“A ship is always safe on the shore, but that’s not what ships are for.”- Kendrick Castillo
“Is Kendrick OK?”
The answer to that question still haunts me. It was asked of me by my patient in the Emergency Department, who was a classmate of Kendrick’s. Just a few minutes earlier, my patient and Kendrick had helped subdue a shooter within their classroom and now was himself another student victim of gun violence. My answer was simply, “I don’t know, but let me check.” There was no patient named Kendrick in the Emergency Department.
It was early in the afternoon and the Medical Director of the Emergency Department and I were getting ready for a staff leadership meeting. As President of the medical staff, it was my responsibility to make sure everything for the meeting was ready and I was finishing my presentation.
The overhead page sounded out, “Trauma Activation Emergency Room #2, 5 minutes.”. About a minute later came the second page, “Trauma Activation Emergency Room #3, 5 minutes.” At this point my Medical Director came back to the office to inform me we have an active shooter at a local school. During the next 17 minutes we were about to receive five students with gunshot wounds, all received within their school. Our own Chief Medical Officer for the hospital activated our Disaster Response command center, and within 10 minutes of the initial announcement we had six Emergency Physicians in the department, four Trauma surgeons, one Neurosurgeon (simply waiting to see if there would be any patients with head injuries), 10 extra ED nurses in addition to the usual staff, and multiple anesthesiologists. Five operating rooms were cleared, and elective cases were cancelled.
This is what happens in our hospital when an active shooting occurs. We are very good at this, which is both a blessing and a problem. The blessing is we train and prepare at least twice per year for similar circumstances. The problem is we are very good at our response because during my 30 years working in this hospital, we have received victims on five different occasions from either mass shooting events, school shootings, or both.
It all started on April 20, 1999, with Columbine, when 10 victims were transported to our facility. The entire community was devastated, but we thought it was just an aberration, that we would never see anything like this again in our nice suburban environment. Then came February 2010, Deer Creek Middle School shooting, two victims. December 2013, Arapahoe High School shooting, one victim with fatal injuries. December 2017, Douglas County Deputy shooting, five victims, one with fatal injuries. And most recently, the Stem School Shooting, May 2019, with five victims to our facility.
If you find yourself thinking, “Weren’t there more mass shootings in the metro Denver area?” you are right. These are ONLY the ones with victims our hospital has received during my Emergency Medicine career.
In the aftermath of these events, we all become victims — the community and especially the Providers. After all the victims of the Stem shooting were stabilized, we started taking care of our own staff. We had an immediate debrief in the ED of everyone present. It was then I found out one of our own nurses had a child at the school at the same time, yet had to take care of patients while also trying to check if her own child was OK. We then had another debrief of the Incident Command Center, and honestly we were all feeling really good. Five victims, only two with serious injuries, yet all expected to survive.
And then the answer to the question, “Is Kendrick OK?” started to reveal itself. Kendrick was a senior just three days from graduation and was planning to study to be an electrical engineer. He was truly a hero and rushed the shooter along with two other students who were also injured.
Just as we thought the disaster incident was over, the parents of Kendrick Castillo[i] were brought to the Emergency Department by law enforcement. They were taken directly through the ambulance bay and had one question for our charge nurse: “Is our son here?” Sadly, the nurse had to tell them their son was not one of our patients and then escorted them to a family waiting room so that we could try and help these parents find their son. At that point, an officer informed the parents that Kendrick was identified at the scene and that he had passed, and his body was still at the school.
The answer to the question — “Is Kendrick OK?” — was NO, Kendrick was not OK.
The trauma doesn’t stop there. The families are forever affected, the students at the school are forever affected, and our care providers are forever affected. The providers are affected by having to care for students injured in gun violence, by taking care of kids who may be the same age as their own children, and by dealing with the trauma of having to tell parents that their child did not survive.
Two days later we had a hospital-wide professional debriefing, with at least 50 providers arriving to get assistance with their own mental health. We even had two physicians who were not part of the Stem shooting response, but were part of the Columbine response. Twenty years later, the feelings never go away.[ii]
What is our aftermath? We have a community and victims who are forever scarred. We have two nurses who, despite unlimited support, have quit emergency medicine because they do not want to ever see children with gunshot wounds again. We have an Emergency Department which now sends notes and letters of support to the hospitals taking care of all the other mass shooting since our Stem shooting.
The facts should not be neglected. Between the time of our Stem Shooting on May 7, 2019, and the Dayton, OH, Shooting on August 4, 2019, there have been 142 mass shootings in the United States with 148 deaths and 648 wounded.
I don’t have answers, just my experience. I am praying I don’t have to have any more experience in taking care of mass shooting victims, but I also know I probably will. Something needs to be done. I won’t pretend to have the solution, but I do know taking no action is not a solution. To honor Kendrick Castillo, everyone needs to do what they can so students don’t need to attack shooters in school. As Kendrick stated: Don’t let the ship of action stay on the shore.
Mark Elliott, MD, MBA
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