Mammoth local in ER during Tucson tragedy
Saturday morning, Jan. 8, Tuscon, Ariz. Outside a Safeway supermarket, U.S. Congresswoman Gabrielle Giffords and her staff set up for Congress On Your Corner, one of a series of meet-and-greet opportunities for Giffords to hear from her constituency. At about that same time, across town, at University of Arizona’s Medical Center, Mammoth local Sierra Bourne, who’s doing her Emergency Medicine residency at the campus hospital, began the final day of her trauma surgery rotation as the on-call intern by seeing a bicycle accident victim.
10 a.m., local time. Shots ring out at the Safeway. Gunfire fells multiple victims; as many as 20 are hit. University Medical Center, Tuscon’s chief trauma center, will receive the majority of the seriously wounded shooting victims, including Giffords.
In the ER, a text message from EMTs on scene delivers an ominous heads up: “10 gunshot wound victims.” The bicycle accident patient is moved to another part of the hospital as Bourne and her colleagues prep the ER to receive the victims.
“I was ‘on loan’ to trauma surgery; the interns do those rotations to get more experience in various specialties,” Bourne explained. There are three levels of trauma: red, white and green. Trauma surgeons show up for red and white. This was red.
Until the ambulances started arriving, Bourne said she had no idea what actually happened. “It sounded bad, but we see a lot of different circumstances. It could have been a hunting accident.” The 20 minutes of waiting “felt like years” to Bourne.
A lucky break … all three surgical teams happened to be there, since it was early in the day, as opposed to the middle of the night, when there would have been only one team. At the height of the event, 40-50 paramedics, nurses, surgery residents and attending physicians were deployed in seven rooms.
“We started in one room and luckily not all the patients arrived at once,” Bourne recalled. “In addition to the triage the EMTs did on scene, we were able to evaluate who needs to go to the OR, who’s stable and who can wait. We check airways, breathing, circulation … check them all over. We found one bullet where we wouldn’t have expected. It ricocheted through the body. Gunshot wounds can be unpredictable like that.”
UMC treated 11 victims; 10 were saved, including the Congresswoman.
A Bourne family tradition …
Her family, which has called Mammoth Lakes home since 1985, has medical professionals on both sides. Her father, Jonathan, is an anesthesiologist, and his brother, Andrew, is a surgeon. Sierra’s brother Eric went pre-med and is now in medical school. However, there are also members who are in radiology, nursing … even dentistry. “My mom was a med-tech in medical school, but decided medicine wasn’t for her. Her favorite class was statistics,” Sierra quipped.
After graduating Mammoth High School, where she was class Valedictorian and on the ski racing team, she headed to UC San Diego. “In high school, I was able to take a college-level Anatomy & Physiology class. It was so cool … it was tailored to all the things a teenager would be interested in … metabolism, the effects of high-altitude.” She considered anesthesiology, but during her first year of med school, she heard recruitment pitches from ER programs. “ER is bad-ass; it’s really sexy! I wanted to save lives … which is idealistic, maybe, but I got to like ER the more I heard about it.”
(Sheet note: Which also explains why there’s never been a drama series called “Anesthesiology.”)
Lately, her life has been largely dictated by education. Her UCSD classes had 400 students, and Bourne yearned for a smaller learning environment. “There’s an interview system, sort of a Match.com for medicine. You rank your choices, and a computer matches you for compatibility,” she described. “It’s not guaranteed you get a spot, and I could have gone to Denver, Utah, New York, Philadelphia. Between college and med school, I took off a year last year to ski … traveling to Argentina and spending a lot of time in Mammoth. Then, last March, I pulled Tuscon. I have a hard time believing that every physician goes through that … it’s emotional turmoil!”
Residency is “a lot of work,” with 60-80 hour weeks, and while a career move to Mammoth could one day be in the cards, for now, the girl who grew up around snow has gotten to like Tucson. “It’s the perfect size city, very southwest, native American and Mexican influences. Great mountain biking!”
Reflections on a Saturday
By 3 p.m. the ER had settled down. Bourne was in charge of compiling all the information on the patients, including angiograms, CT scans and other data. Her information was used by Chief of Trauma Surgery Dr. Peter Rhee in his initial press conferences. Dr. Rhee, who has combat military medical experience from tours in Afghanistan, called the shootings “a mini mass-casualty event,” which Bourne thinks appropriate. “Nothing overwhelmed the system. We were trained for it. Everyone from the other surgical teams pitched in and helped. The group mentality Dr. Rhee fosters in the staff worked great.”
All during the event, the team was getting text messages from off-duty personnel watching reports on TV and online. “Smart phones were huge … Dr. Rhee really likes using them. We’d take a photo and show it to a surgeon, asking, ‘This is what it looks like … what do we do with this?’”
Looking back, Bourne thinks what happened that Saturday is still sinking in. “It was exciting; I’ve started a collection of newspaper and magazine articles,” she said. “People use the word ‘surreal’ to describe it … it’s weird, to have the country and the whole world talking about it. The EMTs told us afterward that it took longer than they would have liked, but the police had to secure the scene. And then the miscommunication, the early reports of the Congresswoman being dead at the scene. We heard that and some of the surgeons started standing down. Then we heard from the EMTs and they said, ‘Oh, no she’s very much alive and we’re bringing her in.’”
Bourne acknowledged that at some points she cried. “Young people … getting shot … a politician. The media was outside. Law enforcement was everywhere. I had to show my ID a lot. It was a long day.”
How does she handle the pressure? “It’s blood and guts … you have your hand in their chest, but it’s okay. That’s what we do. I think it would have been much worse to be at the scene.”
Would she relive that day over the same way if she had to? “Oh, sure. Absolutely. I had another shooting victim [unrelated to the Giffords incident] later that night. The world keeps going. Life goes on.”
Firmly fixed on ER medicine as a career, she winces at her student loans, but is even philosophical about those. “It’s not about the money. It can’t be about that. You have to be motivated, you have to be passionate. Would I love to be here skiing every powder day? Sure. But there are responsibilities and I have to look at three years down the road, when I’m managing people. I have to be ready. And I will be.”
What does her dad think? “He was bummed I didn’t go into anesthesiology, but he’s really proud of me. “
After all the tests and studying, there are still sacrifices. She won’t be able to go on a weekend trip with friends to support John Teller during the X-Games, and could have gone to President Obama’s memorial speech as a VIP, but was on duty. “That was a bummer. I am hoping to make it to my 10 year HS reunion, though.”
At the end of the day, especially one particular Saturday, Bourne says, “It’s all worth it.”