Flat Rock School Fire Tested Hospital Disaster Planning

Since North Carolina Baptist Hospital opened a century ago, one day in the Emergency Department stands out for its enduring relevance to hospital disaster planning. On the afternoon of February 22, 1957, a dozen burn victims arrived in ambulances and cars from 40 miles away in Surry County, where Flat Rock Elementary School near Mount Airy had burned to the ground.

Expecting 100 or more casualties, hospital personnel scrambled to carry out a disaster plan still in draft form. No training or drills had occurred. Ultimately, only eight children and one teacher were admitted, but the lead doctors later wrote, “It will take only one small group of catastrophe patients to convince any hospital staff of the importance of disaster planning and organization.”

David Monroe Holder, director of Emergency Management and Business Continuity, Atrium Health Wake Forest Baptist, grew up in Surry County and worked in its fire marshal’s office, where memories of the school fire live on. He succeeded Ken Bishop, who founded the department in 2007, largely in response to new regulations after Hurricane Katrina cut off a New Orleans hospital for five days.

"Looking back from today's perspective, these physicians were visionaries," David observed. “They wrote about issues we still deal with today. I would say the actions these Baptist Hospital physicians took in 1957 were very innovative and were not being thought about at many hospitals.”

Lives Lost and Altered

The blaze is believed to have started when hot stage lights or sparks ignited curtains in the auditorium after a morning program. Flames spread so rapidly most fled into the cold without their coats. Those who retrieved personal items were badly burned. Some jumped from second-floor windows into the arms of rescuers. Nine-year-old Larry Adams, gripping his desk in fear, died at the scene. Third-grade teacher Cora Beasley, unable to save him, died five days later at Baptist Hospital—the only other fatality. Both are memorialized at the rebuilt school.

Two black and white photos side by side.
Wake Forest University School of Medicine, Dorothy Carpenter Medical Archives, Publications collection, NC Baptist Hospital Topics

Most victims found care in Surry County. Of the 12 transported to Baptist Hospital, three were treated as outpatients. Two required three-week hospital stays. The six most badly burned remained inpatients for 61 to 248 days.

The “Flat Rock Six,” as they became known, formed bonds that remain strong among the five still living. They are Bobby Burkhart, Benny Goodman, Frank "Frankie" Hensley, Marsha (Semones) Lowe, and Tamela (Hiatt) Midkiff. John Haynes Jr. died in 2012. All overcame physical and emotional scars to lead successful lives.

The group collaborated with Mount Airy News reporter Randall Brim on a book, “Tragedy to Triumph,” and have worked to promote burn aftercare programs. They reminisced at the rebuilt Flat Rock Elementary School on the fire’s 60th anniversary and reunited most recently in February 2024.

Lessons Learned

After the tragedy, Surry County built a volunteer fire department next to the school, and the state revised school building codes and fire safety regulations. At first, North Carolina Baptist Hospital applauded its response to the emergency.

“We Were Ready!” proclaimed an April 1957 story in Baptist Hospital Topics, a quarterly newsletter, attributing the “swift mobilization” to the Disaster Committee’s work. “If it had been necessary for Baptist Hospital to admit as many as 100 patients, it could have done so. In a real baptism by fire, its disaster organization met the test.”

However, Bowman Gray School of Medicine faculty members Drs. E.L. Marston and Louis Shaffner chronicled widespread confusion, inadequate communications, a missing triage officer and lack of a central headquarters. While there were no delays starting treatment, “It was obvious, however, that more than 15 or 20 victims would have inundated the regular areas, and there would not only have been much delay but also much worse confusion in preparing another site,” they wrote in The North Carolina Medical Journal. “We urge upon every community the necessity not only for making a disaster plan but also for having an actual demonstration or trial run.”

Fifteen months after the fire, the entire hospital staff of 1,200 carried out a “simulated emergency” with “quiet efficiency,” Baptist Hospital Topics reported. Drilling continued. By 1974, The Joint Commission on Accreditation of Hospitals required two disaster drills annually. To counter grumbling about drills, a School of Medicine newsletter revisited the 1957 fire, noting, “It could happen again. That is why we drill.”

Modern Disaster Planning

Nearly 70 years after the Flat Rock school fire, potential hospital perils have multiplied from fires and natural disasters to active shooters, terrorist attacks, cyberattacks and much more.

“We have also grown from one hospital to a network of five hospitals and more than 400 ambulatory clinics over a wide area,” David pointed out. “This is why we have several hospital incident management teams that train for disasters and mass casualty events. These teams also participate in regular drills to help us identify where we might be vulnerable and how we can continuously improve preparedness.

“We can’t zero out risk, but we can lay out a plan for how we would respond. We must have an all-hazards approach. Nothing is off the table when planning for a disaster.”