Cooler temperatures, solid rain and a bit of early snow and hail are extinguishing the last burning embers of one of the most devastating fire seasons in U.S. history. One day in August, 98 fires raged on 1.5 million acres of land in New Mexico, Montana, Idaho, Texas, Oregon and Washington.

But this was not the worst fire season on record. About 6.9 million acres burned this year, compared to 7.4 million in 1988 and 7.1 million acres in 1963. "Still this year was different," said Nancy Lull, spokeswoman at the National Interagency Fire Center (NIFC) in Boise, Idaho.

The difference lies in the sheer number and intensity of the fires, and in the environmental conditions-searing heat waves, years of drought, decades of accumulated underbrush-that sustained them. "Some of the fires were among the toughest to fight," Lull said. "The fire behavior was extremely erratic and they lasted for long periods of time.

In Texas, for example, a fire known as the Chicken Fire because it occurred near chicken ranches in Nagadoches County was active for more than two weeks and had flames shooting up to 100 feet.

"Things were more unpredictable," Lull said.

Montana logistics
The unpredictability kept some Montana hospitals poised to evacuate patients for weeks at a time. "You just always had this sense of not if, but when," said Maura Fields, RN, assistant administrator for clinical operations at North Valley Hospital, a 56-bed long-term care facility in Whitefish.

"We were looking at sending our patients to Canada," she said, adding that the state has no burn unit. "Suddenly, you are having to ask yourself where you put 56 people who call this home."

It was nearly midnight Aug. 27 when nursing staff at Beartooth Hospital and Health Center in Red Lodge received the call to evacuate the hospital's sickest patients, said Sharon Norby, RN, director of nursing. A fire, which later became known as the Willie Fire because it happened the night of a Willie Nelson concert, erupted four miles outside of town, ignited by a gasoline tank blown into a field from a motorcycle accident.

Six patients were shuttled to Billings, 60 miles away, and kept there for nearly a week. "It was the first time we've ever had to send patients away," Norby said. Further evacuations were averted when the winds shifted, gusting the fire in a different direction.

Community Medical Center in Missoula came close to evacuating its patients when a nearby fire blanketed the hospital with smoke. "It smelled like a giant campfire in the hospital," said Connie Huber, RN, vice president of patient services. "We had to restrict the air-close all the windows and recirculate the air, just like you would in your car."

Many of the town's residents, including nurses, had to evacuate their homes. "I have to applaud our nurses," Huber said. "They boarded their animals and found places for their kids and did what they always do in a crisis-came in and took care of patients."

The tally
According to NIFC, 17 people died as a result of the fires. Parachute failure and helicopter crashes killed six firefighters, while lightning killed two in northern Utah. Four civilians died while evacuating or attempting to suppress fires on their property. One, a California woman, and the firefighter who tried to rescue her, died after she refused to evacuate her Paradise home.

Idaho lost the most acreage-1,317,160-followed by 453,728 in New Mexico, 441,216 in Oregon, 258,249 in Washington, 225,927 in California, 193,296 in Texas, 126,000 in Colorado, 84,488 in Arizona, and 59,822 in Oklahoma.

The fires reached their apex the weekend before Labor Day when the NIFC reported 31 large fires burning. In Montana, 674,000 acres burned; Idaho reported 26 large fires on nearly 745,000 acres; Wyoming, five large fires on 52,000 acres; and South Dakota, one 65,000-acre fire. The single largest blaze, called the Clear Creek Fire, burned from July 10 to Aug. 26 and devoured 200,000 acres of land in Salmon-Challis National Forest in Idaho. To be listed by the fire center as a large wildfire, a blaze must be at least 100 acres (0.15 square mile) in size.

Triple-digit figures also apply to the cost of fighting the fires. According to published reports, the state and federal governments spent an estimated $2.8 billion on firefighting efforts. Montana spent $273 million; Idaho, $178 million; Texas, $77,000; and Oklahoma, $1.5 million, NIFC said. The agency added that costs in Texas and Oklahoma could be higher.

About 25,000 firefighters and support crew were on the job, including fresh recruits from the National Guard, the U.S. Marine Corps, Indian reservations and local prisons.

On the lines
For one week, Cindy Jimmerson, RN, a self-described "old ER nurse" from Community Medical Center in Missoula, was the medical team. Jimmerson shuttled 30 miles between two medical camps along a restricted "hot road," working out of a trailer at each site. "You had to work with just whatever supplies were there," she said.

Most of the work involved treating exhaustion, dehydration and upper respiratory problems. "Thankfully, we had no tragic accidents or deaths," she said. "Most of the time what you're doing is pumping these guys with decongestants and vitamins so they can go back out again."

A middle-of-the-night emergency that roused her out of her GI-issue sleeping bag encapsulated the makeshift, make-do essence of it all. "I remember thinking, 'This is the first time I've taken care of a patient in my pajamas,' " she said.

Breathing uneasily
Of great concern to health officials was air quality, which was the worst in Idaho and Montana since Mount St. Helens erupted in 1980. "It was as bad as Mount St. Helens but lasted longer and traveled farther," said David Levinson, Ph.D., a meteorologist for the Bureau of Land Management and program coordinator for the Montana/Idaho Airshed Group. "We had smoke traveling hundreds of miles downstream and we were getting calls from the Midwest, thousands of miles away."

"We tend to have pristine air," he continued. "We had visibility of one-quarter to a half-mile and we had what we call air that is in the 'unhealthy for all' category. The smoke was so bad you had to stay inside. Our entire August was taken away from us."

By and large, people heeded officials' health warnings and stayed inside. "I'm surprised we didn't see more respiratory distress, but I think people did what they were supposed to do," Huber said.

To residents' relief, the past month has brought cleansing winds and rain that have returned the region's air quality to normal "The big skies are back in Big Sky Country," Levinson said.

Those close to the Cerro Grande fire in Los Alamos, N.M., have another health concern: radioactive substances dissolved in storm water.

But according to a press release issued Sept. 11 by Los Alamos National Laboratory, such substances were comparable to or elevated above pre-fire levels in runoff. Dissolved gross levels were found to be below the EPA's maximum contaminant limits for drinking water systems.

For Jimmerson, the fires will always represent humanity at its best. "I felt kind of odd when I was driving away from the camps," she said. "We had people from all over the world who came to help us. I felt like I was leaving a family and entering a different world."