Uncovering the Past
Dr. Yasmine Ali tells the story of her hometown’s legacy
Yasmine S. Ali, MD, is a board-certified cardiologist with a degree in history from Vanderbilt University. She grew up in Waverly, Tennessee, the daughter of Drs. Subhi and Maysoon Ali, a surgeon and an internist, respectively. After she returned home from residency, she struck up a conversation with family friend Elton “Toad” Smith, a former police sergeant in Waverly. It was then she learned a chapter of her hometown’s history she had been completely unaware of, but felt compelled to write a book about.
On February 22, 1978, a freight train derailed in the heart of downtown Waverly, including two tanker cars. No one was injured at the time – but two days later, as it was being moved, one of the cars exploded. The resulting fire destroyed much of downtown Waverly, resulting in more than $6 million in damage by today’s standards. Six people were killed instantly; 10 others died of their injuries later. Yasmine’s parents took charge of the chaos at the local hospital, triaging patients and helping those they could with what was on hand. The magnitude of this incident, along with other train derailments around the same time, led to the creation of the Federal Emergency Management Agency (FEMA) the following year. While this interview was conducted in 2024, the conversation is timely, as April 1 marked the 46th anniversary of FEMA’s establishment.
Dr. Ali details all of this, plus the history of emergency management, in Walk Through Fire: The Train Disaster That Changed America. I spoke with Yasmine about why she wanted to write the book, her experience researching and interviewing for the story, and how the Waverly train disaster shaped disaster response in the U.S. today.
Jeff Zagoudis: This is a remarkable story. Why was this a story you wanted to tell?
Yasmine Ali: Waverly is my hometown; I grew up with this. My parents were an integral part of what happened with that disaster and the response to it. And yet, it wasn’t until I had finished residency in cardiology fellowship and I went back home and had this encounter with Toad Smith, whom I knew also but had never heard him tell the story. The way he told it, I thought, “Why have I never read this before? I’m from Waverly – why don’t we know the history of this? Why isn’t there a book about this?” So now there’s a book about it.
It took a lot to research this book because it hadn’t been written down anywhere. This was a time where there wasn’t internet. So I did a lot of primary source research. I did a lot of interviews with all of the survivors I could find. At some point I realized I knew more about the Waverly train disaster than anyone else on the planet. That was a huge responsibility when I realized that, and an obligation.
JZ: Why was this story interesting to you as a medical professional?
YA: In addition to being a cardiologist, I’ve worked in emergency rooms. I also helped draft the public health and disaster response document for the state of Tennessee. All of that helped me understand what the physicians and nurses were going through, what it’s like to staff an emergency room in a rural county, and what they were missing in terms of all we know about emergency management now. Now we have an entire profession of emergency managers that came out of that. And now we have protocols for what you do with mass casualty disasters and hazardous materials handling — all of these things that were not in place when that train derailed in Waverly in 1978.
JZ: What do you think the key was to the excellent disaster response in Waverly?
YA: The way the medical staff responded — and the way the first responders on the scene got these people to the hospital in the first place — the way that all worked out in the absence of the knowledge we have today, in the absence of a coordinated plan, was remarkable.
My father, who was chief of surgery at the hospital [Nautilus Memorial Hospital at the time], had been involved in the Tennessee Medical Association. He also had his military training, and he’d recognized from friends in other states how they had disaster plans at their hospitals, and he thought “Why don’t we do that in Waverly?” So literally two weeks before this disaster occurred, they drilled on what they called Operation Black. That allowed them to mobilize all of their personnel. When they realized the train had exploded, they immediately called [Operation Black] and everybody was called on the hospital staff, one-by-one. They sent a courier at the same time to the radio station to broadcast the SOS message: “Mayday, mayday in Waverly, Tennessee. If you have any ambulances please send them. We have a disaster.”
I think what was also key was having a central leader. Now, we call that an incident commander; that wasn’t even a concept then. But it was what my father ended up doing when he stood up and said, “I’m in charge.” All of the nurses that I talked to said that just made them feel like they were going to be okay. So I think having the incident commander (IC) is key to a successful disaster response.
JZ: How many nurses did you interview for this book?
YA: I talked to four nurses, both separately and in a group. Talking to people in a group, they jog each other’s memory, so you get different aspects of the story than when you talk to them alone. And the nurses were the only ones I did a group interview with.
Carolyn Tucker, who’s known as Sam, put all this stuff together. She became my de facto research assistant. She called all these people, and we got together for this group interview in her living room.
What Nancy Daniel did was really remarkable. She was a scrub nurse then, and now, I think because of this disaster, she’s moved into the public health realm, where she’s a team leader at the same hospital [now Ascension Saint Thomas Three Rivers]. She had remembered at the time these ID tags you could put on a patient you’d given a medication to. So she grabbed the tags and put them around patients’ wrists because they didn’t check anybody in. They had all these patients flooding the emergency room, and you didn’t know who anybody was because they were burned so badly. If they could tell you their name, she’d put their name on it; if they didn’t have their name, she’d still put a tag on and say “Morphine given” and the time, so that the nurse coming behind her didn’t overdose them and possibly kill the patient. I think that was ingenious because again, there wasn’t any plan to do that. She just remembered something in her training, or maybe in their mass casualty drill.
It’s important to remember the power was out as well. They were doing all of this with flashlights!
JZ: What were some of the main themes from your conversations with the nurses?
YA: What struck them the most was the level of pain the patients were in. I painted a scene where Nancy and Sam are walking down the hallways, and the burn victims are pulling on the legs of their scrub pants saying, “Can you just give me something for pain?” And that has really stuck with them the rest of their lives.
The other thing they mentioned was not being able to get IV access, because usually it is the nurse who gets the IV line. They couldn’t do that in these patients because they were so severely burned. They needed a surgeon, like my father, to do it. I think Sam said it best: She wanted to scream because she didn’t know what to do. It was really overwhelming for them because a lot of the things they would usually do in an orderly fashion weren’t available to them.
JZ: How might this story play out in Waverly today, or any other small town in America?
YA: I’m asked that a lot. I really think it depends on the quality of the community hospital, which is why I put a chapter in the book on the struggle of the community hospital. Since this book has come out, the hospital in Waverly has turned around. A year ago, I was telling people I don’t know how it would go in Waverly because they don’t have a trauma surgeon at that hospital. That was really fortunate that they did [in 1978] — not a lot of rural hospitals have that.
JZ: Would they be more or less prepared to deal with this type of disaster than they were in 1978?
YA: Having been in the hospital system myself, these are drills that are done again and again. Everyone gets the plan, and it’s just so much more organized now. They are more prepared because it’s a standard of training now. Everybody at every level goes through what their role would be if there were a mass casualty event or disaster.
The other thing to note is that we now have medical evacuation helicopters that are not just military helicopters. Ambulances are better equipped than they ever were at that time. There are just more transportation capabilities.
The one thing I tell people in closing is, I think the biggest lesson of the Waverly train disaster story is the triumph of community over chaos. When you ask, “How did they overcome the chaos,” I really think it is the resilience of the community. They knew each other, they pulled together and everybody pulled their weight. It’s a great community story.
Since writing the chronicle of her hometown, Yasmine has also released her debut novel, A View From the Cliffs.