It struck in the early morning on April 18, 1906, an earthquake so powerful it destroyed more than 28,000 buildings and left tens of thousands of people homeless. The quake touched off fires that wiped out 4.7 square miles of the city and became known as the San Francisco Horror.

Urgent calls went out for health care professionals. Red Cross officials declared on the front page of the San Francisco Chronicle that “nurses from all over the United States are needed. Those who it is within their means, please come to San Francisco.” The officials also asked for donations of “automobiles, carriages, drugs and money,” adding that the association was “also in need of doctors.”

At St. Mary’s Hospital, physicians and the nuns who were nurses there launched an evacuation. “As our patients were removed from their beds, the mattresses were thrown through windows, and the patients were carried to waiting trucks,” the hospital matron, Mother Euphrasia, later recalled.

Closing in on the hospital, the fire showered down red-hot cinders on staff as they moved the patients. Someone handed a nurse a baby, the final evacuee. “Nobody knew to whom it belonged,” Mother Euphrasia said.

A river paddle steamer called Medoc had been transformed into a floating hospital, and that’s where the medical team headed with patients and supplies. “Surgical dressings, trolleys, instruments, [and drugs] were dumped into laundry boxes, loaded onto trucks and rushed to the Pacific Mail dock,” wrote Gordon Thomas and Max Morgan Witts in their book, The San Francisco Earthquake.

Rows of mattresses stretched across the deck for about 150 patients. Those who died were laid inside a lifeboat. The Sisters of St. Mary’s later set up a tent hospital near Golden Gate Park.

The Chronicle published wonderfully vivid and colorful accounts from the front lines of heroic efforts by firefighters and ordinary citizens to stop the fires, sometimes with success, while sometimes they could only move to a safe spot and watch in despair as flames leveled entire neighborhoods. One fire missed Fisherman’s Wharf by half a block “having found a more delicious morsel in the shape of the gas plant at the foot of Powell street.” 

But “it was on Telegraph Hill that one of the most picturesque and stubborn fights during all the horrors of the past three days was made,” the newspaper reported. “Perched up there on the eaves of the city the residents of that historic landmark made an almost superhuman fight for the preservation of their homes and the honor of the Hill and they won out. When their water supply was exhausted, they had recourse to red wine.”

The 1906 quake led officials to develop plans for future catastrophes, but as history has shown time and again, planning can only go so far. Eighty-three years later, in 1989, another devastating earthquake rocked the San Francisco Bay area. A stretch of Interstate 880 collapsed, killing dozens of motorists. As one physician told The Los Angeles Times, “No amount of medical preparedness can address the problem of collapsed concrete.”

This installment of Throwback Thursday was drawn partly from an article by Jack Bess, published in 1999 in the American Hospital Association’s 100 Faces of Health Care.