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Police Find 42 Guns In Shooter's Hotel Room And Home; University Medical Center Took Most Critical Victims; Trauma Surgeon: Hospital "Was Like A Ware Zone". Aired 11-11:30a ET

Aired October 3, 2017 - 11:00   ET




KATE BOLDUAN, CNN ANCHOR: Hello, everyone. I'm Kate Bolduan. More than 24 hours after the attack, still more questions than answers as to why 22,000 people became the target of a lone gunman in Las Vegas.

The stories of those who survived harrowing. The stories of those who were lost heartbreaking. The story behind their killer, still makes no sense. The shock of Sunday night's massacre is giving way to grief for the 59 people who were killed and the realization of a long, very long, road ahead for the 527 people who were injured.

And also, gratitude for the many heroes and there were many who helped each other make it through. We are going to have much more on that in a moment.

There is one simple question, though, today with an elusive answer, why? That is a challenge facing authorities right now, trying to piece together the gunman's motives. So far, his past offering few clues or red flags. But they are learning much more about him and his arsenal.

CNN's Dan Simon is in Las Vegas. He's following the very latest on this investigation to start us off this hour. Dan, what are you learning?

DAN SIMON, CNN CORRESPONDENT: Well, hi, Kate. At this point no clear signs of motive, apparently no signs of mental illness, no criminal history and his brother says no political ties, no religious ties. Those are the things that you immediately look for.

It appears that the only thing he had a real passion for is high stakes gambling, poker gambling here in Las Vegas. Of course, he had a passion for weapons, 23 guns found in his hotel suite at the Mandalay Bay. Another 19 found at his home in Mesquite.

He apparently purchased the guns legally across many states. This is what one gun store owner in Utah had to say. Take a look.


CHRIS MICHAEL, GUN STORE OWNER: He didn't set off any of my alarms, anything that I felt there was a problem in any way, shape, or form with him. He was a normal everyday guy that walks into my door 50,000 times a day.


SIMON: Well, experts say he apparently took those guns and modified them in some fashion, apparently turning them into military-grade style machine guns. That is one of the things that investigators are going to be looking at.

Of course, they're also going to be looking at surveillance footage at the hotel. How did he get all of those guns up to the room? Of course, Las Vegas probably has more security cameras than any place in the world.

You can't go undetected whether at check-in or at the elevator. Authorities will be looking at all of that surveillance footage to see if they can glean any information -- Kate.

BOLDUAN: Over and over again to be sure. Dan, thank you so much. I really appreciate it.

So, joining me now to discuss all of the latest and what still remains many questions regarding this investigation, Sam Rabadi, a retired ATF special agent, John White, a forensic psychologist, and Jonathan Wackrow, a CNN law enforcement analyst and former Secret Service agent under President Obama. James Gagliano is a CNN law enforcement analyst and retired FBI supervisory special agent.

Gentlemen, it's great to have you here. Thank you so much for being here. Sam, first to you, the arsenal that this guy pulled together that Dan Simon just laid out, 23 guns in his hotel room. There were 19 more in his house in Mesquite. Thousands of rounds of ammo, authorities are saying.

What's your reaction when you hear this and also then that his brother says that he's not -- I think the way he put it was, he's not an avid gun guy at all.

SAM RABADI, FORMER ATF SPECIAL AGENT: Well, with that many firearms in his possession and that much ammunition, I would disagree there. Your typical collectors are the types of folks who would be able to purchase this many long guns and use them for resale and profit. An individual who is not a collector and amassing these many types of firearms is not somebody I would describe as a collector and probably had some other motivations.

BOLDUAN: And Sam, everyone has heard this video, it's a heart wrenching video of the rapid fire coming from the gun, coming from his weapon, the pause then fire once again and everyone has said it sure sounds like automatic fire. No way is that a semiautomatic. I don't want you to broadcast anything, absolutely not, but is it really that easy to convert a semiautomatic to a fully automatic?

RABADI: Unfortunately, it is, Kate. There are a number of ways to do it. There are conversion kits out unfortunately through the internet that an individual can easily obtain, and with some basic machining skills or if you have a buddy who has the skills, they can be readily converted into fully auto, unfortunately.

BOLDUAN: Unfortunately is exactly right. John, let me ask you this. It almost feels like today we're getting further away from getting an answer of why than closer.

[11:05:08] What stands out to you at this moment? Does anything about this shooter? Hold on. To John. Sorry, buddy.

JOHN WHITE, PSYCHOLOGY PROFESSOR: OK. What stands out is control. This man wanted the ultimate control is life and death. He has the power to control that. He's extremely angry. You may not see a lot of diagnosed mental illnesses in his past, but I will bet you a lot of cognitive distortions and thinking errors that have to do with anger, anger retaliation and getting back at people.

I'm really looking forward to a psychological autopsy or some -- even a neuro problem, a neurological problem that may have to do with brain pathology. We need to know the answers to this so that we can try to prevent this in the future, but I would say anger and control. That stands out the most.

BOLDUAN: Jonathan, let me get your perspective. Everyone talks about a profile. I'm starting to believe there doesn't exist a profile anymore. This guy is older than they're supposed to be. His brother -- he lives in a retirement community. His brother says he has money. There's no hate group ties, no political motivation right now. I could go on and on.

JONATHAN WACKROW, CNN LAW ENFORCEMENT ANALYST: I think what we're seeing time and time again with this attack and others, is that there's, you know, the norms don't exist. You know, there's a changing face of terrorism, we see that constantly, a changing face of, you know, people who are engaging in this horrific act. There's no simple answer.

That's a challenge for law enforcement. But the advantage to law enforcement is that there's patterns. There's patterns of preattack behavior and we need to start looking at through an investigative process what were those patterns. Who was this individual talking to beforehand?

In the days that immediately that came before this event who was he, you know, in contact with. What was his activity, talking to on his cell phone, texting? What was the e-mails that he was utilizing? Where was he eating?

There's a clue out there and the investigative process is going to run out and it's going to start building who the -- in reality who this individual is. We hear one narrative he's a nice guy, not a gun guy, not -- he kind of walks his dog or -- into the community.

But the reality is, this individual stockpiled weapons and ammunitions and launched a horrific attack in Las Vegas. There's a delta between what we're seeing and reality was. BOLDUAN: James, Jonathan sitting on something that seems tough for everyone to square right now, I'll include myself in the group, how did no one know something like this was coming or that something was wrong with this guy beforehand?

JAMES GAGLIANO, CNN LAW ENFORCEMENT ANALYST: Kate, I kind of put this in the same context of like Timothy Kaczynski, 10 or 15 years ago, the unobomber, where for 10 or 15 years nobody knew anything about him. He had limited contact with family. I know we've heard from some of the family members contextually.

I don't know how good that is because sometimes family members say things to protect the subject and other times they just don't know. What I did when I got out here was I went to the 32nd floor of the hotel just to kind of get in the mindset and do a little bit of deconstructing what he must have been thinking.

And from his perspective, we are obviously trying to trace this back to motive, to figure out what caused him to snap. What was the trigger event and grievance that caused him to snap?

The way he had it set up and the methodical way that he went about this, it seemed so much like a military operation. It is baffling to me that he had no military training that we know of. He essentially set up on the 32nd floor with automatic weapons and those weapons, their maximum effective range may be 500, 550 yards.

The actual distance between the hotel windows down to where the crowd was, was 500 yards. And then he's also employing plunging fire, which a military tactic where you are shooting rounds up and out and they basically come down like parabolas so that they go even further than that.

In this instance so much chaos. People didn't know where the rounds were coming from so instead of running out of the kill zone many of them might have stumbled and turn around and run back into it.

BOLDUAN: James, we also know that the girlfriend is out of the country. Law enforcement says that she's not thought to be involved, but when she returns, would you have more questions for her?

GAGLIANO: Are you speaking to me, Kate?


GAGLIANO: Yes. Absolutely. I know that initially the sheriff had labeled this person a person of interest. You don't want to immediately assess they're a suspect. This is somebody we want to talk to. Now, further on down the road, could there be evidence gathered or things that would cause this person to come under scrutiny and indictment. Absolutely.

But this is a critical piece, a piece of human intelligence. Just a small analogy, last night as I was on my way coming over here to the set, one of the cab drivers leaned over, knew my background, and said I want to show you some video I took the other night on my phone. [11:10:12] And my first response to him was, why is this not in the hands of the police? So, I married him up with a uniformed police officer. There are more pieces of human intelligence out there. Signal intelligence that we've got to make sure that the police and the sheriff's department get.

BOLDUAN: Another element, a lot of reports, right, Jonathan, some reports he gambled a lot so that, of course, we could talk about a gambling debt. Some reports he was sending a bunch of money overseas. Do you think -- does gambling enter your realm of possibility right now?

WACKROW: Again, it's a clue. It's a clue to his behavior, his mindset. Again, what makes it difficult for law enforcement is filtering out, you know, the signal from the -- all of this noise.

BOLDUAN: Absolutely.

WACKROW: What is reality? Who was this guy, what was his motive? Right now, there's a lot of pressure on law enforcement to come up with that motive. You know, for the victims, right.


WACKROW: It's part of the healing process, but law enforcement has to let the investigative process play out. We can't outrun their headlights.

BOLDUAN: It's always slower than people --

WACKROW: Exactly but in this instance it has to take its time.

BOLDUAN: Can I get a real quick reality check from you, Sam, 23 weapons in the hotel room. We don't know how many he used or ammo he went through but how much higher of a death toll could we have been looking at, looking at converted semiautomatics to fully automatics?

RABADI: Well, certainly with the ammunition that some of the reports that are out there that he had with him in the room, certainly with some additional minutes, of him being able to fire on to the crowd he could have done even more horrific damage.

I just want to, if I may, comment on something Jonathan said a little earlier about the indicators. I think that's really critical in this situation because as an ATF agent looking at these folks for a number of years, from armed career criminals to folks who may be part of an anti-government group or hate group, this individual would -- had basically what I would describe as no indicators.

Nothing in his background, there was no prohibitive factor that would sort of pique our attention into looking at this individual a little closer. That's kind of the disturbing part about this, just his complete lack of background that would draw the attention of law enforcement.

BOLDUAN: Yes. One of many troubling things play out right now. The investigation continues. Gentlemen, thank you all very much. I really appreciate it.

Coming up for us, we are going to talk about the extraordinary effort to save the hundreds of people who flooded hospitals in the aftermath of the shooting. Many are still there fighting for their lives. A live update from the only level one trauma center in the state coming up next.

Plus, any moment now, President Trump will be landing in Puerto Rico amid the continued recovery efforts there in the aftermath of Hurricane Maria and also the storm of criticism he's faced over the federal relief effort. What's the president going to see while he's on the ground and what will he say to the mayor of San Juan who he criticized so harshly. Stay with us.



BOLDUAN: Fifty nine people killed, more than 527 wounded. Many of them are still in the hospital. Some of the most critically injured were rushed to University Medical Center in Las Vegas the only level one trauma center in the state.

The hospital spokesman, Danita Cohen, is joining me live once again. Donita, thank you so much for coming back on. I appreciate your time.


BOLDUAN: What is the latest update on the victims in your care today?

COHEN: I recently checked on the most critically injured patients and they are still listed in critical condition this morning. As you can imagine recovering from those critical injuries can take some time, but we are hopeful, of course, for their recovery.

Yesterday afternoon, we had 40 patients who were treated and released, so that's good news. But today, our hospital staff is back at work, caring for those patients right there at the bedside, many of which are in our critical intensive care units.

BOLDUAN: So, 12 -- the last number that I think we had gotten from you, it was 12 were still in critical condition. It remains 12 today?

COHEN: It remains 12 this morning, correct.

BOLDUAN: How -- what are the injuries? Can you give us a range of the injuries of those who are in critical right now?

COHEN: Sure. And because, you know, HIPPA regulations are stringent on what we can and can't say about patients, but as you can imagine, with all of those gunshots fired the majority are gunshot wounds and injuries sustained when folks were trying to get out of that big mass of people early yesterday morning.

BOLDUAN: Are you hearing that these patients still face more surgery? Of course, it's, you know, the question is, the long road of recovery that they will likely have. Are you anticipating more surgery for these patients?

COHEN: I can't comment specifically on the patients, but what I can say is often times in our trauma center our patients will have maybe one surgery to begin with, just to sort of make sure that they're OK, any life-threatening injuries are calmed down.

And then once they can recover a little bit from that and their bodies are strong enough they can go through other surgeries as need be, perhaps to fix broken bones and those sorts of things, the things that can wait that aren't life-threatening injuries that need to be seen right away.

So, in the later days, of course, they could have more surgeries and, of course, we're wishing for the best recovery for them.

BOLDUAN: Of course, and everyone is. And a lot -- when dealing with these mass trauma situations is the prioritizing that doctors have to do, who goes where, who can wait, who can wait a little bit longer.

Doctors from UMC I was looking through really great piece done by the "Las Vegas Review Journal," and they described the scene kind of in the aftermath as a couple doctors said, Danita, was controlled chaos. A combat medical hospital, blood everywhere.

[11:20:08] And another doctor saying it was likely we were in a war zone. What did you -- I guess --

COHEN: Exactly.

BOLDUAN: What are you hearing from the doctors as they've had a moment to process what they all witnessed and went through together?

COHEN: The piece that you're referring to was done by a local reporter, Paul Harrison, who spent a lot of time at our trauma center side by side our physicians and the folks at Ellis Air Force Base, the Air Force actually trains here with us because when we aren't in a war time situation they still need to keep their skills up, and the closest thing to a war time situation that they will see those types of injuries, happened here right behind us, at the UMC Trauma Center.

So, that's the kind of injuries that we see that are likened to war time injuries. So even the Air Force trains side by side our UMC trauma surgeons because that's the kind of care we provide.

And you're right. That triage is so important to make sure that patients are taken to the right level of care and that those who are the most critically injured, obviously, are treated first. And that triage process is so important, both out in the field and then here when patients come in.

BOLDUAN: Danita, thank you for coming on and giving us updates when you can and thank you so much to all of the hospital staff for everything they've done for all of the victims of this horrific mass shooting and -- COHEN: You're welcome.

BOLDUAN: -- every other trauma they deal with. Thank you so much.

So, as we are speaking with Danita about the priorities and what it is like to be in the middle of this. What is it like to be a doctor in the middle, I don't know how else to describe it, mayhem.

Joining me now a doctor who has faced something like this. Dr. Buck Parker, an emergency and trauma surgeon at St. Mark's Hospital in Salt Lake City, Utah. Doctor, thank you so much for coming in.

I mean, can you take me inside, inside your trauma center when I mean likely maybe have not seen 527 trauma victims coming in through your doors but when you see this number of patients just flooding in, what it's like to be a doctor in the middle of all of that?

DR. BUCK PARKER, EMERGENCY AND TRAUMA SURGEON, ST. MARK'S HOSPITAL: Yes. First, I worked at a level one trauma center in Detroit for a long time and we saw not 500 patients at one time, but we have mass casualties. A lot, most level one and level two trauma centers train for these mass casualties on a regular basis, even now active shooter scenarios.

You know, obviously, it is a little bit foreign when you have a lot of patients coming in like this but it is a big team effort and the team, you know, training kicks in. Even though you do have a lot of training with that, when you do see a lot of patients coming in the front door, blood everywhere, it is controlled chaos like he was saying.

And you do just have to keep your wits about you. We do this a lot and so, you know, we do have some algorithms, simple algorithms like the ABCs and things like that to sort the previous speaker was talking about triage.

And that's really, really important. You need to be able to triage these patients and find out which ones are the critically ill patients and you can save their lives in the next 15 to 60 minutes and which ones do you not need to see and get out of the way so you can save those critically ill patients.

BOLDUAN: And those are critical decisions that have to be made in seconds. The doctors at UMC describing it like a war zone, like controlled chaos like you said. I mean it's really amazing having them describe something like that for a hospital in Las Vegas and the trauma center in the middle of Las Vegas.

PARKER: Yes. Probably that is more of a war zone than many of the kind of combat hospitals that you'll see. I've talked to a lot of the combat trauma surgeons and sometimes they may see six or eight patients, but they're not triaging 500 patients. Honestly this is a bigger war zone than many of the kind of combat hospitals.

BOLDUAN: What do you see is the biggest needs? Everyone kind of wonders do they need more blood? What are the biggest needs? When you talk about the type of injury that these patients are sustaining, this type of fire, high-powered rifle, raining down bullets on this massive crowd, so many deaths and so many people living through this, it's not just the physical needs but what kind of trauma are all of them going to be dealing with if not even just they're physically injured going forward?

PARKER: Well, I mean, as far as the hospital is concerned I see the biggest problem is space. You have this huge influx of patients. You already have a big medical center and even sunrise is a level two with a lot of patients that are already there, right now, you have the huge influx of patients and where you put them all?

Where do you put the family members trying to show up? And the space just to put these patients if you don't triage them correctly, even if you do triage them correctly you have a lot of patients and people wandering around. That's a big problem.

[11:25:05] But you know, I think a lot of people get stuck on do we need more doctors to take care of these patients and really the biggest bottleneck is the nursing staff and the ancillary staffs, the radiology techs, you know, the lab, the staffing, everything like that.

Because you know, you sometimes -- the biggest problem with hospitals is not having the nursing to take care of the patients. Often actually I heard that one of the fellows training there actually was able to go home in 24 hours because the doctors, you know, can handle, you know, influx of patients, but you need nursing on those patients to make sure they're doing OK.

BOLDUAN: Yes. For an extended period of time after the doctor has seen them. Dr. Buck Parker, thank you so much for coming in. I appreciate it.

PARKER: Thank you.

BOLDUAN: Coming up for us, they were teachers, mothers, fathers, first responders, and friends, who simply wanted to enjoy a night out at a country music festival. Then a senseless act of violence cut their lives way too short. We are going to bring you their stories. That's next.