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August 3 Walmart Shooting Health

“The El Paso trauma system worked that day” — surgeons reflect on Aug. 3

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The morning of Aug. 3, 2019, started as a routine Saturday at University Medical Center of El Paso and Del Sol Medical Center. Until 10:39 a.m. 

That moment, where the first call came into 911 reporting an active shooter at Walmart, opened a brief window for the hospitals to brace themselves for the worst mass casualty event in the Borderland.

Twenty-three people were killed and dozens were injured after a white supremacist gunman targeted Latinos, shattering the lives of multiple families and sending a region into grief, despair and anger.

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, has another  timestamp ingrained in his memory.

“My clock started at 10:53 a.m., 14 minutes after the 911 call,” Tyrock said. That’s when Tyroch received the notification that there was an active shooter and when he activated the hospital’s emergency response.

The vast majority of the gunshot victims who made it to UMC and Del Sol that morning would survive their wounds, thanks to skilled surgical teams and years of preparation.

Far from home

Tyroch said he has told the story many times over the last year. He was in Las Vegas for a family celebration. His mother-in-law wanted to celebrate her 90th birthday at the Circus Circus Hotel and Casino.

Dr. Alan Tyroch

He was standing in line at the breakfast buffet when he started to get the calls and notifications for an “active shooter Walmart GWW.”

He made several calls to confirm it wasn’t a drill or a false alarm. He said he initially thought it happened at a Northeast Walmart, but then realized GWW meant Gateway West.

After that 10:53 a.m. notification, he made a flurry of calls to make sure the hospital was ready to receive and treat multiple patients.

Seven minutes later, the first patient arrived by private transportation to the trauma bay. The hospital staff would treat 14 victims on Aug. 3 and received one more victim the following day who was transferred from Del Sol. One patient died of the injuries.

The hospital had trained for mass casualty events multiple times in the past, but was put to the test on a hot Sunday morning.

“I was really upset that I wasn’t there from the beginning, but in retrospect it probably was a good thing,” Tyroch said.

He said traveling the first part of the day allowed him to make the necessary calls to make sure everyone at the hospital was prepared. He said if he had been there from the beginning he would have likely been trying to help with surgeries while also managing staff.

Tyroch said all of the training the hospital undergoes paid off that day.

“We were hoping we’d never see that. I tell everybody we are going to get a disaster here in El Paso (and) you have got to act like you are going to be ready. You have to practice this. It’s not if it’s going to happen; it’s when it’s going to happen,” Tyroch said.

He said everyone at the hospital from residents, to nurses, to environmental service workers stepped up to take action without having to be micromanaged.

“People rise up to be leaders and they really did that day,” Tyroch said.

Coping with the trauma

Tyroch said he was on adrenaline most of the first day. “I finally went home that evening and I felt guilty for going home, I felt guilty for not being there at the beginning. I felt like I needed to stay,” he said.

He also knew he would need to rest because caring for the patients was going to continue well beyond day one. The next few days were busy with helping to relieve staff from the day before and dealing with press conferences and meetings, he said.

As he was leaving the hospital on the Monday evening after the shooting, he noticed the chapel at UMC, a place he hadn’t been to in some time.

“If there’s any day to walk into a chapel by yourself, that was the time,” Tyroch said.

The gravity of the situation hit him all at once when he got into his car that night. On his drive home the billboards reading “El Paso Strong” nearly brought him to tears.

He said he knew post-traumatic stress disorder would affect the hospital. Tyroch made sure they were taking care of their own by talking through the event and offering counseling.

Dr. Alan Tyroch testifies before Texas Senate Select Committee on Mass Violence Prevention and Community Safety. (Photo courtesy of Texas Tech University Health Sciences Center El Paso)

He also made sure to take care of himself by doing what made him feel healthy, such as taking long walks and eating right. He visited the makeshift memorial that was erected near the Walmart and attended the memorial event at Southwest University Park a few days after the shooting.

“It was a good healing process,” he said.

He has since testified before the Texas Senate Select Committee on Mass Violence Prevention and Community Safety, when it met at the University of Texas at El Paso months after the shooting to discuss the tragedy.

“The El Paso trauma system worked that day,” Tyroch said.

The memories of that day never go away

Dr. Stephen Flaherty, medical director of trauma at Del Sol Medical Center, said people have experienced the passage of time in different ways.

Del Sol Medical Center quickly braced for multiple shooting victims. Flaherty said the hospital received 11 patients in 23 minutes. Three patients died of their injuries.

Dr. Stephen Flaherty

“It’s one of those things where it keeps coming back. It resurfaces in different ways at different times, to different people,” Flaherty said. “(Sometimes) It’s a glance that kind of says I know what you’re thinking.”

Flaherty said everyone working at Del Sol was doing what needed to be done seamlessly and did everything they were trained to do, but better.

He said they needed to focus as a team on several areas, from immediate patient care and surgeries, to caring for the families and making sure the community knew what was going on.

Del Sol also had to take care of its own. Flaherty said one thing they did as a hospital to support each other was to talk about what happened right away. The discussions have continued throughout the year, and counseling services still are available.

Flaherty said he has also reflected on the community as a whole since the tragedy.

“This came in from outside of our community. This came from outside El Paso to come in here and wreak this horror on Aug. 3,” Flaherty said. “This was not from the El Paso community itself and people should be proud of that. They should be proud of living in this region, and who they are and who they are as a community and they truly are ‘El Paso Strong.’”

Constant preparation pays off

Dr. Susan McLean, Texas Tech University Health Sciences Center El Paso professor of surgery and surgical ICU director at University Medical Center of El Paso, was the trauma surgeon on call that day.

Dr. Susan McLean (Photo courtesy of Texas Tech University Health Sciences Center El Paso)

McLean said the preparation for UMC as a level one trauma center is ongoing and the response to a mass casualty incident starts way before the event and continues well after.

“That means that we are constantly prepared for whatever may come our way,” McLean said. “When the event happened, people just sprang into motion as they had practiced.”

McLean said more than 160 people from multiple departments arrived to help at the hospital that day.

“I think many people felt like they were fulfilling their mission in the hospital. University Medical Center, that’s part of its mission — to take care of critically injured patients.”

Getting grounded

McLean said things went by very quickly in the immediate aftermath of the shooting, with everyone staying focused on what needed to get done for patients.

“Once we were out of the immediate thing, it just seemed kind of surreal and it was also kind of exhausting,” she said.

McLean said she stayed away from the site of the shooting for a few weeks, but then felt compelled to go.

“This is my community, it’s my home, and I kind of wanted it to not be surreal, like I was in a dream,” McLean said.

She said going to the makeshift memorial with one of her colleagues served as a grounding experience. She remembered it was a hot Wednesday morning when she visited the site. It highlighted how such a horrible thing happened on an average day, to people who were just trying to go about their daily business.

“I think that it was helpful for me because I felt like it was more somber and it was emotional to go out there,” McLean said. “You just felt it, you felt the weight of it when you went out there.”

McLean said the patients were very resilient and helping to care for them was uplifting. “They were all determined to get better,” she said.

McLean said one of her patients who was shot in both legs wanted to get up and walk the day after the surgery, regardless of pain. She said the patient told her she needed to get better for her family and her husband, who was in another hospital.

“They were all like that,” McLean said, adding that the joy of seeing them improve was inspiring. “Many of them had more than one surgery. Some of them had to return to the hospital for months. They really all went through a lot, but they had an amazing attitude to get through it.”

Cover photo: Dr. Alan Tyroch and other University Medical Center officials held a press conference about patients treated after the mass shooting on Aug. 3, 2019. (Alex Hinojosa/El Paso Matters)

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Elida S. Perez

Elida S. Perez is a longtime community and investigative reporter. Her experience includes work as city government watchdog reporter for the El Paso Times, investigative reporter for El Paso Newspaper Tree and communities reporter with the Salem, Oregon, Statesman Journal.

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