As a gun battle continued in bursts inside the Tree of Life Synagogue on Saturday morning, suspected bombs were found on the third floor and outside the temple, keeping rescuers trapped on a second floor landing.
What if the packages were explosives, thought Justin Sypolt, a city paramedic with special training who — along with other rescuers — was on the landing. He began to imagine blast injuries, calculating that the responders didn’t have nearly enough help at the scene for that kind of emergency.
Mr. Sypolt had to find a way to get patients out of the building. “What are we going to do if all of this is real,” he remembered thinking about the possibility of the packages detonating.
They hatched a plan to use the fire escape to evacuate the injured. But where, exactly, was the fire escape in what seemed like a sprawling building filled with the sound of guns?
“I just defaulted to my level of training and did what I knew I had to do,” he said.
What Mr. Sypolt and other city tactical paramedics did Saturday, authorities say, was to save lives.
Mr. Sypolt, a city paramedic with special training for mass casualty incidents, was among the first nine responders to enter Tree of Life with SWAT officers as a lone gunman — armed with a semi-automatic assault-style AR-15 rifle — shot to death 11 worshipers and injured six others at Shabbat services.
Rendering emergency medical care in the age of Columbine, Virginia Tech and the Aurora Movie Theater tragedies is a rapidly evolving specialty that borrows from combat trauma experience. The goal is to protect life, even if that means preventing death.
The city’s Tactical EMS Team, which has 16 members and a specially equipped ambulance, was created in 2011. Its paramedics are armed with handguns, unlike traditional paramedics, Mr. Sypolt said.
Saturday was Mr. Sypolt’s day off. He was preparing for a Halloween party when the alerts began chirping on his radio.
“Within seconds of listening to the radio, I knew this was it,” he said. He changed into his camo gear uniform “like my clothes were on fire,” then raced in his car the five or six miles from Westwood to the corner of Wilkins and Shady avenues.
At the synagogue, the paramedics were issued 9mm Glock pistols from a SWAT supply truck. They drew their weapons before entering the temple on a mission to save as many lives as they could.
Sounds of panic came from inside.
“We could already hear them screaming for medics,” said Mr. Sypolt, 34. The entrance windows had been shot out. It wasn’t immediately clear where the gunfire was coming from.
The task of deciding which of the injured is treated first and which are bypassed in such situations borrows heavily from battlefield experiences, said Leonard Weiss, 33, a UPMC emergency medical physician who went to the synagogue from home a few blocks away after hearing the gunshots Saturday. Patients are quickly divided by severity using triage assessments.
“A lot of the school of tactical medicine is derived from military tactics,” said Dr. Weiss, who is also assistant medical director of the city EMS.
“But we need to employ those in our regular society in the U.S. because this has become a war zone in this neighborhood.”
At the Tree of Life Synagogue, just inside the Wilkins Avenue entrance, Mr. Sypolt and other tactical medics identified four people with severe gunshot wounds. All four were dead.
A fifth person, who was alive, was promptly treated and carried outside — from the first floor — to an ambulance.
The medics re-entered the building, found more bodies and an injured woman this time. They treated her, then carried her outside to a waiting ambulance.
Then — with the sound of gunfire echoing above their heads on the third floor — the team moved to the temple’s second floor landing area, which they planned to use as a collection point for treating other casualties, Mr. Sypolt said.
“We were trying to protect this area we called our own,” he said. “We call that hardening in place.”
An exchange of gunfire was followed by the report of a police officer hurt.
He was treated on the second-floor landing, then quickly hustled downstairs and out the door.
A second officer was injured after another exchange of gunfire. Tactical paramedic Jonathan Atkinson, 37 — who helped recount the story with Mr. Sypolt on Monday — rescued the officer from a stairway leading to the third floor, then continued to render care on the way to the hospital in an ambulance.
“We just went through the process the way we knew to do it,” Mr. Sypolt said, his voice calm, measured Monday as he described the tense situation two days earlier. “Our mission is to save life and if that means preventing death, that’s what we do.”
Then there was that moment in Mr. Sypolt’s retelling of Saturday’s horror.
In searching for a way to the fire escape from the landing, he glanced into a room that looked as though it were a daycare center. He didn’t yet know that the suspicious packages would turn out to be nothing dangerous. At the time, all he was thinking about was how to get the injured outside.
“I’m looking at all these crayon drawings on the wall that kids made and then I’m thinking, ‘What in the world is happening,’” he said.
In the room was a toy box, foam puzzle pieces, but no children.
“That was my hard moment,” he said, his voice catching. “I don’t know if I would’ve been able to do it if the kids were there,” said Mr. Sypolt, the father of a 3-year-old son. “That may have been my last call.”
Kris B. Mamula: kmamula@post-gazette.com or 412-263-1699
First Published: October 29, 2018, 11:07 p.m.
