Sikh temple shootings sent Froedtert into emergency mode

Inderjit (Drew) Pooni, Clinical Nurse Specialist, Surgical Intensive Care Unit, and also a member of the Sikh community, checks equipment for a room being prepareded in the SICU.

(JSOnline) The rapid response team had just hustled to the aid of a critically ill patient on the floor. Clinical nurse specialist Inderjit “Drew” Pooni joined them. It was 10:30 on what promised to be a busier-than-normal Sunday morning.

A large portion of Froedtert Hospital had just gone live with a new system of electronic medical records, a change that would affect every employee who touched a patient. So extra staff filled the hospital.

The surgical intensive care unit where Pooni works, where patients arrive from motorcycle accidents, shootings and other traumas, would usually have eight nurses. On this morning, Aug. 5, there were 12.

As she helped a colleague examine the patient, a male voice came over the loudspeaker:

“Attention hospital staff: Code yel low.”

It took a few seconds to register, and then, there it was again.

“Code yellow.”

For Pooni, a nurse of 17 years, the words sank in. A disaster. Mass casualties.

Code yellows are rare. The 2005 mass shooting in Brookfield. The explosion at Falk Corp. in 2006. The hospital holds code yellow drills twice a year.

It’s not a drill, Pooni told herself. You have a job to do. You need to stay calm and focused.

Her thoughts turned to the unit and its 21 beds. Some of the patients there would have to be moved to make room for casualties. Pooni, a wife and mother of two, began determining whom to move.

In a disaster, information is gold, but there was precious little to guide Pooni and her colleagues in those early minutes. Word came from paramedics at the scene: expect as many as 20 casualties.

The first word hospital staff received indicated a shooting at a church. The unit filled with the sound of rushing legs and beds rolling across the floor and phones ringing and pagers going off.

Second indication: shooting at a mosque.

On Pooni’s floor, patients were now watching live reports on television. Outside their rooms, staff hurried by carrying armloads of IV fluids.

Confirmed: shooting at a Sikh temple in Oak Creek.

The word “Sikh” stopped Pooni. She was raised Sikh. Her husband wears a turban. Her daughters have never cut their hair, a Sikh tradition.

There are two Sikh temples nearby. Pooni’s husband and daughters have been to both, though they usually attend the temple in Brookfield. The nurse’s calm focus crumbled.

She had to call her husband. She had to call her family – 600 miles away in Winnipeg, Canada, they were soon hearing the news at morning worship. Shooting at a Sikh temple near Milwaukee.

Pooni’s husband and children had other plans that morning. They had not gone to temple. They were safe.

She retreated into the nurse’s report room where it was quiet, sank into a chair, and wept as she stared out the window.

After an hour, she took deep breaths, gathered herself, and went back to work.

Throughout Froedtert, where survivors of the shooting were brought, everyone from hospital security and housekeeping to the nurses and trauma surgeons went about their jobs. They volunteered. They asked: What do you need me to do next? They prepared beds and inserted breathing tubes. They evaluated gunshot wounds and hooked up IVs. They fought fatigue, staying with one patient through an 11-hour surgery. They forgot to eat.

And here and there, for a moment, the emotions of the day seeped in.

Pooni thought of her people, as other nurses stooped to hug her. Carlton Moore, a security officer at the hospital who’d worked in law enforcement for 29 years, half his life, thought of the wounded police officer.

Trauma surgeon Travis Webb, 39, talked to two of the wounded before he operated on them. He spoke in a soothing voice: You’re going to be OK.

And afterward, when he realized that in addition to the three survivors, six worshippers had died, Webb thought how discouraging it is to operate on so many gunshot victims. Not just the victims he saw that Sunday, but the steady stream he sees, day after day, week after week.

“You really would like to see that all stop.”

First word of the shooting arrived in the communications center near the hospital’s ambulance bay, a kind of command bunker where a lone worker sat surrounded by a bank of computers and a series of TV monitors.

The call arrived as “an altercation,” then a shooting. Scraps of information came from the first ambulance crews on the scene, and very quickly it added up to a need for more staff in the communications center.

“Generally, there’s two people, but you know, it’s a quiet Sunday morning. A second communicator was immediately called in, as was his supervisor, as was myself,” said Kenneth Sternig, program director for Milwaukee County Emergency Medical Services.

Sternig was supposed to drive his daughter back to school at the University of Wisconsin-Madison. Instead, he drove to work and began checking the capacity at area hospitals. How many patients can you take?

The code yellow reached other staff outside the hospital. When the call came, Gary Colpaert, the vice president of surgical services, was driving to the wood shop to pick up material for a piece of furniture he was building for his niece. He was at Froedtert in five minutes.

Colpaert proceeded to the hospital’s boardroom, where a command center was being set up along a U-shaped configuration of dark wooden tables. A small television was wheeled in. A series of plastic bins arrived, one for each of the 10 people in the center. Each bin contained a laptop computer, a telephone and a large binder. The binder contained a plan and checklist outlining the team member’s responsibilities for precisely this kind of disaster.

The plan’s title: “Multiple Shooting Victims.”

While the command center was being set up, Gary Seabrook, a doctor at the hospital for the last 30 years, made a sweep of the surgical floors, taking a head count. Seabrook, the senior medical director of surgical services, has seen all manner of medical emergencies in his time. With that experience comes a deep sense of calm. Based on his sweep and on initial information from the shooting scene, he decided to open four operating rooms – one more, it would turn out, than needed.

Each of the operating rooms contained equipment waiting to be unpackaged. There were catheters and prep sets for washing the patients and pads to cushion their arms during surgery. There were steel pans containing all the instruments needed to cut into a patient’s abdomen. There were machines that can raise the room temperature 15 degrees in five minutes in order to warm a patient who might be in shock. Within five to 10 minutes, each room was ready.

Webb, the trauma surgeon, had been at the hospital for almost two hours already, working a 9 a.m. Sunday to 9 a.m. Monday shift. After receiving a page alerting him to expect up to 20 casualties, Webb called one of his surgical partners who’d just gone home after finishing a shift. The colleague turned around and returned to Froedtert.

Although he has been a trauma surgeon for seven years and operated on hundreds of gunshot victims, Webb still felt the familiar adrenaline rush. He did not feel nervous, just ready.

Five minutes had passed since Pooni heard the words code yellow. Now the first ambulance arrived.

How many more would follow, the staff at Froedtert did not know.

The three survivors arrived in succession, about 10 minutes between each. They presented doctors and nurses with a variety of medical challenges. Oak Creek Police Lt. Brian Murphy had been shot at least eight times at close range.

Punjab Singh, 65, suffered a single gunshot wound to the face, causing facial fractures and damage to his right carotid and vertebral arteries.

Santokh Singh, 50, sustained a single gunshot wound that penetrated his chest, diaphragm, stomach and liver.

One by one, the injured were wheeled into the trauma room. Each bedside became a hub, alive with the beeping of cardiac monitors and the hissing of oxygen, and surrounded by as many as a dozen doctors, nurses and technicians.

All three patients were fitted with breathing tubes.

Emergency Services Nurse Dina Derocher was among those working at the bedsides of the second and third patients. She spoke very briefly to the second patient, careful not to talk out of turn, not to let her voice disrupt the established order that governs input from the bedside staff. She made sure to offer her patients the comfort of human contact.

“You touch someone,” she said. “That is a nurse’s job.”

Webb performed triage, assessing wounds, then routing patients toward the intensive care unit or surgery. He felt no need to know the particulars of why the patients were here. His job was to stabilize and fix them.

He assisted on the first surgery, which took place in Operating Room 6. The procedure lasted an hour or so. Surgeons found the track of the bullet and stopped the bleeding. Near the end of the operation, Webb scrubbed out.

Soon afterward, he stood in Operating Room 1; it would be his work station for the next 11 hours.

Eleven hours in surgery is physically exhausting, tiring on the feet, demanding of mental concentration. Including doctors, nurses and technicians, there were about 10 people in the room.

Over the years, Webb has noticed that once an operation has begun, the room takes on a particular smell, something hard to describe to those who have not been there. It is a human, organic smell.

The long surgery proceeded gradually, and Webb felt more confident as the hours passed. It was slow, he said, “but progressing in the right direction.” The procedure wrapped up around 1:30 in the morning.

There would be no other victims on which to operate. Around 1 p.m., 2½ hours after news of the shooting, officials at Froedtert finally learned they would not have to handle 20 victims. They had their three.

Gradually, the electric surge they all felt began to shut down.

Kenneth Sternig left the communications center around 2 in the afternoon, feeling relief that the shooting had not been worse, but sadness for the lives that had been lost. In the moment, you separate yourself from the sadness as much as you can. Sternig got back in the car and drove his daughter to college as he’d planned. Yet he felt as if a part of him were still at Froedtert, still looking out at the ambulance bay.

Colpaert left work at 5 that night, thinking about the families of the victims and about the hospital workers who had performed under difficult circumstances. Many, he knew, were still working.

Seabrook kept checking on the three patients, getting updates on how each was doing and relaying news to family members. Around midnight, he walked through the surgical unit and operating rooms one last time to make sure everything was OK. He thanked the staff for the long hours they’d put in. Then he went home.

Travis Webb worked his 24-hour surgery/ shift until 9 a.m. Monday, then kept working, tracking the progress of his patients. He left the hospital at 5 p.m. Monday, some 30 hours after the code yellow announcement. When he arrived home his two sons, ages 8 and 11, ran up and hugged him.

Despite the long shift, Webb felt wound up. For a while he sat and watched the news on television and learned the details of the shooting; at work, there’d been little time to absorb any of it.

The patients before him had been all that mattered.

As for Pooni, she had recovered, put her grief on hold, and returned to work. There she stayed until finally she was made to leave at 5:30 p.m. Sunday. She hugged her colleague Sheri Coffen.

“She told me to go home and hug my children, and that’s what I did,” Pooni said.

The nurse sat down with her daughters. They are 7 and 11 years old.

The 7-year-old asked: Why did this happen?

As best she could, Pooni tried to explain.