Six years ago, 23 people were killed and 22 others were injured as a result of a mass shooting at the Cielo Vista Walmart in El Paso on August 3, 2019.
That date, and the memory of what went on inside the emergency department at University Medical Center of El Paso (UMC), is forever etched in the memory of the medical professionals who responded that day.
UMC’s Emergency Department (ED) was unusually slow that Saturday morning, with only a few patients in the waiting room.
“I remember it was eerily quiet,” said Michael Kennedy, the Administrator on Duty (AOD) for UMC’s ED the morning of August 3, 2019. “I think we only had four or five patients in the ER, which usually we have 90, especially on the weekends, which is when it gets full.”
By 10:30 a.m., the calm of that morning had dissipated as radio traffic from incoming paramedics began to flood the ED’s overhead speakers, ‘Level 1 trauma, code 3.’”
The emergency system notification alerted there was an active shooter at a Walmart, but the magnitude of the situation was unknown to the nurses, residents and physicians working in the ED.
Alejandra Carzoli, the ED’s charge nurse at the time, stood by the ambulance entrance ready to receive patients.
“We looked at the ambulance bay and we saw someone trying to open the ambulance bay. We usually do not get any traffic there unless they are calling us from the ambulance,” said Carzoli.
She went on to explain, “A paramedic and I approached the [ambulance] bay and asked, ‘what’s going on?’ We saw a man agitated and nervous. He said, ‘I have a patient, I am an off-duty officer, there was a shooting at Walmart and I’m going to bring more victims.’”
As the off-duty officer left, more and more victims of the shooting began to come in. Some were transported by ambulance, others by strangers who drove them to UMC.
“As soon as you came into the ER, you could hear radio traffic and the patients just started showing up. I believe we got 14 Level 1 traumas in 43 minutes. They just started coming through the door,” said Kennedy.
Dr. Susan McLean, Texas Tech University Health Sciences Center El Paso Professor of Surgery and Surgical ICU Medical Director at UMC, was the on-call surgeon that Saturday. She had been called in the night before and was finishing a surgery when she first heard about the shooting.
“Right at the same time, all the pagers went off in the operating room, they were Level 1 traumas, multiple casualties, everyone had to report to the ER,” said Dr. McLean.
UMC is the region’s only Level 1 Trauma Center, able to care for some of the most complex cases.
Victims of the shooting were sent to various hospitals in El Paso, but those who were determined to be Level 1 trauma patients were sent to UMC for treatment.
“We have a very modern trauma area, it is actually right next door to the emergency room, so when we got those calls I could just walk about ten steps and I was in the trauma area. This trauma area has six main trauma bays and six more rooms that are called critical rooms and they can function as trauma bays, but they are kind of like Intensive Care Unit (ICU) rooms,” Dr. McLean explained.
Not long after the first couple of patients showed up, more physicians and medical staff began rushing in to help.
“I got to the hospital at 11:15 in the morning trying to find out where Dr. Mclean was because she was the trauma surgeon on call and I knew she had another surgery that was semi-urgent that was going on at the same time,” said Dr. Alejandro Rios-Tovar, Associate Trauma Medical Director at UMC on August 3, 2019.
Seventeen of the general surgery residents training at UMC at the time arrived within minutes without being called in.
“There were a whole bunch of nurses and technicians who were not supposed to be working that day. They heard the news and just came into the hospital to assist,” recalled Dr. Jose Burgos, Medical Director of UMC’s Hospitalist Program.
“That day we saw other physicians coming into the hospital who were not supposed to be there. People with other specialties, gastroenterologists, nephrologists…they just wanted to find out what they could do to help.”
Burgos said they came up with a plan. They began by expediting discharges for stable patients, to make more patient beds available. ICU patients were quickly moved into a patient room to keep the six trauma bays open.
The ED was crowded. It was an all-hands-on-deck operation with nurses and physicians running in, patients in every corner and families in tears, desperately searching for their loved ones.
Despite the chaotic scene, the medical professionals at UMC functioned as a highly effective, highly trained hospital unit.
Many of the physicians who cared for patients on that day can still remember what trauma bay each patient was in and what their injuries were.
Dr. Rios-Tovar particularly remembers one of the victims who was conscious when she was brought in.
“I saw Michelle in Trauma Bay 6,” Dr. Rios-Tovar explained. “I asked her what her name was and she said, ‘Michelle Grady.’ For some reason I heard Grandy, so I said it and she corrected me. She said, ‘Grady!’”
Michelle Grady had finished grocery shopping and was donating to a local soccer team’s fundraiser outside the Cielo Vista Walmart when the shooting began.
“I remember turning around and looking because it sounded like fireworks and I remember just being confused. It was morning, Saturday morning,” Grady said as she recounted the events of that day. “I remember turning around and seeing the shooter come closer to the building and then I decided I should try to move out of the way and run.”
As Grady tried to escape the bullets, she felt a pain on her side and fell to the ground.
“A Walmart employee named Thomas came out after the shots stopped and he worked in the deli, so he had on multiple layers of clothes. It was cold. He came out and asked me ‘Are you okay? ‘Where were you shot?’’ I was very aware of where I was shot and how many times. I told him and he began taking off layers of his clothes so he could wrap my wounds to try to stop the bleeding.”
Not sure if she would survive, Grady called her mother to say goodbye.
“My mother made me repeat it because she did not believe it. Grady told her mother, ‘There was an active shooter, and I have been shot three times!’”
Grady’s mother made it to the scene before the ambulances arrived. She and the Walmart employee carried Grady onto a flatbed cart from the nearby Sam’s Club and wheeled her up the hill to where the ambulances were.
Grady still vividly remembers the ride to the hospital.
“[The paramedics] were trying to understand what level of trauma I would be and whether I needed to go to one hospital or UMC. Me, being so full of anxiety and conscious, I’m thinking, ‘oh my gosh, I hope that they take me to UMC.’ My sister had worked there for years, and I knew the type of doctors that they had there. I knew it was the number one trauma center,” said Grady.
Dr. Rios-Tovar examined her CT scan results and determined Grady had an intra-abdominal injury that required him to perform immediate surgery.
“We went from the CT scan room to the OR, and I had to make sure someone else was going to be able to continue doing the triage of the remainder of the patients that were coming in,” said Dr. Rios-Tovar.
Surgeons were running four operating rooms at once, performing as many life-saving procedures as they could to stabilize patients in critical condition.
Meanwhile, news about the shooting had reached national airwaves.
Network reports had cut into regular programming with live interviews from the scene. It was not long before the news about the mass shooting in El Paso was known worldwide.
Dr. Alan Tyroch, Professor and Founding Chair of Surgery at Texas Tech University Health Sciences Center El Paso and Chief of Surgery and Trauma Medical Director at UMC, was out of town when he was first alerted. He caught the first flight back to El Paso to be at UMC that same afternoon.
“Like a crazy person, I started telling the TSA agents, ‘I need to get through, I have people in El Paso who are dying.’ At that point, they had already seen the news so [people] were letting me go to the front of the line,” Dr. Tyroch recalled. “The last thing I heard before I got on the plane was that there were probably 30 to 40 victims. I realized this was going to be a long night, so I said a quick prayer, took a nap and as soon as I landed I went straight to the hospital and right away we had a press conference.”
Nancy McGrail was the Emergency Department Director at UMC at the time of the shooting. Since the shooting happened during the weekend, she was at home when she first got the call from paramedics at the scene.
“This was highly unusual,” said McGrail. “This was a mass casualty like nothing we had ever experienced before, certainly not since I have been at UMC and I think in El Paso in general. It was just something that is unforgettable. I hope I never have to go through it again.”
McGrail described the scene in the ED as organized chaos. A drill they all knew by heart, but never thought would have to be put to the test.
She remembered being heartbroken by the sight of a woman crying after she had found out her husband had died.
“It’s almost like you are in a trans or in a dream. I just could not believe what had happened and now talking about it five years on, I still get that heaviness and that feeling of, ‘what did we just go through?’”
The memory evoking tears from McGrail as she described what she felt that day.
“Sadness, anger, happiness I was there to help, it is a lot of conflicting feelings. Talking about it makes it all very raw again, very real,” she said.
The day seemed endless, yet it all seemed to have happened in an instant.
UMC’s Environmental Services Department had been working nonstop to quickly clean up each trauma bay to prepare for the next patient coming in.
The days following the shooting were just as tiring, but the community had stepped up.
The ED was flooded with donations from people who wanted to help or show their appreciation to the medical professionals who worked tirelessly to save their neighbors.
Food, ‘Thank You’ cards and letters were dropped off to thank the healthcare heroes who answered the call to aid their community in a time of distress.
“I struggle with the word ‘hero’ because of military. I feel people who are in the military and are police officers and people who put themselves in harm’s way every day are the true heroes. I became a nurse because I wanted to help people and that was just a day I got to help a lot of people on a really bad day,” said McGrail.
Michael Lowe, the nightshift manager for the ED during the shooting, remembers the selflessness that was displayed that day.
Now the Assistant Administrative Director of the ED, he is proud to lead the same team that stepped up on that tragic day.
“By the time I came into work, some of the dust had already settled and I remember looking at the team, looking at the emergency department and seeing everything very much organized.”
There were no lack of resources in the ED that day.
Lowe counted with a packed ED of surgeons, doctors, and nurses, and even more who were on standby waiting to be called in from the hospital’s parking garage.
“I saw my staff when I came in maybe a little physically exhausted, but very much focused, very much ready. There was a lot of preparation,” Lowe added.
August 3, 2019 will forever hold significance for UMC. In honor of the six-year anniversary of the tragedy, UMC stands with the community in commemorating the victims and their families, as well as thanking the first responders and medical professionals who acted swiftly and compassionately when the community needed them most.
We will always remember.
