Two trauma surgeons speak with PEOPLE about victories and defeats, with lives lost and saved
Credit: Our Lady of the Lake

They call it a “mass casualty event.”

On July 17, staff at Baton Rouge’s Our Lady of the Lake hospital knew they had one on their hands when a police cruiser pulled up on the hospital ramp. Inside was one of the six officers who had been shot in an apparently targeted attack on law enforcement.

“They just snatched [him] and came to the first place where they knew the best care was going to be,” Dr. Stewart Cayton, OLOL’s trauma surgeon on call that day, tells PEOPLE.

Cayton, 43, supervised the hours-long trauma operations, in which five of the six attack victims were treated at OLOL. He and Dr. Tomas Jacome, another trauma surgeon at the hospital who was brought in to help, spoke to PEOPLE about that day: its victories and defeats with lives lost and saved.

“It was the longest four hours of my life to date,” Cayton says. “At the same time, it was the shortest four hours because there was a lot going on.”

Initially, all they knew were that “there were multiple gunshot victims coming in, all policemen,” Cayton says, recalling the page he received around 8:30 a.m. that Sunday, less than two hours after he started his shift. He thought four officers had been shot.

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“I needed as many boots on the ground as I could muster,” Cayton says.

He got them. Multiple non-trauma surgeons and many more nurses pitched in. “We had 19 nurses that came in from home that were not even working that day,” Cayton says. “Everybody showed up en masse to help.”

“None of what we did would have been possible were it not for the cool heads our law enforcement kept,” he says. “And I tell you, they were all under extreme duress because these are their brothers being hunted.”

Still, they could not save everyone.

Officers Matthew Gerald and Montrell Jackson and Deputy Brad Garafola died from their injuries soon after the shooting, Cayton says. A fourth officer came in more than an hour later, one of the “walking wounded,” and was treated and released, Cayton says.

‘When We Lose, People Die’

Much of their attention that day, Cayton says, was on victim No. 5: Deputy Nicholas Tullier.

It was a fight for his life that remains in the balance: Tullier is still hospitalized in critical condition.

Still, doctors took quick, decisive action to give him a chance: First, they were able to get his pulse back to the point where doctors could operate. Then Dr. Jacome, 45, worked to control Tullier’s bleeding and intestinal damage – but he had to do that as quickly as possible, so the neurosurgeons could step in.

“It’s almost like a ballet,” Cayton says. “It’s a complex balance to do all this.”

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Both surgeons say such intensity has a way of warping their perception of time.

“To me, time was screaming by, and to Dr. Jacome, I’m sure he could hear the seconds ticking by on the clock,” he says.

Jacome says that sometimes it feels like “everything takes, in your mind, a lot longer than it actually does.”

Both doctors say the camaraderie of that day was inspiring. Along with keeping Tullier alive and ensuring the hospital ran normally for other patients, the camaraderie was one of several small bright spots amidst a day of tragedy.

Still, emotional scars remain. Cayton says having to treat a law enforcement officer or any first responder, those same people that hospital staff would usually see while they were working, not as patients, “does add a huge slathering of emotion.”

“It’s the equivalent of your brother or sister or cousin or mom or dad, even, coming in,” Cayton says.

As everyone pulled together to work that day, the staff couldn’t escape word that they were losing people. “And that added layer is Atlas’ world sitting on top of their shoulders while they’re continuing to do what they can,” Cayton says.

“Whenever I fight that hard for someone and I lose – when we lose, people die,” he says. “And that’s hard to deal with, regardless of who the patient is.”

‘Back in the Heat of Battle’

The mass casualty event protocol ended about 12:30 p.m. that Sunday, Cayton says. The attack’s sixth victim was treated at a neighboring hospital and the gunman, who died during a shootout with police, was never brought in.

When they finally had a moment, Cayton says many of the staff gathered in the trauma bay and prayed together.

“There was a lot of emotional trauma that happened to the staff that day,” he says, adding, “For them to jump back in, to get back in the heat of battle in the same room where someone passed away and they’re still reeling from the emotional fall out, that’s a special person that can do that.”

Dr. Jacome went home late that afternoon. He says the staff’s work was proof that they were not going to let someone come to their city, bringing evil, and stop them from doing their jobs to the best of their ability.

Cayton, who would have usually been working a 24-hour shift as the on-call trauma surgeon, was working a “very rare” 12 hours. He went home about 11 p.m.

He called a friend on the drive home. He hugged his wife. He sat on his porch for about 20 minutes, alone, with his thoughts.

“And then I went back inside and called it a night,” he says. “Because I had to be back the next day.”