hate, we'll throw a thousand messages of love. >> ultimately love trumps hate. >> that's pretty good. >> sounds very good. that's going to do it for me. i'm chris jansing here in orlando. coming up, jose diaz-balart will pick up our coverage. >> and good morning. we begin with the orlando massacre. here is the very latest. just 30 minutes from now we're going to be hearing some of the survivors of that horrible night. they'll speak alongside doctors at the orlando regional medical center which received most of the victims. we'll bring that to you live. in about two hours from now, president obama is expected to address the shooting following a meeting with his national security council. we will also visit orlando thursday to pay his respects to victims' families and to stand in solidarity with the community here. throughout all of this, federal officials digging into the gunman's background, trying to figure out what motivated omar mateen to launch the attack.

among the angles they're looking at, reports mateen was a frequent patron of the club that he targeted. jeh johnson and director comey will brief house members later this afternoon. i'm joined by nbc justice correspondent pete williams. pete, what can you tell us? what is the very latest? >> i think the main focus, and there are many prongs to this investigation, but one of the most intense right now is focusing on those who were closest to omar mateen. his family members, especially his wife, perhaps to some extent his father. what did they know, if anything, about his plans and did they do anything to help him, did they fail to speak up. those are key questions that we are told the fbi is drilling down on and has been for the past 24 hours. it's only natural that they would ask these questions, according to the secretary of homeland security who talked about this this morning on "today."

>> the reality is that when someone self-radicalizes, there is almost always someone else close to that person in a position to see the signs, which is why the efforts we've been making in the department of homeland security to build bridges to communities is so critical right now and not vilify american muslims and drive them into the corners. we want to build bridges to these communities and encourage them if you see something, say something. >> the picture that's emerging of omar mateen is a very complicated one. he professed interest in isis when he made his 911 calls from the nightclub, but he also said he was interested in hezbollah. he claimed to be a member of it. he said he had family members who were in al qaeda. he said he supported other terrorists who weren't connected to isis. that's a very muddled picture. so the fbi director said it seems clear that he was radicalized from the internet

but to what extent and in what direction is not a clear, obvious picture this morning. also his own past, he seemed to be very troubled, angry, sometimes prone to violence. now all these accounts from people who say they saw him in gay nightclubs in orlando in the months leading up to the shooting. the fbi is looking into those and at this point doesn't know quite what to make of them, jose. >> pete williams, thank you very much. meantime, we're less than 30 minutes from a press conference at orlando regional medical center. sarah dallof is there. sarah, good morning. what are we expecting at this press conference? >> reporter: good morning, jose. this hospital where the press conference is being held is where the majority of the victims, including the most gravely wounded, were taken after the shooting, both because it is so close to the nightclub just blocks away and also because it is a level one trauma center. in this press conference we are expecting to hear from eight surgeons who jumped into action to save lives as well as two of the patients that they treated.

now, among the 50-plus wounded was tony morero. he is recounting the horror of what he saw in that nightclub. he couldn't get out, so he made the decision to lay down and to pretend to be dead. >> more and more people, i saw how he was blowing up people's heads. so the only way that i could -- had a chance to survive was making it seem like i didn't have a head. so i picked up the sofa that was over there and i put my head in it, but apparently he saw that i didn't have much blood so he still shot me in the back. >> reporter: marrero was shot four times, three times in the back and once in the leg. today some good news from the hospital. they say he and all of the other patients, including those still in critical condition, are

showing signs of improvement and are considered stable right now, jose, the hospital says the prognosis for all right now is good. back to you. >> sarah, just the ruthless nature of this killer and these stories that are emerging, to think that he was in there for three hours and they were in there for three hours with him is just horrible. >> reporter: yeah, that's exactly right, jose. three hours of terror in which we're learning the s.w.a.t. team worked to rescue whoever they could reach. and people frantically texted their loved ones from inside that club. that's something that we're hearing from the family members, that these victims' last messages were to reach out to their loved ones and tell them what they felt about them and tell them good-bye and how much they loved them. >> sarah, thank you very much. we will, of course, bring that press conference to you live when it begins right here on

msnbc. but first, a tragedy here in orlando is taking center stage in the presidential race. the two presumed front-runners offer their contrasting plans for fighting terror here at home. meantime, a powerful scene here in orlando last night as thousands gathered to remember the 49 victims killed in sunday's pulse nightclub attack. >> orlando is such a tight-knit community. orlando has been attacked. but as an lgbt community, we are so close and such one big family. and when you attack one of us, you attack all of us. with bking.com's range of properties, bel and key n wing it all the way to jordan and chelsea's wedding. rumble! road trip. there she is. uh oh, oh, oh, oh, what? so here is our road trip itinerary. what's this? a bunch different places... nah, bro. we gotta go off-script. rip to shreds every motel, cabin and teepee, between here and the wedding.

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we are waiting to hear from

house speaker paul ryan at his weekly press conference. one of his predecessors, newt gingrich, raising eyebrows for saying congress needs to bring back the house an american activities committee. he said it would rout out americans who plan terror attacks inside the u.s. >> in the late 1930s, president franklin roosevelt was faced with nazi penetration in the united states. we originally created the house on american activities committee to go after nazis. we passed several laws in 1938 and 1939 to go after nazis and we made it illegal to help the nazis. we're going to presently have to take similar steps here. >> mark murray is in washington, d.c. mark, good morning. what are the chances of something like this actually happening? >> you know, jose, i don't know about the chances of it happening, but i will say the fact that we're even having this conversation shows you that this isn't your normal type of democrat versus republican presidential election, liberal

versus conservative, blue versus red. this really goes at the heart of what it really -- what kind of country the united states is and what it means to be an american. of course newt gingrich, a former historian, was talking about moments in american history where we've had these types of debates before, the 1930s, certainly the 1940s and 1950s after world war ii and the showdown with the soviet union over capitalism versus communism. but it does seem to be that we have actually entered this, and of course the biggest driver was donald trump's speech yesterday where he was talking about the ability to close off immigration with nations that actually have proven terrorism against the united states, reiterating once again his temporary muslim ban. and so this entire debate, what newt gingrich was talking about in that clip, what donald trump was mentioning in his speech yesterday really goes at the heart of what it actually means to be an american and what the united states is. >> you know, mark, i'm just

wondering there's a lot of semantics here involved, but is it legal -- is it currently legal to join a terrorist organization? i don't think it's something that's accepted. >> you know, jose, no. and again, we've seen our law enforcement certainly rout out any type of planned activities, any type of involvement in terrorism. you're right, these laws are already on the books. but what we've seen is just this kind of reaction to the unfortunate and tragic events that happened in orlando. of course there is, as we've been getting more information, there is now kind of a legitimate question on was this more motivated by terrorism, by an allegiance to isis, or was there something more involved. we're going to find out more and more information as the reporting and days go on. >> mark murray in washington, d.c., thank you very much, appreciate your time. we are just beginning to learn about the stories of those lost in the tragedy. each one meant the world to those who loved them.

their loss is unimaginable. that includes 34-year-old edward sotomayor. one friend describes him as, quote, one of the greatest guys i've ever met. joining me now is edward's cousin, david sotomayor. david, thanks for being with me. >> thanks for having me. >> you describe edward as an angel, one of your best friends. tell me a little bit about just how special he was. >> he was amazing. he was amazing. for those that didn't get to meet him. the tens of thousands of people that did get to meet him can agree that he was a warm-hearted spirit. he's one of those who whenever you are down, he would bring you up. those memories of my cousin is what gets me out of bed to come out and make sure i send that message out to my community and let them know to stay strong, stay positive and just continue forward. you can't let this bring us down. >> tell me a little bit about those memories that you have and that you will always treasure.

tell me some of those moments that you will forever treasure. >> well, one of the things is that he was -- i was able to meet him and he began to work and we would do cruises together but he wasn't involved too much with the drag scene but he knew everything about us. he was just always there. he would wear his silly top hat and just always be there, knew what we needed and just always supported the lgbt community and all of us and just made sure that we were good. that's why i'm saying like honestly i'm here to just tell you that his spirit would want us to stay strong. it's been too long, too many decades that we've been bullied, we've been pushed down, kicked to the curb but we still rise. we rise from the ashes like a phoenix and we will continue to stand tall in pride. and this is not going to take away our pride.

>> edward loved to travel the world. friends say he was keenly aware of the dangers facing gay travelers but he never let fear stop his adventures. i know you talked a little bit about that, but talk to me about that sense of fearlessness in a sometimes fearful world. >> he -- he would just -- he was always there. he just made sure that we were taken care of and he always wanted to make sure that we were strong and stood strong and be that positive role model that we were. i'm telling you, i just wish he was still around because he had so much more to give and so much to offer and so many people needed to meet this person. i've been talking to so many people that i would have not even imagined have met him and told me so many great stories about him that it's just -- it's so overwhelming and i'm just -- i'm just sad. just sad. >> david, i've spoken to so many people here that lost loved ones

and it's just -- how do you process this? how do you go forward when -- how do you process this, you know? >> well, i think i haven't had a moment to actually really process it. unfortunately i woke up and found out through social media, through my fans, and since then i've just been making sure that i go out there and make a voice and let people know that we need to stand together and stand strong. when i fly out tomorrow to orlando i'll have some time to process it all, but as of right now i just need to know that he would want me to be strong and be out there and spreading the word to everybody that we are together. you have a family. and we are strong. we go through so many other things and we will get through this and we will make this work. >> a perfect way of saying it, david, thank you very much. i want to underline what you just said. thank you for your time. we'll be right back. >> thank you.

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we're awaiting a press conference from survivors of the pulse shooting and the trauma doctors who treated them. that is the scene right there at the hospital. we're going to bring that to you live as soon as it happens. the aftermath of the nightclub shooting is creating a toxic political environment. both presidential candidates laying out sharply different plans to defeat islamic extremism. republican donald trump going directly after hillary clinton, saying she's trying to enable terrorists. >> her plan is to disarm law-abiding americans, abolishing the second amendment, and leaving only the bad guys and terrorists with guns. she wants to take away americans' guns and then admit the very people who want to slaughter us. >> for her part, clinton did not

mention trump during her speech, something we are told was by design. later today she has a private one-on-one with bernie sanders as the primary season officially comes to an end. more or both of those things in a moment. this morning trump is catching some flak for something he said monday when he appeared to connect president obama to the orlando attack. >> we're led by a man that are either is, is not tough, not smart, or he's got something else in mind. and the something else in mind, you know, people can't believe it. people cannot -- they cannot believe that president obama is acting the way he acts and can't even mention the words "radical islamic terrorism." there's something going on. it's inconceivable. there's something going on. >> our political team has this all covered for us this morning. nbc's katy tur is following the trump campaign. katy, good morning. is he really suggesting that

president obama had something to do with this attack or with shielding terrorists? something is going on. what is he implying here? >> that seems to be what he is implying and he said that multiple times yesterday in interviews in the morning and also repeated it again on fox news later last night and has said that multiple times in the past as well, suggesting that president obama is sympathizing with terrorists, that he can't stop terror because he doesn't want to. this is not the first time, jose, that we've heard him bring conspiracy theories into his platform, into his campaign rallies, his campaign speeches. remember, he talked about ted cruz's dad, rafael cruz, maybe being linked to the assassination of president kennedy. he talked about general pershing dipping bullets in pig's blood and killing terrorists. that's long been associated with an e-mail chain conspiracy theory. and on president obama himself he's talked about his birtherism

over and over again. not necessarily this campaign, certainly before saying he was born in kenya and suggesting that he's a muslim, not a christian. so the subject of his attacks politically have certainly seemed to focus on president obama a number of times in the past. this is just the latest iteration. >> i don't even know what to say on that one, but i want to play for you a bit of what trump said on immigration in that speech. let's listen to that. >> when i'm elected, i will suspend immigration from areas of the world where there is a proven history of terrorism against the united states, europe or our allies. until we fully understand how to end these threats. >> can a president of the united states do that, katy? >> well, yes, he can. the federal law does give him fairly unilateral authority to restrict immigration but notice

he used very specific language in his speech yesterday. that language was pulled directly out of the statute giving him that authority, saying that he has the authority to suspend the entry of all aliens or class of aliens in general when they would be, quote, detrimental to the u.s. he used that word, that language very specifically. but in modern history, it's more policy goals and not necessarily people based on religion or race that have been banned from coming into this country. so certainly he would face extreme pushback on that not only on capitol hill, but especially in the courts, jose. >> katy tur, thank you very much. kristen welker is on capitol hill this morning. kristen, let's start with the differences between trump and clinton on fighting isis specifically. >> reporter: well, jose, good morning. one of the key differences is that donald trump reiterated his call for the muslim ban. secretary clinton in her speech on foreign policy yesterday said it is critical to work with the

muslim community here and abroad to fight terrorism. let me read you some of her key policy proposals that she mapped out yesterday in that speech, jose. she called for ramping up air attacks. she called for more resources for intelligence sharing, pressuring middle east allies to get more engaged in the fight against isis. she also called for stemming the flow of jihadists as well as restricting gun sales. of course that is a key difference with donald trump. and she called for partnering with the private sector as well as muslims to try to address this ongoing and pressing problem. now, jose, according to our latest nbc news/"wall street journal" poll when americans were asked about who would be the better commander in chief, take a look at the numbers. hillary clinton gets 43%. donald trump gets 33%. now, of course it is only june. it is still early. but that is the view right now amongst voters, jose. >> okay, kristen, let's hold on that for a minute because paul ryan is on his weekly press conference and they're speaking

about this issue. let's take a listen to that. >> a refugee bill because we want to make sure that we have a security test so that we know who is coming into this country and that we have properly vetted that person based upon the security threat that they may or may not pose to this country, and that is what we have passed. also out of the house that bill is sitting over in the senate being filibustered by the democrats. so we believe that we should have a robust security test to make sure that law enforcement gets the tools they need so that we actually do control who comes and goes in this country. as far as the muslim community you mentioned, i think there's a really important distinction that every american needs to keep in mind. this is a war with radical islam. it's not a war with islam. muslims are our partners. the vast, vast majority of muslims in this country and around the world are moderate, they're peaceful, they're tolerant. and so they're among our best

allies, among our best resources in this fight against radical islamic terrorism. so i think it's very important that we hone that distinction, we honor that distinction. let's remember we're all in this together. you know, we're not lgbt americans, republican americans, democrat americans, muslim americans, we're americans. and as americans, we need to up our game to deal with and confront this real threat. we don't think the administration has done a good enough job confronting this threat. we think more needs to be done. that's one of the reasons why we put out a 67-point plan last thursday to deal with the terrorist deal, to deal with our national security, to deal with homegrown jihad, to deal with homegrown terrorists, to deal with all of these issues, including immigration, foreign policy and the rest, and that is what we want to offer the country, a better way to fix these problems and prevent this from getting out of control. >> aside from vetting which you want to perfect so people don't

come in, should there be an actual ban regardless of religion immigrants from countries that have terrorist ties or have terrorist ideology. >> again, we've addressed part of this issue with the visa waiver. we thought there was a problem where you had people from different countries with a visa waiver where they could come without even a visa. we passed a law addressing that. we believe ultimately that we ought to have the tools where we have a security test. not a religious test, a security test. we think that's the preferred route to go. >> speaker ryan, you said that donald trump's call for a ban on muslims coming into the country was not conservatism. that rhetoric can actually help the recruiting of isis. was donald trump wrong to double down on his -- >> i stand by my remarks. i bet you do too as well. i do not think a muslim ban is in our country's interest. i do not think it is reflective of our principles, not just as a party but as a country. i think the smarter way to go in

all respects is to have a security test, not a religious test. >> constitutionally do you think donald trump if he were president would enact a ban on -- >> that's a question about immigration law and you can go into the 1952 immigration naturalization act to determine whether or not the president has that kind of discretion or not. >> last question. >> appropriations, how does the orlando attack affect the appropriations bill and when do you expect to -- >> our conferees are making very good progress on zika. that conference is making good progress. we're proceeding with appropriations. we've got defense under way. we delayed the homeland security markup just in case there was something that needed to be addressed in that appropriations bill because of this terrorist attack. thank you very much. >> paul ryan in his weekly press conference touching on some of the issues. far different tone and certainly semantics than we've been

hearing on the campaign trail by people like donald trump. we'll take a short break and be right back. we're expecting a press conference to start in the area hospital that has treated some of the survivors of this massacre. we're expecting to hear from some of them as well as some of the doctors that really did extraordinary work for hours and hours and hours. that press conference about to start. you will see it live right here on msnbc. we'll be right back. we got another one. i have an orc-o-gram for an "owen." that's me. ♪ you should hire stacy drew. ♪ ♪ she wants to change the world with you. ♪ ♪ she can program jet engines to talk and such. ♪ ♪ her biggest weakness is she cares too much. ♪ thank you. my friend really wts a job at ge. mine too. i'm aise elf from a far off shire. ♪ ♪ and sanjay patel is who you should hire.♪ thank you. seriously though, stacy went to a great school and she's really loyal. you should give her a shot. sanjay's a team player and uh... i'm terhe is.at golf. but i'd like to keep being terrible at golf for as long as i c. new patented ensure enlive has hmb

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come in overnight with this shooter was that we've had several young men now come forward and say that they had seen him at this pulse nightclub several times before. one saying that this man had frequented pulse nightclub for years. was seen drinking, would go over to the corner and drink by himself. other times he would get so drunk he was loud and bling rent. that's what ty smith told the "orlando sentinel." so the fbi's investigating what relationship he had with this club and whether he had been scouting it out or whether in fact he was a patron, which is what these young men are suggesting, and something may have set him off. there was a turning point that made him think of this club as a target. another young man who spoke with msnbc's chris hayes also says that this shooter was on gay dating sites like grinder and other gay hook-up sites and had reached out to some of these men on those sites. the man we spoke with said the

messages were creepy so he blocked him but that certainly adds a new twist to the case. was this a man who was closeted, who was gay and is acting out in this nightclub shooting. so that's all being investigated by the fbi. a key piece of evidence that the fbi does have to help them now is a cell phone that has been recovered. we're told from our law enforcement sources that in their possession now is a samsung cell phone that did belong to the shooter and they have had no problem accessing that phone. you may remember in san bernardino, in that case they did recover the shooter's iphone but it was encrypted, it had a password, they couldn't get into it for quite some time. that's not the case here. they are able to access that man's samsung cell phone and we all know this is a treasure trove of information when it comes to things like tracking his location, tracking his communications, google searches, for example. so they'll be able to glean a lot of information off that samsung phone if in fact it hasn't been wiped clean. jose. >> blake, do we know where that

samsung phone was found? was it found at the scene? was it found at other places, at his home, et cetera, do we know that? >> we don't. we do know that the fbi has been at his home, which is about an hour and a half away. he also had his car here at the nightclub. so we don't know where that phone was found, but they do have it which is important and it's among several pieces of electronic evidence we're told that they have, jose. >> blake mccoy, thank you very much. let's go right to the hospital at the news conference that is starting right now. >> please feel free to share this information with friends, families, the community. you can text orlando to 20222 to donate $10 to ormc level one

trauma center. of course as always the donation will be on your cell phone bill. or you can donate online at give.orlandohealth.com/ormc and monetary donations can be made by credit card at that site. for additional questions or inquiries regarding donations, please e-mail -- >> we're having, as you can hear, there's some audio difficulties. we want to bring this to you. we fix it. let's continue. >> so this is the latest update literally as of a few moments ago. of the original 44 patients that were brought to orlando regional medical center, the level one trauma center here in central florida, we still have 27 patients that are admitted in the hospital. of these, six patients are in

the intensive care unit and 21 patients are on the floor. of these patients, we have six patients remaining in the hospital that are critically ill. we have five that are in guarded condition. and we have 16 patients that we would consider to be stable. no patients have succumbed to their injuries since the initial nine patients who came to us at the time of the shooting. all of the patients since arrival to the hospital are still with us. they are steadily improving. there were a number of victims that left the scene of the nightclub. they were trying to get away from the shooting. several of those patients have subsequently presented to our hospitals. yesterday we saw two patients

that presented to one of our sister hospitals and there was another patient that presented, i understand, this morning to another of our sister hospitals, health central hospital. we anticipate we may see other victims come into the hospitals over the next few days as -- >> okay. we are losing the -- we've just lost the live shot. we're still trying to re-establish. we have different cameras in the hospital, but there's some transmission signals. let's see if we can -- can we go back to that or should we just continue to monitor? so we don't have that yet. while we do, and we're going to go back and forth as soon as we do. puerto rico has been hit so hard by the tragedy here in orlando. many of those lost were originally were from the island. joining me is the executive

director of the lgbt advocacy group. we're going back to that news conference as soon as we can, but talk to me about just what this means and so many of the people that were lost were from puerto rico. >> it is an unspeakable tragedy for the puerto rican people. it could have been me, you know. i'm gay, i'm puerto rican. i've been to this club. >> you've been to this club? >> i've been here like two years ago. i could have been there, you know. and when i started seeing the names that sounded so familiar to me. then i started to see the faces and i knew some of them. it just hit me hard, you know. i've had rifles like the one that was used on sunday pointed at me and they told me we're going to kill you -- >> we're on the air. and the reason is because you have been threatened because you

are gay and it is something that is very real to you. this is not a discussion that you see on paper. this is something that you and so many live with on a daily basis. how do you process something like this? >> well, we process it with love and we process it with an outpouring of solidarity and empathy that we are receiving from every corner of the world. we see it when we stand strong together. we will not live in fear, jose. we will not live in fear. we have lived too many years with hatred, with intolerance, with attacks against our humanity, with discrimination, and we have always been resilient. so once again we will have to dig very deep inside ourselves and dig very deep inside our collective humanity to stand up and say we are not going to let us -- we are not going to let this bring us down. >> we were talking, you and i, yesterday about, again, how it's not something that you read

about but that you live and it's part of who you are. unfortunately there has to be every single day, every single step you take, there is the possibility of something happening because of who you are. you have so many friends. how do you process it? >> i go back to my family. i go back to -- i go back to the love that i've always received from my family and my puerto rican people. and i understand that we are -- we are all human beings. no matter what they tell about you, no matter how hard they want to bring you down -- >> the insults that people try to throw at you. >> no matter what they say about you, when you know who you are and when you have the love and support of your family, and when you think inside of that

humanity that we all share, then we can overcome this and process this. but this doesn't happen in a vacuum, you know. there are some political leaders who want to divide us and who want to -- to make this country what it is not. we are not going to let the trumps of the life make us something that we are not. we are not a place of hate. we are not a place of intolerance. we don't hate latinos, we don't hate gay people, we don't hate women, we don't hate immigrants. the united states and puerto rico are places of love. >> thank you, pedro, for being with me. we've re-established communication with the hospital. thank you. let's go back to the hospital. >> they are steadily improving. there were a number of -- >> we're going to take a short break and be right back. stay with us. the right things working together

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i just want to tell you what's going on. in the hospital they're having this news conference. we just have a very weak signal and we're working to re-establish it. what we're doing is monitoring it and we'll bring it to you. i just want you to know that we're working on it and that it's happening. there you see it, it's just that there's not enough audio to put it on the air. we're going to continue working on it and we'll be monitoring it for you. meanwhile, we're expecting to hear from president obama in about an hour. right now he is meeting with his national security team at the treasury department. the president expected to offer more remarks on the terror attack here in orlando. i'm joined now by msnbc terrorism analyst.

you closely follow what goes on among these terror groups online. have we learned anything about a possible connection to this guy? >> we know an isis-affiliated media unit claimed omar mateen was an islamic state soldier in america. there's, of course, no indication whether he trained with isis or left the united states to train with them in the ranks there or had been featured in any of their videos. also isis has not released any official statements claiming credit for this attack, although that's still also early to determine. they might at a later time just to take advantage of the propaganda value. >> you know, fbi director james comey says investigators believe mateen was radicalized precisely through the internet. how challenging is it for governments to block these websites and these chat rooms? >> i don't think it's impossible to block these websites and chat rooms. the problem is you block one and ten more pop up.

it's almost like a whack-a-mole game. maybe it's not a great idea to shut them all down and more conduct surveillance on those channels paubecause simply if y shut them down, we won't get any more intelligence from these open source environments. >> laith, you just talked about maybe isis and other groups take credit for things even though they may not have been directly involved in planning it, possibly, but has the post-orlando attack been something that you've seen pop up on terrorist sites? >> absolutely. the discussion has been -- there has been a lot of discussion actually on top isis web forums and websites and chat rooms. discussions have run with hundreds plus comments since the last -- in the last 48 hours. so yeah, they have been -- there's been a lot of jubilation on those channels and they're psyched that they believe that isis caused, you know, the worst

mass shooting in the united states history. so they're pretty jubilant about it. >> jubilant over death. thank you very much. >> thanks, jose. >> much more ahead right here on msnbc. some new information from the hospital in orlando when we come back. trolling for a gig with brndrone? can't blame you. it's a drone you control with your brain, which controls your thumbs, which control this joystick. no, i'm actually over at the ge booth. we're creating the operating system for industry. it's called predix. it's gonna cnge the way the world works.

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milk it. e*trade is all about seizing opportunity. sign up at etrade.com and get up to x hundd dollars. >> we take you back to the hospital. let's listen in. >> we all took care of these patients, but i want dr. bondoni to describe because she was there before i got there initially. >> katherine bondani. so like gary said, we got essentially a call saying that we had some gunshot wounds coming in. we didn't know exactly how many

we were going to get. dr. stone and i, the senior resident, went to the trauma bay to get ready for the patients to start coming in. and our first patient was relatively stable, awake and talking to us. we thought maybe they're all going to be like this and that would be great. and then we quickly got two or three more that were very critical in nature. several of our other senior residents came into the trauma bay as well as dr. parish to start helping us triage the patients. the trauma team, dr. smith and his awesome residents came in and started helping us kind of figure out who was sick, who was the sickest and what we needed to do. we quickly got about five patients and that was a lot for us. we thought maybe that was going to be it and then they started lining up in the hallway. they weren't being brought in by ambulances. there was no paramedics coming in and giving us a report and dropping them off, they were

being dropped off in truckloads and in ambulance loads where our amazing nurses and techs were putting them on stretchers and rolling them in to us and telling us that another patient is here, another patient is here, another patient is here. quickly our trauma bay became full to capacity and we had to move people out. so dr. smith and dr. parish and i started using the residents and quickly figuring out who was the sickest and who could move out of the trauma bay to make room for somebody else so that we could triage and treat everybo everybody. in a matter of 30 minutes, we had multiple surgeons coming in the door to help us out. i saw dozens of nurses who i knew were not on that night who showed up. i saw techs coming from everywhere. we had x-ray in there, we had blood in there, we had everybody in there trying to figure out who was sick and who wasn't.

we just started one by one moving through and trying to figure out who needed to go where and just going one by one and figuring them out. and i think that dr. smith was really the kind of team leader who helped us kind of triage and move from patient to patient. >> let me just make a couple of comments. we in our area as in f many metropolitan areas have a very advanced ems system. fortunately they give us advance notice to patients that are coming in, so that helps greatly in preparing our personnel and our resources. the difficulty in this case was that there was really no advance notice at all because of the proximity. now, that was great for the patients, them being close, but it made it very difficult for the medical staff and the nursing staff to take care of these patients because they essentially were showing up without any notification at all. we really didn't know what their injuries were until they were brought into the trauma bay.

we have a fantastic trauma service. we have a very collaborative and wonderful relationship with our trauma surgeons. the trauma surgeons that were here called in backup quickly and they arrived unbelievably fast, so that was really fantastic as an emergency physician. >> dr. smith, do you want to talk about the trauma team? >> sure. >> my name is chadwick smith. i'm the surgical icu director here at orlando health and i was the attending trauma surgeon on call that night. i got a call from the emergency department resident. she called me on my cell phone and that's kind of unusual and said that there's multiple gunshot wounds coming and i went down to the trauma bay and just

as kate said, the patients just started coming. one came, then another came, then another came. and the first patient, as she said, was shot and needed to go to the operating room, but had stable vital signs. the next patient was not as lucky and i quickly realized that i needed to call backup. i called dr. ibriham was the backup surgeon. i called dr. cheatham. once they got there, the flow did not stop. so i began to call my other partners, dr. havrand. dr. levy called me. he was on call for pediatric surgery at arnold palmer hospital and offered to help. i said please come. please come, we need your help. i then got ahold of dr. luby and then started calling the

residents. you know, you can imagine calling someone at 2:30, 3:00 in the morning. when you get a phone call from work, some people don't have their phones on, some people have them in the kitchen. but i think almost every person that i called answered the phone. i said this is not a drill, this is not a joke, we have 20 plus gunshot wounds coming in. i need you here as fast as i can. every time the answer that i got was i'll be right there. after that, after making those phone calls, again quickly they arrived at the emergency department and i was on the phone with the operating room. dr. mukergee -- we usually run about two ors at night but we got in personnel, nurses, crnas, staff from all over the organization quickly to get these patients in the operating

room. i want to say that looking out here today, as crowded as this is, this is about the level of crowdedness that it felt in the emergency department that night. add in people in pain, people worrying about their loved ones, people not knowing where their loved ones are and we're trying to help them all. quickly, we got a couple of patients up to the operating room. again, our first patient, he needed to go to the operating room but he was stable. there were quickly thereafter probably four to five patients that came in that we were unable to save and then there were several that came in that needed operation almost immediately and they got taken up. i believe dr. luby stayed up in the operating room, dr.