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Encouraged toward service
A school shooting helps confirm a medical resident’s place in her chosen profession
by Melanie Zuercher
Erica Coulter ’00 grew up in Hope Mennonite Church in Wichita, the daughter of Yvonne (Unruh) Coulter ’71 and the late Craig Coulter. She is now a second-year resident in the Family Practice Residency Program at Lancaster (Pa.) General Hospital (LGH).
In the blurb on the program’s Web page for second-year residents, Erica says, “I was born and raised in Wichita, home of tornadoes, wheat fields and Pizza Hut. I went to Bethel College for undergrad where I majored in biology and met some amazing friends. After a brief stint in Boulder, Colo., I went to [the University of Kansas] for my medical training and also developed a deep devotion for KU basketball. My medical interests include the full spectrum of family care, preventive care and international medicine. I also love athletics, adventure (except when it comes to cuisine), historical fiction, cereal, international travel and winning at card games.”
Erica had just begun her second year of residency when, on Oct. 2, 2006, she experienced a Code Green at the hospital – “situation with mass casualties.” The situation turned out to be a shooting at an Amish school in southern Lancaster County.
Context: What made you decide on Bethel and how did your time there contribute to your decision to go to medical school?
Erica Coulter: I don’t remember making a specific decision [about where to go to college]. All the women on my mother’s side of the family went to Bethel College. And I grew up going to Camp Mennoscah, hearing great things about Bethel from my counselors and the staff there. Bethel College was the best decision for me. I needed the individual attention and I wanted teachers who knew me and my strengths and weaknesses. I knew that was the kind of environment I needed, and where I would thrive.
When I graduated, I wasn’t sure I wanted to go to medical school. I applied and didn’t get in. I spent a year in Mennonite Voluntary Service (MVS) in Boulder as a medical assistant in a clinic for low-income clients. After that, I was much more ready to go to medical school.
I think that the environment at Bethel encouraged me as much toward voluntary service as toward medical school. I had a desire to pick a career that was service-oriented, specifically toward international service. MVS cemented my desire to go into medicine and specifically family medicine, which emphasizes forming relationships and seems more applicable to doing service overseas.
Context: How did you pick a program in Lancaster?
EC: After I graduated, I was at the point where I could go anywhere [for residency]. I applied to programs in all four corners of the United States. [I heard about the residency program at Lancaster General Hospital because] Rachel Eash-Scott was there, and her mom, Esther [Eash], talked to my mom at church. I looked at the program online, and I liked that it was a single residency, only in family medicine, and that it offered the full spectrum of family care – it was strong in all that family doctors do. And it’s a large program, with 13 residents [per year].
Context: What was your experience on Oct. 2?
EC: I was part of the inpatient team and we were in a meeting when they called a Code Green throughout the hospital intercom system. I didn’t know what that was – I had never heard of a Code Green. I found out it meant “mass casualties,” so at first I wondered if it was a drill. Then I thought it might be a terrorist attack, since we are so close to Philadelphia and Washington, D.C.
Finally, we heard “school shooting,” and I was thinking something like Columbine, at an inner-city school. We didn’t know how many we would get – we heard there were 13 injuries and our emergency department was prepared to accept 10 injuries.
Four girls eventually came into LGH. One was dead on arrival. Two of the girls who were still alive had sustained gunshot wounds to the head. The other had been shot in the shoulder and leg. They brought one into the trauma bay where I was stationed and I began to take off her shoes and socks. It was only then that I looked at her clothing and saw her braids and realized she was Amish.
She had two bullet wounds in her head, an entry wound and an exit wound. Later, two of the girls were taken to Philadelphia. I guessed that the girl I worked with was only 8 or 9 years old, but I never knew her name, so I don’t know if she lived or died.
The whole situation felt like a dream. Later, some of us residents hung out in the lounge and saw the news on TV and tried to put it all together.
Context: What was it like in the days and weeks afterward? What did you learn?
EC: It was good to see how everyone [at the hospital] could collaborate and work together to do their jobs in a time of extreme stress. It was also a reminder that I have to be prepared all the time. It’s what my profession dictates. The profession of being a physician doesn’t confine itself to 8 to 5 and within the walls of a hospital or clinic. You’re looked on to be the problem solver wherever you go.
I went to church the Sunday after this happened, and one of the first things the pastor said to the congregation was: “Thank God for the Amish, thank God for them! For their witness, for their lack of reactionary violence. I don’t think anyone would have blamed them if they had responded [with anger]. If only we could all respond like they did, without violence and blame and with forgiveness.”
Following the shootings, I remember feeling concerned for the Amish as a community, because I worried they didn’t know how to cope with such a senseless act of violence. I remember a particular incident last year when I witnessed a young Amish child die from complications of a medical illness in the pediatric wing of the hospital. The parents of the child were quietly standing by while the medical staff was bustling around the room, trying to revive the dying child. The parents simply stood back and asked no questions. They showed no visible emotion. They surprised me with their quiet suffering. With a tragedy the magnitude of the Nickel Mines shooting, I feared the Amish community might not have the resources to comprehend or absorb such injustice. But I was so wrong. I was awed and humbled by their Christ-like outreach to the family of the man who killed their daughters.
The fact that the tragedy involved children was more striking to me than that they were Amish. And afterward, I found it awful to see the media descent. Everyone wanted a statement and a photo and a news clip. There was this sudden fascination with the Amish. The story stayed national [and international] much longer than it was a big story locally, probably because we are so much more familiar with the Amish.
I’ve worked in one of LGH’s rural clinics in Quarryville [in southern Lancaster County], where I have taken care of a lot of Amish patients. Most of them pay out of pocket, and we know they will pay all of their bill. It challenges us as doctors to be careful when we order tests or medicines for them, to make sure they’re really necessary. The Amish also challenge us to take care of all we can in the outpatient setting. One of the residents in my program told me of one Amish man who nearly sliced off his entire thumb. Instead of going to the hospital where a specialist would likely be called upon to do the repair, the patient insisted to the family practice resident to “just do what you can” in the clinic.
At the hospital where I work, it’s not uncommon to see an Amish family in the hall and coming right behind them a Latino family with their cell phones. This is one thing I like about Lancaster – it’s a real city, and a diverse city.
Context: How have you found your faith plays into your chosen profession?
EC: Being a physician is a tangible way to demonstrate Christ-like behavior. The communities I hope to serve are the overlooked populations – uninsured, government-insured, self-payers. I chose a career that gives me a service to provide as a demonstration of my faith.
Read Robert Kreider’s ’39 reflections on the Amish school shooting, originating with a convocation he and Dale Schrag ’69 led in fall 2006, in Mennonite Life at www.bethelks.edu/mennonitelife/2006Dec/kreider.php.