Quebec City surgeon's Afghanistan experience prepared him for mosque victims
Hospital's trauma team and emergency medical technicians moved fast to save lives of gunshot victims
Dr. Julien Clément was home in Quebec City on Sunday, relaxing and enjoying some down time with his wife and young family.
It was his day off. He wasn't even on call. But when his phone rang, all of that changed.
"I was planning my summer vacation at home [in] my pyjamas, and I got a phone call from one of my colleagues. There's been a lot of gunshots somewhere, and please come in."
Clément is a surgeon and the medical director for trauma at l'Enfant-Jesus hospital. The hospital is the trauma centre for Quebec City, and it's the one to which five of the victims of Sunday's mosque shooting were rushed by ambulance.
"l'Enfant-Jesus got all the critically injured," Clément told CBC News Tuesday. "All the gunshot wounds."
Team of 8 surgeons
Some patients needed more than one kind of surgeon, he said. "Let's say you got multiple gunshot wounds, and you got a broken leg, and you got torn lips, and something in the abdomen. Well, you'll need three types of surgeons."
l'Enfant-Jesus hospital has a team of eight, including specialists in thoracic, orthopedic and oral/maxillofacial medicine. By the time Clément arrived, six had already been called in.
Clément got to work on one of the critically injured patients. The man had multiple injuries in the abdomen, the liver, the small bowel and the pancreas.
'I'm also a bit angry about that guy that shot them. There's no bound to human craziness.' - Dr. Julien Clément
When that was done, Clément co-ordinated all medical care for the rest of the gunshot victims. At one point, four of the operating rooms were in use.
"Its a team play," said Clément. "That's what it is. If you want to manage a situation like this, you cannot do it by yourself."
He said the unsung heroes were the emergency medical technicians, who performed triage on the victims swiftly and delivered them to the hospital.
By 5 a.m. Monday all surgeries were completed. For the 37-year old surgeon, only then was there time for reflection.
"Afterwards, you're like, whoa, poor guy. He's got two kids. How [can this] happen in Quebec City?" said Clément.
"I don't think anybody could be totally emotionless with what happened."
Usually, most of the gunshot wounds doctors see in Quebec are from suicide attempts or hunting accidents. Either way, Dr. Clément is no stranger to them.
He was a member of the Canadian Armed Forces for 16 years and was deployed on three separate occasions to Afghanistan. At the Canadian base hospital in Kandahar, he treated victims of improvised explosive devices.
His experience in that country prepared him for events like Sunday's.
"I think it helped on two points," he said. "First, the capacity to take care of gunshot wounds. I've just seen more than many other people.
"The biggest issue is how to deal with multiple patients at the same time. That's something I really took from Afghanistan, because it was day in, day out."
But what happened Sunday night in his hometown, he said, is different from what he experienced overseas.
"That happened in my backyard," he said, pausing. "And I really don't like that."
Emotional and tense
What he'll remember most from Sunday night, he said, is the families of the gunshot victims. Up to 40 were at the hospital that night, standing vigil in a waiting area by the operating room.
It was "emotional" and "tense," he said, and he made sure the families were kept abreast of any medical developments with their loved ones.
"Facing 40 persons outside the operating room, it's something I was not prepared to do. There's no fun of doing that."
He paused again.
"I have difficulty expressing myself on that topic, because it's more emotional."
On what has been called the terrorist act Sunday night, he doesn't hesitate: "I'm so sad for the Muslim community of Quebec City. I'm also a bit angry about that guy that shot them. There's no bound to human craziness. In French, we say 'la folie humaine.'"