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Brett Gardner, Yankees elder statesman, leads comeback at the plate and in the field

October 4, 2017 by  
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NEW YORK — A raucous Yankee Stadium was very quickly quieted in the AL Wild Card Game on Tuesday night. The Minnesota Twins hammered New York Yankees ace Luis Severino for three runs, including two home runs, in the first inning. Severino recorded one out in the game. He was historically bad.

Minnesota’s early 3-0 lead lasted a half-inning. Not even. The Yankees answered with three runs in the bottom of the first on a Didi Gregorius three-run home run. That rally was set up by leadoff man Brett Gardner, who worked a six pitch walk against Ervin Santana to put the offensive wheels in motion.

“Leading off the bottom of the first, I don’t have much time to talk. Just keep up the enthusiasm (in the dugout), stay optimistic,” said Gardner following the Wild Card Game. “There’s a lot of game left, we’ve got some guys in the lineup that do a really good job getting on base and seeing a lot of pitches and driving up Santana’s pitch count. Things worked out for us.”

In the second inning, Gardner gave the Yankees a 4-3 lead with a solo home run into the right field second deck, and after the ball left his bat, he stared down Santana for buzzing him up and in with the previous pitch. Gardner is typically an old school put-your-head-down-and-run player. He was mad and he let Santana know it.

“I was pretty excited to just be able to jump back in the lead there in the second inning,” added Gardner. “I know it’s early in the game, but any time we can give our bullpen the lead, we feel good about our chances. Those guys did a great job.”

Two innings after his go-ahead home run, Gardner helped create two insurance runs with a one-out single the other way against hard-throwing Jose Berrios. That set up Aaron Judge for a two-run home run and a 7-4 Yankees lead. All told, Gardner went 2 for 4 with a walk and a home run in the Wild Card Game, and scored three of his team’s eight runs.

There are two dimensions to Gardner’s game, however. He is also a shutdown defensive left fielder likely to win his second straight Gold Glove this season. His defense became a factor in the sixth inning, when Joe Mauer lifted a long fly ball into the left field corner with two on and two outs. The Yankees were still up 7-4 at the time, so Mauer was representing the tying run. Gardner ran the ball down in a full sprint a few steps in front of the wall.

“I was pretty confident I was going to catch the ball. I was pretty confident that I would get to hope. I was just hoping I didn’t run out of room,” said Gardner.

For obvious reasons, the bullpen is the story of the Wild Card Game for the Yankees. Those guys were phenomenal. Gregorius hitting the game-tying home run and Judge hitting the big two-run home run were the highlights offensively. Those were the swings that helped the Yankees get back into the game and eventually win it.

Both home runs were set up by Gardner, the leadoff man and the longest-tenured Yankee, and the team’s unofficial captain. He’s a leader in the clubhouse, a mentor for the young players, and also the class clown. When a prank is being pulled, Gardner is usually involved. He’s not Derek Jeter or Thurman Munson in terms of star power, but he is a leader, and he’s an integral part of the Yankees. On Tuesday night, he was in the middle of everything, both offensively and defensively.

“He’s a spark plug, and he’s a leader in that clubhouse,” said manager Joe Girardi following the Wild Card Game. “The one thing that we’ve seen always in Gardy is fight in him. He’s got a lot of fight. And I thought that’s what our club showed tonight … Gardy is a big leader in that, and he takes every at-bat like it’s his last at-bat and is going to fight you tooth and nail, and he just kind of sets the tone.”

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Controlled Chaos at Las Vegas Hospital Trauma Center After Attack

October 4, 2017 by  
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Outside the University Medical Center of Southern Nevada in Las Vegas on Monday. By daybreak 104 patients had arrived, and more as were expected.

Credit
Isaac Brekken for The New York Times

On Sunday night, Toni Mullan drove 110 miles an hour on side streets from home to get back to University Medical Center of Southern Nevada, where she had just worked a 12-hour shift as a clinical supervisor in the trauma resuscitation department. Her car was smoking as she pulled into a three-hour parking spot close to the trauma center. Ms. Mullan, 54, left her hazard lights blinking as she shut the car door and raced inside.

Around a dozen patients had already arrived from the shooting scene at a music festival on the Las Vegas Strip. Two were dead and two had been “black tagged” — fully assessed and found to have injuries that were not survivable. Ms. Mullan’s daughter, Antoinette Cannon, 29, a trauma nurse who also works at the hospital, was standing out front with a physician assistant, taking injured patients out of vehicles as they drove up to the hospital and quickly assessing whose conditions were the most precarious.

“The minute I got there, I looked at the situation and said ‘How am I going to utilize my resources?’ ” Ms. Mullan, a registered nurse, said in a telephone interview Monday morning. By daybreak, 104 patients had arrived.

University Medical Center is the only level-one trauma center in Nevada and one of only a few free-standing trauma units in the nation. That means it is fully staffed with surgeons and trauma nurses day and night to handle injuries and mass casualties, from vehicle crashes that bring in 10 patients at a time to a 2015 episode in which a woman drove onto the Las Vegas Strip, sending 17 patients to the medical center. Last week, there had been 15 trauma cases in one night.

But even with 11 trauma bays, three operating rooms, a CT scanner, a trauma intensive care unit and a pediatric intensive care unit all under one roof, the trauma center had never faced a torrent like this. For two or three hours, the patients came nonstop. The radio at the clerk’s desk blared with transmissions from paramedics. With the frequency overburdened, other paramedics resorted to calling in patients by phone. Many patients simply arrived in cars or, in one instance, several in the back of a truck.

To an outsider, “it would look like a disaster zone, a chaotic scene, very chaotic,” Ms. Mullan said. “If a nonmedical person were to be sitting there watching this, they would think nothing was being accomplished.”

But in fact much was being done. It had been a busy day, which meant some of the day shift was still present and stayed to work alongside the night shift. Pagers went off with a be-beep be-beep each time a severe trauma case was identified. Patients, most of them with gunshot wounds, were doubled up two stretchers to a trauma bay. At one point, beepers screeched as five trauma cases were clocked in at the same time. “We couldn’t hear each other talk, it was that crazy,” Ms. Mullan said.

The injured also poured into other area hospitals. At Sunrise Hospital Medical Center, about six miles from the concert site, 90 patients arrived in the first hours and by noon on Monday the total had reached 180. Of those, 124 “met the criteria for trauma activation,” said Dr. Jeffrey Murawsky, the hospital’s chief medical officer.

They included patients with single and multiple gunshot wounds to the head, face, chest, body, arms and, in one case, a finger. By Monday afternoon, sixteen patients had died, some on arrival and others after being treated.

Patients were sorted in the lobby of the emergency room on a scale of one to five, with one being the most critical, a system used daily. On Monday afternoon, operating teams at Sunrise were still at work. More than 50 patients had undergone surgery.

Hospital leaders should “think about the unthinkable, practice the unthinkable, even in a limited way,” Dr. Murawsky said.

Dignity Health-St. Rose Dominican received 61 patients at its three campuses, 32 of them to the Siena location, a level-three trauma center.

As of Monday evening, five of those patients were in critical condition, one was in surgery, and at least 22 had been discharged, said Jennifer Cooper, a spokeswoman. None had died. Most had endured gunshot wounds, but others had been trampled while fleeing, or had been hurt climbing fences to escape the gunfire.

Before patients came into the hospitals, medics had to extract them from the scene of the violence.

At 10:08 p.m., the call came to the Clark County Fire Department, which covers the area where the shooting occurred. Not knowing whether the gunman or gunmen had been neutralized, emergency workers wore ballistic helmets and body protection.

“They were exposed to significant trauma, things that are very very unusual — a lot of deaths, a lot of injury, a lot of hysteria in one place, a lot of tragedy, so quite frankly many of them will probably be dealing with this for the rest of their lives,” said Jeff Buchanan, a deputy fire chief with Clark County.

Ultimately, 108 fire personnel worked on the scene, including those from neighboring fire departments. Mr. Buchanan, who served at a command post, was later sent to the scene of the concert, where only the dead remained.

“It felt apocalyptic,” he said. “All the smatterings of blood, the blood footprints, just the pooling of bodily fluids, valuables strewn all over the place, phones, money, wallets, clothing just everywhere.”

Private ambulance companies staged in four intersections to the north, south, east and west. AMR Las Vegas and MedicWest sent 120 trucks and more than 250 personnel, said Damon Schilling, a community affairs manager for both companies. Some of the first to appear were the “walking wounded,” people who were able to escape and had less grievous injuries. Ambulance crews tried to focus on transporting critical patients to nearby hospitals.

At the trauma center at University Medical Center, workers rolled gurneys and wheelchairs outside so they wouldn’t take up space inside — a lesson Ms. Mullan said came from a recent training session with a doctor who had served after the Orlando Pulse nightclub shooting. Still, patients kept filling the trauma center. “We had them in the hallway, we had them everywhere,” Ms. Mullan said. “Wherever we could find a spot we did.”

The next step was to open up more places to receive them — a recovery room, a preoperative area, and an ambulatory surgery center were staffed and made ready. A separate place was set aside for the patients with unsurvivable injuries to receive comfort care until they died. Two areas were established for patients with injuries that were not life-threatening. With staff and volunteers pouring in, these patients, too, received immediate care from a dedicated doctor.

Teams reassessed intensive care patients, moving the less critical to make room for others.

The trauma center repeatedly ran out of supplies including IV tubing and fluids, chest tubes, blood pressure cuffs, urinals and blankets, and “begged, borrowed and stole” them from other departments of the hospital.

The cafeteria was turned into a respite area for families searching for loved ones. Many patients arrived at the hospital and others as unidentified “Does.” Ms. Mullan said as of Monday morning that the list of which patients were where was “still a work in progress.”

In the end, Ms. Mullan said, the systems in place were able to flex with the extra burden and bring care to those who needed it. In the midst of the disaster, the trauma center even took in a burn victim and a pedestrian hit by a motor vehicle.

For other hospitals that may be called on in future mass shootings, Ms. Mullan had advice. “Be prepared and practice,” she said.

As she remained at the hospital late Monday morning, Ms. Mullan reflected on all the people who arrived to help, including workers who were not on shift and every hospital administrator.

“I’ve been a nurse for 30 years, and this was by far the worst moment I’ve had, the worst injuries,” she said. “But it was the proudest moment.”

Correction: October 3, 2017

An earlier version of this article gave an incorrect location for the Sunrise Hospital Medical Center. It is about six miles from the concert site; it is not within walking distance.


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