By Erin Emery and Katie Kerwin McCrimmon
The calls crackled over the police officer’s radio in the hospital ER: “Club Q … Active shooter …”
It was a little after midnight. Saturday night had been unusually quiet in the ER. But the early hours of Sunday, Nov. 20, were about to test medical pros who train to handle the worst possible emergencies.
Patients in dire need of their help were minutes away.
The police officer had been in the emergency department at UCHealth Memorial Hospital Central in Colorado Springs assisting with a suspected drunk driver when he heard the call about a horrific mass shooting. He immediately gave a heads up to charge nurse, Rachel Dupey.
She jumped into action, notifying her team throughout the emergency department (or ED as medical folks call it) along with other key people throughout the hospital.
“One of the police officers just told us that there was a shooting and we’re expecting anywhere from 15 to 20 people. We’re hoping it’s wrong, but if not, it’s all hands on deck,” Dupey told Kayla Ireland, who was working that night as Memorial Hospital’s nursing house supervisor.
“OK. I’m headed down there,” said Ireland, who had been working upstairs in the hospital.
Until news of the shooting hit, the emergency staff and providers mostly had been helping people who were sick with the flu, RSV and COVID-19. But Memorial is a Level I Trauma Center, the highest level possible. That means that highly trained teams must be ready 24/7 for emergencies of all sorts —including a mass shooting.
The hospital is just 12 minutes and a little over five miles away from Club Q, which had always been a refuge for LGBTQ people. Now club goers who had been enjoying a fun Saturday night were fighting for their lives.
‘Don’t let me die’
About 10 minutes after the ED crew first heard about the mass shooting, live updates started arriving from paramedics and EMTs aboard American Medical Response ambulances. They confirmed everyone’s worst fears.
“GSW. Two minutes out,” a emergency responder said over a radio while en route to the hospital.
GSW stands for “gunshot wound.”
The same call kept repeating again and again. More patients were coming one after another after another. Each time, the description was the same.
“GSW. Multiple GSWs. Back, thigh, shoulder, arm,” the voice on the radio said.
Staccato status reports kept pinging over the radio: “Two minutes out. Five minutes out.”
Inside the hospital, the team raced to get ready.
“We just started emptying out rooms and moving people,” said Ireland, the nursing house supervisor. “We were trying to get rooms clean and get ready for that huge influx of patients.’’
As the patients arrived, Dupey, the charge nurse, told emergency responders where to take each person.
“We got them all in back-to-back,” Ireland said.
“There was a lot of moaning and screaming and people saying, ‘Help me. Help me,’” Ireland recalled. “One person was screaming, ‘Don’t let me die.’”
A few minutes earlier, Dupey had used an app called Pulsara to instantly send a message both internally and externally to emergency medicine experts, trauma doctors, surgeons, orthopedic surgeons, radiologists, nurses, respiratory therapists, pharmacists, EMS workers and CT technicians.
All had rehearsed their roles. Every month, they hold drills to practice responding to trauma. This time, they were dealing with the real thing.
Camaraderie at night
Dr. Katy Picard is an emergency medicine specialist. She was one of two on duty at the ED that night. Dr. Leslie Moats was working with her.
“I just showed up for a regular shift,” said Picard, 36.
At first, it was completely regular.
Picard loves working nights because the teams grow so close.
“You have this camaraderie at night that’s incredibly special. You’re up and taking care of people when everyone else is asleep,” she said.
“We were actually having a really nice night. It was steady, but not too bad,” said Picard, who has worked at Memorial since 2018.
Then, soon after midnight, a nurse told Picard the news. Sometimes, there are false alarms, but this alert felt different.
Picard immediately focused on how she could get ready.
“I had a couple of sick people who I’d been taking care of. I made sure everything was ordered for them,” Picard said.
Then she stepped into the other part of the ED where the team was preparing for an influx of people who would need every ounce of the team’s expertise and focus.
Picard put on a pale blue gown and dark blue gloves. She took a breath and braced herself. Everyone stood at the ready. It was the last moment of stillness they would experience for several hours.
Minutes later, at 12:21 a.m., the first patient from Club Q arrived.
Over the next 29 minutes, paramedics brought in nine more people. The 11thpatient arrived at 1:15 a.m. A 12th later was transferred from Memorial’s sister hospital, UCHealth Memorial Hospital North.
As the patients came to Memorial, a team of three dozen people worked furiously with a singular goal: to save as many lives as possible.
Picard didn’t know much about the shooting at first, or what may have fueled the hatred.
“My heart sank when I heard it had been at Club Q,” she said.
Picard happened to be wearing a colorful pin on the lanyard that holds her ID badge. She had spotted a nurse wearing one about a month ago, admired it and found her own on Etsy. The pin has a colorful rainbow with the comforting words: “You are safe with me.” Picard, herself, is straight, but over the years, she has cared for many LGBTQ patients.
“It’s a community that already has experienced so many hate crimes and so much loss,” Picard said. “For some people, just going out and being who you are is dangerous.”
That appeared to be the case on Saturday night.
While bullets had ripped people apart, the team at Memorial raced to fill them with love — and life.
“We’ve got you,” Picard kept telling each person.
Years earlier, one of Picard’s fellow ED doctors once had told a patient, “You’re going to live.” He was devastated when the patient later died. Since then, Picard doesn’t make promises. But in her heart, she’s pleading with the universe for each person: “Please live.”
A,B,Cs: Airway, breathing, circulation
The immediate goal was to assess and stabilize people.
Picard has no idea how coworkers carved out space for so many critically ill people at once. She attributed that to “charge nurse magic.”
Nickie Klein, a clinical nurse manager in the ED, said: “We want to get them to the operating room or to the medical floor as fast as possible. If they’re not stable enough to get to the OR, we keep them until they’re stable enough to go. Sometimes, it takes 5 minutes. Sometimes it’s an hour or more.”
The team had an early win soon after the shooting victims arrived.
“We got two to the OR quickly, emergently,’’ Klein said. “These were big traumas.’’
To stay calm amid the chaos, Picard leaned into her training and experience. She was raised in Kansas, then attended medical school and did her emergency medicine residency in Michigan.
Mentors years ago taught her an alphabetical mnemonic device that she uses to assess and treat patients. “A” stands for airway, “B” for breathing, “C” for circulation, and so on.
“It’s a plan. It’s what you do. You don’t move on to the next step until you’ve addressed any major issues,” she said. “If a patient can’t breathe, you put in a breathing tube. If someone has a bleeding arm or leg, and they need a tourniquet, you get that taken care, then you move on.”
The system is known as the Advanced Trauma Life Support method. The “ABCDE” part of it is called a primary survey.
Picard and all of the ED providers worked seamlessly while every additional team member assisted them.
“One might be hanging fluids or starting blood. They might be putting on a tourniquet or applying ‘quick clot’ (to reduce bleeding). Nurses were grabbing drugs and supplies for us and starting lines. If we said we needed something, it was in our hands,” Picard said.
“Everyone was there: respiratory therapists, X-Ray, CT, trauma nurses. That’s what happens. We do our best to stabilize patients, then we decide where patients are going,” she said.
The ED was humming. The blood bank was bringing units. Each team member was functioning beautifully, just like they had practiced.
“It was the most controlled chaos that I have ever seen,” said Ireland. “Everyone came together from all the different departments; it was fantastic.’’
One employee dislocated her shoulder during the response yet waited until the end of her shift before seeking medical care.
“I am not sure how it happened, whether it was during CPR or what, but she dislocated her shoulder and refused to be seen until everything calmed down and everyone was cared for. She popped it back in, continued working,” said Ireland. “It’s people putting other people first. We have our mission and our vision and our values.”
Then you see it in action.
“I could never be more proud than working with this team,” Ireland said.
She, herself, has experience as a critical care nurse. So, she jumped in where needed.
At one point, a doctor asked, “Hey, can you hang blood?”
Ireland moved to a trauma room and started a massive blood transfusion.
The team uses what’s known as a Belmont machine to quickly pump patients full of blood.
“You can put a whole bag of blood in someone in less than a minute,” Ireland said.
After assisting in the trauma unit, Ireland thought to herself, “What needs to be done now?”
She remembered that she had to plan for the worst possible outcomes. What if patients didn’t make it? She notified the coroner and the Donor Alliance.
Then she and many others tried to help figure out who was who.
“At first, we registered all of the patients as a ‘Doe’ just to get them in and get them care as soon as possible,” Ireland said. “The ones who were up and talking, we got their identification.”
For four or five of the most critically wounded patients, “we didn’t know their names at first.”
Later, Ireland started fielding calls from dispatchers.
“Hey, this brother is looking for (this person). Here are the identifying tattoos.”
The team worked to identify everyone and connect patients with loved ones.
While most of the ED staffers tended to shooting victims, Zach Hamilton cared for others who arrived needing help. He’s been an EMT for five years. Amid the chaos, one person came in with a broken knee, and Hamilton helped her.
“I wish that I had been able to do more for the people in the back, but obviously someone had to watch for the other people coming in. I did all I could during that time. I was hoping I helped her. It was a rough night.’’
‘I’ll be there’
Dr. Paul Reckard is a seasoned surgeon and the former trauma medical director who had helped Memorial become certified as a Level 1 Trauma Center in 2018.
During the day on Saturday, Reckard had been on duty in the ICU. Doctors in hospitals go “on service” when they’re working. The word sounds so simple but conveys so much. Hospital workers serve patients, colleagues, community members, everyone.
Reckard, who turns 65 this month, had just gone to sleep at about 10 p.m. He figures he got about three hours of sleep before his phone started ringing at 1:15 a.m. Reckard wasn’t on call that night, but the team was trying to reach every trauma surgeon who was in town. Reckard recognized the name of one of his partners on the phone.
“Uh oh. Something’s going on,” Reckard thought to himself as he answered the call.
His colleague only needed to say two words: “Mass casualty.”
“I’ll be there,” Reckard responded.
He didn’t ask any questions about what had happened. He knew neither of them had time to talk.
Instead, he rubbed the sleep from his eyes, raced to get dressed, jumped into his car and sped across town to the hospital.
He walked in, changed into scrubs and put on one of his favorite scrub caps. It shows a coral reef full of colorful, tropical fish. When Reckard’s not working to save lives, he loves scuba diving. When he is saving lives, he likes to wear unique scrub caps.
“Lots of us are wearing them these days. It brings some individuality to what is, otherwise, a room full of people in green scrubs,” Reckard said.
Multiple trauma surgeons were on duty that night including Dr. Sarah Kolnik.
“Where do you need help?” Reckard asked.
His partners directed him to one of the operating rooms.
Reckard went straight to work assisting with a patient who had no pulse in the left arm.
Reckard theorized that the patient has suffered a spasm in the artery that transports blood to the arm. When he exposed the artery, the patient’s blood began flowing again. Mission accomplished. After the team stabilized each patient, they sent them to recover and took care of the next.
“We were running two ORs at that point,” Reckard said.
Once he was in surgery, a calmness descended.
“You get down to business, and you get people taken care of,” Reckard said.
As Reckard and others worked, police officers and an FBI agent stood at the ready to gather evidence and preserve the chain of custody. In all, as many as two dozen police officers and an assistant police chief were in the hospital.
Everyone credited Army veteran Richard Fierro for saving countless lives. When the gunman started firing at people at Club Q, Fierro ran over and tackled him. He hit the shooter with one of his guns and called a drag performer over to attack the gunman with high heels. Together, they held the shooter down until police arrived.
They saved countless lives.
“This would have been Pulse Nightclub all over again. We would have had 50 or 60 victims and at least 20 would have died,” Reckard said of the June 2016 attack on a LGBTQ club in Orlando, Fla. that left 49 dead and 53 others wounded.
“Those folks deserve a medal,” he said of the Club Q survivors, Fierro, and others who were able to interrupt the attack.
“We were fortunate this time,” Reckard said. “Over the course of six to eight hours, we got everybody taken care of.”
As the sun rose Sunday morning, exhausted hospital workers began to take stock.
And a remarkable realization dawned on them. All but one of the 12 patients who had arrived from Club Q were alive and recovering. The first patient transported to Memorial Hospital had passed away en route. Doctors tried to resuscitate that patient but were unsuccessful.
In all, five people from the shooting died. They are: Daniel Aston, Kelly Loving, Ashley Paugh, Derrick Rump and Raymond Green Vance.
While sorrow and loss have descended on Colorado Springs, so, too, have glimmers of pride and hope. Thanks to heroes at Club Q, countless first responders and dozens of medical experts, many shooting victims survived.
The team’s work and quiet prayers had worked.
Picard left the hospital at about 8 a.m. on Sunday. The night of the shooting had been her first on duty during a nine-night stretch over the Thanksgiving holidays. She had to rest. Colleagues offered to take subsequent shifts for her, but she wanted to work, to be back with her team.
When Picard arrived home, she hugged her husband and dissolved into tears. A mix of emotions hit her.
“We kept people alive,” she told him. “We kept people alive.”
She was enraged about the tragedy, but immensely proud too.
“This was horrible and traumatic and terrible,” Picard said. “And I was so proud and amazed by the team. What we collectively did was just so incredible. I felt honored to be a part of this amazing team, this amazing place. I felt proud and wanted to go back to work.”
But first, she had to sleep.
Picard allowed herself a two-minute cry, then showered and headed to bed.
She worked again on Sunday night, and thankfully, it was calm.
On Monday, she went to visit her Club Q patients.
Some were able to speak to her. She told them that her heart was with them.
“It’s incredible. They’re all alive,” Picard said, still in awe a couple of days later.
“Many wouldn’t have lived without the collective efforts of so many people, from surgeons to anesthesiologists to blood bank staff to nurses to all of these people who make a difference when you’re taking care of trauma victims,” Picard said.
Reckard also went to visit patients.
Some were talking. Others made him laugh. Their positive attitudes and ebullient spirits comforted everyone in the hospital.
“The thing that amazes me is the courage of our patients. In the face of this adversity — they were almost killed through no fault of their own — they were keeping us going,” Reckard said.
A gem: ‘Prince Royal 47’
One of those courageous survivors, Ed Sanders, 63, had been gussied up in a red velvet jacket to attend a ball on Saturday night. He decided to stop by Club Q before heading home and was shot minutes later. (Read Ed Sanders’ full story.)
As he recovered at Memorial, Sanders smiled and reassured his caregivers that he was going to be OK.
Among them was nurse Heather Hageman. She arrived at the hospital at 6:45 a.m. ready for a 12-hour shift. She hadn’t heard about the horrific shooting until the morning huddle when the night crew handed off care to the day team.
Hageman, who graduated from nursing school a year ago, was assigned to take care of Sanders. He was recovering from gunshot wounds to his upper back and leg but wasn’t complaining in the least.
“Good morning,” Sanders said to Hageman.
She loved his positive attitude.
“He’s a gem,’’ Hageman said. “He brightened my day.’’
A little while later, Sanders went to surgery to have his wounds treated. While bullets had missed his major organs, one left a wound like “an ice cream scoop” in his upper back.
When Sanders first arrived on the medical floor, his hospital wristband showed him as a “Doe” since ED staffers didn’t know who he was.
Hageman worked on getting him a new wristband with his real name.
Sanders, who has been a resident of Colorado Springs for 31 years, has been going to Club Q for many years. He’s active in the LGBTQ community, and recently earned the title of “Prince Royal 47’’ from the United Court of the Pikes Peak Empire, a nonprofit organization that raises money for charities.
As Hageman checked on Sanders frequently, she got to know him better. He filled her in on his role in the community and the recent royal moniker he had earned.
The next day, Hageman decided to make Sanders yet another wristband. She got on her computer and printed out his new title: “Prince Royal 47.’’ She even added a little crown emoji.
“His face lit up,’’ Hageman said.
‘Let’s not feed anger’
The Rev. Dr. Christopher Keith, chaplain supervisor at UCHealth Memorial Hospital, arrived at the hospital at about 5:30 a.m. on Sunday. He called three other chaplains, who also came to help.
Keith and fellow chaplains tend to patients, families and staff members. They divided up duties in the wake of the shooting.
“One of us was keeping track of the trauma patients and identifying names and numbers. One of us was working the telephone, writing down all the names and phone numbers of those who called,” Keith said.
The chaplains received dozens of calls from people inquiring about patients or offering to help. Because of confidentiality laws, Keith’s team could not provide any specifics about patients. But he could take down information and relay it to the right person.
Most of the callers asked this: “Can you tell me how they’re doing?’’
One caller said he hated the man who shot up the bar but felt sorry for him and his family.
“When you hear the amount of grace that people extend, it’s very moving. It’s very emotional,” Keith said.
At about 2 p.m., Keith left the hospital to take a break and change clothes. His wife was picking him up near Boulder Park, adjacent to the hospital. There, a group of 14 or 15 well-wishers had gathered.
The crowd swarmed Keith after seeing his UCHealth badge. They wanted to know the same information that the callers had been seeking.
“How is everyone doing?’’
Keith could not provide any information, but he comforted them.
“I’m glad you are here and that you care,” he said. “As a chaplain, I would invite you to send the best spirits and the best prayers. Whatever you do, do it for a good thing. Let’s not feed anger, let’s not feed hatred.’’
Keith saw that one man was trembling.
“I’m not a hugger, but I said, ‘Do you need a hug?’ He just glommed onto me,’’ Keith said.
Before he knew it, Keith was in the middle of a giant group hug. Everyone in the group gathered around him and embraced him.
“And I’m standing in the middle, and I am just bawling, and they’re all bawling,’’ Keith said.
“And I said, ‘Thank you guys for caring.’ Please, take your energy and do something positive.’’
Before he got in the car with his wife, a man pressed a crumpled card that he had created for those who were hospitalized and those working in the ICU.
The card had a small, red heart and said, “There is no good card for this. I’m so sorry.’’
The well-wisher had written a simple note: “Sometimes life really sucks. You don’t know me, and I don’t know you. I am devastated about this event. … ‘’
It was signed: “Sincerely, a CS queer resident.’’
Army hero, police, fire, EMS
Reckard, the trauma surgeon, has been through mass casualty events before. But the Club Q shooting was by far the worst.
He encourages everyone who was impacted by the shooting to get help.
UCHealth managers jumped into action quickly.
Edina Hanes, a director of Human Resources for UCHealth’s southern Colorado region, worked with chaplains and ED leadership Sunday to identify all those who had worked on the event. That day, they called every employee to make sure they were OK. In the next two days, virtual support sessions were held for staff.
“We offered a safe and confidential place to share, with a focus on resiliency,” Hanes said.
Reckard always has handled stress by celebrating successes at work and enjoying travel and other hobbies during his time off.
For Thanksgiving, he and his wife took a road trip to Sacramento to spend the holiday with their daughter and her family. Reckard and his wife are proud grandparents of seven grandchildren.
As Reckard reflected on the Club Q tragedy, he praised his co-workers.
“The thing I love about Memorial is when stuff is hitting the fan, like it was on Sunday morning, everyone pulls together and gets the work done,” he said.
Like nearly every person who helped that night, Reckard said he was just doing his job.
“The real heroes are the guy who took down that shooter and the police and the EMS workers. They were all on the front lines,” he said.
As for the shooter, Reckard is trying to think about the kind of pain that causes people to act out violently. While he’s infuriated that anyone would apparently target LGBTQ people, he thinks many folks are suffering and could use a dose of kindness.
“All of these problems are incredibly complex, and the solutions are going to be even more so,” Reckard said. “Somebody out there needs a hug. Give someone a hug.”
Emergency careLevel I Trauma CenterTrauma services