Kimberly’s Call

The Girl She Had to Leave Behind

There are moments in emergency medicine that split a paramedic’s life into two versions of themselves:

Who they were before the call…

And who they became afterward.

For Kimberly, it happened during a mass casualty shooting.

The dispatch tones dropped just after noon.

“Multiple victims… active shooter… all available units respond…”

At first, the information came in fragments.

Unknown number of patients.
Possible pediatric victims.
Law enforcement still clearing rooms.

Kimberly’s ambulance staged several blocks away with dozens of other units while helicopters circled overhead and terrified civilians ran from the building. Officers carrying rifles sprinted past the ambulances toward the entrance while dispatch continued transmitting overlapping radio traffic filled with panic and confusion.

Then the message everyone fears came over the radio:

“Warm zone established. EMS move in.”

The inside of the building looked unreal.

Fire alarms screamed overhead.
Glass covered the floors.
Blood trails disappeared around corners.

Victims were everywhere.

Some walking in shock.
Some crying for help.
Some unnaturally still.

Kimberly and her partner began triage immediately.

Red tag.
Yellow tag.
Black tag.

Training took over because emotion could not.

Not there.
Not then.

They moved quickly from patient to patient trying to identify who could still be saved with the limited resources available.

Then Kimberly found her.

A young woman lying partially beneath a collapsed desk near the back of a classroom.

Maybe eighteen.
Maybe younger.

A gunshot wound had torn through the side of her head above her temple. Blood and fragments of bone covered the floor beneath her. One pupil was fixed and blown wide. Her breathing came in irregular wet gasps.

But she was still alive.

And conscious enough to look at Kimberly.

Kimberly dropped to her knees beside her immediately.

She suctioned blood from the girl’s airway while stabilizing her head against the floor. Around them, officers shouted commands and medics yelled patient counts through the hallway, but Kimberly’s focus narrowed to only the girl in front of her.

The patient’s hand weakly grabbed Kimberly’s sleeve.

Kimberly remembers that more than anything else.

Not the blood.
Not the noise.
Not the chaos.

The hand.

The girl tried to speak but could only produce a wet choking sound through the blood filling her airway.

Kimberly leaned closer anyway.

“You’re not alone,” she whispered.

Because paramedics say things like that even when they are no longer sure medicine can change the outcome.

Then the triage officer reached her position.

More critical patients were being located.
Children with survivable injuries.
Victims bleeding out who still had a chance if crews moved fast enough.

Resources were running out.

The officer looked down once at the girl and his face hardened with the terrible calculation only disaster medicine demands.

“Kimberly… we need you to move.”

She stared at him.

“No.”

It came out automatically.

Because in fifteen years as a paramedic, Kimberly had never intentionally walked away from a living patient.

Never.

The officer repeated the order quietly but firmly.

The injuries were catastrophic.
The girl was not expected to survive.
Other patients still had salvageable injuries.

This was triage.

The brutal mathematics of survival.

And in those moments, medicine becomes less about saving everyone and more about saving as many as possible.

Kimberly knew the protocol.

She understood the logic.

But none of that mattered while the girl was staring directly into her eyes.

The patient tightened her grip weakly around Kimberly’s sleeve again.

Kimberly wanted to stay.

Every instinct inside her screamed to stay.

But somewhere farther down the hallway another medic was shouting for help with pediatric victims who still had pulses and survivable wounds.

So Kimberly did the one thing that would haunt her long after the shooting ended.

She stood up.

The girl’s eyes followed her as she backed away.

Still breathing.
Still conscious.
Still terrified.

Kimberly told herself she would come back in minutes.

But mass casualty scenes do not operate on promises.

They operate on priorities.

And by the time Kimberly returned nearly twenty minutes later, the girl was dead.

---

Kimberly finished the remainder of the shift in silence.

That’s one of the darkest truths about EMS.

The world expects paramedics to absorb unimaginable trauma and then continue functioning as though nothing happened.

There is no pause button.

There are reports to finish.
Equipment to clean.
Another call waiting.

So Kimberly kept working.

But the shooting came home with her.

At first it was the nightmares.

Not dreams.

Replays.

She would wake up drenched in sweat hearing fire alarms in the dark silence of her bedroom. Sometimes she swore she could still feel the girl’s hand gripping her sleeve.

Sometimes she saw her face the moment before Kimberly walked away.

Then came the hypervigilance.

Kimberly stopped sitting near windows in restaurants.
Memorized exits in every building.
Flinched whenever someone raised their voice unexpectedly.

Crowds made her anxious.
Schools made her nauseous.
Fireworks sent adrenaline crashing through her body before her brain could process the sound.

Her nervous system no longer understood safety.

Then came the emotional withdrawal.

She stopped talking to coworkers between calls.
Stopped answering messages from friends.
Stopped sleeping more than a few hours at a time.

Her family noticed the irritability first.

Tiny things triggered explosive reactions.
Noise became unbearable.
Questions felt invasive.

But underneath all of it was guilt.

The endless second-guessing that defines so much of PTSD among first responders.

Could she have stayed longer?
Would comfort alone have mattered?
Did the girl think she abandoned her?
Did she die alone?
Could Kimberly have ignored the order?

That is the cruelty of moral injury.

The mind keeps replaying impossible choices searching for a version where nobody dies.

But there wasn’t one.

Mass casualty medicine forces providers into decisions no human being should ever have to make.

And sometimes the deepest psychological wounds in EMS are not caused by mistakes…

But by moments where there was no right answer at all.

Months later, Kimberly responded to another shooting.

The moment dispatch said “female victim with head trauma,” her chest tightened violently. Her hands trembled opening airway equipment. Sounds became distant and distorted around her.

For the first time in her career, she experienced a panic attack on scene.

That’s the hidden reality of PTSD in emergency medicine.

Not weakness.

Injury.

Psychological trauma caused by repeated exposure to suffering, death, fear, and impossible decisions.

It can appear as:

• Nightmares
• Insomnia
• Hypervigilance
• Panic attacks
• Emotional numbness
• Depression
• Irritability
• Isolation
• Intrusive memories
• Survivor’s guilt
• Moral injury
• Burnout
• Substance abuse

And too many paramedics carry these symptoms silently because EMS culture still mistakes emotional suppression for strength.

Kimberly eventually sought help after another medic found her sitting alone behind the station after shift, crying uncontrollably because she could still hear the girl trying to speak through the blood in her airway.

Therapy did not erase the memory.

Nothing ever will.

But over time Kimberly learned something important:

The fact that it still hurt meant she had not lost her humanity.

The pain existed because the patient mattered.

Because that girl mattered.

Because despite every protocol, every triage algorithm, and every operational necessity, paramedics are still human beings forced into impossible situations.

And sometimes the calls that destroy you are not the ones where the patient dies immediately…

Sometimes they are the ones where you have to walk away while they are still alive.

For Kimberly, that girl will always remain part of her story.

The patient she could not save.

The girl she had to leave behind.

And the call that followed her home forever.