Jewish nurse: I treated mass shooting suspect out of love
Monday, November 5
PITTSBURGH (AP) — A Jewish nurse who treated the Pittsburgh synagogue shooting suspect says that he saw confusion but not evil in the man’s eyes, and that his own actions stemmed from love.
“I’m sure he had no idea I was Jewish,” registered nurse Ari Mahler wrote in a Facebook post Saturday about suspect Robert Bowers, who was taken to Allegheny General Hospital after the Oct. 27 rampage at the Tree of Life synagogue in Pittsburgh’s Squirrel Hill neighborhood that left 11 people dead.
Mahler described his role as “The Jewish Nurse” who treated the suspect, saying that he felt nervous about sharing his account but that “I just know I feel alone right now, and the irony of the world talking about me doesn’t seem fair without the chance to speak for myself.”
“I didn’t say a word to him about my religion,” Mahler said in the post. “I chose not to say anything to him the entire time. I wanted him to feel compassion. I chose to show him empathy. I felt that the best way to honor his victims was for a Jew to prove him wrong.”
An Allegheny General Network representative confirmed the authenticity of the post.
Bowers, 46, pleaded not guilty Thursday to a 44-count grand jury indictment charging him with murder, hate crimes, obstructing the practice of religion and other crimes, for which he could face the death penalty. Authorities say Bowers raged against Jews during and after the massacre. He remains jailed without bail.
Mahler, whose Facebook page noted that he started his job in the hospital’s emergency department March 1, said he didn’t see evil in Bowers’ eyes but “a clear lack of depth, intelligence, and palpable amounts of confusion.” He said he couldn’t go into detail about their interaction due to medical privacy requirements, but Bowers thanked him “for saving him, for showing him kindness, and for treating him the same way I treat every other patient.”
He noted that this came from the same person accused of mass murder who “instilled panic in my heart worrying my parents were two of his 11 victims less than an hour before his arrival.”
Mahler, who said that his father was a rabbi and that he experienced anti-Semitism “a lot” as a kid, said he acted out of love.
“Love. That’s why I did it,” he said. “Love as an action is more powerful than words, and love in the face of evil gives others hope. It demonstrates humanity. It reaffirms why we’re all here. … I could care less what Robert Bowers thinks, but you, the person reading this, love is the only message I wish instill in you. If my actions mean anything, love means everything.”
Pittsburgh trauma surgeon: ‘Stop the Bleed’ training saved lives after shooting, but stopping the need must be next
November 5, 2018
Matthew D. Neal, MD FACS
Roberta G. Simmons Assistant Professor of Surgery, University of Pittsburgh
Matthew D. Neal, MD is a trauma surgeon affiliated with the University of Pittsburgh Medical Center. He serves on the steering committee of the Western Pennsylvania Stop The Bleed initiative.
University of Pittsburgh provides funding as a member of The Conversation US.
I am a trauma surgeon who cared for many of the critically wounded victims of the Tree of Life synagogue shooting. As we raced to find the source of blood loss in one of the most severely injured patients, one of my trauma surgeon partners, a U.S. Army veteran of multiple tours, joined me in the operating room to assist.
His first comment upon seeing the injuries that we were managing struck me. He said he last saw such destruction from military weaponry when he was serving in Afghanistan.
Two doors down, a second badly injured patient arrived to the operating room with extensive injuries to multiple extremities from a burst of gunfire.
Although the patient’s blood pressure was perilously low, the bleeding had been stopped prior to surgery by tourniquets applied to the limbs. Additional victims arrived, again with potentially life- and limb-threatening injuries rendered by an assault rifle, but all had received lifesaving care even prior to arrival at the hospital.
Some of this is due to an approach called tactical emergency care, where specially trained teams of physicians and emergency medical service practitioners respond and provide care along with law enforcement. A brave team of providers entered Tree of Life under active fire, along with the SWAT team. The early identification of injured victims allowed for rapid transport from the scene to our trauma center, providing the opportunity to save lives that would have otherwise been lost.
While all of the patients who arrived at our trauma centers in Pittsburgh are alive today, the sense of accomplishment and pride associated with this is blunted and seemingly selfish in the face of the carnage that occurred. No one will say “it could have been worse,” because the magnitude of this massacre that impacted the world and my hometown of Pittsburgh is incomprehensible.
Nonetheless, many of the surviving victims who will live to amplify and strengthen the message of unity that emerged in the days that followed are alive because of the evolution of a system of pre-hospital care that has necessarily changed the way the lay public, law enforcement and emergency medical care respond to intentional mass injury events.
Stop the Bleed
In the wake of the shooting at Sandy Hook Elementary School, the “Stop the Bleed” program emerged as a way to empower the public to act as immediate responders. Dr. Lenworth Jacobs, a trauma surgeon at the Hartford Hospital, recognized that the skills and tools to stop bleeding could not help when confined to a hospital setting during a mass casualty or intentional mass injury event.
That’s because a person can bleed to death in as little as five minutes, and thus time is critical in bleeding control.
Jacobs led the effort to create Stop the Bleed, a program to enhance survivability after such events. It is an initiative of the American College of Surgeons and the Hartford Consensus, and it seeks to promote the message that anyone can save a life.
Supported by the White House, Stop the Bleed originated in October 2015 with the goal of making education on bleeding control as common as CPR training.
Stop the Bleed teaches basic bleeding control techniques and provides tools, such as wound packing and tourniquets, to the general public should they need to respond to life-threatening bleeding.
Pittsburgh had prepared for such an event
Having faced intentional mass injury events in the Pittsburgh region, both in schools and our own hospital system, our team of trauma surgeons immediately began to push this public health initiative.
Through generous philanthropic support by the University of Pittsburgh Medical Center and a partnership with the Copeland Regional Trauma Council, we embarked upon the ambitious task of teaching Stop the Bleed throughout the region, with a goal of providing a tourniquet to every law enforcement officer and a bleeding control kit in every public school building.
We recognized that teachers and law enforcement are frequently the immediate responders to horrific events such as shootings, and we sought to empower those people with the tools and techniques to save a life. The program has grown rapidly in our region, with over 37,000 people trained, over 500 bleeding control kits distributed, and over 9,000 tourniquets provided to law enforcement officers, including the Pittsburgh Bureau of Police and the Pennsylvania State Police.
My trauma colleagues and I estimate that tourniquets applied by police officers and emergency medical services at the scene of the massacre at Tree of Life saved the lives of at least three victims.
Synagogue members in Squirrel Hill asked for training
Early in our regional initiative, the Jewish Healthcare Foundation recognized the critical importance of Stop the Bleed.
In a forward thinking and proactive manner, they supported the training of the Jewish community and purchased bleeding control kits for every synagogue in the city of Pittsburgh.
I vividly remember teaching the classes at synagogues in the Squirrel Hill neighborhood of Pittsburgh. I would lead every class with the disclaimer that we hoped this training would never be necessary but that the community needed to be prepared.
Finding that some members of the public were at times overwhelmed by the training, I would frequently take my 9-year-old son along with me. Volunteering his time to teach and understand the issues was a valuable lesson for him, but it also provided strong evidence that “everyone” can indeed save a life by having a young child expertly demonstrate the basic skills of bleeding control. My son taught with me in Squirrel Hill synagogues, and while he taught community members how to apply tourniquets, they taught him about their place of worship, their community and their faith.
When I finally returned home from the hospital the night of the Tree of Life synagogue shooting, I faced the challenge that all parents faced that day: how to explain what happened to my young child. With more resilience and poise than I could maintain, he asked me important questions. He asked me if this had happened where he had taught Stop the Bleed.
I said yes.
He asked me whether Stop the Bleed had helped people. I said yes.
He asked whether people had died. Through tears, I told him that many had.
And then the question to which I had no simple answer: “Daddy, why wasn’t Stop the Bleed enough to help them?”
Stop the need
Three thousand five hundred pairs of children’s shoes were placed at the Capitol on March 13, 2018, to represent the life of each child in the U.S. killed by guns since Sandy Hook. Martinez Monsivais/AP Photo
The heroics of pre-hospital care and the efforts of our community to promote Stop the Bleed are extraordinary, but they are designed as a response to a series of public health crises that remain unaddressed. The number and magnitude of the wounds that we treated are irrefutably and indisputably the consequence of a weapon that, I believe, has no place in civilian life. Would the assailant have killed and maimed so many with a lesser weapon? Perhaps.
But as the first surgeon to lay hands on one of the victims of that horrible day, I submit to you with unabashed confidence that this was worse due to the use of a high-powered semi-automatic weapon. The dialogue about this issue often falls short on data, owing largely to the lack of dedicated federal funding for gun violence research.
Despite the rise in preventable deaths by firearms, the research into how and why remains largely unfunded. The complexities of understanding the role of mental illness, racism and religious prejudice in such events leave me with no easy answers to my son’s query.
However, I would submit that Stop the Bleed is an example of how we can start. This program mobilized trauma surgeons, largely warriors of reactive medicine, as champions of prevention. If we, as a community, can enact such a grassroots effort in public health to save lives, it is incumbent upon us to champion the next cause.
The unaddressed complexities of our modern public health epidemic in gun violence deserve the immediate and full attention of the medical community. Research from our trauma colleagues has shown that assault weapons bans save lives, and our professional organizations have provided position statements of varying strengths to support interventions to stop gun violence. The rally cries and calls to action occur after each of these events.
In days to weeks, Pittsburgh will be replaced by another location subjected to this horror. Another physician responder may write a similar piece. I have no answer as to how to make this time different.
What I know, however, is that as a basic public health initiative, Stop the Bleed has saved innumerable lives. If we can organize phase II of this remarkable response to attack even the smallest fraction of our modern epidemic, we can save more.
Please help me answer my son.
Synagogue shooting worst of many hateful attacks in October
By COLLIN BINKLEY
Monday, November 5
Kevyn Perkins stopped cold when he saw the letters scrawled on the door to his dorm: “N——- go back” it said, inked in messy red marker. First he was blinded by confusion. Then rage. And then all he could think about was dropping out, finding a new school, escaping for good.
“I thought maybe I don’t belong here. So I called my brother and I said, ‘pick me up,’” said Perkins, 19, a freshman at the University of St. Thomas, a private and mostly white school in St. Paul, Minnesota. “He said that’s what they want you to do — you have to stay there and stay strong.”
Often overlooked amid the recent intense spasms of hatred — 11 dead in Pittsburgh synagogue, two African-Americans gunned down in a Kentucky grocery store, 13 mail bombs sent to prominent Democrats — are nearly daily flashes of hate that are no less capable of leaving their victims with deep and permanent emotional wounds.
In October alone, there were dozens of examples of the kind of hatred that smolders without ever reaching national attention. It stretched from coast to coast, targeting victims because of their race, religion, sexual orientation, gender and myriad other differences.
An Indiana woman was arrested last week after leaving a racist letter directed at African-American neighbors, urging them to leave the neighborhood because black people weren’t welcome. As early voting started in North Carolina, a black Republican volunteer was accosted with slurs and had a gun pulled on him at a polling place, leading to one man’s arrest. An Uber passenger in Colorado was arrested after threatening his Middle Eastern driver and chasing him down the street because police said he “hated all brown people.” Violent clashes broke out in New York City after a speech by the founder of a far-right group, leading to three arrests.
In a Texas courtroom, a man was sentenced to 24 years in prison on Oct. 17 for torching a mosque near the U.S.-Mexico border last year because of what authorities said was a “rabid hatred” of Muslims. In sending the arsonist to prison, Judge John Rainey declared: “This must stop. It is like a cancer to our society,” adding that incidents like this create “fear all over the world.”
Anti-Defamation League CEO Jonathan Greenblatt said xenophobic rhetoric is feeding the anxiety of the current political moment, and that anxiety is prompting fear and promoting resentment and “all the worst impulses.”
“We’re living in a moment where hate crimes are on the rise,” said Greenblatt. “We need more than ever for our leaders to ratchet back the rhetoric. People feel like they’re on edge across the country.”
President Trump’s critics have accused him of fanning the flames with his divisive political rhetoric — something the president pushed back against Friday. He put the blame back on reporters for “creating violence” with he has called “fake news” stories.
Several cases happened on college campuses, which strive to reflect the nation’s diversity but sometimes attract its intolerance.
At more than 40 colleges, racist flyers or stickers were found posted on campus in October, according to the Anti-Defamation League, which has reported a surge in activity by white supremacist groups since Trump took office.
At the College of the Holy Cross in central Massachusetts, a student was beaten in an assault that officials say was motivated by the victim’s sexual orientation. No one has been arrested in connection with the crime.
Students at DePauw University in Indiana reported four separate cases of hate speech in October. In three, racial and homophobic slurs and threats were yelled from cars passing by campus. In another case, a threat with the N-word was found in an elevator on campus.
Anti-Semitic posters appeared at the University of California, Davis, blaming Jews for allegations of sexual assault that were made against Justice Brett Kavanaugh. Several Jewish groups on campus wrote a letter demanding a stronger response from the school’s administration, saying Jews on campus have faced mounting prejudice in recent years.
“Anti-Semitism is very real and alive on our campus,” the letter said. “Jewish students should not have to be scared of walking on campus. Students are choosing not to openly identify as Jews through our clothing.”
For Perkins, the red lettering marred the image of the friendly, welcoming campus that was sold to him by college officials.
The incident led to a student protest that prompted the school to cancel class for a town hall meeting discussing racial tensions on campus.
Since he found the note Oct. 19, Perkins has become more withdrawn, he said, less outgoing. And although he decided to stay at St. Thomas, he’s left to wonder who on campus felt such hatred for him, and why.
“I’m already the odd one out, and the words, the hatred behind it really made me mad,” he said. “Degrading someone based on the color of their skin, I just couldn’t understand why someone would do that.”
AP National Writer Errin Haines Whack and AP researcher Monika Mathur contributed to this report.
How to make meaning in aftermath of Pittsburgh and other violent acts
November 5, 2018
Joan M. Cook
Associate Professor of Psychiatry, Yale University
Joan M. Cook has received funding from the National Institute of Mental Health, PCORI and the AHRQ.
As the last of the funerals were held for the 11 people gunned down at the Tree of Life synagogue in Pittsburgh, many of the survivors, their loved ones and the world are left with terribly heavy hearts. How do we emotionally digest such hatred and tremendous loss of life? How do we make sense out of something so senseless?
As a trauma psychologist, let me say there is no single formula for recovery from traumatic events. But creating meaning and finding a coherent narrative is often very positive adaptive psychological response.
For many of us, trauma shatters our basic assumptions. The slaughtering of innocent people, be it in a place of worship, a school, a nightclub or a concert, violates our sense that the world is a good and safe place. We wonder how some people in our world have become, not only unhinged, but venomous and vile. In an attempt to make sense out of extremely stressful and traumatic events, some people find that finding or creating meaning or purpose helps them transcend the pain. Meaning-making goes beyond a surface understanding of the facts. It is a concerted attempt to process and resolve violations by restoring a sense that the world is meaningful and life worthwhile. It involves people reappraising their experiences and looking for opportunities to learn and grow. For some, meaning-making is a core coping mechanism, a salve to the aching soul.
Viktor Frankl’s gift to the world
Dr. Viktor Frankl, an Austrian psychiatrist, was a prisoner in four different German concentration camps, including Auschwitz and Dachau, during World War II. His parents, brother and wife were all killed in the camps. Frankl witnessed people being sent to the crematoriums. He watched fellow prisoners descend from denial to apathy. How did Frankl and others like him work through their traumas and transcend such historic and mass violent loss?
Frankl’s survival strategy in the face of such prolonged and severe trauma was to try to help his fellow prisoners re-establish their own psychological health. In 1946, he wrote a book titled “Man’s Search for Meaning,” describing his concentration camp experiences as well as a new type of therapy.
In this piece of survival literature, Frankl argued that even when an individual is transgressed upon in the most vicious and evil of ways, they must make a choice to search for value and meaning and move forward with renewed purpose. By the time of Frankl’s death in 1997, “Man’s Search for Meaning” had become incredibly influential – having sold more than 10 million copies in 24 languages.
Curbing the pain as best as possible
Extensive research has taken place on the concept of meaning-making after a wide variety of traumatic experiences and stressful events. In an examination of how 133 older adult Holocaust survivors dealt with their trauma, many reported that even while they were still imprisoned, they kept hope alive by believing in liberation, trying to envision the positives the future might hold, and cultivating constructive attitudes, such as gratitude. Post-captivity, these survivors empowered themselves by taking moral stands to fight oppression and hatred where they could.
In general, when a person is successful in meaning-making, he or she often experiences less emotional distress. But, meaning-making takes effort and is multifaceted. And, whether it’s necessary or adaptive depends on a number of factors. The meaning-making process typically occurs in one of three ways: searching for and finding meaning; searching for and never finding meaning; and never searching for meaning.
Many find that trauma puts good things in perspective. For some, it can improve relationships with others and promote religious or spiritual growth. Some even experience a greater appreciation of life and become more aware of their psychological strengths. Others, however, find it impossible to make any meaning of their trauma. Some struggle with wondering “Why me?” or “Why us?” Although this is normal and understandable, if left unresolved, this might actually maintain psychic harm.
Harden not our hearts
It’s no secret that many Americans are feeling frightened that the social fabric that binds and weaves us together is under attack. There is a cost to being unaware of evil, but there is a larger price to hardening our hearts and closing ourselves into a heavily fortified bunker. Social and behavioral science researchers know a lot about how hate happens and why. Developing a psychological, sociocultural, or philosophical explanation or view may help to make it more digestible, or at least a little less personal.
Creating meaning post-trauma is often the product of effort and intention. It is frequently a struggle or a deliberate search and can facilitate multiple positive changes. For example, individuals who offer support to others during a traumatic event also experience lower levels of distress themselves. Their show of compassion also increases their ability to find meaning in the trauma. Moving from dread or numbness toward vital connection with others is important.
Some people find meaning through action – volunteering to get the word out to vote, campaigning for open-hearted political candidates, making donations, joining a civic organization, or engaging in spirituality. Down deep most of us realize that the alternative is to be isolated and alone, excessively fearful and restricted.
Living in a world of violence
It will likely remain hard to bear witness to the kinds of suffering we saw in Pittsburgh, to remind ourselves of good when we see so much evil and hatred. It is likely true that many of us will probably not see an ending to such senseless violence and hate in our lifetimes.
But, I hope we can all tap into Dr. Frankl’s amazing will and strength to endure and find ways to repair, heal, grow and learn. May we forge meaning and closure to this violent loss.
Thank you very much indeed for trying to forging meaning and closure to this violent loss through such a nice article. Please write in more details about various meaning- making ways and means to help people who need that urgently in your next article. I look forward to reading that in near future. Best wishes and regards.