By Lillian Lockwood, MD
On April 13, 2014, an anti-Semitic, white supremacist, opened fire at two separate Jewish based facilities in Overland Park, Kansas, a suburb of Kansas City. His intention was to murder Jews on Palm Sunday. The first shooting occurred in the parking lot of the Jewish Community Center of Greater Kansas City forever changing the lives of the Corporon family. The day was supposed to be filled with music as Dr. William Corporon accompanied his talented 14-year-old grandson, Reat Underwood to a singing audition for KC Superstar. Dr. Corporon had spent 42 years dedicated to caring for others and was now enjoying time with family. Sadly, this gunman shot and killed Dr. Corporon and Reat. Shortly afterward he also killed Terri LaManno who was visiting her mother at Village Shalom, a Jewish retirement community. During his rampage, the armed perpetrator took aim at multiple other people. A few were able to escape unharmed. During the time of the first shooting, teenagers were inside the building auditioning for KC Superstar, and numerous others were in the White Theater preparing for a performance of To Kill a Mockingbird.
Mindy Corporon, mother to Reat and daughter to Dr. Corporon, initially was scheduled to attend her other son’s Lacrosse game, but the game was canceled due to inclement weather. She arrived at the Jewish Community Center immediately after the shooting, before the arrival of law enforcement and emergency services. She discovered her father’s truck doors open and her father lying on the ground apparently lifeless. She ran around the truck and found Reat being held by two individuals. Another bystander quickly grabbed her and pulled her away from the scene. Once inside the community center she saw evidence of the shooting and realized what had happened. She requested that as soon as the ambulance arrived to take Reat to the hospital, that she be notified so she could ride with him. Because the area was an active crime scene, she understood why she needed to “stay put” temporarily as the police arriving on scene had no way of knowing who was involved in committing the crime and who were innocent bystanders. Mindy had given her phone to Reat earlier, so she did not have a phone to call out with. Mindy’s mother and wife to Dr. Corporon, Melinda Corporon, was called by another family member and told to go to the Community Center. When she arrived, the Community Center was placed on “lock down”, and she was also placed inside the Community Center but in a different area from where Mindy was located. Therefore, she was not in contact with Mindy. Unfortunately, no one notified Mindy when her son was taken by ambulance to the local trauma center. Eventually Mindy and Melinda both went to the hospital. They describe a very chaotic hospital atmosphere. Numerous loved ones and friends were arriving at the hospital, soon packing the consultation room. Reat’s injuries eventually proved to be fatal. The hospital staff were very empathetic, but the in the turmoil, the physician was unable to distinguish who Reat’s parents were. The physician seemed to deliver the devastating news to the entire gathering. Mindy was in a state of shock. She was prepared to hear that Reat went to surgery, but she did not expect to be informed of Reat’s death. Subsequent questioning from law enforcement, and inquiries regarding identification of Reat, made an already emotionally traumatic situation even more stressful for Mindy. Both Mindy and Melinda Corporon were having trouble wrapping their heads around what happened. Mindy describes being in such shock that in retrospect, due to her emotional devastation, she does not recollect much information conveyed to her at the hospital that day. In the interim, the gunman was arrested outside of a nearby Elementary School. According to witnesses, he made antisemitic remarks as he was led away. The FBI later confirmed that antisemitism was the motive behind the shootings. Ironically, no one killed that day was Jewish.
This particular act of violence was perpetrated by someone with a hatred for those of the Jewish faith, but, regrettably this is certainly not the only shooting motivated by religious or racial hate. In June of 2015, a white supremacist murdered nine people at the Emanuel African Methodist Church reportedly in hopes of initiating a race war. In a 2017 Olathe, Kansas shooting, three were shot, one killed and two seriously wounded, when a gunman mistakenly targeted two of them believing they were Iranian.
Not only is it important that Emergency Medicine practitioners be prepared for and know how to respond to the active shooter disaster, but prevention of these horrific acts of violence should be a goal. The Corporon family opened the Faith Always Wins Foundation with the mission statement of “Promoting dialogue for the betterment of our world through kindness, faith, and healing”. In memory of Dr. Corporon and Reat the family continues to focus on this mission. In this way, Dr. Corporon and Reat continue to make a positive influence, hopefully preventing senseless acts of violence. By being vigilant of emergency department patients who may present in need of psychiatric stabilization and with indicators of risk for future violence, Emergency Medicine providers may be able to intervene, preventing dangerous thoughts from progressing to life-threatening actions.
Other measures that may improve active shooter disaster response includes integrating community organizations and local leaders into disaster preparedness exercises. With the input of local emergency responders, organizations such as churches, schools, college campuses, and sports arenas can identify optimum locations for family reunification, pre-determined safety areas, and areas that may be used for initial triage and ambulance transport. Certainly, the safety of EMS personnel and non-injured citizens remain a continued concern throughout the active shooter response. With organized pre-planning, it may be possible to keep family members together, so they can support each other during this extremely difficult time. The physical structure of the building, location of exits, and proximity of safety locations to main buildings may need to be considered when identifying safety areas. Emergency personnel may not be as familiar with the building as the citizens who use the facility regularly. Thus, preparing together to develop a disaster plan for the public venue can be extremely beneficial. During the disaster response, it is optimal to make every effort to keep surviving family members informed of patient transport and patient’s current location in this hectic situation. Any delays in patient care should be avoided, but EMS might be able to designate staff to contact on-scene family members and inform them of the receiving hospital or trauma center. Mindy reminds us that it is nearly impossible for family members under this type of stress, to absorb information as they are attempting to process the unexpected, tragic events taking place. She suggests that appointing a hospital victim advocate such as during court proceedings may be extremely valuable. This person could help walk the family through the hospital process, explain ongoing efforts being made to care for their loved one, and keep the family generally informed, while emergency department providers are involved in resuscitation efforts. This person also can help introduce the main family members to hospital staff to eliminate confusion for the emergency department physician. When a family discussion needs to take place, the advocate can direct immediate relatives to a more private area to speak with the physician. This location may also be a more suitable location for law enforcement officers who may have some very difficult questions for the family.
Active shooter incidences are becoming less rare, involving areas of varying populations, from large cities to small towns. Therefore, it is incumbent upon Emergency Department personnel and first responders to become actively involved in preparing for these events, regardless of the size of the Emergency Department. Preparation for patient care is mandatory, but consideration of on-scene bystanders and family needs is also critical.