San Bernardino terrorist attack first responders reflect on where things are 4 years later

Trauma impacts everyone. A tragedy like the San Bernardino mass shooting on Dec. 2, 2015 — four years ago today — sends ripples through communities, while bringing those who live and work there together.

Events like dedications of memorial gardens and community vigils honor those who lost their lives that day, and for those who were first to the scene, every day becomes a day to advocate for change.

“Trauma is the same. Emotionally you will have the similar increase of heart rate and sober sadness when you see people in agony. In that particular time, I felt the community in agony,” said Michael M. Neeki, Arrowhead Regional Medical Center trauma surgeon.

Neeki, 55, has remained in contact with families of the victims and has attended dedications of several memorial gardens.

The emotions brought forth by the deadly attack on Dec.  2, 2015, were different than those he usually endures as a result of his life-or-death operations, he said.

That feeling has inspired Neeki, who treated victims at the Inland Regional Center as medical director of the Inland Valley Swat Team, to push for ways to get quicker triage and treatment in similar situations.

He remains concerned that victims who could be saved with immediate advanced care, instead bleed to death. Neeki said his efforts to create what he calls a special medical response team are making progress, but with so many agencies involved, that progress is slow.

The team he envisions would include a trauma physician, emergency room physician, trauma nurse and perhaps a respiratory nurse. They would travel in a vehicle specially equipped with tools for amputations, respiration and other care typically only found in hospitals and work alongside police and firefighters.

“What we are proposing is not intervening in their daily routine,” Neeki said. “What we are proposing is when you see a condition where there’s an indication of amputation, advanced airway, advanced intervention of blood product administration, that’s not the skills paramedics would currently have. So my hope and my prayer is that someday we all come together that our priority is our patient.”

Benjamin Archambeau, 32, is an Arrowhead physician who works alongside Neeki on the SWAT team. They train with police right down to carrying firearms. Archambeau said lives can be saved with advanced intervention in the first 15 minutes. To that end, Neeki is also trying to gain traction for a proposal to have a team of elite paramedics cross-train with doctors at hospitals and in the field.

“We are getting there. It’s not as fast as an emergency physician and trauma physician would like,” Neeki said.

In the meantime, the hospital has created a residency for emergency medicine, and Neeki said he hopes those new doctors will work with local law enforcement agencies. And a Hospital Emergency Response  Team, a scaled-down version of Neeki’s vision, is deploying to the field and saving lives.

“The issue is not really only financial,” Neeki said. “We do have a lot of patriots who are willing to give their lives and their energy and their expertise. However, the regulations are something we have to maneuver through.”

Visual interpretation

Juan Garcia-Ruiz was home sick from work on Dec. 2, 2015, when he learned with the rest of the world about the terrorist shooting at the Inland Regional Center in San Bernardino that left 14 people dead and 22 wounded.

The graphic artist wanted to express what he felt that day. “I didn’t have any relatives or anyone close to me” harmed in the shooting, “but I still felt sad, and felt like it was a big loss,” the San Bernardino native said.

Some graphics memorializing an incident were a version of a black ribbon, but Garcia-Ruiz wanted to be specific about his hometown.

“The first thing that came to mind was the arrowhead — when you think about San Bernardino, what you think about is the arrowhead,” referring to the landmark natural formation in the foothills north of the city.

He set to work at home. “It came to me almost instantly. It might have taken me about 30 minutes or so — I didn’t put too much thought into it,” he said.

And there it was: The arrowhead, with “SB Strong” and “12.02.15” inside the borders.

“I could not foresee it would go viral,” he said in a recent interview.

But it did.

He posted it as an updated profile photo on his Facebook page, he said in a recent interview. Someone suggested posting it on a San Bernardino community social media page, “and it took off from there.”

“Some people thought San Bernardino County had contacted me. But I did it out of my own good will,” said Garcia-Ruiz, now the senior multi-media designer for Innovacyn, a Rialto company that makes wound-care products.

He said at first he didn’t copyright it, and was letting anyone reproduce it. But that stopped when he learned some were selling items and making money for themselves. “The idea of someone making a few bucks over their lost lives…” he said.

He had SB Strong trademarked, with authorized users such as Cal State San Bernardino, San Bernardino Valley College and the Inland Empire 66ers minor league baseball team agreeing to put all profits to helping the victims and their families.

“I have never made a dime off it,” Garcia-Ruiz said. One year after the logo was created, about $46,000 had been raised and distributed from SB Strong items, he said.

In 2019, Garcia-Ruiz doesn’t know what the amount might be — the 66ers, for instance, still sell the shirt on their merchandise website, he noted.

The SB Strong logo is still ambient in the area, he noted, “especially at this time of year,” seen on car stickers, T-shirts and at venues such as San Bernardino Valley College, where his youngest brother, now a student, noticed it.

“It’s not something I brag about, but if it comes into the conversation, I will say ‘I actually created that,’” he said.

Police chief

The man who became the face of San Bernardino and the investigation into the attack is planning his next move.

Should he ride his bicycle around Redlands? Or San Bernardino to Riverside? How about along the Orange County beach trail? And if he can’t find part-time work, then a full-time job will suffice, Jarrod Burguan said.

But after retiring as San Bernardino’s police chief on Aug. 16, seven months after knee-replacement surgery, Burguan, 49, said the days of him wearing four stars on his lapels are over.

“There’s nothing about being a chief I miss,” Burguan said. “I miss aspects of being a cop. Being a cop was fun. Most of us get into our profession in our early 20s and we want to work the streets and do other assignments. I enjoyed that aspect of my career. … Not going to budget meetings.”

Burguan led the department when it lost scores of officers during the city’s bankruptcy, and the city’s political environment has always been a challenge for police chiefs to navigate.

But he remained steady, winning praise for bringing calm to a chaotic situation after the terrorist attack.

“I viewed myself as somebody who was doing my job that day. I happened to be the one sitting in the police chief’s seat. This extraordinary event happened, and I was comfortable enough taking the lead with a lot of the messaging taking place,” Burguan said. “That entire day and everything that happened was a partnership, including the FBI and a lot of other organizations that came to assist us that day. I was always a little reluctant to have so much of that attention cast on me.”

Burguan said his phone still rings about Dec. 2 – as it did for this story – from others seeking advice on policing. He does some training for other organizations. At the time, the attack caused the largest loss of life domestically since 9/11.

But it’s no longer an anomaly, which Burguan is reminded of “when you flip on the TV and you see another one has happened. Because I’ve been so deeply involved in it for several years now and still talk about it, I think I have a different perspective than others, and I’m extraordinarily upset about the violence,” Burguan said.

“The fact that we really truly don’t have answers to stop it frustrates me,” he said.

First on scene

Mike Madden was one of the first officers to enter the conference room at the Inland Regional Center that day in December 2015. The lieutenant’s description at a news conference — “It was unspeakable, the carnage we were seeing” – was reprinted and replayed over and over.

Madden, 52, retired in August 2018 to his home in Yucaipa, but he is still battling terrorists.

Madden is now a private contractor for the Institute for Intergovernmental Research, a nonprofit organization that provides expertise in training, technical assistance and more for law enforcement. He teaches street cops about handling situations similar to the San Bernardino attack.

“This is training that is very hands-on,” Madden said. “How do we work to prevent these acts? Are we connecting the dots and recognizing suspicious activity? Who do we forward the information to? What do we do after the incident; how do we help the community, the organization and ourselves?”

That last focus – the physical and mental well-being of officers – is receiving increased attention from public safety agencies.

“For too long we have taken the mindset not to show emotion or show you are compromised by a single incident or the wear down from everyday activities. The old-school mindset was ‘Rub some dirt on it and get back in the game.’ Some coping mechanisms (such as alcohol abuse) were unhealthy,” Madden said.

The IIR was just one of many agencies that asked San Bernardino police officers about what worked and didn’t work in their response, Madden said.

“I feel like I hit the lottery. I’m passionate about what we do. I think it has real value,” he said. “Not a day goes by that to some degree I think about what happened on December 2nd. Do I feel it has not allowed me to lead a healthy and productive life? No.

“The true victims that day were the 84 attendees. Those are the people we need to keep working toward and serve them and keep others safe against other potential future attacks,” Madden said.

SWAT medic

On Dec. 2, 2105, Ryan Starling was an engineer paramedic with the San Bernardino City Fire Department and a reserve officer with the San Bernardino Police Department, as their SWAT medic.

By the middle of that day, those two roles would combine to help save 17 seriously wounded people who were rescued and treated by Starling and others in the minutes after the terrorist shooting at the Inland Regional Center.

Starling was at an active shooter training at the Arrowhead Springs Hotel, about 10 miles from the center, when the radio calls started.

Four years later, Starling is a captain with the San Bernardino County Fire Department, which took over firefighting duties in the city from the financially strapped city department in 2016.

In a recent interview, he was quick to take the focus off himself for the rescues on Dec. 2.

“It was teamwork across the board,” he said.

Instead of waiting for paramedics to arrive and treat people at the scene, officers got the wounded out of the center and into a cycle of critical emergency treatments even before they arrived at a hospital.

Some of the patient transportation was done with a pickup truck, the private vehicle of a county probation officer who responded to the scene.

“All I did was organize that,” Starling said.

“The first line of defense is the citizens. We saw that on Dec. 2,” Starling said. “There were so many stories, motivational stories you would hear afterwards — people that were in the room and they just helped each other, they helped the other person out. One person lay on another person so they wouldn’t get shot again … you hear all these heartfelt, touching stories and you just see the good in people.”

Starling has since then taught about early treatment — the difference a properly applied tourniquet or chest seal can make between life and death. He estimates he has spoken to more than 50 agencies across the nation about policies and procedures for response and treatment at mass shootings.

“We’re trying to continue that,” he said of the spirit among the victims of the shooting. “Just by educating the community, and if they are ever faced with this again, they have the training to put on a makeshift tourniquet and stop bleeding and know what to do, and have that confidence.”

Starling was alone as a SWAT-certified paramedic for the San Bernardino Police Department on Dec. 2, 2015.

He said now there are two available for the department including him, and two more paramedics are about to undergo training and will be affiliated with the Fontana Police Department, he said. He said the number of SWAT-certified paramedics in the department could eventually go as high as six.

Starling said he doesn’t know if the Dec. 2 shooting pushed forward the need for SWAT-certified paramedics, “But it definitely justified the need for a tactical medic program.

“Fourteen deaths that day weren’t for nothing,” he said. “There are  so many people that are alive because of what we learned that day … And that’s what I think is phenomenal. People are still teaching on it because there are so many good lessons that can be learned.”