It was relatively quiet the morning of July Fourth at Highland Park Hospital.
About half a dozen patients were in the emergency department of the more than 100-year-old hospital, which sits in a leafy neighborhood of the normally peaceful suburb. The 21-bed ER was staffed the same way as it would have been on any other day: five nurses, two patient care technicians and one doctor.
That all changed within a few hours, after a gunman fired into the town’s Fourth of July parade, killing seven and injuring dozens.
By late morning, nearly 30 nurses and 20 doctors were bustling through the ER. By mid-day, six surgeons were operating on 8-year-old Cooper Roberts, trying to keep him alive. At one point, doctors and nurses were treating patients with minor injuries in the waiting room, trying to keep space available elsewhere in the ER for people with more severe injuries.
Twenty-six people wounded at the parade would be treated at Highland Park Hospital that day, with others sent to NorthShore’s Glenbrook and Evanston hospitals and Northwestern Medicine Lake Forest Hospital.
NorthShore University HealthSystem’s Highland Park Hospital, which does not usually see many victims of gun violence, had become the epicenter of people wounded at the parade and their worried families.
Even as patients were sent home, admitted to other areas of the hospital or transferred elsewhere, dozens of medical workers manned the ER until late in the day, when the alleged gunman was caught. The hospital wanted to be ready in case he shot more people.
“As terrible as all these events were, I think it highlights the good in people,” said Dr. Ana Velez-Rosborough, who was the on-call surgeon at the hospital that day. “All the people that stepped up, from the first responders to the bystanders that were there, to all the medical professionals, it takes a lot of good to combat someone doing something so terrible.”
‘They just keep coming’
Around 10:30 a.m., the cellphones of doctors, nurses and other hospital staff pinged with alerts that multiple casualties were headed to the facility. Many received the alerts before they even knew there had been a shooting.
James Thompson, the hospital’s ED clinical nurse manager, had been about to go into a restaurant with his family when his phone beeped with the alert. He called the ER registrar to see what happened and if he was needed.
“She said, ‘They just keep coming. They just keep coming,’ and she hung up,” he said.
Immediately, he knew he needed to go.
When he arrived, patients’ family members were standing outside the ER and people were being triaged in the waiting room, he said.
“When I walk in, it’s just organized chaos, all the doctors, all the nurses who have come down from different floors to help us out,” Thompson said.
Meanwhile, Velez-Rosborough was already in surgery with Cooper.
Velez-Rosborough was rounding on other patients at the hospital July Fourth when the alert went out that there had been a multiple casualty event. She immediately made her way to the ER, where patients were just starting to arrive. In the beginning, they mostly came by ambulance, and as the minutes progressed, more began arriving by car.
When an ambulance brought Cooper to the hospital, it was clear that he would need surgery immediately.
Often, people with gunshot wounds go to hospitals that are designated as Level I trauma centers, meaning they have a certain number of services immediately available 24 hours a day. But Cooper’s injuries were so severe that he was taken to nearby Highland Park Hospital, which is a Level II trauma center, rather than spend extra time in an ambulance going to NorthShore’s Evanston Hospital, which would have been the nearest Level I trauma center.
Cooper had been shot through the upper part of his abdomen while watching the parade with his parents and twin brother. He suffered injuries to his liver, esophagus and aorta. Doctors would later discover a spinal cord injury as well.
“The goal in someone who is that critically injured, it’s called damage control — go in, stop the bleeding and stabilize the patient,” said Velez-Rosborough, who is a trauma and acute care surgeon. Before joining NorthShore about a year ago, Velez-Rosborough trained at busy trauma centers in Miami and New York. She had expected the job at NorthShore to be quieter than her last one in Miami.
At first, Velez-Rosborough was the lone surgeon operating on Cooper. As the minutes passed, more surgeons joined her.
In all, she spent three to four hours operating on Cooper and was able to stabilize him. Right after the surgery, Cooper was flown by helicopter to University of Chicago Medicine Comer Children’s Hospital on the city’s South Side — a hospital that’s accustomed to treating children with complex needs and is part of a pediatric partnership with NorthShore.
Cooper has since undergone additional surgeries. He’s paralyzed from the waist down, and is now at the Shirley Ryan AbilityLab in Chicago, undergoing rehabilitation.
Cooper’s mother, Keely Roberts, has said the staff at Highland Park Hospital saved her son’s life.
“They fixed what could not be fixed in that little boy. It was nothing short of a miracle,” Keely Roberts said in a video statement. “They refused to give up on Cooper. They were not going to let that little boy die. How do you say thank you for that? What words as a mother, as a family, what words do you possibly have for people that would not give up on your son?”
Training pays off
Velez-Rosborough credited her training for allowing her to stay calm and focused.
“Emotionally and personally, it’s very difficult having to do that operation on a child,” Velez-Rosborough said. “I have a child myself. I have a 20-month-old little boy, so it’s hard to kind of not see him in Cooper, but in the moment, you just kind of focus on doing what we need to do to keep him alive.”
The Miami hospital where she worked offered mass casualty trainings each month, she said. Highland Park Hospital does two disaster drills each year, one on its own and one as part of a larger regional drill, said Dr. Brigham Temple, NorthShore’s medical director of emergency preparedness. The federal Centers for Medicare & Medicaid Services requires hospitals to have emergency preparedness plans and hold exercises to test those plans twice a year.
While Velez-Rosborough operated on Cooper, the dozens of other medical workers in the ER that day also fell back on their training to carry them through the morning and afternoon.
“I can’t say enough how well the ER team really managed that,” Velez-Rosborough said. “While I was taking care of one patient, they were taking care of 25 other patients.”
At first, as patients poured into the ER, there was “a little bit of a feeling of being overwhelmed, but that quickly turned to calm and focused care,” Temple said.
Temple, who lives in Highland Park, arrived at the ER about 20 minutes after the shooting. Temple was at the parade with his wife, three teenage sons and parents when he saw members of the high school marching band running for their lives. He and his family were able to dash to their car about a block away.
He saw the alert on his phone that a code triage had been called at the hospital. He dropped off his family and headed to the hospital, where his job was to help run the emergency department and assist with patients.
“Of course I never wanted to see an event like this happen anywhere in this country or anywhere else, and especially not in our own backyard, but there was no hesitation on my part or any other individual who showed up to respond,” Temple said. “I knew something needed to be done, and that was what I’d been training for.”
Highland Park Hospital had just conducted a drill weeks earlier on how to respond to a surge of burn patients. In past years, drills have focused on mass casualty events, such as shootings, Temple said.
“You can train all day, but when you actually do get to that time you just hope the training is going to kick in and for the group that was here, that training definitely kicked in,” said Thompson, the ED clinical nurse manager, who left a career in finance 15 years ago to work in medicine, in hopes of helping people in a more hands-on way.
“I think it was well oiled because we had practiced so many times.”
‘It does leave a scar’
The doctors, nurses and other medical staff remained in that focused state-of-mind for much of July Fourth as the hospital was put on lockdown amid a manhunt for the suspected shooter, Thompson said.
About eight hours after the shooting, Robert E. “Bobby” Crimo III, was arrested. Crimo, 21, entered a not guilty plea at his arraignment in Lake County Circuit Court on Aug. 3 after a grand jury indicted him on 117 felony counts.
“Once he got apprehended we all took kind of a big deep breath and could say, ‘OK, we can all go home to our families,’ ” Thompson said.
Still, even after the medical workers doffed their scrubs, the ordeal was not yet over for many of them. One person, 88-year-old Stephen Straus, of Highland Park died in the Highland Park ER that day.
“We’re so focused on taking care of the patients and making sure we’re there doing what we need to do, you just don’t think about the fact that everything is happening,” Velez-Rosborough said. “It really wasn’t until a couple of days later that it really hit me what had happened.”
It didn’t fully hit Thompson until he was driving home from the hospital that evening.
“I just had me and my thoughts to myself, and it was in that moment, in my car driving myself home, that I really got to reflect on, ‘Wow, what have you just been through?’ ” he said.
In the days and weeks following the shooting, the hospital had crisis counselors on-site, and held three debriefings for those who were in the ER that day aimed at their emotional well-being. Thompson attended all three gatherings.
“It does get to you, and it does leave a scar and being in (emergency medical services) and emergency medicine, you have to deal with those scars because, at some point, if you don’t deal with them, bad things can happen with you mentally,” Thompson said.
It’s a comfort to him that his team worked so well together on the Fourth of July. He said he’s “extremely proud” of them and their dedication.
“They did exemplary work that day,” he said. “If you could say you wish there was a miracle every day, that would have been the miracle you would have wished for.”
