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The shifts start like any other night.

Treating Bed 7 for chest pain, Bed 8 is a pregnant woman with abdominal pain after a car accident. Bed 9 has a large eyebrow laceration from a bar fight. Bed 10 is a college hockey player who broke his arm. The ER is full – the waiting room has 10 people, and you’re seeing patients in the hallways- and you have no idea how you will catch up.

Then you get the phone call. There was a mass casualty– an event where not just one person is injured. Not just two. Not just ten. But twenty….thirty… more. It could be from an apartment fire, a factory explosion, a stadium risers collapsed… Or most recently, from a lone gunman.

You have 0.3 milliseconds to recognize the pit in your stomach. That feeling that you can’t breathe. That you wonder if you know anyone who you know – or worse – love—was there.

Then you move. The ER “Mass Casualty” protocol is activated. Suddenly you see the ER…the hospital… every single staff member and many of the patients— work together in a way you have never seen. Activate the emergency on-call line for additional nurses and doctors, techs, staff to come in NOW. Every patient being admitted goes upstairs immediately. Everyone that is being discharged—goes. Move the beds. NOW. Get the portable x-ray tech here NOW. Call the blood bank to bring up more O negative blood

Somehow, this happens all in 10 minutes. The trauma surgeons come down to the ER. They stand alongside you. You grab a surgical gown and gloves. Cover shoes and boots that go up to your knees. A mask and a hat.

Then, for about 30 seconds, you listen to the EMS radio, and the 50 of you, gowned in matching plastic protective-ware wait.   Just when it starts to sink in again, you hear the first siren of an ambulance approaching.

You take the first patient – a young male that the paramedics are bagging. He’s unresponsive. Bleeding from a wound at his chest. You don’t look up, but in comes the next, and your surgical colleague takes that one. In come a third…a fourth….a fifth… they keep coming, until the Gynecology room is now a trauma bay as well.

Some you can save – stabilizing many that your surgical colleagues then take to the OR for definitive treatment. Some you don’t. And with each one of those, you curse a little bit – but you don’t have time for that right now- because right now, there’s only one thing that matters.

Of course, you don’t always just treat the victims. Sometimes, you find that the bastard that caused this – is laying right on the stretcher in front of you. After the Boston Bombing, both of the Tsarnaev brothers were treated at the ER where I worked, by my wonderful ER colleagues.

Yet even then, you still do your job. To the very very best of what you were trained. Even better than you ever thought you could.

Because he may not value human life. But dammit, you do. And that’s why you’re here tonight.

 

Thank you to all of the many men and women of Orlando: doctors, nurses, paramedics – everyone who worked so hard over the past 2 days – and likely continues to do so right now.

 

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