“You`re running on adrenaline, instinct. And flat

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“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.