On Jan. 7, a bit after 6 p.m., Ravi Salgia was at his Eaton Canyon home, at the edge of Angeles National Forest.
He was watching the news.
Like everyone else in Los Angeles, Salgia and his family were following updates on a wildfire driven by the Santa Ana winds as it raced through Pacific Palisades. Of course, the Palisades Fire was clear on the other side of Los Angeles, by the ocean.
Photo courtesy of City of Hope
Suddenly, his wife, Deborah, thought she saw a glow in the backyard. She looked out, then stepped outside into the back yard to get a better look. “And so, she saw the house above us on fire and flames coming down,” Salgia said. “And she said, ‘Honey, we’ve got to go.’
“We had five minutes. Otherwise, the flames would’ve engulfed us all. And so, we got in the car, only got the passports and marriage certificate, clothes on our back, and that was it—left everything behind. We were the first ones to evacuate from Eaton.”
When he spoke with this reporter two days after the hurried evacuation, Salgia, chair of the Department of Medical Oncology & Therapeutics Research and Arthur & Rosalie Kaplan Chair in Medical Oncology & Therapeutics Research at City of Hope, didn’t know whether his house was still standing.
As of Jan. 10, at least 19 City of Hope employees are known to have lost their homes. Altogether, 317 of the cancer center employees were mandatorily evacuated from the fire zones. Of those, 87 were in the burn zones.
Through tense hours that ensued, City of Hope, located roughly six miles from the Eaton Fire that covered about 13,690 acres and engulfed 4,000 structures, appeared to be in the path of the fires driven by the 90 mile-per-hour winds, essentially a hurricane driving walls of fire. At this writing, the Eaton Fire is still classified as “active.”
Luckily, as the cancer center’s leadership, including Salgia, was making plans to arrange for possible evacuation of 220 very sick inpatients, the wind changed direction.
All the cancer centers in the greater Los Angeles area were affected by the fires that killed at least 10 people and destroyed as many as 10,000 structures in the area.
Cedars-Sinai’s Samuel Oschin Cancer Center is located approximately 4.5 miles from the Sunset Fire, which spanned 42.8 acres as of Jan. 9, and which is now fully contained. As of Jan. 10, Cedars-Sinai is approximately nine miles from the Palisades Fire, which spans 19,978 acres and is at this writing only 8% contained.
“Our hearts go out to everyone affected by the devastating fires across Los Angeles County. We are continuing to evaluate the impact of this evolving disaster,” Cedars-Sinai said in a statement. “We are actively supporting our staff to ensure their safety and ongoing ability to care for patients and the community. We will share further updates today as we navigate this challenging time in our community together. Until then, we urge everyone to stay safe and out of harm’s way.”
The UCLA Jonsson Comprehensive Cancer Center is located approximately 4.5 miles from the now reportedly contained Sunset Fire. UCLA is also located approximately four miles from the Palisades Fire. In a statement, UCLA Health said the fire has impacted operations in six of its clinics.
“Clinical operations at UCLA Health Jonsson Comprehensive Cancer Center locations in our hospitals were not disrupted,” UCLA Health said in a statement. “Patients with appointments at ambulatory clinics closed due to utility power shutoffs, proximity to mandatory evacuation zones and other factors have been rescheduled or seen at other UCLA Health locations.”
USC Norris Comprehensive Cancer Center, located in downtown Los Angeles, is over 12 miles from the Eaton Fire and 20 miles from the Palisades Fire as of Jan. 9.
“The devastation is unimaginable, and the losses experienced by faculty and staff at USC Norris are heartbreaking,” Caryn Lerman, director of the USC Norris Comprehensive Cancer Center, associate dean for cancer programs, and the H. Leslie and Elaine S. Hoffman Cancer Research Chair at the Keck School of Medicine of USC, said to The Cancer Letter. “Entire communities have disappeared. Our hospital is not presently in a high-risk zone but we are all on high alert as the situation is unpredictable. As the fires rage and new ones emerge, our focus is on helping those in need.”
A close call in Duarte
A bit after 6 p.m., Jan. 7, in Pasadena, Marcel van den Brink was considering going for a run.
“Then I started to get messages that we had to get ready,” van den Brink, president of City of Hope Los Angeles and City of Hope National Medical Center, chief physician executive, and the Deana and Steve Campbell Chief Physician Executive Distinguished Chair in Honor of Alexandra Levine, MD, said to The Cancer Letter.
Instead of a run, van den Brink returned to the Duarte campus to prepare for the worst.
She saw the house above us on fire and flames coming down. And she said, ‘Honey, we’ve got to go.’ We had five minutes. Otherwise, the flames would’ve engulfed us all. And so, we got in the car, only got the passports and marriage certificate, clothes on our back, and that was it—left everything behind.
Ravi Salgia
“I’ve been through COVID in New York, so I’ve seen something,” he said.
In New York, van den Brink, the former Alan N. Houghton Chair in Immunology and the head of the Division of Hematologic Malignancies at Memorial Sloan Kettering Cancer Center, has seen a lot—two floors of COVID patients, at a time when scared physicians and nurses were trying in vain to obtain protective masks.
That’s rough stuff, sure, but is it as rough as fire-breathing hurricane-force winds menacing a hospital full of very sick people—about 220 of them—who may have to be moved out of harm’s way while still continuing to receive treatment?
“The fire started at around 6:30 p.m. Jan. 7 and was predicted to move very fast. The reason for that, of course, were these winds; right?” van den Brink said. “The forecast that we got from the Los Angeles Fire Department and others was that we should be seriously concerned, that the fire was completely out of control.
“As you read all of these updates from LA websites, they tell you if a fire is contained or not. For this fire that we’re dealing with here, south of the San Gabriel Mountains, they kept on telling us it was 0% contained. At that point—it was already Wednesday morning, the message was that it was coming in our direction—and you could see that on the map—and that we had to be ready for evacuation.”
Meanwhile, after leaving their house, the Salgias found a hotel room in Arcadia, not quite 10 minutes away from the City of Hope campus.
Salgia’s initial idea was to leave Deborah and daughter Sabrina at the hotel and head to the hospital, to make sure everything was okay.
“I told my wife and daughter that if the fires would also reach the hotel in Arcadia, they should go to another hotel, in Orange County, to Anaheim Hilton, as an example,” Salgia said. “They said, ‘We’re not going to leave you, honey. We want to be with you and help.’”
Deborah had recently retired from the supportive care and bereavement unit at City of Hope, and Sabrina is a fourth-year medical student.
“So, since both my daughter and wife actually used to work here at City of Hope, they knew it very well. We walked into the hospital together,” Salgia said.
By 2:30 a.m., Jan. 8, Salgia was on the ward, taking care of patients—and taking part in planning what was increasingly looking like an imminent evacuation.
“We wanted to make sure that senior-level people were there, in the trenches, on the ground, making sure everything goes smoothly,” Salgia said. “And if we had to evacuate, to provide the leadership, to provide the expertise that we have to be able to say how we should deal with the ICU, how we should we deal with transplant patients. Really, making sure that the gravitas of the senior leadership is there.”
More than 50 faculty members, including all senior leadership, as well as hundreds of members of clinical and non-clinical staff showed up during the first night.
“We got everybody in, in the middle of the night, to start working on plans in case we had to leave the campus, on finding places for about 220 or so patients, who were at that point hospitalized. Where could they go? And some of these patients, of course, were very complex, because those were transplant patients and CAR-T patients, and so on,” van den Brink said.
Photos courtesy of Ravi Salgia
The logistics weren’t simple.
“The reason why we immediately started to prepare in the middle of the night is when we talked with all of our teams about how much time would we actually need to empty the whole campus,” van den Brink said.
According to projections, this would require take six or seven hours, with a chain of ambulances going back and forth to pick up patients and bring them to other hospitals that had the capacity to accommodate them.
“We had a plan ready, if that would be needed, to evacuate every patient. And we had dedicated nurses, doctors, and in most cases also places where they would go,” van den Brink said. “We were getting ready for that.”
The team decided that it would be too risky for the Duarte campus to practice at its normal capacity.
“So, on Wednesday, we basically closed the campus for outpatients, and we closed our clinics while we were trying to figure out where this is going, and all of the signals that we were getting were that we had to be ready for the worst,” van den Brink said.
“At that point, again, with our amazing staff, who basically worked all night, we were able to come up with plans for all these different cases. We’re talking about literally thousands of patients, the visits, the treatment schedules for radiation, for radiation oncology, surgical, all of the patients who were in the middle of a transplant, and so on.
“Incredibly complex—and very high numbers.”
Fortuitously, by Wednesday evening, City of Hope started to hear that the Eaton Fire was starting to change direction, away from the campus.
“I’m a big believer that there’s a higher being, and I believe in having faith and hope,” Salgia said. “And clearly, our name is City of Hope, and we were watching the fire come in from the west to the east, and, at a certain point, around 7 or 8 p.m., that tide turned, and it went northwest. Thank God. Otherwise, we would’ve had to evacuate.”
The cancer center was able to open for outpatients on Thursday.
I’m a big believer that there’s a higher being, and I believe in having faith and hope. And clearly, our name is City of Hope, and we were watching the fire come in from the west to the east, and, at a certain point, around 7 or 8 p.m., that tide turned, and it went northwest. Thank God. Otherwise, we would’ve had to evacuate.
Ravi Salgia
“We were fortunate that we have opened a second campus in Orange County. Orange County doesn’t have an inpatient hospital yet, as you know, but we do have outstanding outpatient clinics there,” van den Brink said. “And, of course, the faculty there is completely connected. Some of the faculty members practice on both campuses. This specifically helped us with our transplant and CAR-T patients, because many of them we are treating already in an outpatient setting. We could simply move them over to Orange County and let them get their care there.”
Now, the center’s operations are largely back to normal, van den Brink said.
“And what we’re doing now is, I just finished a whole series of meetings with my clinical leaders, Ravi being one of them, where we looked carefully at what we might have missed in outpatient care during the day that we closed at the campus. What do we need to do to catch up?”
During these trying days, Salgia, who under normal circumstances believes in wearing a shirt and a tie when interacting with patients, has had to make accommodations.
“I’m in scrubs currently,” he said. “But I’m thankful that the night nurses in the unit were able to get me scrubs. They got me toiletry as well. So, we’re providing that for everyone and making sure that everyone is really able to have all of these, and whatever else that they would need.”
City of Hope officials said they are activating assistance programs for employees who were affected by the fire.
This includes providing City of Hope-paid accommodations for those under mandatory evacuation orders, activating hardship loans available through retirement plans, initiating crisis care for child or adult dependents, and establishing an employee assistance fund.
“I can tell you, the way that the City of Hope faculty and staff stepped up was just absolutely phenomenal,” van den Brink said.
“Ravi likely lost his house. He is walking around in scrubs, because he doesn’t have any other clothes, but he is here, helping us to take care of our patients.
“And not just that, not just the normal working hours—no.
“He is providing leadership.”
Jacquelyn Cobb and Katie Goldberg contributed to this story.
