Another day, another mass shooting in America. And last night’s is close to home.

At 8:30 p.m., our house phone rings. Must be one of our parents or spam (they’re the only ones who call our house line). I look at the caller ID – it says “Michigan State.” Because I’m faculty for MSU’s med school, I’m on the list for their emergency system’s warning calls. I answer, and the computerized voice begins: “There are reports of shots fired on Michigan State’s East Lansing campus…”

I tell Doug. He pulls up the police scanner app on his phone, puts it on speaker, and we listen. It’s real.

Multiple casualties. They’re requesting all available emergency medical support.

We have three children. A subset of their friends are our children. We have friends. A subset of their children are our children. We have friends whose children are friends with our children. Those children are our children. Our sons are in their 20s and we live in the metropolitan Detroit area. You can do the math – this is close to home.

I call the kid down the street, a junior at MSU. He doesn’t answer. Of course not. Kids don’t talk on the phone. I text him: “There’s a shooting on your campus. Are you ok? Call your parents to let them know you’re ok, and then text me back.” Two minutes later I text him what we’ve heard on the scanner about the location of the shooting. And I implore the kid to call his folks and me. Three minutes later I’ve somewhat lost it and text him something to the effect of “Jesus Fucking Christ, call me.” That does the trick. He responds. We talk. He’s safe.

At this point, I’m in my clinical detachment state. Doctors have to have this psychological skill or we wouldn’t be able to do our jobs. Everyone, medical or not, employs this defense mechanism at times.

Youngest son and girlfriend are home with us, middle son in Ann Arbor, eldest in D.C.

Family group chat is going. We try to figure out whose kids, whose siblings, which friends, are in East Lansing. I’m no longer trying to message known East Lansing kids first to have them contact their parents – I’m reaching out to parents directly, even though I know what it will do to them if they hear from me before they hear from their children, because I would want to know if my child were there. Some parents have heard. Some haven’t. At some point, it’s late enough that they all know. Our/our kids’ most direct connections are safe.

Clinically detached.

Listening to the scanner.

Texting in family group chat. Detached, but listening for tone, observing, watching for evidence of any danger sign in psychological state of offspring. Watching, listening to offspring/significant other in my house, observing body language and facial expressions, listening to tones of voice. Watching and listening to my husband, who hasn’t stopped listening to every word on the scanner.

Talking to other parents. Clinically observing tones of voice. Figuring out who needs to hear what words as they process the situation of texting with their children who are locked and barricaded in buildings on campus.

Watching news briefs. Detached.

Listening to the scanner. Clinical.

That scanner, though.

Detached. Clinical. Listening to the radio conversations between dispatch and the rescue response teams. Listening. Observing. Drawing parallels, as I am wont to do, to medicine.

It’s all about communication. It’s all about objective information. It’s all about being methodical. And yet the communication is fragmented – so many moving parts, reports from all over the place. The theoretically objective information is overwhelmed by the subjective tainting of terrified humans. The method takes time, it is not instantaneous.

I am detached, clinical. Observing, considering, interpreting, and synthesizing information, trying to make sense of it.

Sons are scouring internet. Mostly Twitter. Texting in our group chat. D.C. son, who lives in a sea of helicopters, is incensed that the shooter is still at large and that there isn’t chopper support. Engineer son is incensed that all campus security cameras haven’t been used to triangulate and locate the shooter.

But there is helicopter support. It’s not on the scanner channel available to us (much of police communication occurs on encrypted channels inaccessible to the public). There is analysis being done on what has been captured on the cameras.

The scanner channel we’ve got access to covers communication between a central dispatch and rescue response teams. But at this point, there are hundreds of police officers from campus police, city police, state police, police from not only the local county but other surrounding counties as well, the FBI, all on campus, all coordinating to ensure students’ safety, to secure buildings, to question witnesses, and to find the shooter. We are hearing one part of that.

The rescue teams are checking out all of the areas of reported shooting. And Doug is keeping track of all of the reported locations – at least ten buildings on campus if not more. But most of the reports of shooting turn out not to be actual shooting. The dispatcher will report that people heard gunshots at building X, and there will be a response from a team at that building saying they’re there, and nothing is going on, that all is quiet.

But there are 50,000 scared students. A door slamming can sound like a gunshot. If you hear something, you report it. We hear the dispatcher relay a report that someone saw someone throw something into a trash can. An explosive device? A gun? A sandwich wrapper?

There are multiple reports of people with guns. Of course there are. It’s dark. People are looking out of windows. There are tactical units of law enforcement everywhere, carrying guns. Is one of the sightings the shooter?

It’s like practicing medicine.

As a doctor, I have a person in front of me. One whole person. With a lot of parts, a lot of systems. And a family. And friends. And perhaps an imperfect memory of his symptoms. Or an interpretation or a descriptive term that differs from a specific medical term.

Get five people reporting “dizziness” and get five different phenomena being reported. Feeling of room spinning? Feeling that you are spinning? Feeling lightheaded as if you are about to faint? Feeling “off balance”? Feeling a little “fuzzy”? What was tossed into that trash can above?

Did the dizziness start last week? The patient in front of me is adamant that it did. His wife is certain it’s been going on for a month. His daughter never heard him complain about dizziness, but right now she feels like she is going to pass out. Is something serious going on with her right in front of me?

Figuring out what’s going on. Clinical. Observing. Detached enough to stay objective, to see what’s in front of me and find the answers and find the problems, and at the same time looking and listening closely so I can connect and communicate and help.

Diagnosing and assessing and planning. History, family history, social factors, lifestyle, physical exam, laboratory testing, imaging studies. All take time. If a family member only focuses on one, it looks like we’re not doing anything and why is it taking so fucking long to figure out what’s happening? And no one is talking to anyone else! No one knows what’s going on!

But we are talking to one another. It takes time. We’re all caring for multiple people and multiple families and coordinating with multiple departments. Information comes at different times, and one piece may come for one person while we’re looking at a different piece for another person.

The coordination and communication logistics are mind-boggling.

Detached. Clinical. Seeing how the moving parts in East Lansing are analogous to the moving parts in my own profession. Seeing the reactions of those outside of the active team, those who have no control over the situation and who feel that lack of control to their core. Their fear. Their anger.

We hear on the scanner that the shooter has shot himself as officers approached him. We hear that officers are doing CPR on the suspect. A short time later, there is another briefing – confirms that the shooter is dead. And three of the people he shot are dead. And five are in critical condition. There will be more details later. The investigation is ongoing. There is no further physical threat.

It’s one a.m. and I’m exhausted. I’m clinically detached. I hold Doug as I try to fall asleep. You know that little jerk awake that sometimes happens as you’re falling asleep? That happens. But the jerk involves a scream. I’ve never done that before. It wakes Doug up. I apologize.

I have no idea what actually happens with my sleep last night. My exhaustion this morning is overpowering. And whatever tossing and turning I did has pulled a muscle in my neck.

There is more information today. All of the dead and critically injured are students. Two names of the victims have been released. The shooter has been identified – a 43-year-old man with no (as yet known) affiliation with the university.

I’m clinically detached.

Our neighbor kid gets back home this morning. I see his car, knock on his door, and hug him. He knows one of the deceased people.

I’m clinically detached.

A 43-year-old man has killed three people’s children and critically injured five other people’s children.

I’m clinically detached.

Putting ice on my neck makes it worse.

I’m clinically detached.

Another day in America, another mass shooting.

I’m clinically detached.

And if you believe that, I have a bridge to sell you.