A Firsthand Account From Inside Fort Hood
Tuesday, November 10th, 2009A letter a blogger friend forwarded:
Dear Family and Friends,
Thank you for your thoughts and prayers for us and the Fort Hood community, a community that has been deeply wounded both physically and spiritually. The past day and a half have been very challenging. I write to share my somewhat-insider perspective on the events. Please know these have been humbling hours for me and I write not to glamorize myself or this tragedy. I hope my personal experience is helpful as you all are processing the events.
At about 1:40 pm local time on Thursday, I was informed that a mass casualty situation was evolving at Fort Hood. At that time I was working in a trailer adjacent to the hospital. The only information I had was that one or more gunmen had opened fire at a SRP site, a type of processing facility where many soldiers pass through daily. Knowing the high density of soldiers at the SRP site, I braced myself mentally for the possibility of a large number of casualties. Upon exiting the trailer, I immediately heard sirens and saw several ambulances driving up to the ER bays, dropping off casualties, and turning right around to pick up more. I ran up to the hospital.
The hospital has pre-designated areas for personnel to report to in the case of a mass casualty/disaster situation. Ours (family medicine docs) is the family medicine clinic, located on the first floor of the hospital, about 100 feet from the ER. All casualties were going initially to the ER, where they were quickly triaged and dispersed from there to the operating room, our clinic, or elsewhere. There were already casualties being treated when I got to the clinic. We broke up quickly into teams, with one or more docs and nurses with each patient. All the patients had bullet wounds-not a common site in a family medicine clinic. Fortunately or not, several of the staff had extensive trauma experience from prior deployments. Initially there was no morphine available, so the halls were filed with shouts of pain as the patients were examined.
My first patient was a young second lieutenant. Her uniform trousers were cut almost completely off, a standard practice during trauma evaluation, designed to avoid missing any injuries. A bullet hole can be pretty small, and one injury can easily distract from others. The less immediately obvious wound can become deadly if not appreciated on the initial assessment. I had never treated a patient with a gunshot wound before Thursday. Thankfully the Army has sent us all the Ft. Sam Houston to an ATLS (Advanced Trauma Life Support) course, a course designed for exactly this setting, where a non-trauma-surgeon is evaluating and stabilizing a trauma victim.
When we asked the 2LT what happened and she was able to tell a sensible story in complete sentences, I knew that for the moment her airway, breathing, and circulation were intact. She had a tourniquet and some bright red blood on her left thigh, and said the shooter had looked her in the eye, then shot her in the leg. “He could have shot me in the head, but he didn’t.” I left the tourniquet in place, since it seemed to be working fine. I swept my arm under her body, looking for any blood when I pulled it out. Her vital signs were good. Her heart and lungs sounded good. She had IV access with fluids running. She had no other pain other than her leg where she was wounded, and she had good pulses and sensation in that foot, all encouraging signs. We gave her some morphine, removed the dressing and saw an entry wound, but no exit wound was visible. We got ready to take her to get x-rays.
Then, here comes the cavalry-the orthopedic surgeons arrived! They quickly examined the 2LT, agreed she was stable, and moved on. X-rays showed a bullet near her hip with no fractures. Much later in the night, after reviewing the patient’s x-rays with ortho again, she was released to go home with instructions to come back to our clinic in the morning for a re-check. A couple ER physicians came through to offer their help; not satisfied at saving lives in their own area, they offered their expertise to us as well. We were glad to have it.
We moved from patient to patient, making sure everyone was accounted for and getting the appropriate treatment and that their loved ones were contacted, to know that they were safe. Soldiers barely out of high school were dying in the ER. A new, young mother died on the operating room table. A family medicine intern with a baby of her own was there. There was no time to pause or grieve.
Based on the numbers you have heard, the vast majority of victims were treated at our hospital, but the flow of patients eventually abated. I was hearing little bits and pieces of what had happened; there were conflicting reports on the number of soldiers killed, the number of shooters, and the number of locations. A patient told me the shooter was in uniform, a Major, a field-grade officer, and he had called everyone to attention before opening fire.
Later we heard the unthinkable, that this was indeed an Army officer, but worse, a physician, entrusted to heal but causing great harm instead. This man had on occasion worked at the hospital, covering on weekends. Sometimes the family medicine inpatient service admits patients that have intentionally overdosed or are drunk and saying they want to harm themselves. Once these types of patients are cleared medically, they need psychiatric evaluation to determine if they are safe to go home; one of the family medicine staff physicians, Dr. K., had consulted this psychiatrist (the shooter) on such a patient only 2 weeks ago.
When she heard who the shooter was, Dr. K. was besieged with guilt, saying that she knew he wasn’t quite right, that he seemed depressed, that she should have done something. She broke down in sobs in the middle of the clinic. A couple of us sat down in a clinic room with her and listened. My mentor, a female Major and West Point grad, hugged her and let her cry. It was probably the first hug she’d had since her husband deployed to Iraq in September. They got 10 days notice.
I have never been so proud of our clinic. There wasn’t a nurse in that clinic that wouldn’t run to the other side of the hospital to get something if a patient needed it. The cleaning lady was unreal-I thought some of that blood would never come off, and by the time she was done (quickly!) I would’ve eaten dinner of those tables.
Things were letting up for us in our area, so we went to other floors of the hospital, helping do things like write admission orders for patients so there medications could be brought up from the pharmacy. The general surgeons were doing yeoman’s work. They were cutting open chests and bellies and battling their mightiest to repair the damage done by the bullets. They mostly succeeded, doing the work of specialists in cardiothoracic and vascular surgery, simply because they were it, they were our best hope.
My fellow residents and I did what we could to help; most of us left around 9 pm simply because there wasn’t anything else to do. I was so proud of those guys and their families; they would have stayed the whole night if there was a way they could help out. A good friend of mine stayed to carry the Internal Medicine on-call pager; I went home to xxx, then went back around 2 am to take the pager back from him. No matter, no one was going to the ER, so there were no admissions. I think they thought, “You know, I’m not shot, I think I’ll be okay.” I did what I could to help out in the ICU.
Another patient died in the time I was at home, a clean-cut 21-year-old. He had extensive chest and abdominal wounds, the worst to his aorta. When he arrived to the ICU from the OR, he had what surgeon’s call the “unhappy triad” of hypothermia (his rectal temperature was 88 degrees), acidosis, and coagulopathy. It is rare to survive after reaching that point. He got 50 units of blood. Hospital workers were donating their blood. He was getting 4 IV medications to raise his blood pressure. He went back to the OR. He had cardiopulmonary arrest, was successfully resuscitated once, but not the second time. They gave him everything they had, even when it was probably futile, because what else can you do but everything? This is a kid who will never know what it’s like to fall in love and marry, to have children, to grow old. There is no tomorrow for him.
There was another young 20-year-old private with a bullet in his chest, only it inexplicably stopped at his sternum, and one in his back, only it never made it past the muscle. When I saw him up on the wards, all he was worried about was when he could go downstairs and smoke. A little walking miracle with a pack-a-day habit, no clue how lucky he was and, for the moment, some extra metal in him.
Friday, there were a lot of generals at our little hospital. They visited every single injured soldier. George W. Bush, the former president, visited the hospital in the evening. Say what you will about his politics, but that man was here, and that counts for a lot in my book.
Keep everyone at Fort Hood in your prayers, especially the families of the fallen. There are not words to describe how sad and tragic this is. As a Christian, it is difficult to understand and hard to accept. Abstract ideas about the effects of sin on creation, the depravity of mankind as a whole, and the presence of evil forces in the world give way quickly to the concrete reality that mothers will bury their sons and daughters in the days ahead, and everyone knows that is not the way it’s supposd to be. If I can offer you hope in the midst of this darkness, it is that I have seen all around me in these troubling hours people realizing their potential to do great good and to come together in unity to sacrifice for others. We as Christians must always remember that our God, not willing to allow us to suffer alone, took the form of a man and suffers along with us. When His friend Lazarus died, John 11:35 tells us that, like us, Jesus wept, and I know He still weeps along with us tonight..
God bless you all and we love you,
xxx and xxx
Ted Kennedy Died After Living A Full Life
Wednesday, August 26th, 2009I can’t say much nice, so I won’t say much of anything–except to acknowledge that the man lived, died, served his constituents, and was rewarded and acknowledged for that service.
Life is short. And we are all but a blink. Wealth, privilege, connections, power cannot give a person eternal life. They cannot give a person love. They cannot confer happiness. Life must be made in the moment.
P.S. Using Ted Kennedy’s death to prop up horrible legislation is disgusting. Politicizing death: it’s what Democrats do.
You Don’t Know, You Don’t Want To Know
Sunday, December 14th, 2008Why does it take getting pounded by life to tenderize our hearts to the suffering of others? Some don’t get tender, of course. Some, like Javert, feel wronged and pursue “justice” until the end of their days. They keep track of every slight and spend their days plotting revenge. Mercy is weak, kindness naive.
Some who suffer retreat from life and become a non-entity. And some who see these people retreat condemn them. The Anchoress addresses this notion:
John never demanded notice. Likely he never believed he was worth anyone’s noticing. When you are rejected by your parents at a young age, never quite included in “the family,” that can happen.
It has never been my habit to decide the spiritual fate of someone else; in fact I loathe nothing more than folks who presumptuously declare they know the state of someone else’s soul, because of this scripture verse or that. These people, to me, seem unloving, empty and oddly disconnected from the scripture they quote…as though their intellect has cut off from their heart. Other people mean well, but…I know tomorrow my email will contain a few missives from people who will quote scripture at me and enumerate to me all the reasons my brother is not now in the peace of Christ.
I say to hell with that. He was loved into being; he was baptized and sealed. The people who were supposed to teach him the way in which to go spun him madly, incessantly – then allowed him to get dizzy and lost. He lived a sad, tortured life the best way he knew how – quite imperfectly, but then his tools were also very insufficient and his trust was non-existent. I cannot claim to know anything, but I do not believe that a loving God would look upon this much-sinned against man and reject him once again, as he was rejected all his life.
Pain. There is so much pain. And while many people have empty souls, who knows what their lives would be like if love touched them? Only God knows the answer to that.
Obama’s Abortion Position
Wednesday, September 17th, 2008Here (h/t Ace):
Just to clarify.
And also, related: Why Sarah Palin is immoral for NOT having an abortion. No, they aren’t joking. Says Cassy Fiano:
So, I guess in this guy’s mind, we should have no Helen Kellers or Franklin D. Roosevelts; no Lord Byrons, Lord Nelsons, or Beethovens. Is that the argument? That unless you’re 100% “healthy” — and by whose standards is “healthy” defined anyway? — you don’t have a right to live? And what gives this guy the right to decide?
I grew up with my Down’s Syndrome cousin. She was as integral to the family as any chromosomally “perfect” person. The funeral home could not fit all the people when she died. She was loved and she loved. She lived on the farm and she contributed.
What amazes me is that these same people will go to any length to save a dog or get naked for PETA and will turn around and show callous disregard for human life–either flawed or inconvenient.
A note on late-term abortions: My sons were born at 24 weeks gestation. One died after contracting MRSA at the hospital. One received the best medical care and is now in 5th grade. These are children. People. The notion of having a botched late term abortion and then allowing that child to die, or actively kill the child is beyond barbaric.
Radical leftists like Obama embrace eugenics and a life inconvenienced by unplanned children. It is horrifying. What birth defect do you have that makes you unworthy? What circumstance created your inconvenient existence?
Birthing A Baby To Save A Baby and Dying At Will: The Ethics Of Saving Or Losing A Life
Tuesday, August 5th, 2008It seems impossible that 18 years have passed since the controversial decision by the Ayala family who chose to get pregnant with a baby to save their daughter, Annisa, who suffered with leukemia. She needed a bone marrow transplant to save her life, but there were no matches. Her parents had another child who ended up being the perfect match. Both girls are alive and well today. Watch the whole story here.
An ethicist made the argument that it was wrong to have a child, and before the baby could consent herself, take her bone marrow to save her sister. I watched the family, imagined watching my daughter die and can see making the same decision. The thought did occur to me, though, what if the child wasn’t a match? How would that reality affect the family? After the older daughter died, would the new child be a solace or source of pain? That’s a lot to put on a child. I’m sure the parents thought this through. What say you?
This case also reminded me of end of life decisions, too. No one likes to talk about it, but I know for a fact that parents, children and doctors make tough choices every single day in hospitals across America. The Terri Schiavo case was especially divisive because of the nature of her husband’s relationship and the questionable circumstances surrounding her coma. At any rate, her case wasn’t typical. Most people at the end are suffering and the question is whether to intervene and end it, or less overtly, just remove the life support; or, should nature be allowed to take it’s course, meaning that the person dies when the body quits. Again, I’m curious about your reaction to this dilemma.
Cross-posted at Right Wing News
Tony Snow Dead at 53, DeBakey Dead at 99
Saturday, July 12th, 2008
I’ve said it before, I’ll say it again: Life is short. He struggled against colon cancer and lost the fight.
Tony’s humor and humanity stood out in whatever role he played. I delighted in his sparring with the press when he was Press Secretary. I delighted in his sparring with politicians in his role at FOX. He just seemed like a smart, dedicated, nice guy.
Michelle Malkin says:
He was a true mensch, multi-talented–and one of the kindest people I had the honor to meet in the news business.
Even a long, meaningful life is short. Yesterday, surgeon Michael Ellis DeBakey also died. He is the father of modern cardiovascular surgery:
He remained vigorous and was a player in medicine well into his 90s, performing surgeries, traveling and publishing articles in scientific journals. His large hands were steady, his hearing sharp. His personal health regimen included taking the stairs at work and a single cup of coffee in the morning.
DeBakey’s death was mourned Friday night by the leaders of Methodist and Baylor. Methodist President Ron Girotto said, “He has improved the human condition and touched the lives of generations to come. We will greatly miss him.” And Baylor President Dr. Peter Traber added that “he set a standard for preeminence in all areas of his life that those who knew him and worked with him are compelled to emulate. And he served as a very visible reminder of the importance of leadership and giving back to ones community.”
It occurs to me that both of these men shared a trait: recognition that time is short and impatience with those intent on wasting it:
”He’s not hard to work with if things are done right,” said Noon, DeBakey’s colleague of more than three decades, in a 1995 interview. ”He was hard on people who slacked off or made mistakes. But he was so busy. He had to depend on people, and he could be tough. But he was always tough for a reason.”
Tough, impatient, perfectionistic, driven, curious, kind, smart. Good traits to be remembered for.
R.I.P. Tony and Dr. DeBakey.
