At hospital, the agony of not being able to help school shooting victims : Shots - Health News A pediatric surgeon and his colleagues at Vanderbilt University Medical Center had prepared for a mass casualty event, but the victims of Monday's shooting had already died by the time they arrived.

At a Nashville hospital, the agony of not being able to help school shooting victims

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Doctors at Vanderbilt University Medical Center were on their morning rounds Monday when pagers alerted that an ambulance with a badly wounded gunshot victim was headed their way. Then came another alert - and another. And soon, 5 of the 6 victims of the shooting at The Covenant School in Nashville had arrived at the hospital. NPR's Becky Sullivan has this report.

BECKY SULLIVAN, BYLINE: The staff at Vanderbilt Med Center have long prepared for what they call a mass casualty event. Basically, they have a roadmap for how to mobilize the hospital when something happens that could send a lot of people there all at once.

ALEX JAHANGIR: So whether it's the tornadoes that happen near Nashville or a really bad accident on the interstate or, unfortunately, previous mass shootings here in our region.

SULLIVAN: This is Dr. Alex Jahangir who heads Vanderbilt's trauma center. They practice every month, he says. Trauma surgeons and nurses get ready. They clear and prep the operating rooms. Someone calls the blood bank and gets blood ready for transfusions. They clear space for patients' families to gather. On Monday, it was the real thing.

JAHANGIR: I was seeing patients, and the mass casualty alert came across my phone. It became evident that this was serious, and this was - it's what I think many of us, especially those of us with young children, always dread.

SULLIVAN: Of the victims who were brought to Vanderbilt, three were children. The trauma surgeon on call at the children's hospital was Dr. Joseph Fusco.

JOSEPH FUSCO: Obviously, you're in a bit of shock when you get something like that. This should never happen to children.

SULLIVAN: Fusco was among the team of doctors who assessed the victims as they came in. By the time the young patients arrived, they had already died, hospital officials say.

FUSCO: I think the feeling, when those patients come in, is that you're so geared up, and we're so well prepared to help. Everyone is there, and they want to help. And the feeling of sheer helplessness when you have patients that come in, and - with injuries that are just completely unsurvivable.

SULLIVAN: Gunshot wounds are a fact of life for trauma surgeons in major American cities - even for pediatric surgeons like Fusco. Firearms are the leading cause of death for children in the U.S. But there's a big difference between the wounds caused by a handgun versus those caused by military-style rifles, he says. That's especially true for children, with their compact abdomens and major organs so close together. In all the years that Fusco had spent training and working as a surgeon, he says, he had never seen this kind of injury on a child.

FUSCO: There are a lot of things that I can fix. There are a lot of things that I could help a kid - and we see bad cancers, bad traumas. We see a lot. And it weighs on you, of course, but we get a lot of wins, and we're able to help a lot of people. But this was different.

SULLIVAN: As the hours passed on Monday and it became clear that they had done all they could, about 20 doctors and nurses gathered for a few moments in a conference room. Some sat in silence. Some cried. In the days since, Jahangir says the hospital's operations have, of course, gotten back to normal. But, like the rest of Nashville, they haven't forgotten.

JAHANGIR: Everyone is still shaken up in the hospital, just like they are in the community. You know, unfortunately, all of us have seen this before - play out, right? We've seen it on TV. We've seen it in other communities. We've seen it in our own community. But it hits home.

SULLIVAN: Funerals for the six victims began today, with a ceremony for 9-year-old Evelyn Dieckhaus. For the five others - school head Katherine Koonce, custodian Mike Hill, substitute teacher Cynthia Peak, and third-graders Hallie Scruggs and William Kinney - services will take place this weekend and next week.

Becky Sullivan, NPR News.


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