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In addition to helping coordinate hospital transfers during the initial crisis, STRAC sent mental health professionals to help staff and local first responders process their trauma. The organization deployed extra health care workers to Uvalde in the weeks after the tragedy to relieve the usual emergency department (ED) team members who needed to rest and recharge.

Uvalde is a close-knit community where “everyone has only two degrees of separation,” Dr. Arbelaez said. And if everyone is connected, everyone is sharing this pain. He thinks it’s too soon to know how much this trauma will impact those involved, but he knows the anguish is acute and widespread. 

“We’ve seen multiple parents coming in with anxiety,” he said. “It sort of relives everything again, right? Because then you put a face to the parents who were searching for their kiddo. They’re anxious and distraught and there’s nothing, nothing I can say or do to help ease their pain and grief.”

For his part, Dr. Arbelaez sometimes wakes up in the middle of the night, his mind racing through different aspects of the tragedy. 

He thinks about the stoic looks on the kids’ faces as he took care of them that day. “These kids did not cry at all—the kids who got shot,” he said. “They came in scared, but I didn’t see a single tear in those kids, not a single one.”

He thinks about how his training prepared him for this day. Dr. Arbelaez is grateful that he had mass casualty training during his emergency medicine residency at the University of Connecticut. “I had a moment after all of this where I thought, ‘Imagine if I had not trained at a Level I trauma center?’ I’m just glad I had the tools and the staff to be able to save a couple lives that otherwise wouldn’t have been saved.”

He thinks about the way the Uvalde Memorial ED staff responded to the shooting. “[That hospital] has one of the most efficient and cohesive teams I’ve ever worked with,” he said. His team was ready and waiting, but what if they didn’t have to wait so long? Could they have saved more lives?  

He thinks about school shootings. He was in high school when Columbine happened. He was an emergency medicine resident in Connecticut when 26 people were killed at Sandy Hook Elementary. And now this. “It feels like no kiddo is safe,” he said.