By Larry Johnson, NRP, CHW
Editor’s note: On February 28, 1993, Larry Johnson, NRP, CHW was the Senior Flight Paramedic for CareFlite Dallas when the ATF raid on the Branch Davidian compound in Waco, Texas went catastrophically wrong. He treated the wounded, flew the critically injured by air, and rotated off and on the medical perimeter for all 51 days of the standoff that followed, from the mass casualty incident of February 28 through the fire of April 19, 1993, in which 76 Branch Davidians, including 22 children, perished. “Into the fire: A paramedic’s battle with Waco and the aftermath,” is his firsthand account of the Waco siege told from inside the emergency medical response, covering the raid, the FBI negotiations, the fire; and the long psychological aftermath that paramedics, flight crews and law enforcement personnel have carried ever since, an honest and overdue reckoning with what it costs to go into the fire, shift after shift, and what the profession owes the people who do.
Let’s go, let’s go — and the children who came out
Chapter 1
It was Sunday, February 28, 1993, at approximately 0900 hours when I walked into the dispatch center at CareFlite in Dallas. There was nothing remarkable about the morning. That is how these things usually begin. No warning. No sense that history is about to reach out and pull you into it. Just routine. Coffee brewing somewhere in the background. Radios humming at the frequency they always hum. A few jokes exchanged between people who have done this long enough to understand that humor is part of the survival kit, not a luxury, but a necessity.
I poured a cup, leaned against the counter, and let the caffeine do what it always does. Just another shift.
Then the radio broke the rhythm.
“Let’s go, let’s go!”
The voice came sharp and urgent through the speaker. Lance Hillhouse in dispatch. I had heard that voice in every tone imaginable, calm, irritated, focused, exhausted at the end of a long night. This was different. There was an edge to it that cut through everything else. Not panic. Lance did not panic. But an urgency that told you, without requiring explanation, that something had changed.
“We’ve got a mass casualty incident. Multiple shooters. Multiple down. Head toward Waco.”
For a brief second, everything stopped. The words did not fit together in any way that belonged to normal operations. Mass casualty and multiple shooters were phrases that lived in training scenarios and tabletop exercises. Hearing them in a real-time dispatch call produces a particular form of internal recalibration, a narrowing of focus, a clearing of everything that is not immediately relevant.
My pilot did not ask questions. He moved. That is how this works when everyone in the aircraft understands what is at stake. CF-142 began to come alive as the engines spooled up. I pulled the APU and climbed aboard. We lifted off without ceremony.
In this work, you stop thinking about the next call and start just answering it. That is what years of doing this looks like from the inside.
Chapter 11
In the first six days of the standoff, twenty-one children came out of the compound. Most of the children who came out had never encountered a flushing toilet. Inside the compound, sanitation had been primitive. What the outside world considered basic infrastructure was, to them, something entirely new, something that required explanation, something that in more than a few cases produced genuine fear. They were not being difficult. They were simply encountering a world their previous existence had given them no preparation for.
I watched one little girl, she could not have been more than five or six years old, standing in front of a toilet with an expression I can only describe as cautious wonder. Someone flushed it for her. She took a step back. Her eyes went wide. Then, after a moment, she leaned forward and watched the water settle, processing what she had just seen with the focused concentration of a child encountering something extraordinary. She was not frightened, exactly. She was working it out.
I have thought about that little girl many times over the years. I have thought about what it means to grow up inside a world so contained that a flushing toilet is a revelation. I have thought about what those children carried with them when they walked out of the compound, not just the trauma of what happened there, but the sheer weight of everything the outside world expected them to already know.
There was a boy as well. He was approximately ten years old when he came out of the compound during that first week of releases. He carried himself with a military bearing that no ten-year-old should have, shoulders squared, chin level, eyes moving the way eyes move when someone has been taught to assess a room rather than simply inhabit it. No emotion was visible. None.
I wanted to reach him somehow. Not clinically. Just humanly. To find some point of contact between his world and mine, however small. I offered him a Coke.
He looked at the can the way you look at something you have been told nothing about and therefore cannot evaluate. There was no recognition in his expression. He genuinely did not know what it was. He did not reach for it. He studied it. Watched me hold it, watched the condensation on the outside of the can, watched my face for whatever information my face might offer. I did not push. I just held the can and waited.
Eventually he reached out and took it. Turned it in his hands. Then, carefully, the way you approach something whose rules you are still learning, he pulled the tab. The sound of it startled him slightly, a small thing, that flinch, but it was the first unguarded moment I had seen from him. He brought the can to his mouth and took a small, cautious sip. Whatever he had expected, it was not that.
He looked at the can. Looked at me. Then he drank the entire thing steadily and without stopping, as if once the decision was made there was no reason to delay the rest of it. When it was empty he held the can for a moment, then looked up.
“Can I have another one?”
Those were the first words he had spoken to me. It was such an ordinary sentence, the kind of thing any ten-year-old says without thinking, in kitchens and at ballgames and in the back seats of cars, every day, everywhere. But coming from him, in that context, after the silence and the watchfulness and the careful study of an object as simple as a can of Coke, it landed differently.
I gave him another one.
Excerpted with permission from “Into the fire: A paramedic’s battle with Waco and the aftermath,” by Larry Johnson, NRP, CHW, published in August, 2026, by Vista Bonita Publishing, available for purchase at Amazon.
ABOUT THE AUTHOR
Larry Johnson is a nationally registered paramedic and veteran EMS executive with nearly five decades in emergency medical services. On Feb. 28, 1993, he was the senior flight paramedic for CareFlite Dallas when the ATF raid on the Branch Davidian compound in Waco, Texas, went wrong. He treated the wounded, flew the dying and maintained the medical perimeter for all 51 days of the standoff. He was there when the compound burned on April 19, 1993.
Johnson helped build Columbia One Dallas, the nation’s first all-paramedic critical care transport program, and coauthored the first Critical Care Paramedic textbook with Dr. Bryan Bledsoe. He served as adjunct faculty at the University of Nevada, Las Vegas School of Medicine; held national leadership roles with NAEMT; and currently serves on the Board of Directors for the National Association of Mobile Integrated Healthcare Providers and as Commander at Albuquerque Ambulance Services, Presbyterian Healthcare Services.
