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Reno obstetrician Dr. Bruce Farringer has always felt safe at work.

In his 33-year career, he's practiced at hospitals across the country, including some in violent neighborhoods in big cities.

But he has always felt safe.

"You risk your life driving to work. You risk your life parking your car; walking into the building," Farringer said. "But as soon as you're inside, that's where you're safe. My safest places, all my life, have been medical places."

Farringer repeats "I feel safe" — even with tears in his eyes — almost as a mantra as he tries to come to grips with the massacre that happened just one floor above him on Tuesday at the Renown Regional Medical Center campus while he was in an exam room with a patient.

At 2:05 p.m., Alan Frazier walked into the medical building at 1500 E. Second St. carrying a pistol-grip 12-gauge shotgun. He took an elevator to the third floor, walked through the reception area at Urology Nevada into the back office and opened fire.

Frazier, who blamed a vasectomy he'd had in 2010 for a painful condition that plagued him for three years, shot and killed Dr. Garo Gholdoian. He critically injured Dr. Christine Lajeunesse and seriously injured 20-year-old Shawntae Spears, who was with a family member at the doctor's office.

He then shot and killed himself.

Doctors and nurses in Northern Nevada have spent the past two years patching together victims of mass violence here — from shootings at Sparks Middle School and a Carson City pancake house to a horrific crash at the Reno Air Races. Now the medical community is trying to heal from violence on their home turf that took the life of a friend and forever changed the life of another.

"The first thing that goes through your head is, it can't happen here in Reno," said Susan Drossulis, a hospice nurse who worked for 14 years in the oncology ward at Renown. "We just had a school shooting. We don't do that here. My first thought was shock and disbelief."

Through the initial shock and through the sadness that came with confirmation of what had happened, they continued to care for their patients.

'They were crying'

On Tuesday afternoon, Farringer had begun a procedure that turned out to be more complicated than anticipated. He had just stopped to regroup when a nurse knocked on the door to tell him the police had ordered them to "get the hell out."

"That was unusual," Farringer said with a touch of dry humor that helped him through the next several hours. "Usually it's some doctor that wants to talk to you."

Farringer waited in the hallway for his patient to dress and then, at the direction of the police, they walked together to the skywalk that links his office building to a parking garage. There, Farringer and dozens of other doctors and patients remained suspended above the street where a veritable war zone unfolded beneath them.

"We were hoping it was a drill, or maybe a crazy man with a gun who was waving it around," Farringer said. "That was the original hope. But the sheer number of cop cars told me it was something else.

"Then, I saw my friends from urology. They were crying. The sight of them crying made me think this was more than just a crazy man waving a gun around."

Shootings at doctors' offices are relatively rare. In the past 15 years, nearly 9,600 people across the country were killed in workplace homicides, according to the Bureau of Labor Statistics. Only 15 were doctors.

Still, physicians are accustomed to dealing with disgruntled patients — even if the majority of the people they take care of leave happy.

Drossulis, who teaches nursing at UNR, said personal safety is stressed during course work.

"People, they're not in their best situation when they're not feeling good or you have to give them bad news," she said. "They are in a very vulnerable spot, and if they don't have good coping mechanisms, they can lash out."

"We all know it could have been any one of us. At any time," Farringer said. "Statistically, there have to be some disgruntled patients, no matter how many are happy with you. But I've never felt threatened in any hospital or office. Not in 33 years."

Getting back to work

Farringer didn't know for several hours that his friend had been killed in the shooting, and that another friend was clinging to life in the operating room. He had gone to visit a patient in postpartum when he overheard someone say, "Dr. G. didn't make it."

"So then I knew a friend of mine, an office neighbor, had been massacred right above me as I had been working," he said.

Farringer gathered outside the operating room doors with a handful of other doctors. They cried and embraced.

The next morning they returned to work.

"It was a very somber mood," Farringer said. "Everywhere I went, it was like the world was in black and white."

Then, they got back to work.

When the 911 call came in reporting an active shooter, police from across the region flooded Renown's campus, shutting down streets, closing hospital exits and rushing into the office building to do a floor-by-floor search for the gunman.

Police evacuated the offices as they went, funneling everyone into the skywalk so they could identify witnesses necessary for the subsequent investigation.

Doctors' reactions to the police response was mixed, Farringer said.

"Some doctors thought it was overkill to evacuate the whole building," he said. "They thought they should keep working as normal on floors 1, 2 and 4, even though there was a massacre on floor 3. On the other end of the spectrum, some doctors were dumbfounded that the entire neighborhood wasn't in lockdown."

Drossulis expects little change in the way she or her colleagues conduct business in the wake of the shooting.

"Maybe we'll be a little more aware. Maybe we'll be a little more attentive to the person expressing a lot of anger," she said. "But we'll just go to work every day and do the right thing by our patients. That always comes first."

Farringer noted one change at his office. The door between the reception area and the exam rooms at his practice — the one Frazier walked through just upstairs at Urology Nevada — had never been locked before.

"We locked it this morning," he said. "But that's the only thing that will change. I've already determined I can't change society's attitudes."

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