The Day Oklahoma Changed Forever: How the Oklahoma City Bombing Shaped OU Health's Level I Trauma Center

The morning of April 19, 1995, began like any other Wednesday at what was then the University Hospital in Oklahoma City. Surgeons were in the operating rooms performing scheduled procedures. Clinics were preparing to see patients. Medical students were attending classes.

Then at 9:02 a.m., everything changed.

"We heard even in the depths of Everett Tower (now inside Oklahoma Children’s Hospital OU Health) a boom. Obviously, we did not know what it was or what it signified," said orthopedic trauma surgeon Dr. David Teague, M.D., Chair of the Department of Orthopedics at the University of Oklahoma College of Medicine. "Shortly thereafter, word came up to the operating room that there had been some sort of explosion downtown."

That explosion was the devastating bombing of the Alfred P. Murrah Federal Building, an act of domestic terrorism that claimed 168 lives, injured more than 680 people, and forever changed Oklahoma City, Oklahoma, and our nation. It also revealed a critical need in Oklahoma's healthcare infrastructure that would transform how the state responds to mass casualty events.

The Immediate Response: A Community Mobilizes

As news of the bombing spread, physicians and staff across what is now OU Health at various University of Oklahoma colleges on the Oklahoma Health Center campus quickly transitioned from their regular duties to emergency response mode. Routine surgeries were completed as quickly as possible, clinics were shut down, and the cafeteria was transformed into a triage area. Outside the emergency room, another triage zone was established, all in preparation for what everyone expected would be a massive influx of injured survivors.

"We began pretty quickly to presume that this was a mass casualty situation," Dr. Teague said. "We made the cafeteria into a triage area. We made the area outside of the ER a triage area and shut down all of the clinics and the operating rooms and prepared them for what might be a need to use every space we had to take care of casualties."

While the hospital staff prepared, two physicians — Dr. David Tuggle, M.D., a former OU Health pediatric surgeon, and Dr. Andy Sullivan, M.D., the former chair of orthopedics and current pediatric orthopedic surgeon at Oklahoma Children's Hospital OU Health — rushed directly to the bombing site to provide first response medical care under harrowing conditions in an unstable building with the threat of additional explosions. Their response became one of the most poignant stories of medical heroism from that day.

The Reality of Mass Casualties

As the day unfolded, the nature of the tragedy became clearer. The casualties arriving at the hospital were not as numerous as initially feared, not because injuries were minor, but because the devastation was so complete.

"Throughout the rest of the morning, the word was, 'Stand by. We are going to bring you a bus load of casualties,'" Dr. Teague said. "What the presumption there was, is that once they could safely, or relatively safely, enter the rubble, they would find a bunch of patients with severe injuries that needed to come here."

But the reality proved even more heartbreaking.

"What they found, sadly, was that the people in what's called the pancake zone, the area where the floors collapsed, only one person survived,” Dr. Teague said.

The hospital's response was efficient and organized, despite the unprecedented nature of the disaster.

"We spun up and everybody stood down on what they were doing, and everybody reported, just like you're supposed to do in a mass casualty drill, to whatever place they needed to go, and people were ready," said Dr. Teague. "It worked pretty well."

Trauma surgeon Dr. Jason Lees, M.D., FACS, now Section Chief of Acute Care Surgery and Associate Dean of Graduate Medical Education at OU College of Medicine, was a first-year medical student at the time.

"We showed up and tried to figure out what we could do to help," he said. "It was very surreal.”

Though medical students had limited clinical abilities, they contributed however they could. They spent time at First Christian Church’s triage area (now known as Frontline Church or Renaissance Center) and helped hand out blankets and water.

“We didn't do anything real medical," Dr. Lees said. "It was odd. We could name every muscle in the body and the biochemical pathways, but we really had no idea as first-year medical students how to take care of the patient."

The experience proved formative for many future physicians.

"I think it highlights the journey of a medical student, because at some point you know a lot, but you can't do very much, and the more you know but can't do, the more helpless you feel. We all felt we should be able to do more," Dr. Lees said. "It makes you feel more committed to trying to get through the whole journey to be a competent physician."

The Case for a Level I Trauma Center

In the aftermath of the bombing, as Oklahoma City began its long process of healing, questions arose about the state's preparedness for major disasters. National media outlets questioned whether Oklahoma could handle such a catastrophe. The state's response was "Oklahoma can, and we will," a statement that became emblematic of what would later be called the "Oklahoma Standard" of community response.

But for medical professionals like Dr. Teague, who had been advocating for enhanced trauma care since joining OU Health in 1994, the bombing underscored the urgent need for a nationally verified Level I Trauma Center in the state.

"Leaders throughout the state, including the governor's office, realized that in a highly functioning regional system, there should be a flagship trauma center that takes the lead on disasters," Dr. Teague said. "Some of us had been pushing for a few years, saying that when our neighbors' house catches on fire, they call the fire department. They know somebody's ready, it'll come right away. And it should be the same for trauma care."

The critical difference, he points out, is readiness.

"Trauma centers, Level I Trauma Centers in particular, are ready 24/7, 365,” he said. “They don't have to find an anesthesiologist. They don't have to hunt down a neurosurgeon. They're available. And trauma is often too time-sensitive to be delayed."

This advocacy, combined with the stark reality of the bombing, catalyzed action. The bombing and the Oklahoma Standard, which the response came to be known as, all galvanized state, hospital and the University of Oklahoma leaders to say that the state needed a Level I Trauma Center and Oklahoma City is the place that should do that, said Dr. Teague, who, along with Dr. Tuggle, is credited as helping spur the new trauma program at OU Health.

Dr. Tuggle, who had rushed to the bombing site that fateful day, would go on to become the first trauma medical director for the newly established Level I Trauma Center in 2001. Despite his primary role as a pediatric surgeon, he stepped up to lead the adult trauma program until Dr. Roxie M. Albrecht, M.D., FACS, FCCM, tenured emeritus professor and Division Chief of General Surgery/Trauma/Critical Care for the Department of Surgery at OU College of Medicine, was recruited from New Mexico to take over the position.

The Legacy: Three Decades of Saving Lives

Today, as Oklahoma approaches the 30th anniversary of the bombing, OU Health's Level I Trauma Center stands as a living testament to those lost, providing life-saving care daily and where the lessons learned from tragedy continue to inform medical practice.

The center has responded to numerous disasters since 1995, including devastating tornadoes that struck Moore, Oklahoma, a shooting at a local restaurant, prison riots, other severe weather, and the tragic incident at the Oklahoma State University homecoming parade. Each event has reinforced the importance of having a trauma center that's always prepared for the unexpected. OU Health also stands ready to deploy in regional and national response, as it stood at-the-ready following Hurricanes Katrina and Rita and serves a role in the Federal Emergency Management Agency’s (FEMA) readiness.

"These disasters, whether natural or man-made, that our Level I Trauma Center has taken a role in responding to actually verify all of the readiness preparations that we do on a regular basis," Dr. Teague said. "To see that in action, where everyone shows up where they're supposed to be, plus people who don't have to show up show up, but do just in case we need more help, it's a joy and an honor to get to be a part of something like that."

For Dr. Lees, whose career was shaped in part by his experience as a medical student during the bombing, the trauma center represents something fundamental about community care.

"Would you live in a city that didn't have a fire department or police department? Most people would say no," he said. "You don't know when stuff will happen. This isn't somebody scheduling a surgery where you can get your ankle fixed on a Friday afternoon. It happens in the middle of the night, happens in the middle of the day, happens on ice, happens in sunny weather, happens when you're on vacation, happens when you're at home working in the yard, running your own business. You don't know when you're going to need a trauma center, but more will need them than often realized."

The growth of the trauma program over the decades reflects OU Health's commitment to providing the highest level of emergency care. This expansion has enhanced not just the trauma center's capacity but also its ability to provide comprehensive care.

"Just because patients have traumatic conditions doesn't mean their other diseases go away," Dr. Lees said. "Sometimes they're already taking their blood thinners, or they have cardiac disease. So, we have all the other specialists that go along with treating their comorbidities. It just makes it more complicated."

Personal Connections That Endure

The most powerful testament to the impact of OU Health's response to the bombing comes from the personal connections that have endured for decades.

Dr. Teague recently experienced a touching reminder of these connections when a patient from that day recognized him 30 years later.

"He's a wonderful story of resilience, just an Oklahoman who had a terrible thing happen, and he went on and made incredible contributions with his personal and professional life," said Dr. Teague.

Such connections extend beyond the hospital walls. Dr. Teague shared that he will be attending the wedding of the brother of the last baby pulled out alive from the federal building, a testament to how deeply intertwined the medical community has become with those affected by the bombing.

"It's kind of hard to think about it," he said, "but we happen to wind up being friends with the family. It's a great story again of how tight knit this community is, how interwoven our lives all are."

Looking Forward: The Continuing Mission

As Oklahoma commemorates the 30th anniversary of the Oklahoma City bombing, OU Health’s Level I Trauma Center stands as both a reminder of past tragedy and a beacon of hope. What emerged from one of Oklahoma's darkest days has become a vital resource that saves lives daily and stands ready to respond when the next disaster strikes.

The physicians who responded that April morning in 1995, some of whom still serve at OU Health today, helped lay the foundation for a trauma system that has grown into a comprehensive, multidisciplinary program capable of managing the most complex injuries and mass casualty events.

Their legacy lives on in the hands of the current generation of trauma surgeons, emergency physicians, nurses, and support staff who maintain the state's only Level I Trauma Center, a resource that ensures that no matter when disaster strikes, Oklahoma is ready.

"It's an incredible, incredible story,” Dr. Teague said. “Out of something so horrible came something so impactful, and 30 years later, it's still saving lives and responding to some of the worst things that have happened."

That commitment continues today at OU Health's Level I Trauma Center, where every patient receives care from teams prepared to handle the unexpected, honoring those lost by saving lives today.

Learn more about trauma and injury care at OU Health’s Level I Trauma Center.