“You`re running on adrenaline, instinct. And flat
Transcript
“You`re running on adrenaline, instinct. And flat
10B» HEROES AMONG US sunday, july 29, 2012 B denverpost.com B the denver post 66 ME DI CA L P E R SO N N EL | T H E L O N G E ST N I G H T Angel Chavez, a nurse at Denver Health Dr. Comilla Sasson, University of Colorado Hospital Dr. Gilbert Pineda, Medical Center of Aurora Dr. Tien Vu, Children’s Hospital Colorado Cheryl Stiles, a nurse at Children’s Hospital Colorado “You’re running on adrenaline, instinct. And flat-out guts.” By Michael Booth The Denver Post By Michael Booth The Denver Post By Jennifer Brown The Denver Post By Karen Augé The Denver Post A ed and blue police lights bouncing off the windows of the emergency bay, Dr. Comilla Sasson reached for gloves. She didn’t usually carry extras. But suddenly a cop cruiser was backing into University of Colorado Hospital, full of bodies gushing blood. And then another cruiser. And then another. Sasson stuffed 50 pairs of gloves into pockets of her scrubs. This was not going to end anytime soon. “At some point, it was the longest night of my life. And at some point, it was ‘How did that five hours go by?’ ” she said. Sasson and her shift partner that Friday morning, Dr. Barbara Blok, spent the next hours triaging 23 victims from Aurora’s movie-theater shooting. Surrounded by trauma surgeons, charge nurses, orthopedic specialists, radiology techs and cleanup crews, they pointed fingers, steered gurneys and tried to bolster the spirits of first-year residents three weeks out of medical school. And peeled glove after glove after soiled glove. It’s the quantity of blood that sticks in Sasson’s mind. Blood from head wounds. From shattered limbs. From chest cavities opened to stem internal bleeding. Underneath all that blood was more to worry about. A bullet powers in and bounces, doing more damage on the way out. Or worse, stays inside and threatens veins and tissue. Sasson describes her triage duty as a constant circling. A patient with a pulse, talking, will suddenly crash from unseen internal bleeding. The ER doctor must cycle around and around the arrayed beds, heading off that crash. University’s ER was already full and on divert status, with 10 more in the waiting area, when the shooting started just after 12:30 a.m. With gunshot trauma, you make room. The first hour is the golden hour for those on the brink. “The first nine to 10 patients were all in the resuscitation area,” she said. “More than five could not tell us their names.” Aurora police cars kept rolling in, Sasson remembers looking from indoors to outdoors. “These people are really sick,” she thought, “and I’ve got two minutes to figure it out before the next one comes in.” Six hours after it began, at a 7 a.m. shift change, Sasson let out a deep breath and said to herself, “Wait — what did I just see?” But inside that six hours? “You’re running on adrenaline, instinct,” Sasson said. “And flat-out guts.” R D he first inkling of what was in store came rolling up to the Children’s Hospital Colorado emergency room without warning — and without lights and sirens — a little before 1 a.m. A car — not an ambulance or police car, just some ordinary car that not long ago had transported people to a movie theater — drove up. Inside was a passenger who had been shot. “That’s when we were told — and it’s a little fuzzy now — but they said there’d been a shooting in a theater,” said Dr. Tien Vu. Soon, the victims came too fast for Vu to track. Cheryl Stiles’ phone rang just after 1 a.m. A self-professed night owl, she had been asleep only an hour, and she had already put in a full shift the day before. Stiles started her nursing career at Children’s 25 years ago — and 24½ of those have been in emergency medicine. Now that she is director of emergency services, those late-night calls are part of the job. In Colorado’s hierarchy of trauma care, Children’s has the highest ranking. For children, that usually means a car accident or a fall. To get multiple gunshot wounds within an hour probably had never happened, Vu said. Stiles was in her car within minutes of getting the call. When she arrived at the hospital, Stiles said, the first thing she saw was a group of staffers standing just outside the emergency-room doors, in the ambulance bay. “The team was in a circle. Some were holding hands, some hugging,” Stiles said. They had just needed a moment, she said. Stiles joined them briefly, then they all walked together through the glass doors back to the emergency room. Stiles remembers a nurse torn because a patient was afraid to have the lights turned off or be left alone. She held his hand while a colleague did whatever clinical things were required. Twelve hours after it began, Vu’s shift was over; Stiles still had seven more hours — her scheduled shift — ahead. Vu got into her car and headed north on Peoria Street. She had gone only a couple of blocks when she saw red lights clustered around a brick building. “I went home and turned on the TV,” she said. “That’s when the enormity of what happened hit me.” It is also when she learned the red lights were gathered at the booby-trapped home of the man suspected of causing the carnage. She turned off the TV, kissed her 2year-old daughter and, exhausted, went to bed, hoping finally to get some sleep. She didn’t. good portion of Angel Chavez’s job is to be calm when she realizes the patient coming out of the ambulance has three fingers blown off by a gun. And to swallow shock when the captain’s chair of the next ambulance holds a girl sitting upright and bleeding, gunshot wound to the chest. And not to let a burgeoning massacre 10 miles away distract her team from the usual patients facing death outside the spotlight. Chavez was the night charge nurse in the Denver Health emergency room when the theater shootings began. Alerted by dispatchers around 1 a.m., she checked which ER rooms could be safely cleared and how many hallway spaces were open for overflow victims. “We could have taken 20 ourselves,” Chavez said, with potentially more in the children’s ER. All without forgetting the current traumas: A patient in deep septic shock who would later die. Head injuries to a helmetless motorcycle rider. Early on a Friday morning in summer, the Denver ER is often stuffed with the aftermath of bar fights, car wrecks and gang posturing. One of the tricks is to not set everyone in motion immediately, no matter how strong the instinct, said Dr. Chris Colwell, Denver Health’s emergencymedicine chief. He was woken up by cellphone calls after midnight, but part of his job is to think three days down the road. Colwell, who treated students on the ground at Columbine High School’s shootings in 1999, allowed himself one brief flash that Friday’s call was “eerily similar”: dozens of young people shot in a place that should have been safe. In the next moment, Colwell felt lucky there was something he could do about it. Just a few hours after 1 a.m., the ER bays were quiet again, and parents of the theater victims checked in the hospital lobby to meet social workers and doctors. Chavez looked forward to the Saturday yoga class she takes to slough off stress and thought of the girl missing her fingers. Who was, surprisingly, cheerful. “She was so happy it wasn’t worse,” Chavez said. The trauma-response culture is all about “What did we learn?” “It’s so positive, it makes you feel you could be positive as well, in something like this,” Chavez said. r. Gilbert Pineda grabbed a full bottle of water and chugged all of it in a few gulps. He shook his head a couple of times. “Focus. Focus. Focus,” he said, only to himself. Pineda walked down the narrow, stark-white corridor of the emergency department and added up the scene. A man with a bloody bandage on his head. One patient intubated, on life support. Another man with “graphic” gunshot wounds to his arms and legs. Patients lined up in the hallway, including a man with a belt wrapped around his thigh like a tourniquet. A man screaming: “I need pain medication!” More screams coming from one of the rooms. Pineda told himself not to let the yelling distract him — just because patients are loud doesn’t mean they’re critical. He saw a doctor in a white “moon suit” preparing to decontaminate people exposed to a noxious gas. Eighteen patients, 13 with gunshot wounds. Before walking into the Medical Center of Aurora early that Friday morning, Pineda had been up 20 hours. He had worked a 12-hour shift, then gone to dinner with his daughter who was in town from college. He was as tired as he had ever remembered being and went to bed at about 11:45 p.m. Thursday. Pineda was asleep for about an hour when his phone rang. It was the hospital’s emergency medical chief, Dr. Frank Lansville. His voice was direct and solemn. “Gilbert, there has been a mass shooting in Aurora. There may be as many as 20 patients. I need you to go to the emergency department.” Pineda slipped on a pair of Levis and grabbed his medical bag. As he was leaving, he thought, “Boy, what an idiot you are. You are in your car, backing out of your driveway, and this is something that’s been a dream.” He turned on the EMS radio in his car. What he heard snapped him alert. Pineda went from one patient to the next, unwrapping bandages and checking for signs that shotgun pellets had entered the chest or the bloodstream. One man had 20 pieces of buckshot in his body. Pineda, the hospital’s EMS medical director, said it’s those kind of days that remind him why he chose emergency medicine. “This is what I trained to do,” he said. “When something like this happens, you just click into this mode of ‘Wow. This is what I like to do.’ Not that I want to see people injured, but if they are injured, I want to have the opportunity to take care of them.” T WE WILL REMEMBER VERONICA MOSER-SULLIVAN ALEX SULLIVAN Innocent and beautiful, her aunt says. Veronica was a 6-year-old, vibrant, excitable child who a few days before she died was chatting away about learning how to swim. The blond, blue-eyed girl attended Holly Ridge Elementary School and loved to play dress-up. Her mother, critically wounded that night in the theater, was pregnant and later miscarried. Veronica had gone to the movie with her mother and her mother’s boyfriend. “Veronica was just so full of joy every day. She loved life, no matter what we did,” her father, Ian Sullivan, told London’s The Sun. “She was the sweetest, most innocent, angelic little child anyone could ever ask for.” Her father took her on a camping trip near Georgetown a few days before Veronica died, he told the newspaper. They slept in a tent, went fishing, saw elk and deer and cooked over a campfire. Friends and family will miss his big heart and his bear hugs. Alex Sullivan was a loving husband, a good-humored guy, a comic-book lover and film fanatic who could quote “Caddyshack” from start to finish. He died on his 27th birthday, keeping a family tradition started at age 6 to go to the movies that day. A year ago last Sunday, he married his wife, Cassie. Sullivan stood 6-feet-4 and weighed about 280 pounds. He played football and wrestled before graduating from Grandview High School in 2003. Later, he went to culinary school. Sullivan worked at a Red Robin restaurant and went to the Aurora theater with several of his co-workers that fateful night; seven of them were injured. Sullivan was the family peacemaker. He hugged his sister each time they met and loved his wife so much it showed on his face. “A lot of my memories growing up, we always had a great time together and had fun and played and climbed trees, and I was right there with him on everything,” said his sister, Megan.