The firefighters who tried to save REESE FALLON’S life can’t shake the memory of her CELLPHONE ‘It was ringing and ringing and ringing and ringing. Vibrating, DANCING on the sidewalk right off the curb.’ ‘Someone was LOOKING FOR HER’

The Danforth tragedy, as seen by the men on Pumper 323, Page A8, and a trauma surgeon,

Dr. Bernard Lawless lives five minutes away from St. Michael’s Hospital in downtown Toronto. After a relatively uneventful Sunday in July as the on-call trauma surgeon in the critical care unit he had made the call, as he sometimes will, to duck home around 8:30 p.m. for a hot meal — he loves to cook — a hot shower, some television and to be, well, “civilized” for a spell, before heading back to work at one of the busiest hospitals in the country.

“We always hate to use the Q-word — quiet — because the minute you say it, is the very minute things change,” Lawless says.

Sure enough, shortly after 10 p.m., just as the 49-yearold was settling in to watch the news, things changed. Lawless’s phone started buzzing with a text message from one of the other trauma team leaders indicating four patients, suffering from gunshot wounds, were en route to the emergency department, a number, minutes later, that was upped to five.

“I’m always kind of on the ready when I’m on call — I’m in that mindset,” he says. “And knowing something serious could be coming in, I drove. We have a designated parking spot right outside the emergency department doors and as soon as I got there I knew something big was happening, because there were police cars all around.”

Just a short cab ride away, on Danforth Avenue, Faisal Hussain, a 29-year-old with mental health issues — and a handgun — walked a popular strip with lethal intent. Firing at innocents, reloading as he went and ultimately killing Reese Fallon, 18, and Julianna Kozis, 10, while wounding 13 others before taking his own life.

Five of the injured were rushed to St. Michael’s. Three required immediate life-saving surgery, a situation Lawless walked into after parking his car, throwing on a surgical gown, mask and gloves and entering the trauma bay, a big room capable of accommodating multiple casualties that is outfitted with ventilators, heart and blood pressure monitors, X-ray machines, IVs and EKGs.

Lawless stresses that he wasn’t the only medical person in the room Sunday night. The trauma team is a team — consisting of several nurses and other doctors, social workers and even a chaplain. And after the shooting it was “all hands on deck.” Plus some additional hands, as soon as Lawless had surveyed the situation and texted his trauma-surgeon colleague, Dr. Najma Ahmed, who raced to work, so both could be operating simultaneously. (Lawless is also quick to add that the care the wounded received at the scene from firefighters, paramedics, police and bystanders, who rushed to help, was vital in getting them through the emergency room doors alive).

The soft-spoken, blondhaired, hazel-eyed surgeon isn’t able to talk in specifics about the work he did Sunday night and into Monday morning, due to patient confidentiality. But, after almost 20 years on the job, he can speak about guns, and the havoc a bullet creates when it penetrates the human body.

Looked at from the outside, a gun shot wound from a handgun appears as a defined circle, about the size of a dime. It is on the inside where things get messy. Bullets kill people in two ways: either by striking a vital organ (think: heart) or major blood vessel, and causing massive hemorrhaging and a rapid death, or by injuring major organs — the bowel or spleen, for example — and causing the body to effectively contaminate itself, leading to catastrophic infection/ sepsis.

“If your stomach was perforated and spilling gastric contents inside your ab- dominal cavity, you want to control that, because if you don’t, you’ll be looking at complications,” he says. “Even before that, you need to stop any significant bleeding. So the ultimate goal isn’t finding the bullet. From a trauma surgeon’s perspective, it’s about finding what injuries the bullet has caused.”

And bullets aren’t necessarily predictable. They don’t always travel in straight lines, and the things a bullet will encounter — tissues, blood vessels, organs and bone — can alter its trajectory. Bone stops some bullets. But a heavy calibre bullet can smash straight through bone — the calibre of bullet used by Hussain has not been disclosed due to an ongoing SIU investigation — or else ricochet off of it, and start rattling around the chest cavity, say, or the stomach, causing trauma to the surrounding tissues and posing a threat to whatever organ happens to be in its way.

If a gunshot victim is not at immediate risk of succumbing to their wounds upon arriving at the trauma centre, the team may order a CT scan and a series of X-rays, to gather intelligence on what’s going on inside the patient before beginning to operate. Should they arrive with their life in the balance, as three did Sunday night, the trauma team does a rapid assessment, gets an IV flowing, checks blood pressure and breathing, scans the body to make sure nothing has been overlooked — and, within minutes, gets the patient on an elevator and on their way to the OR on the building’s fifth floor.

Danielle Kane, a 31-yearold nursing student, was among the three in dire need at St. Michael’s Sunday night. Not long before she arrived, she had been in a restaurant on the Danforth with her boyfriend, Jerry Pinksen, and another friend. A woman rushed into the place saying a girl had been shot. Pinksen, an emergency room nurse, charged through a side exit to help, followed by Kane. Hussain was near the exit, and would fire multiple rounds at the couple, striking Kane. The bullet breached her chest wall, punctured her diaphragm and stomach, shattered her T11 vertebrae and exited through her back, according to a CBC Radio interview with Pinksen and a Kane family message posted to a GoFundMe page in support of Danielle.

Lawless’ colleague, Najma Ahmed, saved Kane’s life, and that, he says, in his line of work, is where he finds the most fulfilment.

“It’s the ability to hopefully alleviate suffering and sometimes do things that are actually life-saving, that’s where the real gratification exists,” he says.

One of the curious things about a bullet is just how mercurial the path it travels can be. Lawless has moments where he will marvel, standing over a patient and looking down, and not at his surgical handiwork, but at how a bullet can pass within a millimetre of the heart — and miss — an impossibly close brush marking the difference between a patient’s chance at life, and a near certain death.

“You start to think, ‘Wow,’ if the patient had turned differently, or been slumped over, or if they were walking or running away, there are so many factors — and part of it is fate,” he says. “Sometimes you think, that was so close, and how it could have been catastrophic.

"And sometimes it is catastrophic, sometimes it is fatal.”

Lawless emerged from surgery at about 5 a.m. Monday morning. He was jacked on adrenalin, and he wasn’t done yet. There were two more patients to check on, who hadn’t required immediate surgery. Part of the story of the Danforth shooting is that it is not over. Not for Danielle Kane, who remains in hospital at St. Michael’s, as do two others, and may never walk again, and not for her family or for all the other families who have had a hole punched through their hearts by the murderous actions of a man with a gun.

“Sometimes patients with penetrating injuries will be in hospital for weeks and months,” Lawless says. “And that is part of the job, working toward how do we get these people out of the hospital — and how do we support them.”

The veteran surgeon briefly left the hospital Monday morning, long enough to zip home, grab a coffee and a hot shower and come right back again to be with his patients’, and continue a day that he had started the morning before.

“It wasn’t until later Monday night that I got home, and got myself off my feet, when things really sunk in,” he says. "I think I’m doing fine with it, and that’s not to say that what happened hasn’t been impactful.

“But I think I am just like so many other people in this city who have been asking, how could this happen?

"How could something so senseless happen?”

YOU START TO THINK, ‘WOW,’ IF THE PATIENT HAD TURNED DIFFERENTLY, OR BEEN SLUMPED OVER, OR IF THEY WERE WALKING OR RUNNING AWAY, THERE ARE SO MANY FACTORS — AND PART OF IT IS FATE. — DR. BERNARD LAWLESS, ST. MICHAEL’S HOSPITAL

JOE O’CONNOR / NATIONAL POST St. Michael’s Hospital trauma surgeon Dr. Bernard Lawless, 49, was the first surgeon to arrive after the Danforth Avenue shootings last Sunday evening. The night had been so quiet he was just settling in to watch the news when he was notified that four patients with gunshot wounds were en route to the trauma bay.