It was 12:36 a.m. when the first patient arrived in the emergency room at MedStar Harbor Hospital, the small community hospital in South Baltimore.
“He hopped in,” said Malkia Murray, a registered nurse, who immediately recognized the teen had been shot in the leg.
“I thought it was a one-off, something that happened in the community. We quickly got him in a room,” she said. “Then, it never stopped.”
Over 45 minutes or so, 19 patients would arrive, mostly teenagers rushed in cars driven by friends. One patient came by ambulance. One, with a serious chest wound, came in the back of a police car.
The hospital that is more accustomed to tending gunshot wounds once every other week or so had set a grim record.
An annual summer party at Brooklyn Homes, a neighborhood just over two miles away, had erupted in gunfire early on Sunday, July 2, leaving two dead and 28 injured. Nearly two-thirds of the victims, mostly scared teenagers and young adults, got themselves to the familiar low-rise hospital on the Patapsco River in the earliest hours Sunday.
Alert security officers stopped one person who tried to drive through the glass double doors of the emergency department.
On a steamy night shift just days after the mass shooting, medical staff members were back together treating their usual slate of belly and chest pain, accidents and intoxications. Some were there for the first time since it happened.
They talked about the experience — about setting aside their own safety fears, their aching for the children streaming into their beds and Baltimore children generally making up a disproportionate share of shooting victims this year.
At midnight, there are normally one emergency room doctor, one physician assistant and five or six nurses. There are about 18 bays for patients, with two more set up for serious traumas. That means they have equipment to resuscitate a person, insert a breathing tube, give blood and monitor vital signs.
All but a couple of the bays were full with the normal number of patients who come in on a Saturday night. Others were in the waiting room.
“These are just children trying to have a celebration in their community, and it ended in such violence that it’s hard to process. And they all went home. They all were stable when they left here.” — Malkia Murray, registered nurse
Murray, a triage nurse, and others began to assess and shuffle patients according to the severity of their wounds. Staff reopened what are known as the “fast track” bays, seven basic rooms where someone might get stitches. They are normally open only during the day.
When it was clear many of the patients were friends, they put two or three together in a room. They moved existing emergency patients to higher floors or discharged them if they could. Several patients realized they were witnessing a mass casualty event and volunteered to give up their beds, which Murray called a moving act of community.
There still wasn’t enough space, and there weren’t enough medical staff. Workers started coming down from the ICU, pediatrics and other departments. Someone from obstetrics checked on a patient who thought she might be pregnant. Several workers who live nearby came from home.
Dr. Alfie Mingo, an emergency room doctor, was supposed to be off duty before midnight but had stayed to wrap up care for other patients. Then security rushed back and said there was someone with a gunshot wound. Then there were two more, and three more, and four more.
“I’ve never seen a mass casualty event before. In 20 years, I’ve never seen anything like this. I thought I had seen it all. This was definitely another level of experience.” — Dr. Alfie Mingo
Security officers followed procedures and locked down the hospital while still managing the influx of patients unloading from their friends’ cars. A wave of parents soon began pouring into the emergency department, adding to the urgent tasks for the officers and nurses: reuniting families, answering questions and calming fears.
In the bays, the critical work was underway. Mingo said they searched the young patients for the small holes made when bullets enter bodies and the larger holes made if they exit. Those holes were in limbs, a shoulder and, more alarmingly, a chest and an abdomen. The scene, he said, was bloody.
“The sicker got more attention,” he said. “Other doctors floated around, making sure the patients didn’t have devastating injuries. … It was sad to see. They were teenagers from our community. I have teenage children.”
Mohammad Faisal, a physician assistant, said there was no playbook for the number of patients, so staff just performed precision procedures when and where they were needed, making due with supplies at hand to, for example, insert central lines. Those are the long IV catheters used to give blood and medicine.
“It was chaos, but it was organized chaos.” — Mohammad Faisal, physician assistant
Faisal said they leaned on their training: the ABCs of treatment. That stands for airway, breathing and circulation. He added something of a D, delivering care through the “organized chaos.”
Patients needed breathing tubes and new supplies of blood to survive, he explained. Ten patients were seriously injured and needed more advanced trauma care. Harbor staff stabilized and transferred them to the University of Maryland Shock Trauma Center and Johns Hopkins Hospital, two of the region’s designated trauma centers.
Baltimore’s Emergency Medical Services got assistance moving all the patients from Howard and Anne Arundel counties’ emergency services, MedStar officials said.
Although Harbor is not a designated trauma hospital, the staff all had training and had been put through regular drills. Most have years on the job and have tended to gun wounds. Dr. Neil Majmundar, who was working his normal overnight emergency shift, said he had trained at the University of Maryland Shock Trauma, a top-level center.
“We’ve joined the over 300 mass shootings in this country this year in 2023. Over 30,000 dead. To die in a school shooting is a unique experience in America. And, after countless additional tragedies in our history, the time to act is now.” — Dr. Neil Majmundar
“Fortunately no one lost their lives thanks to the quick thinking and action that we took,” Majmundar said.
Upon reflection days later, he said the staff shouldn’t have been faced with such a scene.
“We’ve joined the over 300 mass shootings in this country this year in 2023. Over 30,000 dead,” he said. “To die in a school shooting is a unique experience in America. And, after countless additional tragedies in our history, the time to act is now.”
He said the hospital welcomes survivors needing more medical care or mental health services. He also said the staff should focus on self-care.
Faisal said he went to breakfast and talked with other hospital staff after they finished their shift Sunday morning. Mingo said he fielded a call from his wife, a nurse. “She wanted to talk. I wanted to sleep,” he said. He slept, and then returned to work Monday morning.
Most didn’t learn what had happened to send 19 gunshot victims to their emergency room until later Sunday. Since then, police have said bullet casings were found from more than a dozen guns at the mass shooting scene in Brooklyn, though they don’t know how many were used in the shooting. A 17-year-old was arrested five days after the shooting on related gun charges.
“These are just children trying to have a celebration in their community, and it ended in such violence that it’s hard to process,” said Murray, the nurse.
“I’m still processing what happened,” she said. “I’m proud of the compassion that I saw a lot of my co-workers providing. We did what we were trained to do.”
The hospital has held a meeting to check in on workers and review their work to see if there were other supplies or preparation needed. The staff, still unsure of their own needs, said they feel pride in their collective performance. They feel sorrow for the community but gratitude for assistance directed to residents.
Dr. Christopher Wilbert, Harbor’s chair of emergency medicine, was out of town when the patients began arriving at the hospital and was awoken by a call. After making his own calls to bring in medical reinforcements, he drove straight to the hospital, arriving at 6 a.m.
“I mean, it was just mind-boggling what happened, right?” — Dr. Christopher Wilbert, Harbor’s chair of emergency medicine
Wilbert said he couldn’t have hoped for a better outcome at the hospital. Everyone had been treated by 4 a.m. The last patient, a 17-year-old boy, was sent by ambulance to another hospital around 6 a.m.
No one died.
“I got here at 6 a.m., and I was glad to see that when I showed up the department was calm,” he said with a tone of surprise. “I mean, it was just mind-boggling what happened, right?”
The Baltimore Banner conducted these interviews with our media partner WJZ. Watch WJZ’s story here.