How the Cocoanut Grove Fire Survivors Gave a Mass General Psychiatrist Insights into Acute Grief

Image of the aftermath of the Cocoanut Grove fire
The Cocoanut Grove fire broke out in the basement of the club, known as the Melody Lounge. Photo is courtesy of the U.S. Army Signal Corps

A recent article in the Harvard Crimson by Eva K. Rosenfeld, The Fire That Changed the Way We Look At Grief, took an in-depth look at how treating the victims of the Cocoanut Grove Fire in Boston contributed to a Massachusetts General Hospital psychiatrist’s research and clinical work into how people experience and process losses due to death or injury. Here are five things to know:

1. The Cocoanut Grove Fire in Boston on Nov. 28, 1942, was one of the country’s deadliest building fires. The club was packed to two times its legal capacity and the only working exit was a revolving door, which quickly jammed as the panicked crowd tried to exit. The fire killed 492 people and severely injured hundreds more. Massachusetts General Hospital and Boston City Hospital (now Boston Medical Center) treated the majority of those who were badly injured in the fire.

2. Surgeons who treated the victims developed new medical techniques that were useful not only for burn victims but for service members who were injured in World War II. However, the reactions of victims and their family members to this highly advanced care was not always positive– instead of being grateful, they were angry at their doctors and nurses.

Photo of Erich Lindemann, MD
Erich Lindemann, MD
Courtesy of MGH Archives & Special Collections

3. Erich Lindemann, MD, a psychiatrist at Massachusetts General Hospital, studied the reactions of the victims and their family members and found that the anger was a symptom of acute grief.

In a paper titled “Symptomatology and Management of Acute Grief,” Dr. Lindemann described acute grief as a definite syndrome above and beyond normal grief. Symptoms include tightness in the throat, shortness of breath, frequent sighing, weakness, intense mental distress, guilt and a feeling of unreality.

4. According to Lindemann, proper psychiatric management of grief reactions may help to prevent prolonged and serious consequences. Grieving individuals have to accept that their bonds to the deceased have dissolved and form new bonds to replace them. They also have to accept and work through the pain of bereavement and the emotions that it produces, such as anger, fear, sorrow and guilt.

“It is the essence of life to be intertwined with death and the rhythmical coming and going of generations.”


5. Lindemann used the insights from this study and his previous work with victims of loss to inform his later clinical, research and educational efforts, often meeting resistance from the medical establishment. In 1954, he became Chief of Psychiatry at Mass General and Professor of psychiatry at Harvard Medical School.

As a professor, he encouraged his students to view their patients as more than just sick organisms, but as individuals navigating an uncertain pathway between life and death.

In the early 1970s, he was diagnosed with a rare cancer and had a chance to test his own theories about confronting death, which he chronicled in an essay entitled “Reactions to One’s Own Fatal Illness.”

Learn more about the Cocoanut Grove Fire

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