Doctors, nurses spring into action for Texas high school shooting victims

Dr. Safi Madain and ER nursing director Margaret Reed recalled treating the students who were injured when another student opened fire at Santa Fe High School

By Jenny Deam
Houston Chronicle

SANTA FE, Texas — At 8:17 a.m. Friday, Dr. Safi Madain had just poured himself a cup of coffee after helping hustle his older kids off to school and his wife to work. He had been on duty for 10 days in the emergency room at Clear Lake Regional Medical Center and was ready for a day off.

Then his cellphone buzzed.

Dimitrios Pagourtzis opened fire at a Houston-area high school Friday, killing multiple people, most of them students, authorities said.
Dimitrios Pagourtzis opened fire at a Houston-area high school Friday, killing multiple people, most of them students, authorities said. (Photo/Harris County Sheriff's Office)

Active shooter incident at Santa Fe High School. We are getting 5 so far.”

Madain closed his eyes and exhaled. He typed a one-word expletive in reply.

They had drilled for this. Planned for what to do if a mass shooter opened fire in their corner of Texas. Now it was real.

His wife, Dr. Amy Ray, was pulling out of the driveway with their two youngest in the car. He sprinted to tell her. To ready her.

“You’re never emotionally prepared to have children come in with injuries,” the father of four would later say. He was an emergency physician, medical director and chair of emergency services at the hospital in Webster. “Anytime a kid comes in it’s hard to separate from your own kid.”

He pulled on scrubs and ran a hand through his hair, all the while willing himself to be calm. If he showed stress or seemed frantic that was the wrong message to send to the staff and to patients. The joke was to always use your indoor voice.

Still, his mind raced. “What am I going into?”

The morning text had come from Margaret Reed, emergency department nursing director. She had arrived at work about 7 a.m. She heard things had gone smoothly in the overnight shift and felt relieved. Ever since nearby Bay Area Regional Hospital had closed they had often been slammed with 30 to 40 more patients in the ER each day.

She was at the nurses’ station when she got an alert from an ambulance crew that there was a mass shooting at the high school about 15 miles away. It was 8: 10 a.m. Almost simultaneously there was another. They were on their way.

She quickly gathered her staff and told them what she knew. It wasn’t much. Outwardly, everyone was composed. There was a job to do. But the molecules in the room had changed in that moment.

Reed ran through her staff in her mind. Did any of them have kids in the Santa Fe Independent School District? Some did. None at the high school. She is a mother and a grandmother. She wears a Wonder Woman pin on her name tag. “My nurses are also my kids.”

Three minutes later a hospital-wide warning blasted through the loud speaker. Mass Transfusion Activation. That is code for get lots of blood ready.

Then, suddenly, the first three victims, all shot, were rolled through the double doors on gurneys. They seemed in shock. Not screaming, not saying anything at all. Just staring. The paramedics had done a good job of dressing their wounds. It didn’t look as bad as Reed had feared. It was like a carefully choreographed ballet as doctors, nurses, and the staff all moved efficiently in time. They knew the steps of this dance. Reflection, despair, anger -- that all comes later.

Another student was rolled in. A girl. Oxygen was being pumped into her. Her eyes were closed. She seemed unresponsive but then she answered when asked her name. A good sign.

More arrived. And then more. A boy was wheeled in who had been shot twice. His wounds were serious.

In all, there would be eight. Six were stabilized and sent home. The boy and the girl with the gravest injuries stayed. One was critical Friday night, the other in fair condition.

Five more went to other hospitals. In all, nine students and one teacher were killed.

When Madain arrived, nearly three dozen doctors, nurses and other staff were clustered near the trauma rooms. He made the rounds, offering encouragement and praise. It was oddly quiet given the circumstances. None of the yelling and chaos of TV emergency rooms. In real life, the scene is calmer but grittier. More blood, uglier wounds.

“A gun can do a lot of damage to a body,” Madain said.

A mother came running down the hallway, weeping.

“Where’s Room 15?” she called out, her voice nearing hysteria.

“I will show you,” Madain said, gently clutching her arm and steering her into the room where her child was being treated. Mother and child began to cry together, clutching each other in relief and terror. Madain pulled the curtain shut and silently backed out of the room.

“I just left them to have their moment. There is nothing anyone can say,” he said, “Have I ever cried? Absolutely. But it is always later.”

He finds the gun debate, sure to roar to life once again after Friday, emotionally exhausting.

“I believe you should be able to own a gun, to protect yourself and your property. I would never take that away from people,” he said, “But we need to do a better job of keeping them out of the hands of people who shouldn’t have them.”

Reed worries about scars less visible that take longer to heal.

“These kids who survived are going to have survivor’s guilt, they are going to have post-traumatic stress disorder, they are going to have nightmares,” she said. “This is going to impact our whole community for years to come.”

Counselors arrived at 11 a.m. to help staff work through their feelings.

As the day wound down, Reed had nothing but praise and pride for her nurses, for the entire hospital.

“It was a machine and every piece ran smoothly,” she said.

Then she paused, a single thought that pushed aside all the rest.

“This isn’t normal.”

Copyright 2018 Houston Chronicle

“This isn’t normal.”

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