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Complicated recovery awaits victims injured in Vegas attack

| Tuesday, Oct. 3, 2017, 7:18 p.m.
Virginia, right, and Natalie Ramos light candles as students from University of Nevada Las Vegas hold a vigil Monday, Oct. 2, 2017, in Las Vegas. A gunman on the 32nd floor of the Mandalay Bay casino hotel rained automatic weapons fire down on the crowd of over 22,000 at an outdoor country music festival Sunday.
Virginia, right, and Natalie Ramos light candles as students from University of Nevada Las Vegas hold a vigil Monday, Oct. 2, 2017, in Las Vegas. A gunman on the 32nd floor of the Mandalay Bay casino hotel rained automatic weapons fire down on the crowd of over 22,000 at an outdoor country music festival Sunday.
Kris Delarosby, right, and Colleen Anderson, left, hold Charleen Jochim, center, as they walk towards a hospital in search of information on a missing friend, Steve Berger of Minnesota, Tuesday, Oct. 3, 2017, in Las Vegas. Berger is missing since he attended the Route 91 Harvest festival Sunday, and friends and family continue to search for him.
Kris Delarosby, right, and Colleen Anderson, left, hold Charleen Jochim, center, as they walk towards a hospital in search of information on a missing friend, Steve Berger of Minnesota, Tuesday, Oct. 3, 2017, in Las Vegas. Berger is missing since he attended the Route 91 Harvest festival Sunday, and friends and family continue to search for him.
Kris Delarosby, right, and Colleen Anderson, left, hold Charleen Jochim, center, as they walk towards a hospital in search of information on a missing friend, Steve Berger of Minnesota, Tuesday, Oct. 3, 2017, in Las Vegas. Berger is missing since he attended the Route 91 Harvest festival Sunday, and friends and family continue to search for him. (AP Photo/Gregory Bull)
Kris Delarosby, right, and Colleen Anderson, left, hold Charleen Jochim, center, as they walk towards a hospital in search of information on a missing friend, Steve Berger of Minnesota, Tuesday, Oct. 3, 2017, in Las Vegas. Berger is missing since he attended the Route 91 Harvest festival Sunday, and friends and family continue to search for him. (AP Photo/Gregory Bull)
Debris litters a festival grounds across the street from the Mandalay Bay resort and casino Tuesday, Oct. 3, 2017, in Las Vegas. Authorities said Stephen Craig Paddock broke windows on the casino and began firing with a cache of weapons, killing dozens and injuring hundreds at a music festival at the grounds.
Debris litters a festival grounds across the street from the Mandalay Bay resort and casino Tuesday, Oct. 3, 2017, in Las Vegas. Authorities said Stephen Craig Paddock broke windows on the casino and began firing with a cache of weapons, killing dozens and injuring hundreds at a music festival at the grounds.
Rosa and Alan Duarte become emotional during a vigil at City Hall in Las Vegas, Monday, Oct. 2, 2017. The vigil was held in honor of the over 50 people killed and hundreds injured in a mass shooting at an outdoor music concert late Sunday.
Rosa and Alan Duarte become emotional during a vigil at City Hall in Las Vegas, Monday, Oct. 2, 2017. The vigil was held in honor of the over 50 people killed and hundreds injured in a mass shooting at an outdoor music concert late Sunday.
A sign asking for prayers is displayed at the MGM hotel on Tuesday, Oct. 3, 2017, in Las Vegas.
A sign asking for prayers is displayed at the MGM hotel on Tuesday, Oct. 3, 2017, in Las Vegas.
University of Nevada Las Vegas students Raymond Lloyd, right, and Karla Rodriguez take part in a vigil Monday, Oct. 2, 2017, in Las Vegas.
University of Nevada Las Vegas students Raymond Lloyd, right, and Karla Rodriguez take part in a vigil Monday, Oct. 2, 2017, in Las Vegas.

LAS VEGAS — Their concert turned into a siege, and now their lives may become a battle.

The staggering count of people injured in the shooting at a Las Vegas music festival means their recoveries are likely to be as varied as the victims themselves. Some injuries are as simple as broken bones, others gunshot wounds involving multiple surgeries and potential transplants, and all come with the added emotional scars of enduring the deadliest shooting in modern U.S. history, with 59 killed.

At least 130 people remained hospitalized Tuesday, with 45 listed in critical condition. Hospitals said 185 others had already been released. At Sunrise Hospital and Medical Center alone, the count of those treated included 120 people who were struck by gunfire, a glimpse of the amount of ammunition unleashed in the attack.

Rehabilitation for the most seriously hurt victims will take far longer than many may realize.

“Years,” said Dr. Thomas Scalea, physician-in-chief at the University of Maryland's Shock Trauma Center in Baltimore, one of the nation's largest trauma centers. “It's not days or weeks.”

Edward Leon raced to Las Vegas from Palm Springs, California, after learning his niece was shot in the stomach. He said he cried the whole way there. Although she survived an initial operation, he worries about what will come next.

“She's out of surgery,” he said, “but it's a long road ahead.”

At the site of the attack, people fashioned stretchers out of fence posts and tarps, and tourniquets from belts. At area hospitals, the scene was similarly grave.

“It was like a war zone,” said Dr. Jay Coates, a trauma surgeon at University Medical Center of Southern Nevada, who operated on three people with gunshot wounds.

Coates saw news of the shooting flash across his phone Sunday night and rushed to the hospital. Ambulances were parked four and five deep. Dozens of wounded filled the trauma bay inside. There were people with injuries to their lungs, liver and spleens, some with huge wounds torn open by bullets. Eight or nine surgeons made flash assessments.

“Who's the most injured?” Coates said they would ask themselves. “Who's dying the fastest?”

He treated similar wounds while on big-city hospital duty in Detroit and Philadelphia, but never so many at once. After the Vegas shooting, eight operating rooms were running simultaneously. It was hours of frantic response before doctors had a moment to catch their breaths.

“At this point, I'm still processing. I have no idea who I operated on,” Coates said. “They were coming in so fast. ... We were just trying to keep people from dying.”

Dr. Douglas Fraser of University Medical Center said most who suffered gunshot wounds were hit in their chests, abdomens and extremities. Most of the victims struck in the head didn't survive, he said.

In the hours after the shooting, workers rushed to mop up blood at UMC's 11-bed trauma center, but by Tuesday, it sat empty and quiet. Those caring for survivors of the attack were working to keep pain controlled and wounds clean and safe from infection. Some people seeking word on a missing friend or relative milled around in hopes of a clue.

“We still don't know if our friend is dead or alive,” said Kris Delarosby, who flew in from Minnesota to search for friend Steve Berger.

For those who did survive, their prognoses depend heavily on where exactly the bullets struck.

“It really is a game of millimeters and centimeters,” said Dr. Jack Sava, trauma director at MedStar Washington Hospital Center in Washington, D.C.

Bullets can pass through a victim's body and miss vital organs, or veer slightly and leave a person paralyzed or dead. Sava cared for House Majority Whip Steve Scalise, a Republican who was shot during a congressional baseball practice over the summer, and said patients and their families have to deal with the uncertainty of their recoveries.

“There's so many things that happen, so many branches in the road,” he said. “A lot of times in trauma we talk about death, and that's a tiny tip of the suffering that's caused by injury and gunshot wounds. For every person we talk about living or dying, there's an ocean of suffering we're not talking about.”

Rob McIntosh, a 52-year-old from North Pole, Alaska, is among those facing that recovery, having been hit by three bullets at the concert, according to his friend, Mike Vansickle. He said McIntosh had emerged from surgery and would survive.

“He'll get through all this and come out with some stories to tell,” Vansickle said.

Others who have been through such trials sounded similar notes of optimism, including Jeff Bauman, who lost his legs in the 2013 Boston Marathon bombing. In a Facebook post, Bauman said those waking up in hospitals may wonder how life could ever be the same again, but they will find a way through the tough moments to go on.

“You will walk again. You will laugh again. You will dance again,” he wrote. “You will live again.”

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