Profile: A Surgeon Who Treated 17 Victims

A 58-year old general surgeon at Montgomery Regional Hospital in Blacksburg, Va., Dr. Randall Lester has been fixing broken bodies since his medical residency at the University of Pittsburgh in the 1970's, when the hospital's pioneering liver transplant program was just starting up and marathon 18-hour surgeries weren't uncommon. So he wasn't overly alarmed when two shooting victims from nearby Virginia Tech were wheeled into Montgomery Regional's emergency department early last Monday morning. One of the victims, a male, was dead on arrival, and the other, a female, had sustained a gunshot wound to the head but was still alive. Montgomery Regional has no neurosurgeon on staff, so Lester helped stabilize the young woman (who would later die) for transport to the level-one trauma center at Carilion Roanoke Memorial Hospital, about 35 miles from campus. Lester then went about his day, performing two of the five routine surgeries he had on his schedule. "Monday was just Monday," he says. It wouldn't be "just Monday" for long.

Around the time Lester finished his second scheduled surgery, (a colon resection) he was summoned back to the emergency room and informed that ambulances were en route to the hospital from Virginia Tech with "several" gunshot wound victims. By the time the ambulances arrived, Lester and three other general surgeons, three emergency room doctors, an orthopedic surgeon, an ear, nose and throat surgeon and an anesthesiologist were scrubbed, gowned and gloved. The team had set up a triage, staffed the emergency department's cardiac unit and two trauma bays and cleared the operating room schedule. They were ready. For what, exactly, they still didn't know. "We didn't have any idea, as far as numbers [of wounded to expect]," Lester says. Then the tide of victims from Cho Seung-Hui's murderous rampage began to roll into the ER. Lester saw a young woman with a 9mm bullet wound in the back. She was suffering abdominal pain, a clear sign that she'd need to go into surgery—quickly. Then came another female victim, this one with a chest wound; a young man shot in the leg, spouting blood from his femoral artery; another female, shot in the right side, with an ominous swelling of the abdomen. "They came in waves, but it was all in a relatively short period of time. It became clear pretty early on that this was the worst I'd ever seen," says Lester. Seventeen of Cho's victims were eventually wheeled into the hospital's trauma department, which Lester co-chairs (other victims were taken to other area hospitals). Most of them were conscious and able to provide at least basic information about themselves, but Lester says only one described what had happened: a student who said, simply, "'A crazy man shot everybody.'"

Lester's ties to Virginia Tech run deep. A native West Virginian, he has undergraduate ('71) and graduate ('77 - Zoology) degrees from the Virginia Tech (his M.D. is from the University of Virginia). His brother, brother-in-law and niece are all Hokie alums. Although he was focused on treating the wounded, and has a surgeon's calm detachment, Lester described as "surreal" the snapshot-like scenes he remembers from the emergency room that morning. "There are TV's everywhere, and most of the time everybody ignores them, but there were people just glued to the TV sets," he says. "I remember glancing up a couple of times and seeing 'Massacre at Virginia Tech' on the screen." He remembers somebody coming into the room and shouting out fatality counts—first 20, then a few minutes later, 30. He recalled glimpses of the unblinking images from TV cameras, focused on Norris Hall. "I remember thinking, 'My God, is that the same Norris Hall where me and my brother spent so many hours studying?'" Lester saw a few hospital staff, some with children of their own at Virginia Tech, struggle to maintain their composure. "I saw a lot of tears, and there were a few people who got hugs, but I didn't see anybody crack," he says. Mostly, Lester was occupied with saving the lives of three victims he saw carried into the emergency department early on—all young women, one shot in the back, one shot in the chest, and the other shot in the side. Each also had additional injuries from shrapnel. "They were all millimeters from death," Lester says.

For the next four to five hours, Lester and the rest of the team scrambled to stabilize the wounded. Surgeons would finish one surgery and pop into the next trauma bay to see if anyone needed help with another patient. Lester found a few spare minutes to call his patients' parents, to let them know where their children were and to update them on their conditions. "I have three sons of my own and I remember thinking 'What if I got a call like that and I was hours away?'"

Of the 17 patients wheeled into Montgomery Regional that morning, 15 lived—one was dead on arrival, the other is the young woman shot in the head who died en route to the hospital in Roanoke. A few were able to leave the hospital later the same day. "I have a lot of pride in the way we handled things," Lester says. "Seventeen patients would be a strain on even a major metropolitan, level-one trauma center, but our communication and coordination were excellent. This is what you train for, and under the circumstances, I think we came up roses," he said. But it's not simply a matter of professional pride with Lester. "This is my school," he says, his voice tinged with an Appalachian drawl. "I'm a Hokie."