanding of post-traumatic stress disorder

The first study of how fire disasters cause post-traumatic stress disorder was also done on fire survivors. Alexandra Adler, a pioneering psychologist, “was among the first to write detailed papers on post-traumatic stress syndrome, reflecting her studies of the surviving victims of the Cocoanut Grove nightclub fire,” The New York Times’s Wolfgang Saxon wrote in Adler’s 2001 obituary. “Besides killing more than 490 people, the blaze left others with permanent brain damage. Dr. Adler studied the anxiety and depression that can follow such catastrophes and later applied her findings to the treatment World War II veterans.”

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