BLACKSBURG, Va. -- While providing insight and practical advice to area EMS providers, Colin Whitmore, the EMS commander for the Virginia Tech massacre, said the primary lesson he learned is for communities to be more attentive to the needs of the mentally ill population.
Whitmore spoke to a crowded conference room Saturday during the annual Miltenberger Emergency Services Seminar at Rocky Gap Lodge & Golf Resort. Whitmore was a lieutenant with the Virginia Tech Rescue Squad when Cho Seung-Hui opened fire, killing more than 30 people on April 16, 2007, in what has become the deadliest mass shooting in U.S. history.
A volunteer agency run by students, Whitmore was behind the scenes managing the medical response, manning about 100 people the day Seung-Hui chained the doors to classrooms and began slaughtering the students and professors inside. The lessons Whitmore learned that day are many, but one of the foremost is that "it's really time to call ourselves to action, to look at what we can do to help these people before they commit these horrifically violent crimes."
Mental illness is something that Americans in general don't like to talk about, and often don't think twice about, Whitmore said, adding that it's true within the EMS population, too.
"I think there's a high level of complacency among EMS when it comes to psych calls. I'm guilty of it. I'm pretty sure a lot of you are, too. You get called out for someone who's ... taken half a bottle of Advil and you take them to the hospital and you say 'what an idiot' and then you go home."
After a few years of dealing with mentally ill patients, Whitmore said there's a marked lack of sympathy "to these cries for attention, these calls for help."
That attitude not only does mentally ill patients a huge disservice, but it also leads to events like the massacre at Blacksburg.
"I'm here to tell you that the next school shooter ... may very pass through an ambulance on his path to making his decision. He may very well have made an attempted suicide and he may very well have assaulted someone ... it's up to us to be that first line," Whitmore said.
Encouraging EMS personnel to take notice of what these patients say and do, Whitmore said not only should it be documented in writing, but also those details should be discussed with hospital staff, to "make sure these people are getting the care that they need."
Whitmore defined an "active shooter" such as Seung-Hui, as someone who "fires at will" and has unrestricted firepower. Perhaps the victims of bullying or a bad family life, he said they feel wronged and externalize their feelings by blaming others.
"It's never any responsibility for your own actions, your own ... emotions," Whitmore added.
As for what EMS agencies can do when situations involving active shooters arise, Whitmore stressed preparation, coordination and Critical Incident Stress Management, or debriefing activities, for emergency responders. "Active shooter exercises are essential," he said, adding that most EMS agencies don't take part in them.
But they can if they cooperate with local law enforcement, who do receive such training, he said.
"And I don't think that, especially nowadays, there would be a single department that would be hesitant to let you play along and I think that the more that you're able to do that ... that ultimately has the greatest benefit," the emergency management consultant added.
According to Whitmore, situations like those at Virginia Tech are inherently stressful, resulting in reaction rather than proactive efforts. Driven not just by the emergency itself, but by "frantic dispatchers" who want EMS to respond immediately, such scenarios can be fraught with danger.
"The phone's ringing off the hook from 30 people with gunshot wounds. Naturally, they're a little bit stressed," he said, adding that one of the hardest things he had to do that April morning "was continually tell them 'no.'
"They're calling you to respond into the building and you can't yet, because it's not safe. You don't know if the shooter's out," he said. "And one of the principles of EMS is if you're injured yourself, you can't help the injured ... something that the public rarely understands is, you're trying to do the greatest good and sometimes that means you have to wait until it's safe to send your own people in."
During the shootings, Whitmore said "one of the toughest things was to hear the dispatchers frantically calling for help because that's their job and not being able to give it to them right now. Knowing that you have people, you have resources, but you just couldn't do it."
To minimize problems and chaos, Whitmore suggested EMS personnel be composed of carefully selected triage teams that can remain level-headed. Second, "don't waste time" by retracing the steps of search and rescue teams who have gone ahead, perhaps already checking certain areas to look for victims, he said.
According to Whitmore, it's impossible to have too many people providing medical treatment at mass shootings. "Make use of your resources. You are not going to have everything you need ... but if you can put people to work ... do it. Improvise," Whitmore said, adding that a field hospital can be set up at the emergency site. "If you have people with training and you don't know where to put them, stick them in your treatment area," he added.
Once the scene is cleared and all victims have been removed to area hospitals, some work remains: Critical Incident Stress Management is "for everyone," he said.
"Every single person on the scene that day ... made use of CISM," Whitmore said, adding that the debriefing began with something as simple as a cookout. At the next session, each person discussed how that April 16 began, from the time they woke up, and how it progressed through the massacre, until the time they went to bed. "It was just good to hear how everybody else was going through the same exact things that you were," he said."The important thing about it is to know where those resources are and who's responsible for calling them," Whitmore added.