In Blacksburg, An ER Physician Still Tries to Heal
Wednesday, April 16, 2008
Forceful winds whipped down from the Appalachian Mountains on the evening of April 15, 2007, gusts lashing through Blacksburg. I slept poorly. The wailing winds unsettled me.
The next morning launched a seemingly normal day in the emergency room at Montgomery Regional Hospital, where I am an emergency physician. I had downed a much- needed cup of coffee and completed a few patient evaluations when suddenly the radio crackled with a strange and uncharacteristic call to the rescue squad at Virginia Tech. Someone was injured. There were vague reports of blood near a dorm room, a student who did not answer the door, who might have fallen off her loft bed, who might be lying inside unconscious.
It has been a year now, and parts of what happened that awful day still keep piercing my thoughts like a splinter. I'd trained in ERs in Richmond and in Albany, N.Y., and had learned to handle the urban tide of injuries from gunshots, stabbings, falls, fistfights and motor vehicle collisions. I knew trauma.
But I could not know the trauma that would rush in that April day to fill our small-town emergency room with horror and grief. We listened to the radio in stunned silence. The rescue squad was able to enter the dorm room. They found two students, both shot. One would not live. The other would be arriving in just minutes.
We called a trauma alert so that auxiliary staff would be ready and present. An anesthesiologist and a general surgeon were on hand as that first victim arrived: a student shot in the head. We worked to protect her airway and breathing, to control the bleeding. Urgently, we transferred her to Carilion Roanoke Memorial Hospital, the nearest trauma center. But the helicopter could not transport her. The wild winds were too strong. We transferred her by ambulance instead.
Night-shift nurses were off duty at 8 a.m. but had stayed until the transfer was completed. We were shaken and tearful. We'd thought our town was safe. But here we were in the midst of a shocking emergency, with police flooding in to ask questions.
We had just settled back into a normal routine when a voice shouted over the radio: "Active shooter at Norris Hall! Active shooter at Norris Hall!"
We launched our disaster plan. The night-shift staffers who had just left heard the news and returned to the hospital. Thankfully, three general surgeons, two anesthesiologists, two orthopedists and our ENT surgeons all quickly arrived to assist, as well as additional emergency physicians and other medical personnel.
Most of the students had been shot several times; others were injured while fleeing out the windows. After triage at the scene, they began arriving at Montgomery Regional -- 17 in all. The ER was jammed and frantic, everyone focused on saving lives.
The students were remarkable -- in shock but still able to talk to us, to answer questions. Their eyes were dilated in fear; primal flight-or-fight adrenaline still surged through them. And yet there was a spirit of almost calm cooperation among them, even amid the chaos and pain.
Time passed quickly. We did our job. We care for the sick and injured. But we do not often see gunshot wounds or stab wounds, not here in Blacksburg, where I'd moved two years earlier. A colleague working alongside me begged me to wake him up from this horrible drill.
It felt almost dreamlike. There could not have been this many injured. Even working in areas with high homicide rates, I did not see this volume of trauma in such a short burst of time. So many healthy young adults shot in the chest, abdomen, head and extremities. Bullets penetrated their strong bodies, shattering organs, bones and vessels in their path. One student was so injured she could not speak; her jaw was shattered and blood pooled in her mouth.