Journalists. Reporters did not consider themselves first responders, yet it was clear to everyone listening that they were. What can be done to reach them sooner and offer the help and support they might need as they cover traumatic events?

Livery Drivers. How can we better train taxi, Uber, Lyft and other drivers to respond in medical crises? As Empey and Donnahie pointed out, while 105 victims came to Desert Springs Hospital for treatment, only 11 arrived by ambulance. Most came in the backs of pickup trucks and cars.

Trauma. Trauma doesn’t discriminate, yet when we talk about what people experienced during and after the Route 91 shooting, we tend to focus on the 58 who died and the more than 700 others who were wounded. What about the tens of thousands of people who attended the concert and escaped unharmed, at least physically? What about the tourists, casino dealers, hotel staff and journalists? What about everyone following the story from afar? Who, exactly, suffered trauma from the Route 91 attack?

“You qualify for PTSD diagnosis if you were running past people who were dying,” Frank Ochberg said. “Jenny [Mark-Babij] is as psychologically traumatized as Chris [Babij], who took a bullet. We must train a new generation of doctors to recognize, treat and teach this.”

It’s just as important to remember that trauma travels. We learned this lesson five years ago, when two bombs detonated near the finish line of the Boston Marathon, killing three people and injuring hundreds more. People from around the world had gathered for the event, and when they went home, they took their trauma with them. In a similar way, Las Vegas is a transient city, and the trauma inflicted by the Route 91 attack has spread its tentacles around the country and the world. Yet like Boston, the shooting also brought the Las Vegas community together.

Mental Health Care. How to prevent people slipping through the cracks?

• All first responders—police, fire, hospitals, newsrooms—should appoint an incident commander for mental health beginning on the first day of the crisis.
• People should seek treatment in their own community, where they can rely on friends and loved ones.
• Ensure that journalists have access to mental health clinicians.
• Just as there are many ways to experience trauma, there are many treatment methods available. Different approaches—CBT, EMDR, the Counting Method, among others—work for different people.

Corporate Response. How do corporate concerns with image, liability and bottom line block education, amelioration and prevention after a tragedy? “The defense against legal action thwarts our legitimate right to know,” Ochberg said. “We’ve got a first amendment and it defends freedom of the press and our right to understand what’s going on.”

Gun Violence. The role of the NRA cannot be understated in this tragedy. As Ochberg put it, “The NRA’s posture is to interfere with research on behalf of gunshot survivors to stymie any meaningful attempt to stop the proliferation of guns. I think the NRA likes the idea that guns are available to the mentally ill. They wouldn’t say it in a public statement, but they have interfered with every attempt.”

Jennifer Longdon, who was paralyzed in a random drive-by shooting in 2004 and is now a disability rights activist who’s running for the Arizona House pointed out that while the Route 91 shooting was a high casualty tragedy, “the number of physically wounded in this incident is equal to four days of everyday gun violence in the U.S.”

Festival Seating. ACIA has the brainpower to create a model regulation for festival seating, including egress plans, loudspeaker communication, capacity limitations,  places of refuge, and an active shooter/terrorist incident assessment. “Had something like this been in effect here and complied with, it might have actually made a difference,” said Ned Benton, a professor at John Jay.

Know Your Exits. Could festivals and concerts create apps with exit information? “Something in bold letters: ‘know your exits, know your safe havens.’ More people are apt to look at that than listen to a loud announcement while drinking,” Mark-Babij said.

Memorialization. Who, exactly, would a memorial honor? Victims of the Route 91 shooting? Survivors and first responders? The Las Vegas community? Competing narratives often make the pathway to memorialization challenging, even contentious. And it’s especially tricky in this case, because many victims and survivors live out of state—and because Las Vegas is a city that wants to be celebrated for its energy, not its tragedies.

“What helped me heal was our neighborhood coming together,” Babij said. “Our neighbors brought us dinner every month. It would be nice if the memorial shows everybody involved, not just the deceased, the survivors, first responders, but the community as a whole. Yes, this horrible thing happened, but we survived and it made us stronger and here’s the good that came out of it.”

Longdon shared her thoughts: “Rocks and glass and grass are for the dead. I don’t mean to be callous. It’s offensive that when people still can’t pay their medical bills, can’t get a wheelchair, can’t get in their house or use a bathroom because they can’t afford it, that we’re erecting monuments. It implies finality. What happens to those living with a lifelong, life-altering experience?”

Two memorials sprung up organically: the healing garden and a makeshift memorial at the Las Vegas Welcome sign. After six weeks, the memorial—a collection of crosses, teddy bears and candles—was moved to the Clark County Museum.

By Abigail Jones

© 2018