39 years ago today, President Reagan was shot and nearly killed at the Washington Hilton hotel. His life was saved by two forces: fast-acting Secret Service agents & highly trained docs/nurses. Some lessons I learned, mostly about ER medicine, in reporting my book about this day
Reagan was shot by John W. Hinckley Jr. at 2:27 p.m. as he left the Hilton after giving a speech. Hinckley got off six shots in 1.7 seconds. He hit Jim Brady in the head, DC officer Thomas Delahanty in the back, USSS Agent Tim McCarthy in the abdomen and Reagan. 
(Hinckley shot Reagan to impress Jodie Foster, the actress. FWIW).
Reagan was hit 4 inches below the left armpit. The shot was lucky. The bullet ricocheted off the side of armored presidential limo and slipped through a gap 1 1/2 inches between door and door frame. It struck Reagan in the side. He didn't even know he had been wounded
He was thrown into the car by USSS Agent @Jerry_Parr @CarolynParr (his widow tagged here). The door was slammed shut and Stagecoach took off. Parr checked Reagan up and down. No blood. Potus seemed fine. So he ordered limo back to the White House. legacy.secretservice.gov/press/GPA02-11…
On the way, perhaps 30 seconds after departing, as the limo hurtled alone down Connecticut Ave, Reagan began complaining of pain in his chest/back. Parr worried the president cracked a rib and punctured a lung when thrown roughly into limo.
This may be the most consequential decision of Reagan's entire presidency. Parr had been trained on 10-min medicine (how to keep someone alive for 10 mins). And he saw frothy blood on Reagan's lips. that mean from lungs. big trouble!
So he diverted car was diverted to GW hospital (@GWHospital). It got there three minutes after the shooting. Doctors and nurses were ready. They had been part of a transformation in emergency medical care that started a few years earlier.
Hard to believe that in the late 1960s and early 1970s, a soldier shot in Vietnam had a better chance at survival than someone shot in downtown DC. Anyway, doctors reinvented emergency medicine. Everything was about speed and treating EVERY patient the same way. Always.
As Reagan walked into the ER -- he insisted on trying -- he collapsed like a dead weight into the arms of his USSS agents. A paramedic there saw Reagan's eyes roll into back of head, slump to ground. "My god," the paramedic thought. "He is code city." Meaning: he is a goner.
Reagan was rushed to the trauma bay. Each person had a job to do. A nurse cut off his suit (brand new one given by Nancy Reagan). Another threaded a long line into an arm to pump in fluids. A third tried to detect his blood pressure. She couldn't find it. She began to cry ...
Most medical personnel thought Reagan was going to die. He was clearly in shock. He wasn't responding. It was dire.
But then came the steady beat of his heart. She could hear it.
But then came the steady beat of his heart. She could hear it.
By acting so quickly, by not waiting for a doctor's orders, these nurses and first physicians got Reagan's blood pressure up, they stabilized him. They figured out he had indeed been shot.
These critical moments (unsung moments) gave the doctors time to figure out that Reagan's left chest was filled with blood. That he indeed at been wounded. Why no blood? The bullet had been flattened into a dime in ricochet and body hit edge-wise. ...
Then it tumbled end over end, chewing up tissue in the lung. So he bled a ton internally but very little through that tiny slit. (in fact a surgical intern was the one who spotted the tiny bullet wound...a vietnam vet, he was experienced in gunshot wounds).
Dr. Joe Giordano, head of the ER, jammed a chest tube into Reagan's side and began draining blood. Normally, that was all that was required. The wound would stop bleeding and docs left bullet in the patient. But the blood kept coming and coming.
It just wouldn't stop. Reagan would lose more than half of his blood on this day. He was rushed into surgery. Again, they treated him like any other patient. Famous docs were clamoring to participate. But Dr. Ben Aaron, the chest surgeon, refused. He kept his regular team
They put the president under, and as Dr. Aaron hunted for the bullet in Reagan's chest, worried it would slip into an artery and shoot into his brain and kill him, a 31-year-old surgical intern, David Adleberg, reached into Reagan's chest....
gently cupped the president's heart in his hand and nestled it aside, giving Aaron more room to work. A 31-year-old surgical intern, who had awoken that day and expected to do a gallbladder operation or something as mundane, held the beating life of the president in his hands!
Anyway, they found the bullet, and they stopped the bleeding. Reagan lived. But only because the hospital had been prepared. Doctors and nurses at been trained. GW had the tools in place. Ready to go.
Because they did, Reagan served 7 more years as president and transformed the world (no political judgment here).
Thinking about those unsung heroes today who made those 7 years possible, and the medical workers who are putting their lives at risk to save us all in these dark times.
If you want to learn more about the assassination attempt and evolution of ER care you can visit the website for my book, Rawhide Down: The Near Assassination of Ronald Reagan (some cool photos): bit.ly/KGytu8.
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