Photos: Gene Dalton | The Roanoke Times

Holly Wheeling, Montgomery Regional Hospital

Geoff King, Christiansburg Rescue Squad

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Holly Wheeling was coming off a rough night.

The wind howled enough to keep her awake, but she couldn't have slept anyway. Her son, just 10 months old, was up coughing most of the night.

She got to Montgomery Regional Hospital before 7 a.m., ready to work a shift and a half in the emergency room. Usually, three doctors split the day into eight-hour slots, but that day two doctors were pulling 12-hour shifts so the third could have a day off.

There had been a death in his family.

Wheeling steeled herself for 12 hours of people with gastrointestinal troubles. A stomach bug had been going around.

She'd barely finished her first cup of hospital coffee when Wheeling heard a call come over the scanner. Something in one of Tech's dorms. Probably someone had rolled out of a loft bed and sprained something. It happened all the time.

More chatter on the scanner.

Trauma arrest. Someone's heart had stopped.

———

James Downing, asleep in his Blacksburg town house, woke up to that call.

A junior majoring in mechanical engineering, Downing will be president of the Virginia Tech Rescue Squad next semester. He knew there was a crew at the station that morning, so Downing didn't leap into action.

Then the crew got to the dorm.

Two people had been shot on the fourth floor of West Ambler Johnston Hall.

A squad member who happened to be at the station drove the crew's second ambulance to Ambler Johnston. Downing and other squad members met him there.

It quickly became apparent that Ryan Clark, a resident adviser, wouldn't survive. So the team concentrated on Emily Hilscher, a freshman who, like Clark, had been shot in the head. The squad thought there was hope for her, so they rushed Hilscher to Montgomery Regional Hospital.

———

In the hospital's emergency room, Wheeling and her staff alerted surgery, anesthesia, the labs -- anyone who might be needed -- about what was on the way.

When Hilscher got there, a surgeon evaluated her wounds. The staff put in a breathing tube and took X-rays. She was hurt too badly for Montgomery Regional to handle. They decided to send her to Carilion Roanoke Memorial Hospital, the closest level one trauma center.

Hilscher had to be driven to Roanoke. The winds that helped keep Wheeling awake were still gusting to 54 mph, strong enough to keep a helicopter grounded. Hilscher died on the way.

More than two hours after the call came in, one Virginia Tech crew was back at the station. They were conducting the debriefing they have after every call. What went right? What could have gone better?

Downing had already arranged for a counselor to talk to the squad members. It's a heavy thing to begin your day by trying to save two fellow students so savagely injured. It's worse when they die, even when you know you did everything possible to save them.

The other crew that went to Ambler Johnston that morning was still at Montgomery Regional, filling out paperwork.

Wheeling heard another call come over a squad radio: "Active shooter in Norris Hall."

———

Geoff King, manager of the Blockbuster store in Christiansburg, hadn't been at work long when his assistant manager's girlfriend called. Something was going on at Virginia Tech. King, a member of the Christiansburg Rescue Squad since May 2006, said he'd go home and get his radio. That would tell them what was happening.

When King got to his radio, the squad was calling for members. He went to the station and jumped on an ambulance pulling out for the Blacksburg Volunteer Rescue Squad station, which had become a staging area.

"At that point, nobody was sure what was going on," King said. "But we did know we had wounded and shots had been fired. SWAT was mobilized and were in the process of breaking down the door.

"The next thing I know, we're flying down to Norris Hall."

King and another squad member started piling supplies on a stretcher, so they could take everything they'd need to treat victims when they ran into Norris. But when the ambulance stopped, Matthew Brannock, a state police sergeant, and three other police officers were running toward it. Each officer had a hold on one of Kevin Sterne's limbs.

Sterne, a Tech senior, had been shot twice in his right leg. One bullet had passed through with relatively little damage. The other had taken a chunk out of his femoral artery.

Brannock said he remembers Sterne speaking only once, when he told officers they were pinching his arm.

King threw the stretcher from the Christiansburg ambulance aside -- it was still covered in supplies -- and borrowed a stretcher from another ambulance. The medics got Sterne onto the stretcher and the stretcher into the ambulance.

Police were gesturing wildly and screaming to King. He and another squad member ran toward Norris, where they picked up another young man who had been shot in the leg. King joked with him, asking if he'd cut his leg shaving. When the second man had been loaded onto the ambulance, King started toward the driver's seat. Somebody from the Blacksburg crew beat him to it. So King turned toward Norris Hall. Maybe there was someone inside he could help.

———

No hospital in the Roanoke or New River valleys is smaller than Montgomery Regional. But no hospital is closer to the Virginia Tech campus, so the most serious cases came there first. Other hospitals -- Lewis-Gale Medical Center in Salem and Carilion New River Valley Medical Center near Radford -- prepared to treat cases that could stand a longer trip. Roanoke Memorial braced for the very worst cases, which would be stabilized at Montgomery Regional and then sent on to Roanoke.

Off-duty emergency room doctors and other staff were called in. Emergency room nurses who had just finished working the night shift headed back to the hospital. Emergency room patients whose treatment could wait were moved aside. A general practitioner came in to care for them so the ER staff could concentrate on shooting victims. Three surgeons were just finishing up elective surgeries when word of the shootings came, so three operating room teams were ready when the first victims arrived.

One of the first had three gunshot wounds. Two in a leg and one in an arm. He was stable, with no excessive bleeding, so several patients moved ahead of him. A gunshot to the chest. Two with gunshots to the abdomen. A serious leg wound.

While the less severely wounded waited their turn, nurses walked among them, talking, comforting.

"I know there was many a patient asked if they called their mom," Wheeling said.

Many of them didn't have to. Mom called them. Patients' cellphones rang and danced all morning.

———

Cellphones were ringing at Norris Hall, too. But no one was answering.

"I think the worst thing for me was walking over the bodies and the cellphones ringing," King said.

"We went upstairs, turned the corner. I just saw bodies. I didn't even bother checking for pulses."

No one could survive the head wounds he saw.

"I remember the blood everywhere," he said. "But you're calm in that moment. Your adrenaline kicks in. All I was doing was saying, 'What can I do? What can I do to help?'

"And you realize there's nothing one can do. They're dead. Cellphones are going off like mad on these students. You know it's their parents and friends checking to see if they're alive."

King had been in Norris about 10 minutes when he heard someone had been shot on the tennis courts near Cassell Coliseum. King and another medic jumped into the back seat of a deputy's car and sped there. Police officers were crouched behind cars, pistols and rifles drawn. King couldn't see a victim, but police had their eyes on a broken window in a nearby dormitory.

Did someone shoot into the room? Did someone shoot through the window from inside the room?

It turned out the alleged shooter was someone leaning out a window with a camera.

King left the tennis courts and climbed into a Christiansburg ambulance, part of a long line of ambulances near the Virginia Tech Rescue Squad station.

"We just waited because we didn't know what else, you know. Maybe we'd find more wounded somewhere. We didn't know if this was the only place he had gone to and barricaded," King said. "And you just sat. And that was the worst time because then your mind has time to reflect."

———

The same thing was happening at Montgomery Regional.

"After the initial onslaught, where everyone was so busy and we had a minute to eat and look at the news, that's when we realized the real magnitude," Wheeling said. "We were involved in it, and we thought we were seeing the worst of it.

"We heard the students say they saw people shot in the head, but I had no idea of the number that would never make it to us."

Then someone said seven more patients were coming in. People taking their first break in hours scrambled to prepare for another bout.

"We all got gowns and gloves, and we thought we were going to get hit with another round of this," Wheeling said.

They weren't. Someone was doing a count of the patients already treated that morning. Someone else misunderstood.

———

King didn't sleep for two days. He couldn't eat.

"Monday night I did not know if I was going to go back into the EMS world," he said.

King entered that world because of his mother. He wanted to see what made her so dedicated to the rescue squad. So he rode along on a call. And he got hooked.

All that enthusiasm had drained away before he got home from Norris Hall.

"I couldn't fathom doing anything. I just wanted to pull up the covers and hide."

People gave him hugs and comfort and tried to get him to talk.

"I didn't want to talk about it because every time I closed my eyes I saw it. I just wanted to be left alone."

It was the squad's old-timers who finally got King to open up.

"Instead of saying, 'Geoff, why don't you talk to me about it?', what they would say is, 'I was on a scene one time, and there were three babies that were dead. I cried like a baby, and this is how I dealt with it.' "

Before he realized it, King was talking about what he'd seen and the helplessness he felt because he couldn't fix it and what that had done to him.

"How do we stop our minds from playing that movie?" King wondered. "And how do we heal inside?"

Sometimes King closes his eyes and he's back inside Norris. Sometimes he walks into a room and suddenly it's there with him.

"The other night I was watching a movie. I saw a gunshot and started crying."

But things are getting better. He's eating now and sleeping some. He's leaning on his rescue squad family.

"It's absolutely amazing to me that I am a part of this. ... Here I have a family. A true family. I have a rescue squad family that would do anything in the world for me, and I would do anything in the world for them. It's awe-inspiring," King said. "And that is what's getting me through this."

Staff writers Duncan Adams, Shawna Morrison and Reed Williams contributed to this report.