The first Kentucky high school shooting victims arrived by air ambulance at Vanderbilt University Medical Center in Nashville just before 10 a.m. on Tuesday. Responding to a school shooting was a first for the medical center's trauma team, but they were ready.
"Yesterday was a tragic and horrible day for kids and the parents and the teachers and the town of that institution in Kentucky, but it was a Tuesday for a trauma center," said Dr. Oscar Guillamondegui, medical director of trauma ICU at Vanderbilt University Medical Center.
That day, a 15-year-old male student opened fire in a common area at Marshall County High School in Benton, Ky., killing two students and injuring 18 others.
Five victims were flown by air ambulance to Vanderbilt, the closest Level 1 trauma center, about 120 miles from the high school in rural western Kentucky. A sixth patient was later transported to Vanderbilt's children's hospital by ground, the hospital confirmed.
When the first victims arrived at the medical center, the staff of trauma surgeons, emergency medicine physicians, nurses and others sprang into action, prepped for the situation from regular mass casualty drills.
"At any given time, when we're told that there are multiple individuals that have been involved in trauma, I think at baseline we're ready to manage that," Guillamondegui said, adding that triage is normal. "The team can grow to as many people as needed to manage those traumas."
But the circumstances weren't typical. In 30 years of being a trauma center, Tuesday was Vanderbilt's first experience responding to a school shooting. The scene was emotional for the victims, their families and for the doctors.
Preston Ryan Cope, 15, died at the medical center from a gunshot wound to the head. The other victim, 15-year-old Bailey Nicole Holt, died at the scene of the shooting, according to law enforcement.
Vanderbilt is still caring for four victims, all of whom are expected to recover and be discharged in the next couple of days.
"At some level what you end up dealing with are the repercussions emotionally more so than the physical injury patterns," Guillamondegui said. "These are young healthy kids who were put in harm's way for no obvious reason, and that's not our standard trauma patient."
During a press conference Tuesday, Dr. Rick Miller, director of Vanderbilt's trauma center, explained that trauma doctors "have to cut our emotions off when we are trying to save somebody's life," adding that, "When everything is said and done, and all the patients are doing OK, then we sit back and that's when it's tough on us."
After caring for the victims, the medical center held a de-briefing to check in on staff. Psychologists were available to speak with them.
"It's about resilience," Guillamondegui said. "We tend to downplay the things that we do, and we don't bring (our emotions) to the forefront, and then that ends up becoming what is considered a defense mechanism and I think it's an unhealthy one. We are becoming more aware of what wellness is in our profession and in doing so I am the first to open up."