Dr. Najma Ahmed was starting to get ready for bed on Sunday, when she got an urgent text from a fellow trauma surgeon at St. Michael’s Hospital.

“Just got 4 GSW,” he wrote, “are you available if need to get a second (operating room) going?”

Ahmed had no idea about the shooting on the Danforth.

But she knew the summons could be serious.

In hospitals, “GSW” stands for gunshot wounds, three letters uttered too often in Toronto’s trauma centres this summer amid recent gun violence.

Soon, Ahmed was in her car, heading down the Bayview extension toward the downtown hospital.

Shortly after that initial text, she’d gotten a call from the chief of critical care, who told her the hospital had called a Code Orange, another ominous medical term — it is reserved for mass casualties and catastrophic events. (It recently entered the city’s vocabulary following the van rampage on Yonge St. that killed 10 people and injured 16 more.)

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In addition to being on call on Sunday, Ahmed was filling in for the head of the hospital’s trauma unit, who had left a few days earlier for Australia.

During the 15-minute drive, Ahmed was on speakerphone with hospital staff, learning about the injuries they were facing, ensuring there was enough blood on hand and clearing space in the intensive care unit (ICU).

But it wasn’t until she was on Shuter St., with the hospital in her sights, that she realized “something terrible had happened.”

“Usually, when I come in at night for a trauma, there’s a couple of ambulances, maybe a police car. This time … I couldn’t count how many ambulances there were. I couldn’t count how many police cars. There were lights and sirens going,” she said. “I knew there were multiple casualties and the nature of the injuries was going to be severe.”

Ahmed was not nervous.

After she graduated from McGill University’s medical school in 1992, she was drawn to trauma medicine because she realized that, with the right training and team, “you could be in a room where a life is being saved.”

At St. Mike’s, where she has worked since 2001, she treats her share of gunshot wounds. She is accustomed to relying on adrenaline and coffee to get her through long nights.

“This is what I do,” she said.

When she arrived at the hospital and changed into her scrubs, one surgery was underway. She immediately prepped a second patient for surgery, and was “very worried” about a third, she said. Two additional gunshot victims who were treated at St. Mike’s did not require surgery.

To protect the privacy of patients, Ahmed said she could not provide further detail on the nature of the injuries. But, in general, she said that, in trauma surgery, particularly in circumstances that involve mass casualties, where patients require immediate surgery, the objective is “damage control.”

“What we’re trying to do is operate, save the patient’s life, stop the bleeding, fix the holes in the bowel so there is not infection and contamination, and get the patient off the operating table, to the ICU, because we know they may be at the limits of their physiological reserve,” she said. “They are going to need further surgeries in the days to come.”

Ahmed didn’t immediately know the circumstances surrounding the gunshot wounds she was treating.

Was this a gang thing? Would there be retaliation? Would there be more patients coming in?

This isn’t unusual. The rush to deliver trauma patients to the operating room means they are sometimes identified only as John or Jane Doe.

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“We treat every patient the same,” she said.

But, as the night wore on, information began to trickle in from nurses, who were monitoring social media and watching the news.

Ahmed soon realized that the nature of this event was unlike anything she’s ever faced; the victims were innocent bystanders, apparently targeted at random by a lone gunman, as they dined in restaurants and on patios on a warm summer night.

Ahmed said she was struck by “the seemingly intentional infliction of as much trauma and injury and loss of life possible.”

“How could this happen here?” she thought. “What are we going to do to make sure it doesn’t happen again.”

A young woman and a girl — Reese Fallon, 18, and Julianna Kozis, 10 — were killed in the mass shooting, and 13 other people were wounded. Victims were also treated at the Hospital for Sick Children, Michael Garron Hospital and Sunnybrook, which continues to treat three patients. Four are still being treated at St. Mike’s. (The fifth patient has been discharged.)

For Ahmed, who is a Muslim, the tragedy hit even closer to home when the gunman, who died near the scene after exchanging gunfire with police, was identified as 29-year-old Faisal Hussain.

“We do hold our breaths,” she said, emphasizing that the vast majority of Muslims “understand that Islam is not a religion of violence and disavows violence in all of its forms.”

“I feel fortunate, owing to circumstance, that I can show that through my actions,” she said.

Toronto police Chief Mark Saunders has said there is “no evidence to support claims” by Daesh (also known by some as ISIS) that it was responsible for the mass shooting and Federal Public Safety Minister Ralph Goodale has told reporters there was “no national security connection between (Hussain) and any other national security issue.” Hussain’s family said in a statement he suffered from “several mental health challenges.”

By the time Ahmed and her team wrapped up the last surgery at St. Mike’s, it was 3 a.m.

She went home for a few hours’ sleep before returning to the hospital on Monday morning, where she has spent most of the last three days. She said she feels fortunate that all of the victims who were treated at St. Mike’s survived, and those who remain at the hospital appear to be “out of the woods.

Ahmed is mourning the loss of “two beautiful young lives.”

“Trauma is a disease of young people,” she said.

“We need to think about building a safer society. That means bike helmets and seatbelt laws and gun-safety legislation, because this, in many ways, was potentially preventable.

“That could be the most tragic thing.”