It started with a call in the middle of the night from the trauma surgeon on call.
Dr. Michael Cheatham still remembers the voice on the other end of the phone.
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“Normally when we call each other in the middle of the night, you start off apologizing,” Cheatham said. “And there was none of that. I picked up the phone and he said, ‘I have 20 gunshot wounds. I need you now.’ And that’s when I knew that this was not a normal night.”
Dr. Cheatham and Dr. Joseph Ibrahim were two of the trauma surgeons inside Orlando Regional Medical Center during the Pulse nightclub mass shooting on June 12, 2016.
At ORMC, the Central Florida’s only Level One Trauma Center, patients began arriving almost immediately.
“We were receiving an injured patient literally one per minute during the first 36 minutes,” Dr.Cheatham said.
The volume of patients forced doctors and nurses to improvise in real time.
“We had to kind of get creative to get all of them in the trauma room because that’s where most of our resources are for the most critically injured patients,” Dr. Ibrahim said.
The surgeons say they relied on the same trauma protocols they use every day, only at a pace they had never experienced before.
“Anybody that was deemed critically ill when they first hit that door, they brought them into that room,” Dr. Ibrahim said.
But while doctors and nurses fought to save lives, another fear spread through the hospital.
Staff received reports there could be an active shooter on campus.
“We get a page gunman on campus,” Dr. Ibrahim recalled. “SWAT team kind of comes in, takes over. You come around a corner and you’re met by SWAT, showing your badge, those kind of things.”
“They thought that the gunman had actually escaped from Pulse and was masquerading as a victim,” Dr. Cheatham said.
The trauma team decided they would not leave their patients.
Instead, they barricaded themselves inside the trauma bay using heavy X-ray machines.
“We did use the x-ray machines, which are hundreds and hundreds of pounds, to block the doors, so that no one could try and come into the trauma bay,” Dr. Cheatham said. “The problem was we then realized well, now we’re trapped in here.”
Still, they kept working.
At one point, Dr. Cheatham moved the barricade aside and walked back into the hallway because more patients needed help.
“We had patients that were dying out there,” he said. “What is going to kill this patient in the next two minutes?”
Dr. Ibrahim says the pace of the night left little room to process what was happening.
“You’re such in that mindset,” he said. “There’s just a mindset of taking care of the next patient, next patient, next patient. None of the gravity of it really hits any of us until much, much later.”
The surgeons also say another group of workers deserves recognition: the environmental services staff who cleaned the trauma bay between waves of patients.
“The environmental service people cleaned the room up in a rapid fashion so that we can have the next patient there,” Dr. Ibrahim said.
“These are people without medical training,” he added. “They’re not used to some of the things that we have to see - and yet they’re in there seeing that. They’re not trained for that. They’re seeing some of these horrific images - and they’re just putting their heads down and going to work.”
Cheatham says it took more than 48 hours before he could finally stop and think about everything that had happened.
“I think the moment that I could actually sit down and start thinking was actually late that Sunday night,” he said. “We had just been going nonstop since two in the morning, and my wife brought me dinner. The two of us just sat in my car in the parking garage while I ate. And I was able to share with her what all had happened.”
Even now, a decade later, Dr. Ibrahim says one question still lingers.
“You know, everybody asks the why,” he said. “Even us that work in the ER, we see it every day and we know there’s no answer to that question. We know it just is the way it is. But still, with those kind of situations, you can’t help but ask why. And then why am I so blessed and why am I so lucky.”