[TODD DEVOE] Hi, this is your host Todd Devoe, and today I have Dr. Kelly Victory here, and we’re gonna discuss disaster medicine, and also a little bit about the active shooter and the role of the emergency manager in the active shooter. So, Dr. Victory, how did you get into disaster medicine?
[DR KELLY VICTORY] Well, I am formally trained… residency trained in trauma and emergency medicine. So, I started my medical career, my clinical career, as a hospital-based trauma physician. I worked primarily… initially, in North Carolina, and then South Florida, and then Cleveland, Ohio. So, a number of level 1 trauma centers, and had a traditional trauma practice at that time. And although I didn’t realize it at the time, I was becoming more and more not just a trauma and emergency physician, but a student of disasters, if you will. I started to realize that the real challenge wasn’t in handling one or two… or even three patients, necessarily, at a time. It was how I, and the staff, and the hospital, and furthermore, the community, handled the larger events. And so, I morphed over a period of time from that hospital based practice into a larger scope of practice and disaster in trauma medicine, and subsequently, was trained out of standard practices of medicine. I trained in a number of different capacities, including with the National Preparedness Leadership Initiative at Harvard, which we can talk a little bit about. It’s actually focused specifically on training people to be leaders in times of crisis and in disasters. And so, I morphed out of my hospital-based practice some time ago, and have become much broader in my scope, and have become very involved in teaching and training tactical response in the management of active shooter scenes, as well as other disaster scenes.
[TODD DEVOE] That’s really exciting. Is disaster medicine becoming a recognized discipline in medicine, or is it still sort of a subset of emergency medicine?
[DR KELLY VICTORY] It’s a subset of not only emergency management, but also trauma surgery, and really, emergency management. So, there’s no specific degree in it. Interestingly, in this country, although there are many, many different organizations now that offer some components of it. I actually went to get training in the medical management of mass casualty. So, I took more of a military… although I am a civilian, I took more of the military approach and did some training with a number of military organizations, and had the opportunity to train with a number of people from the Israeli army, and learn their way of managing mass casualty. Because I do think that there are things that we should be learning and should be applying in the civilian world that come directly from the military approach. So, there is no disaster medicine track right now, specifically, but it’s absolutely inextricably related to trauma medicine, emergency medicine, general surgery, and certainly to everything related to law enforcement and first responders, in general.
[TODD DEVOE] In Orange County, California, we do a lot of pod work with… as far as practicing with the flu medicines and stuff like that…
[DR KELLY VICTORY] Well, one of the things that I realize… I took a hiatus out of just pure clinical medicine and ran a large healthcare company that provided healthcare services for Fortune 100 companies, big companies; FedEx and airlines. What I realized was that one of the real challenges for the United States, and for any country, but for the United States specifically, is these huge companies that we have here, have to think about, and plan for, and have contingency planning for their businesses to continue to run in times of crisis and in disaster.
[TODD DEVOE] Right.
[DR KELLY VICTORY] So, it’s not just looking at disaster from the perspective of how many casualties do you have, how many gunshot wounds, or how many people from motor vehicle crash you need to tend to, but it’s also the impact on the greater infrastructure and on that company. So, during that time that I was running that company, I began to understand how something like a pandemic, or something lesser, even just a flu epidemic, can impact a company. You take a Nissan or a company like that, when the SARS epidemic hit, and most of the material and the parts for those Japanese automotive companies were coming from the Far East, many of them are coming from the Far East, and during that time there was a complete shutdown of air travel for a while, because of SARS epidemic. And you’re thinking: “here is something that is a medically based problem, but is having profound impact on the economic structure of these corporations.” So, it’s really understanding disaster management and how to prepare for it, how to build contingency plans, and how to be resilient, it’s critically important; not just from the humanitarian perspective, but from an economic perspective.
[TODD DEVOE] You’re so right. One of the things that we were talking about when we had the swine flu coming through, and at the time I was the emergency manager for a small city, at again, Orange County. And we were looking at what the damages could be as far as our people coming in to work. And we were talking… we were expecting a 40% potential fallout. Not even just because of the people who were getting sick, but you know, if your child gets sick or can’t go to school, because the schools are shut down, we lose workforce that way. So yeah, it’s a huge impact on businesses and in government.
[DR KELLY VICTORY] Absolutely.
[TODD DEVOE] Yeah, I always find that interesting. One of my favorite books that I go back to all the time is Judith Miller, “Germs”. And yeah, I think that’s a really good book that I’d like to read, regarding… and I have my students read it as well, regarding planning for those types of things, because… I mean, even on the terrorist aspect of it, the study that they did up in Oregon, where that one religious psych tried to influence election by poisoning the… it was the Pizza Hut salad bar. You know? I mean, things like that and just knocking people out that way. So, disaster medicine and pandemic medicine is something that we have to think about as emergency managers in a daily basis.
[DR KELLY VICTORY] Absolutely.
[TODD DEVOE] Let’s switch gears here a little bit. You mentioned active shooter just a little bit ago, and today active shooters are on everybody’s minds. Especially those that are planning for schools. We seem to have submissions associated with school planning, and back in the 80’s… I think it was, when we had the term “going postal.” So, it’s not necessarily a new thing, the post office guys were shooting things up. So, what do you think as far as… what’s the emergency manager’s role that he can play in mitigating, and also in response, to an active shooter?
[DR KELLY VICTORY] Well, I mean, you said it right. The term active shooter, although it’s unfortunate and become a part of our common vernacular, the concept of people wreaking havoc and are causing massive injuries by mass shootings is not new. Unfortunately, the world is full of psychotic, unbalanced… you know, sinister people who can assume that role at any time. You know, if you think about the last decade, we’ve witnessed more than 45 major active shootings in United States, you know, we always had a total… I think it was of 91, 95 deaths as part of that violence. And you know, more than 220 seriously wounded people. So, I can’t overemphasize the need for all communities to develop response planning for an active shooter event. It’s really about developing the response, doing the response planning. So, when you talk about how we, as responders, or emergency managers, can mitigate risks, it’s really about the foreplan. You know, planning ahead, and subsequently, training for it. You cannot… there’s no such thing as putting a bunch of players on the field on game day and expect them to work together, cohesively, in an orchestrated dance, the kind of thing that is required in a mass casualty, if they haven’t done it in training. If they haven’t done it in practice. There is no such thing. There’s not a football team out there that does just white boarding.
[TODD DEVOE] Right.
[DR KELLY VICTORY] So, when I think about really what I would tell emergency managers in all jurisdictions, is… you know, I can’t overemphasize the need for them to develop response plans. No community can declare itself safe from these types of attacks. Certainly Newtown, Connecticut, would have never imagined the horror that a lone teen could unleash in a school full of innocent 6 and 7-year old’s. So, if it can happen up there, it can happen anywhere. These incidents happen in municipalities of all sizes, and they can occur without warning. So, the only way to mitigate risk it to plan for it, and then subsequently, to put together trainings. And I would make the differentiation, Todd, we can talk about this, between training and exercising. You know, a lot of people run these exercises where they’re… ok, once a year, you’re checking the box, you run the mass casualty exercise on a Saturday, and everyone gets jazzed up, and you have a bunch of volunteers, and it’s all very exciting, and you order pizzas for people. I don’t mean to be making light of that, but you need to understand, that is not true… running that exercise once a year is not the same as training. And you would never go to a surgeon who… say, to take out a spleen, so “yeah, once a year I kind of do this thing on a robot, or I sit on my desk and I review the protocol for how to remove a spleen.” That wouldn’t make you, as a patient, feel very comfortable.
[TODD DEVOE] Right.
[DR KELLY VICTORY] You wanna know that people have really trained. And what I mean by that is the kinds of trainings that we are now developing for active shooter, where we bring all of the stakeholders together for a very aggressive training. Which means, it’s EMTs, fire, obviously, law enforcement, the school system, the hospital, all of the stakeholders. If you’re of need among game day, include them during practice. And that’s my best advice.
[TODD DEVOE] Yeah, I know that from personal experience. I worked for the city of Seal Beach, and that was on the day that we actually had a shooter go into a small salon, and he killed 8 people and shot 9. And we were always… you know, Seal Beach is known as Mayberry by the sea, it’s a small community just outside of Long Beach, and yeah. For sure, it took us by surprise, but the one thing that we did have going for us, is that we were a small city, and we have two other cities that we did a lot of work with, which was Cypress and also Los Alamitos. And we had common communications, because we were all on a joint agreement with our com center, and so when the shooting did occur we already had additional police officers from the other jurisdictions on their way in. And as horrific as it was, it could have been much, much worse. We were able to… you know, to stop it just at that one particular place, and we were able to get the bad guy.
[DR KELLY VICTORY] It’s one of those “simple”, and I say that through tongue and cheek, simple things like radios. That really helps. Using common language; when we teach them to say: this is not the time to be using it, because your codes in your jurisdiction may be different from the codes in the jurisdiction… you know, two over, who is coming to help you. So, in times of mass disaster, big, critical incidents… I think about, for example, the Boston bombing. While things went relatively well at the finish line, what happened when they were actually catching the Tsarnaev brothers a couple of days later? It was… everyone with a badge and a gun showed up. And so, you had people from multiple jurisdictions, and multiple levels of government. You know, National Guard was there, FBI was there, the SWAT teams were there, the police were there, and there was nearly, very very nearly, significant, what we would call blue-on-blue injuries. Friendly fire, where people were shooting at the wrong person, because we had people in undercover, we had people in uniform, and it just became somewhat of a free-for-all. And one of the other things we teach in our active shooter, of course, is that the time to be exchanging business cards is not when the bullets are flying. You don’t wanna say: “Hi, I’m Joe Smith, I’m chief of police in this town.” You want to know those people, have trained with them, have some camaraderie with them, have some understanding that: “here is how this is gonna go down, this is the protocol, this is what we’re gonna do.” Because the best way… and if you’ve ever danced with a dance partner, you know that it doesn’t just happen. It’s by doing it over and over again, training for it and saying: “you know when I raise my hand this way, I want you to turn left.” That’s how it works.
[TODD DEVOE] It’s so true. I mean, after managing the scene, I had so many people… legitimate people, show up at the command post. You know, the FBI, the ATF, DEA, I don’t know why they showed up.
[DR KELLY VICTORY] Right.
[TODD DEVOE] You know, Long Beach department, which is next door. Which, interestingly enough, LA county and Orange County, they’re on completely different radio systems. So, our communications people had to trunk Long Beach in to us… LA County Sheriff’s department, Orange County Sheriff’s department. We had like, every agency in the world showing up on our doorstep. And one of the things that we learned quickly is we had to manage who we let stay, and we turned to the FBI and the DEA and said: hey, we appreciate your help, but right now we don’t need you. If we need you, we’ll call you. And they graciously stepped back, I mean, they knew it wasn’t that issue for them. You know, we knew right away it wasn’t a terrorist incident, so the FBI didn’t need to be there. Managing that scene, it became a priority for the commander, not to manage the disaster, necessarily, but to manage who could stay in the ICP, because it just got huge fast. So, that was… my role as an emergency management is that I started doing the logistic action of it, and helped out with a planning session, because we’re small. And that’s what my role was there. And I think that’s where… as an EM, that’s a non-swarm person with the department can really help out, because they don’t need to do standing guard and stuff like this, they can really help with the logistical and planning session.
[DR KELLY VICTORY] You’re exactly right. And if there was one thing, one piece of advice I would give to any emergency manager, and this is… we’ll get back to why I suggest active shooter training as a good place, if I could pick one thing to put your money on, is… if you look back, I’m a student of disasters, and what I mean is I’m a student of: what has gone well? Where we’ve done well in a disaster response? Whether it’s Katrina, or the Boston bombing, or the floods, whatever; whatever the disaster is, the ones that have gone well, versus the ones that have gone poorly, the ones that go well are the ones where unified command is established as quickly as possible. The more quickly you have unified command, and I mean when you have an incident commander, but you have somebody from each of the stakeholders, ideally, in the same place; not even on the same radio. If you can put them physically in the same place and say: ok, good. We’ve got somebody from law enforcement, somebody from fire, somebody from the school system, somebody from the hospital, and we are all here, and we’ve got unified command established. Those events go as seamlessly as possible. They really do. One of the beautiful things about active shooter trainings specifically, is that the standardized protocols that you develop during active shooter trainings, the collaboration between the agencies, all the different stakeholders, and the skills that are learned, are highly transferrable and applicable to any other large scale event. In other words, whether it’s an active shooter, or it ends up being a tornado, or a building collapse, or a massive flood; it doesn’t matter. 80% to 90% of the steps in that dance remain the same.
[TODD DEVOE] Right.
[DR KELLY VICTORY] Regardless of what event it is. So, if we take the biggest thing and think about an active shooter scene, which for most people is the worst of the worst, like you saw in Seal Beach, then you say: ok, 80% to 90% of these things will be transferrable to the event if it’s a flood or something else. An example is that, in a group that I teach with, we taught an active shooter course. A very aggressive, hands-on course in Ouray, Colorado, some years ago. It was 2014. And Ouray is a small town in Colorado, a little mountain town. So, when you talk about law enforcement, we had people there from the forest service, you know, we had a sheriff or two, we had a couple of police officers, so you’ve got people kind of… they put together law enforcement plus, again, people from the school and the hospital, and we trained them on this active shooter. And it was the first time most of them had ever trained together for anything. So, we did an aggressive two-day course, rolled out of town at about 7 o’clock in the last night. In the lesson, 12 hours later, they had a mine explosion in Ouray. And within 20 minutes, they mobilized a group of people and got 33 injured miners out of mine shaft 5 miles up a dirt road, and got them sent out to trauma centers all over the state. And they ended up having only two deaths, total, and I read a really nice article in the“ASPR” (Assistant Secretary for Preparedness and Response) website. They actually went out and interviewed these guys, and said: how the heck does Ouray, Colorado, know how to mount this incredible response? They had it all figured out, and they had patient reunification set up, and triage and transport, all of that stuff. They didn’t lose track of one patient. And it was because we just did this active shooter course! You know, yesterday. And this has nothing to do with active shooter, but it honestly brought them together, and they understood how to manage a big event. And although I can’t tell you that had they not had our training, would they have had more deaths? I have no idea. They may have had the same two deaths. But what I can tell you, Todd, is that the way that they felt about it, as a community, their ability to recover, and their ability to be resilient and to bounce back after that horrific mine incident, which profoundly impacted them, because they knew they had done a remarkable job, they’d done anything and everything that anybody could have done. They worked quickly, they worked efficiently, and they felt competent. And it really impacted the resilience of that community.
[TODD DEVOE] That’s a great story as far as any kind of training that you do. One of the things that I think it’s really… why Orange County, California, does things really well, is for the longest time, and until recently, we had a nuclear power plant just down the street from us, in San Diego and Orange County border. Which causes us to train a lot, regarding just the incident response to a nuclear powerplant meltdown. And because of that, I think that Orange County was more progressive than other counties in California, and maybe in the country; I don’t wanna go too far. But we already had the operability of radios and things like that, we’ve already cross-trained. And I agree with you 100%. I kinda giggled a little bit back when you talked about having those big events and buying the pizza for everyone. Those type of trainings, or those exercises, we should say, those for me always seem to be for the chiefs, the city managers, the city council, for those things. Because I’ve been on the other side of that training, where I’ve been sitting in an ambulance all day long, and going: ok, what exactly am I doing? And we finally get the call, we drive up, they shove a patient in the back of the ambulance, so we ride around the corner and let him out, and we go back.
[DR KELLY VICTORY] Right, right. There really are… they’re a lot more show than they are effective at really training. And what you wanna do is, and there are other groups out there, I’m not the only show in town. They provide training for these things, and you can… there are ways to do it, but it requires getting people together, and rolling your sleeves up and saying: ok, we’re gonna do this! We’re gonna practice, and we’re gonna train for this, and we’re gonna figure out how we’re gonna respond, and when something goes wrong, we say: let’s do that again. Let’s do that play again. Until we get it right, until we figure it out, and figure out where the holes are in our system. It was interesting, we ran an active shooter course in another location in Colorado, where we used to school. We typically do these things like on Thursday, Friday, Saturday, and it was not until we ran, we did the training, that we realized that when you pulled the fire alarm in this particular school, interestingly, you pulled the fire alarm in this particular school, and the doors locked! The school doors shut and locked. And so, the bad guy was locked in the school and nobody could get in! Nobody could get in, the first responders couldn’t get in. And the school principal said: oh my gosh! This is all really messed up! We had no idea that when you pull the fire alarm the school doors unlatched, closed, and locked! And those sorts of things sometimes you don’t realize until you go through a training. So, it could be very, very illustrative, and emergency… I think the emergency managers can come out looking like a champ if they’re the ones who say: let’s do this training, let’s bring everybody together. You will find some areas where there are some holes in your planning or protocol. It may be something simple, like radios that are not interoperable, or maybe something like that, where I’m saying that the school doors shut and locked when the fire alarm was pulled. You never know what it’s gonna be, but I guarantee it won’t be a waste of time.
[TODD DEVOE] Have you found that some people, and when I say people, I’m thinking the brass, are afraid that if they do a drill or some training like that, that it will look like they failed? Because I think if we’re gonna fail, I’d rather do it during training than an actual event…
[DR KELLY VICTORY] Ok, Todd, I think it’s probably… you’re addressing the elephant in the room. I think it’s probably the biggest impediment to training, is that people are afraid to have their inaquecies or their ignorance exposed. So they just don’t do it. And we do it at their detriment. I think that’s exactly right. And in fact, you know, one of the biggest problems, frankly, in law enforcement and in first responders, whether it’s fire or the paramedic side of things, is that after these events, we tend, unfortunately, to pad everybody on the back and say: you did a great job, you did a great job, whether or not they did. And frankly, you know, what we have tried to do, what I have tried to do, and to promote, is the idea that we need to look at this training the same way that surgeons do when… and surgeons, I don’t know if you’re aware, do a thing, and they’re really the only specialist that does it, called morbidity and mortality. And depending on the size of the hospital, every month, at a minimum, and every week in a big hospital, all the surgeons get together behind closed doors and they look at all the cases that went badly that week. And they say: what the heck happened here? And the only way you can do that is if there’s an element, number one, of trust; if people understand that this is not a punitive situation, that nobody is gonna get sued, but we need to understand what the heck happened here. And too often, unfortunately, in law enforcement, fire, rescue, the after-action report tends to be really, really sanitized. And what’s put out to the public is a stellar response was mounted by our fire, EMS, whatever. And while you want the public to have confidence in their first responders, the first responders themselves aren’t doing each other any good if they don’t sit down and go: wow! That was not the way to do that. And you saw that, for example, in Colorado, after the Aurora theatre shooting. That was not a good response.
[TODD DEVOE] Right.
[DR KELLY VICTORY] It was… you know, we first had… Colorado, for a reason, that’s somewhat unclear, seems to be ground zero for active shooter events. So, my home state seems to have, for whatever reason, a lot of these events. And so, we have Columbine, which was the big active shoot that most people can remember; and then unfortunately, had the Aurora Theatre shooting as well. But you are, I really believe, obligated to sit back and be very honest. Not only to do the trainings, but to be willing to expose your inadequacies, expose your ignorance, expose your… you know, go ahead and fail. Because, as you said, boy, if you’re gonna fail, you wanna fail during a training event, not when the real thing happens. Getting back to my story about Ouray, Colorado, and the mine explosion, that’s what allowed them to be as resilient as they were. They mourned the people who died, they mourned the people who got injured, and they got up and moved on very quickly. I’d say the same thing about Boston. That’s why Boston… you know, after the Boston marathon bombing, they adopted that Boston Strong, because they knew they’d done a really good job there.
[TODD DEVOE] Right.
[DR KELLY VICTORY] They trained for it, they were prepared, they did a good job. Everybody, 100% to the people who were transferred to the hospital lived. 100%. That’s really a remarkable thing. So, the ability, if you want to fail, you wanna fail during training, not during a real event.
[TODD DEVOE] What does the recovery process look like for something like the Boston bombing, or Aurora Colorado? I mean, I know what it would look like for a small town; what does it look like for a larger town, and how does that process work, do you think?
[DR KELLY VICTORY] Well, you know, if I take it from the highest level, if you look at resilience or reaction, you know, let’s first just look at that; what are the possibilities for what would happen in any jurisdiction? In a ranger response, it would include, number one, ideally, they’d bounce back better. You know, the capacities are enhanced, the exposure ends up being reduced, and the system is more able to deal with future shocks and stresses. Other communities will bounce back, but the pre-existing condition still prevails. They haven’t done anything to mitigate the risk of that happening again. Other communities that are not prepared to recover, but they recover worse than before. Take New Orleans, after Katrina.
[TODD DEVOE] Right.
[DR KELLY VICTORY] Meaning, their capacities are reduced. They recovered, but they are worse off than they were before, their capacities are reduced. And then worst case scenario, the system totally collapses, and you have a catastrophic reduction in capacities, and that would be something like Heidi, you know, a place like Heidi that absolutely fell apart after the earthquake. So, what determines where you fall on that spectrum, I think, largely, once again, to the risk of sounding like a broken record, comes back to the training. Seriously, clearly some components of luck in this, I would say that in the Boston bombing. If you look at Boston, while they had trained for and were very well prepared for the event, the Boston bombing itself, if you think about it, happened… it was really an artificial setting. When do you have an event like that happen at a scene, a physical venue, where you already have ambulances lined up, with IV bags punctured, hanging, ready, you know? You’ve got your multiplicity of first responders are already there, paramedics, and nurses, and people volunteering. Furthermore, it happened on a Monday that was a holiday, so there was no traffic. So, it was easy to transfer, it was a holiday. And it happened at a change of shift in the hospital, so you had double staff.
[TODD DEVOE] Oh, geez. Right.
[DR KELLY VICTORY] So, there was an alignment of stars, if you will, and I was very familiar with the after action on the entire Boston bombing, because it was heavily critiqued by the National Preparedness Leadership Initiative, because it’s based in Harvard. But that was artificial with the Boston bombing. All that said, the fact that they trained together, that they trained for it, fire, EMS, police, law enforcement, there in the hospital, they had all coordinated and done trainings before that, they knew each other, there’s a great familiarity. Boston is a bit… you know, it’s a small big town, so they bounced back quickly. I think that other places like what happened in Colorado, not so much. There was a lot of… because the after-action reports read very well, for example, on Aurora, but the people at the scene knew differently. They knew that things had not gone down… many, many of the wounded were transported in the back of police cars, people were shot and the ambulances weren’t allowed in the perimeter, so the ambulances couldn’t get people out, so people were bleeding to death and got thrown in the back of police cars, and it was just not a well-coordinated event. So, people didn’t feel great about how that went off, and I think there are still some bad feelings harbored there, that they are working through by doing additional training. And then, you know, part of it has to do with the strengths of the infrastructure going into it. You take a place that’s already fragile, like Heidi, where there’s a fragility based on poverty, and lack of infrastructure already; it doesn’t take much to topple that sort of a community. So, it’s really a number of things. And you can only control the things that you can control. So, I look at it and say: there’s so many things in life, and the trauma physician in me has always lived in the idea that there are so many pieces of life that are unpredictable, that we cannot control, we cannot control the fact that there will be a crazed gunman. The only thing we can control is our ability to anticipate, to be aware, to have trained for it, and have some idea of where to start. And you know as well as I do, that you can… muscle memory is the same. I don’t care if you’re a tennis player, or a golfer, and you practice that swing over and over again, or a surgeon; muscle memory, we build the same way when we build how to respond to trauma, and casualty, and disaster. Once you get started, it becomes easier. But you have to have practiced it, and I think that emergency managers really can get in the game and say: let’s to this, I’m don’t wanna just read a book about it. If I had a dime for every manual people have sitting… you know, I would ask big companies: what are you gonna do, what’s your pandemic plan? Or what’s your disaster plan? Or what’s your fire plan? And they point to the proverbial three ring binder sitting on the shelf. Well, again, I don’t know about you, but if somebody said, you know, “how many spleens have you taken out, Dr. Victory?”, and I said: well, none, but I’ve got a three-ring binder right there that tells me how to do it. You know, I don’t know about you, but I would not trust that doctor, I wouldn’t feel that confident. So, I think it’s about really rolling those sleeves up and putting the time and saying: we gotta plan some training sessions, and if you don’t know how to do it yourself, then bring somebody in who can help you plan it.
[TODD DEVOE] Yeah, I agree with you. I was talking to Craig one day at a conference in Florida, and he made a statement, and it stuck with me for a long time. I even teach this to my students at the college. And he said that the emergency manager is like the football coach. He goes: you get out there, you train everybody, you do the plays, you make sure they know what’s going on. And the day the event happens, you’re gonna make sure they’re gonna know how to do it and you’re going to be on the sidelines coaching them along.
[DR KELLY VICTORY] Great.
[TODD DEVOE] And I agree with that a lot. Although I’m not sure how much in the sidelines, sometimes I think you’re in it, but that’s what the emergency manager is about. And I think that… from my opinion, a strong emergency manager in the city is gonna be out there making sure that he’s coordinating the police department, and the fire department, and EMS, and county health, and these people, to make sure they’re at the table and playing in that sandbox before the event really occurs.
[DR KELLY VICTORY] And that is exactly the secret sauce. Is making sure they’ve done it beforehand, because it’s infinitely easier. It’s essentially impossible to manage them or to coordinate them from the sidelines, or even from the center of the field, if you didn’t do it beforehand. Because in the moment, everybody… you know, the tensions are high, people are scared; in a local event, you never know if some of your first responders already are gonna have personal involvement in it. As you know, obviously, when there are things like pandemics or natural events, hurricanes and tornados and floods, those sorts of things. Sometimes, 30% of your first responders are personally involved. You know? They’re worried about their own loved ones. So, you cannot, as an emergency manager, think about managing this scene if you haven’t done it ahead of time and have those policies, protocols, standards, and have sort of worked through it ahead of time; and then you’ve got a chance. And I agree, I have no problem with emergency managers rolling up their sleeves and digging in, as long as they are able to keep that wide purview, because their job, really, they will undermine themselves immediately if they get in and start doing something, and lose track of the entire scene.
[TODD DEVOE] That’s so true, that is so true. We still need to be at the 10,000-foot level to make sure things are going right. Ok, I have one last question for you, and sometimes this is the hardest question. Especially for my students, and people that are new to this line of work. What kind of publication, or magazine, or book, what do you recommend them to read to kind of get their feet wet and their teeth dirty?
[DR KELLY VICTORY] Well, I guess… I would say two different books, two different things. Because they come at it from a different angle. One is a publication called “Disaster Resilience: A Natural Imperative”, and it is put together by a group of national academies, the academy of science, and engineering, and public policy. This whole community that was put together in increasing national resilience to hazards and disasters after 9/11. And it really addresses the broad issues of increasing the nation’s resilience to disasters. It goes through the whole thing of really understanding beyond the unquantifiable cost of injury and cost of life, really looking at the economic damages from natural and man-made disasters. So, that is worth reading if you are an emergency manager. It makes a good case to invest and enhancing resilience, it makes a really good economic case. So it will provide the emergency manager with some good data points to take to whatever it is. To the council, or whatever budgeting committee they need to do to ask… or more like, beg for money. To beg for the funds to do a training. It makes a really good case to invest and enhance resilience for your community, and the ability to prepare and plan for, and absorb and recover more successfully from an adverse event. So that’s the “Disaster Resilience: a Natural Imperative.” The other one that I think is worth reading is one that is just called “Resilience”, which was written by Eric Greitens, who is a former navy seal. And he dialogues in this book his own recovery, as well as the recovery of one of his comrades, a guy named Zach Walker, after they returned from some pretty heinous tours overseas. And it deals with how their soldiers, and it would be applicable to first responders or any leader who’s been in a big disaster, or crisis, or high stress environment; how we can confront pain, learn to practice compassion, find a mentor during, and then subsequent, to the event. And then ultimately, create happiness, if you will, in the wake of horrific experiences and events. And so, I think, given the incidents of PTSD and other traumatic and post-traumatic related issues that first responders and emergency managers have, and I think in order to prepare for them, some people who may have never been exposed to these things, but they hold the title now of an emergency manager, but may never have been in such a scene. I think reading a book like “Resilience”, by Eric Greitens, can be extraordinarily helpful to think about how they may feel, how they may react, and to get themselves personally prepared for that adventure to happen.
[TODD DEVOE] That’s great, those are two really good book recommendations. And we’ll put those down at the show notes as well. So, if you guys didn’t get those notes you can rewind or it will be down on the show notes. How can we get a hold of you, if someone wants to get in contact with you?
[DR KELLY VICTORY] People are free to contact me directly. I have a website, but it’s a blog that’s not particularly active, DrKellyVictory.com, it’s really… there are some things there. But the easiest way to get in contact with me, and I’m happy to have people contact me directly, via e-mail. Just email@example.com. And that’s the easiest way to get me. Kvictory@victoryhealth.com, and I’m happy to provide with whatever guidance, or support, or direction I can to people who are looking. Whether is to get training, or just for more resources. I’m happy to talk to people.
[TODD DEVOE] Awesome! Thank you so much again, Dr. Victory, thank you for being here and discussing these really important things. Everybody, thank you so much for listening to us, and if you have an opportunity, please leave a comment on the iTunes, or wherever you’re listening to us, let us know how you feel. And again, if you ever need to get a hold of us, please check us out at EMWeekly, and sign up for our information. Thank you again, Dr. Victory.