hirteen days ago, as his computer crunched the mountain of 
        data he hoped would be his humble contribution to medical progress, the 
        researcher - he shall remain nameless - got a phone call he'd 
        never forget. 
        
        
        It was Dr. John Halamka, the former emergency-room physician who runs 
        Beth Israel Deaconess Medical Center's gigantic computer network. He 
        told the professor that his flood of numbers was overwhelming the 
        system, threatening to freeze thousands of electronic medical records 
        and grind the hospital's network to a halt. 
        ''He said, `Oh, my God!' and pulled the plug out of the wall,'' 
        Halamka said last week. 
        It was too late. Somewhere in the web of copper wires and glass 
        fibers that connects the hospital's two campuses and satellite offices, 
        the data was stuck in an endless loop. Halamka's technicians shut down 
        part of the network to contain it, but that created a cascade of new 
        problems.
        The entire system crashed, freezing the massive stream of information 
        - prescriptions, lab tests, patient histories, Medicare bills - that 
        shoots through the hospital's electronic arteries every day, touching 
        every aspect of care for hundreds of patients. 
        Within a few hours, Cisco Systems, the hospital's network provider, 
        was loading thousands of pounds of network equipment onto an airplane in 
        California, bound for a 2 a.m. arrival at Logan International Airport. 
        In North Carolina's Research Triangle area, computer experts were being 
        rousted out of bed to join a batallion of electronic shock troops who 
        would troubleshoot the situation. Closer to home, Cisco technicians were 
        converging on Boston from across Massachusetts.
        The crisis began on a Wednesday afternoon, Nov. 13, and lasted nearly 
        four days. Before it was over, the hospital would revert to the paper 
        systems that governed patient care in the 1970s, in some cases reverting 
        to forms printed ''Beth Israel Hospital,'' from before its 1996 merger. 
        Hundreds of employees, from lab technicians to chief executive officer 
        Paul Levy, would work overtime running a quarter-million sheets of paper 
        from one end of the campus to the other. 
        And hospitals across the country - not to mention investment banks, 
        insurance companies and every other business that relies on a constantly 
        accessible stream of quickly-changing information - would get a scary 
        reminder of how dependent they are on their networks, and what would 
        happen if they disappeared.
        ''It's like the Y2K that never happened,'' said Dianne Anderson, vice 
        president for patient care services at Beth Israel Deaconess. 
        Now, Halamka - the hospital's chief information officer and a 
        networking addict who answers e-mails on his Blackberry device whether 
        he's at a meeting or a family dinner - is hustling to answer questions 
        from all over the country, from community hospitals in Western 
        Massachusetts and major medical centers such as Johns Hopkins 
        University, and financial-services companies that could lose millions in 
        a crash. 
        ''The message,'' he said, ''is make sure you're ready for a massive 
        disruption of your network - whether it's 9/11 or a natural disaster or 
        whatever.'' 
        As a result of the crash, Beth Israel Deaconess plans to spend $3 
        million to replace its entire network - creating an entire parallel set 
        of wires and switches, double the capacity the medical center thought it 
        needed. 
        No other Massachusetts hospital has ever reported such a long-lasting 
        or disruptive network crash, said Elliot Stone, executive director of 
        the Massachusetts Health Data Consortium, a group that brings together 
        chief information officers from hospitals and health plans around the 
        state. He praised Beth Israel Deaconess for being open about the problem 
        and sharing lessons learned, both about technology itself and about 
        policy - such as the need to enforce rules against unauthorized 
        additions of new software onto the network. Not least, Stone said, 
        Halamka's counterparts see the incident as ammunition in their constant 
        quest to convince management to pay for network 
        upgrades.
        The crash surprised experts in the field because most disaster 
        planners mainly worry about backing up hard drives and building 
        redundant servers. But in this case, it wasn't those repositories of 
        information that were in trouble. It was the network itself - the 
        ''pipes'' that carry the information from one place to the other. It was 
        like when at busy times at the office, your e-mail slows down - only so 
        bad that everything ceased to function.
        ''Usually, when you think about backup, you're talking about backing 
        up hard drives. You don't think about the network itself,'' said Mark 
        Tuomenoksa, founder and chairman of Woburn-based OpenReach, a 
        network-security consulting company. 
        Halamka said that was the case at Beth Israel Deaconess: ''We 
        don't just have a backup generator, we have a backup-backup generator, 
        and then we have batteries. Servers are clustered; data writes on five 
        different hard drives.'' There is even a double ''pipeline'' between the 
        computer center on Tremont Street and Beth Israel Deaconess's main 
        campuses - but during the crash, both were clogged. 
        The crisis had nothing to do with the particular software the 
        researcher was using. The problem had to do with a system called 
        ''spanning tree protocol,'' which finds the most efficient way to move 
        information through the network and blocks alternate routes to prevent 
        data from getting stuck in a loop. The large volume of data the 
        researcher was uploading happened to be the last drop that made the 
        network overflow. 
        Halamka said Beth Israel Deaconess's recent economic troubles were 
        not behind the problem. In fact, on Oct. 1, hospital officials had 
        approved a consultant's plan to overhaul the network - just not quite in 
        time. ''Now,'' he said, ''we're going to do it faster.'' 
        The crisis also tapped into medicine's ambivalence about computers. 
        Yesterday, doctors at Brigham and Women's Hospital reported in the 
        Archives of Internal Medicine that 73 percent of medication-related 
        mistakes involved in malpractice claims are preventable and probably 
        could be averted through computerized prescription ordering - the latest 
        in a growing pile of evidence that computerization can cut medical 
        errors. 
        At the same time, clinicians have sometimes been wary of turning over 
        control to a computer, Tuomenesko said: ''When I enter something into a 
        computer, how do I know it got there?''
        That was part of the problem Beth Israel Deaconess had: New 
        information could sometimes be entered, but since network function was 
        fading in and out, clinicians weren't sure whether that information was 
        being delivered. So, the hospital decided to shut down the computers - 
        taping handwritten ''Do Not Use'' notes to monitors - creating an 
        instant generation gap, said Anderson, the hospital's top nurse 
        executive. 
        ''Nurses and doctors over the age of 35 were very much at ease,'' she 
        said. ''The younger nurses and doctors were very uncertain. We were 
        teaching residents how to write orders; we were showing nurses how to do 
        flow sheets.''
        Meanwhile, the hospital was figuring out how to run at its usual pace 
        without the 100,000 e-mails it usually sends a day. The lab was dumping 
        3,000 results a day on paper into plastic bins, to be delivered by 
        runners who came by every 10 to 15 minutes. Microbiologists were 
        ferrying lab results. Cardiac fellows were digging through paper records 
        to find old cardiograms to compare to new ones. People at all levels of 
        the hospital hierarchy had to deal with each other face to face.
        ''The lab is usually anonymous until something goes wrong,'' said 
        Gina McCormack, technical director of the West Campus lab. ''A lot of 
        people realized we're here. People got to understand each other's 
        jobs.'' 
        Anne Barnard can be reached, when the network is working, at 
        abarnard@xxxxxxxxx.