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Dr. Mathieu Raux, head of the trauma department, stands in front of the emergency ward of the Pitie-Salpetriere Hospital in Paris on 18 Nov., 2015.

Maya Vidon-White/The Globe and Mail

On Nov. 13, Mathieu Raux, the head of the trauma centre at one of the largest and oldest hospitals in Paris, was driving with his wife on their way to a weekend in Normandy. Then came the call that no doctor ever wants to receive. Terrorist attacks, multiple shootings, scores of gunshot wounds – a world turned upside down.

In a little more than an hour, he was back at Pitié-Salpêtrière Hospital, a sprawling compound dating to the 17th century. One of six Level 1 trauma centres in Paris, it has long experience with penetrating injuries such as gunshot wounds.

In a strange coincidence, earlier on that day, Paris-area hospitals had participated in an exercise that tests their readiness for emergencies. The drill, which takes place every several months, involves a particular scenario.

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The one for that day: a mass shooting at 13 different locations. For four hours, they tested their systems – where to send the ambulances, how to distribute victims.

That night, the plan became a reality. Starting at 10:50 p.m., ambulances began arriving at Pitié-Salpêtrière in convoys of four or five and discharging waves of patients. The most severely injured were taken directly to the trauma centre in the basement, while less urgent cases went to the emergency room. The hospital received 50 wounded. The dozen operating rooms in the trauma centre were busy all night.

"I was very surprised by the fluidity of things," said Dr. Raux, 40. "It's paradoxical to say, but it went better, in this dramatic situation, … than sometimes in regular times." Doctors and nurses returned to the hospital spontaneously. "Everyone wanted to do this right," he said.

Among the 50 victims, most are still in hospital. A few did not make it (Dr. Raux isn't authorized to discuss those cases). For the wounded, there is a long road ahead. "These were weapons of war, not a little knife," Dr. Raux said. "It does huge physical damage, and there is enormous psychological trauma."

Meanwhile, at Saint-Louis Hospital, just around the corner from the site of one of the attacks, the first victim was carried into the emergency ward by Parisians living nearby.

Jean-Paul Fontaine, 50, head of emergency services at the hospital, and his staff worked quickly to determine which victims needed surgery immediately and which could wait. At one point, Dr. Fontaine recalled, he bent over a woman who was not gravely wounded. "I asked her if she wanted me to tell her husband that she was here," he said. "She said, 'No, my husband is dead.' She said it in a very calm voice."

Looking back on that horrific night, that's what sticks in Dr. Fontaine's mind – the silence. There was no hysteria, no wailing. "The image we have of hospitals in wars is from TV, blood everywhere, everyone screaming," he said. "I think they were silent because they were shocked, frightened. Some of them did not know they had bullets inside of them."

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As of last week, of the 27 victims who made it to Saint-Louis, all were still alive, although several were still in critical condition.

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