During the candidate trainings for my run for the Virginia state legislature this year, one of the biggest takeaways they try to drive home is that you need to prepare for everything that can possibly go wrong. Make a list of every possible roadblock, pitfall, and crisis you can think of- and plan for what it’ll take to get to the other side of it.
I think we did that pretty well for my race, with one exception- Nazis.
Look, I’m a pretty understanding guy. I’m a nurse, and an ER Nurse at that- so I have to be understanding. It’s in our DNA. We’re supposed to be the ultimate safe space- we want people to be able to come to us, no matter what. But reading the recent article in the New York Times that took pains to “normalize” their behavior… sat wrong with me. Dredged up a lot of feelings about my experience here in Charlottesville that fateful day.
This is especially true, because I had an inside view with how close the situation in Charlottesville came to devolving completely out of control. The Nazis came to our town to cause trouble, as much of it as possible, and they pretty much had free reign to do it. It was only the strength and professionalism of our community’s emergency services providers that kept it from being worse than it was.
I honestly don’t know who deserves the brunt of the blame for how Charlottesville went down; there’s a report on Charlottesville coming out shortly that I hope will help shed some light. The one from Richmond seemed to be nothing more than a CYA exercise. All I know is two things- that the people of Charlottesville still don’t have the answers they need and deserve…
And that Nazis friggin’ aren’t nice people.
End of story.
Here’s my little corner of what went on in Charlottesville that day.
We had our campaign’s “kickoff canvass” planned for the 12th of August, hitting target precincts hard in the counties we needed to overperform in in order to bring home a win. Dozens of volunteers were lined up from all over the state to come in. It was quite an exercise to organize!
Instead, as it became increasingly evident how much of an (excrement)-show we had in store- the Nazis weren’t coming because they were interested in dialogue, they were coming to cause trouble, and were gleefully plotting it in some of their online forums from the depths of the Internet- I told all our volunteers to stay away.
I hit the panic button for whatever help I could find to make people aware of the danger posed by that rally. This isn’t easy for an ER Nurse to do; we’re trained to NEVER hit the panic button. We’re supposed to be unflappable in the face of any crisis. But it was too important not to.
Every single person or place I could think of to enlist in helping us keep people safe, I called, emailed, texted- anything I could think of. People were thankfully receptive. I spent an hour on the phone with Chris Hurst; even though he was in Blacksburg and busy with what we knew would be a competitive race, he took time out to help me brainstorm and get the word out about my concerns. Dahlia Lithwick commiserated with me over our mutual feeling of helplessness- like watching an out of control train barreling down the tracks- in what was happening in our community.
We effectively stopped campaigning; I threw our paid staff into helping me organize a coordinated effort to make sure the first responders who were on that day were taken care of. Other candidates in Virginia chipped in what they could, $50 or $100 at a time- Steve McBride, Melissa Dart, Ben Hixon, Roger Dean Huffstetler, Adam Slate, Andrew Sneathern- and combined, we threw over a thousand dollars at making sure our local EMS agencies, Fire Departments, law enforcement agencies, and both area ERs had access to easy-to-eat food, coffee, soda, etc. I know first hand what it’s like to have a max of thirty seconds to inhale whatever sustenance you can before having to hit the bricks non-stop for hours.
A thousand bucks in an insurgent campaign where every single dollar counts was a big deal. What we spent making this happen was a significant percentage of our total budget. But I never batted an eye at it, and certainly wouldn’t change anything about what we did.
After we had the food organized, and told as many people as we could to stay away, I did what I figured I could do best to help- picked up an on-call shift in our emergency department.
While I’m going to be able to share more about what happened on the 12th of August now than I was before- in large part because I refused to use my experiences the 12th as a wedge for our campaign- I still have to be circumspect in parts, because of HIPAA considerations and other privacy concerns. One major network news agency, two cable news networks, and a bevy of internet based news organizations reached out to us in the wake of the 12th about interviewing me, or having me join panels. But when I told them I wouldn’t break HIPAA on their account, almost all of them immediately lost interest.
It would have been incredibly easy to do; I’m probably being more pedantic about violating HIPAA than need be, and the things I experienced and was a part of that day, if articulated at the time in conjunction with a fundraising pitch, would have almost certainly made our campaign a six-digit number in donations.
But nurses are considered the most trusted profession for a reason, and I knew that, for better or worse, when everything was done I’d still be an ER Nurse. I’d still be counted on by my community to stand up for them and help provide a safe place for everyone in our community in their time of need. And that means more to me than any fifteen minutes of fame, or amount of money, will EVER mean.
So now, free and clear of any campaign, fame-garnering, or personal motive other than catharsis, I want to share more of the story of what happened.
The night before the rally, my wife and I took our kids out to Grandma’s house to leave them there for the night; we wanted them out of the city, and we were both going to be working, anyhow. My wife is both a nurse AND one of the administrators of our ER. I like to joke that she’s both the boss at home and at work. She was slated to be in charge the next day; a day she was originally going to take off because the 12th of August was our 5th wedding anniversary.
She’d planned on taking part in our kickoff canvass, knocking doors with me and the kids, and then we were going to adjourn to our favorite hole-in-the-wall restaurant near the downtown mall for dinner and drinks. Instead, she felt an obligation to work the shift as she was originally scheduled, I think, because it was HER shift… and she wasn’t going to inflict the crap-fest we had coming onto anyone else.
After we dropped the kids off with Grandma, we went to dinner and movie, but it was impossible to relax and enjoy it. The specter of the next day hung over us ominously. ER Nurses are cynical by nature, and generally always expect the worst… but this was different. My wife and I never have a problem working together- we’re too professional to let any interpersonal things interfere with providing care for our patients- but I made sure she knew I would stand behind her. I would obey instantly and without hesitation whatever orders she gave, do whatever needed to be done… and I told her that there was nobody else I’d want in charge, including myself, if things went wrong the next day. Not that other folks couldn’t handle it; she is simply the best.
On that depressing note, we went home and went to sleep. Or tried to, anyway. Wasn’t real successful. My wife usually wakes up early to make sure she’s to work by 0630, but there was so much that needed to be done, she was up even earlier than normal. I woke up to give her a kiss, from what fitful sleep I’d gotten, and couldn’t go back to sleep. Instead, I sat up and nursed a cup of coffee in silence at our kitchen table, watching as dawn crept down the hill and through the trees of the holler we live in out here in rural Albemarle County.
I made sure my on-call shift started late enough I could pick up the food we’d ordered and be able to deliver it to the places it’d be needed the most; both of our local area emergency departments, and the EMS call-rooms at both. The Charlottesville-Albemarle Rescue Squad building, where a lot of the agencies who were responding that day were staging from. Charlottesville Police Department. We also made sure to order food from the places in Charlottesville who had to close because of the day’s events, small businesses who couldn’t afford to lose a busy Saturday’s worth of business.
At 7am, as I was picking up food and helping to redistribute it, things were already moving apace. Members of the Virginia State Police and Charlottesville PD and Sheriff’s Department had already deployed… and alongside a lot of them were civilian “militia” members, who were ostensibly there to be “helpful”. I don’t know about y’all, but if I’m being shadowed by a random person I don’t know from God only knows where, who is playing dress-up (wearing camouflage, dark sunglasses, and combat boots) and toting an apparently-loaded AR-15 whose Picatinny rails are loaded up with “close quarters battle” accessories and high-capacity magazine, I’d totally feel safer. Wouldn’t you?
Once I finished dropping food off, I’d intended to hunker down and start on campaign paperwork, hoping I wouldn’t be needed- I would have happily sat in a back room and done paperwork all day if it meant I was 100% wrong- but things had already picked up.
See, the Nazis had had their little march to UVA the night before, their tiki torch march where they’d chanted “You/Jews will not replace us!” It had been considered such a rousing success by them they’d engaged in the sort-of post celebration shenanigans that you’d associate with soccer hooligans from Europe (though I guess, according to the New York Times, that’s just more evidence they’re just “real folks” like you and I).
Their behavior gave emergency services folks the entire county over plenty of work to do. Things like:
- – Nazis who presented in various states of inebriation from a variety of different substances, both legal and illicit
- – Engaging in inappropriate behavior, to straight-up borderline sexual assault, towards emergency services providers
- – Nazis expecting our local EMS/FD/ER/LE providers to sympathize with their world view and being openly flabbergasted and argumentative when informed politely their views weren’t shared
- – Outright and readily admitting glee at the prospect of overloading our community’s emergency services safety net, saying we “deserved it”.
- – Bragging about the damage/injuries they had or intended to cause
- – Invitations to Nazi “after parties” being held in a variety of nearby locales
There are plenty of things I’m coloring over for privacy’s sake; the specific details of the events I dealt with will have to forever remain obscure. I’m pushing what I’m allowed to discuss here. I’ll simply say that the whole ordeal was much worse than I can explain or hint at here.
By sheer luck, our ER’s share of the above BS was resolved… just in time for us to get hit.
As one of our department’s experienced nurses and a theoretical supernumerary, I was in charge of finishing the preparation of our decontamination protocols and room. That’s the mass casualty we were expecting the most- tear gas. For those of you who haven’t been blessed to encounter tear gas, that %#$@ gets everywhere. Clings to everything. And if you let patients in your ER without decontaminating them… it’s bad.
We had a handful of patients come in that we had to strip outside, spray off in our decon room, and lead back to get checked out. I say “we”, but it was just me, stuck in the decon getup in the blazing August heat. Clearly, I need to chat with my wife about the whole “nepotism” thing, since she seems to have it all backwards.
But overall, it was manageable; dare I even say… slow? To be fair, the events weren’t scheduled to kick off until later on, but all aggrieved parties were on site early, and crowds don’t really follow Google Calendar prompts.
That changed. Rapidly.
We had tried to keep an eye on what was going on downtown as best we could- some patients had the news on in their rooms, which was centered on Charlottesville, of course- but even so, it didn’t really give us much of a look at what was going on. I was sitting on a computer doing some charting, as one of our volunteers was perusing Twitter on their phone next to me.
Suddenly, the volunteer shrieked, exclaiming “Oh my God!” Without warning, they shoved their phone in my face. A local journalist by the name of Sean Tubbs had just tweeted about a car plowing into a crowd of protesters.
I read the tweet a few times, trying to comprehend its magnitude, as other tweets poured in confirming what had gone on. Our hospital doesn’t have a Level One trauma center attached to it; our local trauma facility was the University of Virginia, which was also much more centrally located to the protests going on. But if there was a crowd of people involved… it wasn’t going to matter. We were both going to get inundated with patients, and quickly.
I sprinted over to where my wife sat at our department’s charge desk. She saw me approach and caught the expression on my face- and her demeanor immediately dropped. Only by a millimeter, and probably imperceptibly to anyone but me… but I could absolutely tell. Without a doubt.
“MCI,” I said, referring to a mass casualty incident. “Car plowed into a group of protesters.”
She didn’t hesitate even for a second. Picking up the phone to call our facility’s command center, she turned in her chair to inspect the patient board on her computer screen. “We probably won’t get any patients,” she said, “UVA had protocols in place for something like this. But let’s empty every room we can, just in case.” She then rattled off three different rooms where her screen indicated they were ready to leave, only needing a nurse to discharge them.
No more needed to be said; I turned and bolted to get the patients she’d indicated out the door. Luckily, two of those rooms were already empty; the third had a patient simply waiting to be wheeled to their car. I grabbed a wheelchair and loaded the patient in it, wheeling them out to our waiting room entrance as briskly as I thought I could get away with.
“In a hurry?” the patient asked me sweetly. They seemed to be amused by the speed I was pushing them along at.
“Yeah,” I said to them, my tone clipped. “Sorry.”
Only a few minutes had elapsed from us first noticing the tweets, until I rolled that patient through the doors. While that was going on, my radio earpiece had blared non-stop with instructions relayed from the charge nurse and our command center on what we were doing to get ready. Medical Command (MedCom) at UVA had alerted that there was at least one patient receiving trauma CPR, and dozens more injured. But we were assured the on-scene commander would call us with a brief on each patient we were getting, especially since it seemed likely that many would be at trauma levels above what our ER would normally take care of.
This made me breathe a small sigh of relief. I knew the on-scene commander; he is an institution onto himself in the Commonwealth of Virginia, a renowned and incredibly well-regarded expert in emergency medicine who used to work in our ER. Things wouldn’t get too bad.
Any experienced emergency services provider reading this, I know, is now cringing. Because I made a cardinal, nigh-on-unforgivable error.
I dared to hope.
And Murphy is a cold-hearted son of a bitch.
As I stood behind our patient’s wheelchair, waiting for a family member to bring the car around to the entrance, I began to hear sirens.
Wow, I thought to myself, we can hear those sirens all the way here? That’s an awful long…
My thought was interrupted by an ambulance from the Charlottesville/Albemarle Rescue Squad (CARS) company barreling around the curve of our hospital’s drive, followed closely by a veritable parade of private vehicles, a half-dozen or so, with hazard lights flashing.
I froze, my jaw agape.
What I know now is this: the old adage of “no plan survives contact with reality” remained true. Things on scene at the downtown mall were chaotic. The folks on site did a hell of a job keeping everything from devolving completely. It was absolutely only luck, and the professionalism of the on-scene medics, firefighters, and law enforcement folks kept things from getting out of control. The Charlottesville metropolitan area is so lucky to have the dedicated corps of folks working for it that we do.
So a CARS ambulance loaded as many patients as could fit inside it, and took off for our hospital. Maybe they contacted MedCom at UVA to let them know; maybe they didn’t. Maybe MedCom was too busy to let us know in time. It doesn’t matter in the least, it was nobody’s fault; it’s just a thing that happens during times of crisis. You do what’s best for the patient, period. But as they took off, a group of bystanders and good samaritans who had been loading injured victims into private vehicles watched the CARS ambulance began to leave… and immediately jumped in their cars to follow behind.
One of our security guards had come to see if I needed a hand helping the patient I’d wheeled out into their car; there were a half-dozen security and facilities folks preparing our entrance, because during MCI events our hospital goes into lockdown. The triage nurse becomes the arbiter of who is allowed into the hospital and in what priority, and only patients are allowed back- no family members, friends, nothing.
We shared a look. The security guard’s expression shifted from confusion to bewilderment as they saw the look on my face. Without a word, I shifted my patient’s wheelchair in their direction; they took it, and I immediately turned to face the oncoming rush of vehicles.
“Hey!” I barked onto the radio, an edge of panic in my voice, “we’ve got incoming! One CARS squad, lights and sirens, and at least half a dozen personal vehicles- did we hear anything from MedCom?!” My voice broke at the end of that, taking an upward shrill that betrayed the icy cold pit that had developed in the pit of my stomach.
While my comment was meant for the charge nurse- my wife- the call went out over the open net; we only have one channel. Which meant the entire department knew we had patients incoming, much sooner than anticipated.
My wife tells me now that she felt a similar twinge of panic; she had a more global view of the events of the day, being in constant contact with our director of emergency services, our command center, and MedCom at UVA. We weren’t supposed to have been hit yet- it had only been a few minutes since the incident. And as the charge nurse, it was her department to run. Protocol mandated a clear and irrevocable chain of command, which had her at the top.
Everyone was looking at her. Everyone was counting on her. Whatever happened that day would come down to her, for better or worse. The fact we would have to run a trauma center with no trauma experience or equipment, that the unthinkable had happened in our community, that there would be scars that would last forever? It didn’t matter. The only thing that mattered was when the dust settled, it’d be her that shouldered the brunt of the fallout, good and bad. And even if we did everything perfectly, performing miracles and accomplishing the impossible, emergency services folks have a bad habit of carrying that baggage around on our shoulders. It’s not the dozens we save we remember; it’s the one we lost. The thing we could have done, if only we had been clairvoyant.
That’s a crippling amount of pressure and weight for one person to carry. But all I- and the other nurses, techs, and EMTs on duty in our ER- heard that day over the radio net was her voice… as even and cool as could be, with no hint whatsoever of worry or concern.
I don’t remember exactly what she said; she told/asked me to handle triaging the patients that were coming in. She directed a few other folks to come out and help. She told everyone to get ready, told us that “we (had) this”. But while I don’t remember what she said exactly, I DO remember- and will never forget- how even, unwavering, and strong her voice was.
This is where what I can tell you about patient flow and acuity ends. I steeled myself and jumped into doing triage- which patients were priorities, which needed what interventions, et cetera. I did an adequate job; any competent triage nurse could have done what I did. There was nothing particularly heroic about it. Once I’d been emboldened by how strongly our charge nurse was handling things, my training kicked in, and I’m blessed to have the honor of working with one HELL of a group of medical professionals.
There’s been a few numbers bandied about; the Virginia State Police indicated there were thirty-four patients injured and one death (not including the two troopers who gave their lives in a helicopter crash) from the events of the terrorist attack on August 12th, but I’ve heard numbers of total injured ranging from thirty-two to forty-nine. The University of Virginia Medical Center, in a press conference, noted they’d received and taken care of nineteen wounded and the one death from the protest- Heather. Math can help give you an idea of how many patients our ER saw; I can’t.
We did what we were trained to do. The group of nurses, techs, EMTs, respiratory therapists, X-Ray and CT folks, facilities management, and security guards were second to none. I didn’t get to see much of what went on in the back, because after jumping into triaging patients, I didn’t re-enter the hospital for the next four hours or so, standing in the ambulance bay outside receiving patients. But I understand we had plastic surgeons come in just to do simple stitches. Radiologists who came and gave real-time reports on X-rays and CT scans. Neurosurgeons who came in just to be extra hands. Considering how little you can truly prepare for an MCI, we did amazingly- as did our compatriots across town at UVA, and all the local emergency services providers involved.
The only part of what came next that really took me aback was a non-medical incident I had to take care of. At some point after the initial rush of patients arrived, a car screamed up, barely stopping before a middle-aged lady flew out of it. She sprinted to the sliding door of our ER entrance, and almost collided with it- because the door didn’t open. It was turned off because of our lockdown.
It came to pass this person was there to see a close family member; she’d found out her family member was being treated at our hospital, but had no idea how the patient was doing. She’d had no indication whether her family member was barely clinging to life, or had just received a bruise.
Since I was the triage nurse, it fell to me to explain our lockdown- why we were were doing it, why it was important, and letting her know I would inform her of her family member’s medical status as soon as I was able to. But I only got as far as telling her nobody was allowed back but patients… and then she hit me.
I don’t blame her or hold it against her for doing it. It wasn’t a balled-fist clock across the face, more of a vengeful shove and strike. And it was nothing personal to me; I was just the one who told her she couldn’t see her family member, who, for all she knew, was seconds from death. At that time, news had gotten out there was at least one death from the attack.
Besides, I’ve had to wrestle patients high on meth who were threatening to kill me. Assaulting healthcare professionals is very serious, I don’t want to diminish that- but this? I can’t take umbrage with it, even in the slightest.
What sticks with me about it was I felt, in the depths of my soul, how helpless she felt. Told, by the news and social media, there were critically wounded and dead from the attack. And told by me that I couldn’t tell her about how her family member was doing. That she couldn’t go back to see them.
What if it was me, being told my son or daughter or wife who was injured- and then also told I not only couldn’t see them, but couldn’t even be told how they were doing? The helplessness of that kind of situation is staggering. Unthinkable.
That person did eventually get back to see her family member. But knowing how she felt at that moment, and how I contributed to it, is something that’ll stay with me forever.
The day ended. My wife and I picked up our kids. We commiserated silently to one another for awhile, before she cried about the wound this event would leave on our community, the place she was born and raised, and wondering if it would ever heal. We went to bed, exhausted.
And incredibly, my wife woke up early the next morning, after a fitful night of sleep crammed in between me, a preschooler, toddler, and dog… and went back to do it all again the next day. In charge once again, having to shake off the previous day’s events like they’d never happened.
But that’s just what we do in the ER. In EMS. Fire. Law enforcement. We do the impossible, break our backs to make things work. To save lives. To keep our community’s safety net intact… but we’re constantly fighting an infinite problem with finite resources, a rear-guard battle we’re always destined to lose.
It’s one of the biggest reasons I decided to run for public office in the first place; I was sick and tired of legislators who took for granted how readily the folks that make up our community’s social safety net (including people like teachers, social workers, volunteers, etc) dedicate their lives to making things better for everyone. And we don’t do it for fat paychecks or constant adulation; we do it because it’s the right thing to do. All we’re asking is for the folks in Richmond and Washington to stand behind us when we need it. To treat us as part of the solution, not part of the problem.
This is as verbose as I’ve been publicly about what went on that day, and, again, that’s largely on purpose. I kept my mouth shut when approached by news organizations who wanted a narrative instead of a story. As I saw stories I had been an active part of get blown up, pushed out, and mistold from the media and the blogosphere. As I watched other candidates use the 12th to fundraise; I had to bite my tongue when they’d opine to me on “what Charlottesville meant to them” and why it meant I had to give them money. Though, to be fair, what happened in Charlottesville did probably mean something to them; that, and I was too close to what happened to have an unbiased view. So I mostly let it go.
The only time I really opened up was when it came to light my opponent had listened to the organizer of the Nazi rally talk about his white supremacist views at a local GOP party meeting, and just twiddled his thumbs- the local newspaper didn’t deign it as a newsworthy story until I wrote about it on this website, and their “investigative journalism” consisted of asking my opponent if he was, indeed, at a meeting with the white supremacist, and then meekly accepted his explanation that “Roberts Rules of Order” prevented him from speaking out against it, without challenging or following up on it in any way.
Anyway. That’s my story from the 12th of August. What I can tell of it, anyhow. Take it for what you will.
For better or worse, our leaders failed to keep Charlottesville from happening; I got an inside view of part of it. That includes elected officials, both local and national (like Representative Tom Garrett, who legitimized the President’s remarks in the wake of Charlottesville); by the Democratic Party of Virginia; and even by us in emergency services. I know there was plenty that was out of the control of everyone… but that’s the price of leadership. There’s nowhere for that buck to get passed but to you.
As someone who ran for, and may run again, for public office… that realization weighs heavily on me. As does how important it is that we fix these mistakes, at both macro and micro levels. It’s what I’ll be engaged in doing now that my election is over- because it can’t just be about my election. My election was only the start. That, however, is a story for a different day.
But what I absolutely don’t want you do is let anyone tell you, from the New York Times to the President of the United States, that there were “many fine folks on both sides” involved in what transpired that day in our community. It’s just not the case. And legitimizing their viewpoints is unconscionable.
I’ll say this one more time, for everyone to hear: the “many fine folks” were on one side, and one side only.
And it wasn’t the side of the Nazis.