Crozet Annals of Medicine: The Day Hate Came to Town

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U. Va. Hospital on August 12, 2017. Photos courtesy UVA Emergency Management.

At 1:55 p.m. on August 12 a group text went out from the attending on duty in the ER.
“We need help. Car ran into crowd. Multiple victims. Text me back if available. This is not a drill.”

Hate had come to Charlottesville.

I turned off the TV, leaving the images of swastikas and street fighting and headed in to work.

Dr. Sudhir was already there. We exchanged looks, but there was really little to say. We had already worried about this in previous conversations. Now it was here. Deal with it.
A dozen of us had responded. I saw some of my faculty colleagues in scrubs for the first time in 20 years. Apparently every ER doc still has a pair of scrubs in a drawer somewhere, a kind of ER shibboleth. We pitched in to do the work that was familiar to us. We had lots of help.

U. Va. Hospital on August 12, 2017. Photos courtesy UVA Emergency Management.

A mass casualty incident (MCI) had been declared and the MCI plan was being implemented.

Dozens of surgeons, anesthesiologists, respiratory therapists, nurses, unit clerks and registration clerks, X-ray techs, patient transporters, chaplains and social workers had responded to the ER and there was work for all of them. Ten ORs were open on standby. Twenty stretchers were lined up in front of the main entrance to the hospital.

This was our answer to the hate that had come to Charlottesville.

The cavernous lobby of the hospital had been transformed into the triage unit for the ER and was filling up with the bewildered and shocked victims.

In eight trauma bays in the ER, eight trauma teams were running major trauma resuscitations simultaneously.

U. Va. Hospital on August 12, 2017. Photos courtesy UVA Emergency Management.

It was grand and terrible. The teams performed magnificently, everything just got done by the right people at the right times. Everyone knew what to do; little direction was needed.
Then just as suddenly as it began it was over. After two hours every patient had been seen and treated. No more came.

I went home emotionally exhausted and demoralized. I was heartened by the work we had done to restore the victims but shocked and haunted by the cruelty and hatred that had been displayed.

I sat on my porch with friends that night, grateful for the rain that was falling. It felt peaceful and secure. Mostly I was grateful in an ER doc kind of way that the rain would keep people indoors and end the violence that still threatened Charlottesville. I did not want to go back in again.

Recovery and healing will take some time for the victims and our community and for all the caregivers as well. In the meantime I will try to focus on all those clean white stretchers in the open air, waiting. Waiting to take in all those in need.

That is the Charlottesville that I know.

U. Va. Hospital on August 12, 2017. Photos courtesy UVA Emergency Management.

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