Stanford Emergency Medicine physician William Mulkerin, MD was recently awarded the EMS Distinguished Service Medal by the California EMS Authority for extraordinary contributions to EMS in California. Below he shares how his role with local area fire departments has been impacted the unexpected: mass shooter events.
Bill Mulkerin, MD is on a team of Stanford emergency physicians specially trained in Emergency Medical Services (EMS) who provide medical direction for fire departments throughout Santa Clara County. Since the group assumed the role in 2017, a concerning trend has developed: there have been multiple mass shootings which the fire departments have responded to. This has added a new twist to the medical oversight provided to these departments and the Stanford team has had to adjust to this new norm.
Back in June 2019, Dr. Mulkerin had just finished leading a training in cardiac arrest management at a fire station in Morgan Hill when a call came in of an active shooter at the Ford dealership just down the street. Dr. Mulkerin accompanied the firefighters to the incident. "Often if a call comes in when I’m around, I like to be with my crews on the response," he says, "to watch their processes and also help when I can.”
Dr. Mulkerin, who is on staff at Stanford’s Marc and Laura Andreessen Emergency Department and on the faculty at Stanford’s Department of Emergency Medicine, supports and trains fire fighters in Gilroy, Morgan Hill, and the area surrounding Morgan Hill. With the rest of the Stanford EMS team, he also assists with Santa Clara County, Palo Alto, Mountain View, Milpitas, Santa Clara City, and San Jose Fire Departments.
As Dr. Mulkerin watched, medics and fire personnel for Morgan Hill Fire/Cal Fire donned ballistic vests and helmets and, surrounded by officers, entered the dealership. "[Responding to shootings] isn't something fire department teams really signed up for when they chose this career, but more and more it's becoming part of the routine," he says. "I was looking around seeing our firefighters wearing ballistic gear. They aren't eager to go in, but still they do. And it feels like we [physicians] need to be prepared to support them however we can, from training to responding with them."
Less than a month later, Dr. Mulkerin was at the Gilroy Garlic Festival checking in on EMS services and the support tent they established. Then he worked an overnight shift at Stanford before taking the train home to San Luis Obispo. When he heard of a shooting at the festival he immediately headed back north. By the time he arrived, the initial medical response on scene was complete. He checked in with one of the crews that had been one of the first on scene at the shooting and ended up spending the evening with them as they processed the day's events.
"You are never expecting to have to respond to something like that," he says. "But that's the nature of the first responder job now. And unfortunately, it comes with a pretty significant aftermath for most people."
Dr. Mulkerin did not anticipate being involved in mass shooting response when he entered emergency medicine. In his late 20s, after a decade as a mechanical engineer working in medical devices, Dr. Mulkerin realized he wanted to treat patients with his own hands. Always drawn to emergency medical response, he started working as an emergency medical technician (EMT), providing stabilization and transport for patients in medical crisis. He subsequently attended medical school, and then completed his residency and EMS and Disaster Medicine fellowship at Stanford. Mass shooting response was not part of Dr. Mulkerin’s training as an EMT; but over the past 10 years, the increasing frequency of these events has meant fire fighters and paramedics need to train for this possibility as part of their every day response.
Given his experiences, it is not surprising that Mulkerin recently joined two other Stanford emergency physicians and 30 teachers, administrators and first responders in a train-the-trainer two-day exercise on how to react to mass shootings (ALICE Instructor Training). "It is better to be trained than simply hope for the best," he says.
It is a philosophy he espouses as he continues to work closely with fire departments in the Bay Area, who have responded to events as recently as May 2021 in San Jose. As communities try to heal and move forward, and the gun debate continues, Dr. Mulkerin and the rest of the Stanford EMS team will continue providing medical training for situations first responders are most likely to encounter.