Sudden Trauma
by Darla Isackson

Editor’s Note: Trauma enters many of our lives. Sometimes it is dramatic like the Alta View hostage incident described here; sometimes it is invisible to the world but heart wrenching inside like a divorce. A new book Sudden Trauma! When Life Will Never Be the Same Again by Dr. Ross Woolley, Susan Woolley, with Darla Isackson details some revolutionary principles for healing emotional wounds. In Part 1 of this two-part series, coauthor Darla Isackson details the hair-raising events that happened at Alta View Hospital in 1991 when a deranged man killed a nurse and held others hostage for eighteen hours. The survivors carried emotional wounds whose seriousness they only understood over time. Part 2 will discuss some of the coping skills taught in the book that are helping people regain confidence, a sense of control, and even peace in the aftermath of trauma.

How many news breaking stories of people in trauma can you recall instantly? Columbine High School, the San Pedro MacDonald’s shooting, Oklahoma City bombing? Such stories shock us momentarily, but in a few days or weeks life goes on, and we may believe that the impact on survivors, witnesses, family, and friends is minimal. Mounting evidence suggests that nothing could be further from the truth. Dr. Ross Woolley, behavioral epidemiologist, suggests that society’s denial of long-term emotional effects is both frustrating and frightening, especially in view of the fact that trauma impacts every one of us sooner or later. Whether the source is a dramatic occurrence such as the one we will chronicle in this article, or a more common occurrence such as divorce, loss of income or status, failed expectations, loss of a close family member, friend, or even a beloved pet, trauma leaves a void many people don’t know how to fill. Trauma attacks our foundations of trust, and puts us on emotional overload. The effects of trauma are cumulative, so successive traumas increase the risk of developing serious emotional symptoms. Many don’t know where to turn as the downward spiral begins to occur, Woolley said.

The stalking, murder, and hostage siege that occurred on September 21, 1991 in Salt Lake City at Alta View Hospital gives us an excellent case in point. The facts of that siege, which I will summarize, have been chronicled by the press, personal accounts, and the made-for-TV movie, Deliver Them From Evil.

Taken Hostage
Richard Worthington, mentally deranged, armed with a shotgun and a pistol, and determined to kill the doctor who had performed a tubal ligation on his wife, entered Alta View Hospital through the window of a patient’s room at 11:45 p.m. Karla Roth, employed as a nurse at Alta View for just two weeks, encountered him first. Susan Woolley, the charge nurse, responded to the commotion and heard Worthington’s demands to see the doctor. Susan was able to warn the doctor, who then telephoned for help. Worthington directed Karla and Susan to wheel two infants in bassinets from the nursery to a patient’s room. As they were pushing the infants down the hall, Worthington discharged his pistol into the floor.

Karla’s Brave Attempt Leads to Her Death
When the doctor was not found in his patient’s room, Worthington directed Karla and Susan to walk in front of him. At gunpoint they went down two flights of stairs and out the front door to the visitor’s parking lot. Once in the parking lot, Karla attempted to grab the shotgun, failed, and turned to run. She took only two steps before Worthington shot her in the back. Susan, standing only eight feet away, agonized that she could not help Karla. She saw Karla fall and knew she died instantly.

Life and Death Situation
Worthington placed the muzzle of the shotgun at the base of Susan’s skull and took her back to the patient’s room where he hoped to find the doctor. He directed the patient’s husband to go outside and bring a tool box into the building. This toolbox, which Worthington had previously placed in the bushes near the front door of the hospital, contained a bomb with the equivalent of forty sticks of dynamite.

Susan watched in terror as the gunman fired several shots into furnishings, and then pointed the shotgun at the expectant mother’s abdomen. He had a nurse call his wife, then placed the phone on the bed of the laboring patient. Worthington then shot the phone to pieces and demanded another phone.

Feeling exposed because of the windows, he forced all his hostages to go up one floor to a windowless suite of doctor offices. The nurses had no option but to lay the laboring mother on the floor. About 3:00 a.m., without equipment or supplies, Susan and the other nurse delivered a baby in the chaos of an office being demolished by sporadic shotgun blasts.

Susan’s “Last Letter”
During the night Susan wrote what she thought was her last letter to her husband and children. She gave permission to include part of it here:

My Dearest Husband and Family,

Many thoughts and feelings have been racing through my head all night. The overpowering emotion is that of love for all of you. I have made many mistakes in my life that I wish I hadn’t, but they seem quite insignificant in light of what has been going on tonight.

One right thing I did, which I have never regretted for even a moment is marrying Ross and together bringing five choice children into mortality. Each of them has enriched our union and brought many blessing into our lives.

I certainly am not looking forward to dying at this time, but I really do not feel fear. I’m not really sure what exactly the emotion is I feel. I have prayed that the Lord would help us through this and all I can say at this time is that it is in the Hands of the Lord.

One time while [Richard Worthington] was in the other room, four of us knelt in prayer. Although we have prayed for deliverance we will just have to be patient and accept what comes. We really don’t have a lot of choice.

I miss you and wish so much that this wasn’t happening and we were together, safe, and at home. Tonight I witnessed death and then birth within about four hours and it reminded me again of the eternal nature of things . . . Life is eternal and I have no doubt about it.

You know, it’s strange to me that for so many years I’ve seen in movies, etc. that when you are faced with death you have a flashback or an instant replay of your life. I haven’t experienced that at all. My only thoughts are of my family and the deep love and gratitude I feel for each of you. I’m usually anything but poetic but I’ve been thinking about two songs. One is “Love One Another” and the other is “You Are the Wind Beneath My Wings.” And you have all been that for me.

Please never forget my love for you. It is eternal. Go on with your lives as you would, had I been with you. In fact, try to do even better.

Saying thank you doesn’t sound like much but it’s the best I can come up with at this moment, so it will have to do. Please be happy. Love always,


Susan told her husband she did not sign the letter because that would somehow signify she had lost hope.

The Siege Continues
The hostage siege continued for eighteen hellish hours. Worthington repeatedly threatened Susan and told all the hostages they were going to be shot or blown up. There was no food for the hostages or formula for the newborns, and almost no communication with the outside world.

Family, friends, and co-workers stood by. All they knew was that their loved ones were with a madman who had killed once and could easily kill again. He not only had guns but a bomb with sufficient power to destroy the building and adjacent structures.

Secondary Victims
Ross Woolley, Susan’s husband, was nowhere near the hostage scene when it started, but he too was held hostage. He was informed that his wife had survived the point blank killing of her colleague, and he agonized with the awful uncertainty. Would he ever see Susan alive again? A portion of Ross Woolley’s account tells of the reverberating consequences of trauma to those close to the victim–spouses, parents, children, close friends. All those directly impacted by the original trauma are called secondary victims. While their victimization is seldom chronicled and their emotional wounds are rarely the focus of attention, their needs may be even more pressing than those of the primary survivors. Why should their trauma be considered less serious? No data supports the judgement that they are less in need of emotional wound first-aid.

Ross Woolley Tells His Story
The clarity of my memory of the twenty-four hours of the Alta View Hospital siege is remarkable–even seven years later. Perhaps it is because I have relived the event in my mind so often and for so long that it has been indelibly imprinted. If pressed, I could give a running narrative of that experience that would account for all but a few minutes. Here’s a brief summary.

Startling Message
At 2:00 a.m. I was startled into wakefulness by the knock of a security guard. His message was cryptic. “You’re supposed to call [name deleted] who has a message.” I was dazed, but immediately knew there had to be something wrong. I was on a business trip about a six-hour drive from the hospital, which increased my anxiety. The message was, “Call Dianna (my daughter) immediately, there’s a problem at the hospital where Susan works.” On the verge of tears, Dianna told me that Susan had called her and said: “There’s a man here who has taken us hostage and has allowed me to make one phone call. I want you children to know how much I love you and how proud I am of all of you. Please call Dad and tell him that I love him. There has already been one nurse killed and I don’t think that I will live through the night.”

Sparsity of News: Is Susan Dead or Alive?
For the next two hours the only information we could get was from Dianna’s television. Running news commentaries on what was happening proved to be mostly inaccurate. Since Dianna had three-way calling, I gave her numbers to call for possible firsthand information. The television reported that all hostages had been released and transported to other hospitals.

We called all hospitals and found that only one had received any patients from Alta View–mothers and babies who had recently delivered or had gynecological surgery. Susan Woolley was not at any hospital in the Salt Lake area. We then called various police agencies. Some, such as Sandy City would only say that there was a “situation” at Alta View, while others had no information. Since the FBI provides training in hostage negotiation, and kidnaping is within their jurisdiction I had Dianna call them. The agent said my call was the first he had received about a hostage situation or murder.

My frustration was rising with each call. During a two-hour period, the television media twice reported hearing gunfire coming from within the hospital. With a growing sense that my 11:00 p.m. conversation with Susan might have been the last we would ever exchange, I told Dianna I would get to Salt Lake as soon as possible. I tried to find someone at the local airport to see if I could rent a plane and fly. The small airport was dark and deserted, so my only option was to get into my car and drive to Salt Lake. I kept saying to myself as my speed kept increasing, “There’s already been one tragedy; keep your cool and don’t do anything stupid.” I was a special police officer and had a badge and credentials. As I sped along, I kept hoping I would encounter a highway patrol car to provide me an escort. I never saw one.

I stopped and called three times to see if there was any additional news. On the third call I was told that the families of those who were still hostages were supposed to meet at the recently vacated fire station next to Alta View Hospital. By that time I was beginning to pick up some radio news although the static made it difficult to understand.

I cut about an hour and a half off my usual driving time to Salt Lake and got to the fire station at about 10:45 a.m. I immediately saw my daughter Allison wandering around in the parking lot. I went over to her as a Sandy City police officer came on the scene. I told him who I was and he said they wanted all of the families to stay at the fire station so they would not be bothered by the news media personnel. I learned rather quickly that not only were they keeping the media people out—but the families in. We were, in fact being held as hostages ourselves.

The police had set up a command post about a block away, where the hospital personnel–our friends and colleagues–were being kept. At the time both Dianna and my oldest son Rob were employees of Alta View and I knew most of the staff because of Susan’s work and my own position with the School of Medicine at the University of Utah. These were people we knew and trusted as an important part of our support system. Our requests to go and be with them were denied. Our FBI agent friend who had come to see what he could do to help us, had to call his supervisor, the Special Agent in Charge of the Salt Lake City Office, to get permission to go up to the command center. He left but did not contact us again.

Three television sets in the fire station, each tuned to a different station giving frequent “live” updates on the situation, became our only source of information. The mayor of Sandy City appointed himself as the go-between for the families and the command post. He and his wife would come in every hour or so and we would gather around expecting to get some accurate news. But each time his comments were repetitive of the time before–as if someone had pushed the “play” button on a recorder. In a condescending tone he would say, “Well, the situation is about the same; I can’t really tell you anything new. Now, is there anything that I can do for you?” I wanted to scream, since I knew there was absolutely nothing he could do.

As the hours passed, we learned from TV reports that Worthington said he had a bomb and that several shots had been fired. We had no clue as to what was being done to rescue the hostages, if any were dead or injured, or what Worthington’s demands really were. The misinformation being disseminated by the media was of no help to those of us waiting and nearly cost the hostages their lives. Worthington watched one broadcast that stated he absolutely did not want to see his wife, when, in fact, that was one of his principal demands. Worthington became so angry when he heard the erroneous report that he shot the television and threatened to detonate the bomb.

The Waiting Game
So we waited all through the day and into the evening. The Red Cross brought cots for people to sleep on. Nobody wanted to sleep. A social worker circulated. I did not want to talk to social workers, especially ones who knew less about hostage situations than I did. The hours dragged on . . . television bulletins trying to make repetitious statements sound like news . . . Mr. and Mrs. Mayor paying their irritating visits. The rookie police officer keeping us quarantined didn’t care what kind of badge I had or that we had as much right to be with our friends as anybody.

The Hostages Are Freed
Finally, almost eighteen hours after it began, the siege ended. A police car pulled into the parking lot near the Women’s Center and we watched Susan (carrying a baby) and the other nurse who had been a hostage run to the car. When they were in, the car pulled out and drove away. Immediate family members of the hostages were driven to the command post where ambulances were waiting.

Susan did not see me at first. Dozens of fire fighters, police officers, and hospital personnel mingled with additional dozens of reporters who wanted to talk to hostages. Susan refused to talk and gripped the arms of a fire fighter (our neighbor) and our FBI friend. Finally I got through the crowd and she saw me; we hugged and she dissolved into tears.

Re-traumatization and Aspirin
Those in authority insisted that Susan go to the hospital, so we both got into an ambulance and were transported to the Cottonwood Hospital emergency room. Within twenty minutes of our arrival, a detective from the Salt Lake County Sheriff’s Office came in and interviewed her. She was asked to recount the entire event–especially the murder of Karla Roth. The forty-five-minute interview renewed and increased Susan’s traumatic upheaval.

Many times in those first hours after the siege–and in the days to come–Susan chided herself because she had done nothing to “help” Karla. One of the country’s foremost experts on hostage negotiation stated emphatically in a phone call to me that if she had tried to intervene in any way Worthington would have killed her as well, but Susan would not be consoled.

Since she was in an emergency room as a matter of protocol and had not been physically harmed, she was given only aspirin, which did little to ease her discomfort. The hours of intense stress had taken their toll and she was suffering real pain. It was almost 10:00 p.m. by the time we were released and started for home. On the way we passed a panel truck with no rear windows. Susan feared a gunman was going to appear at the passenger window and shoot us. She clung on to me, clearly feeling panic. I was beginning to learn firsthand the symptoms of post-traumatic stress; unfortunately I still had much more to learn.

Attempts to “Debrief” Survivors
With limited awareness of the grave impact of the trauma on both survivors and their loved ones of the potential long-term consequences, the administrative officials involved divested themselves of direct interaction. The whole matter of the victims’ well being was turned over to a volunteer group who offered to provide “critical incident stress debriefing.” (CISD)

The volunteers distributed some [generic] literature to a few people individually and then held a mass meeting with no apparent effort to screen attendees. Some fifty or so people came. The leader of the volunteer team asked that we go around the room and tell our names and how the incident affected us. The answers ranged from “I really don’t know why I am here because it didn’t impact me” to barely intelligible sobbing accounts of the misery, guilt, and turmoil this incident had caused.

After the meeting, everyone was offered pamphlets and disorganized reprints on single sheets. The volunteers (many of whom were untrained and unqualified for work of this kind) said they would be available to help on a limited basis for a couple of weeks and then it was up to the individuals to seek help elsewhere.


This is not all that unusual a scenario for a hostage situation. What is unusual is that Susan’s and Ross’s professional interest and personal involvement caused them to analyze and record it in greater depth.

The ongoing events that have impacted the hostage-scene survivors since the event could fill volumes. The impact on family members, as well as the actual hostage survivors, has been immense, though largely unrecognized by the medical community.

Calls for Help
Within one week it was clear that some survivors were having “great personal difficulties.” In response, social workers provided by the hospital conducted group meetings that some of the survivors found “very threatening.” Three weeks later, Dr. Woolley learned about Frank Ochberg. He was a psychiatrist and internationally respected expert in the treatment of Post Traumatic Stress Disorders (PTSD) unique to victims of deliberate violence. Ochberg was located at Michigan State University, agreed to counsel with the Woolleys over the phone and strongly recommended his book on PTSD. Through the efforts of some hospital personnel he eventually came twice for three-day visits to help those now struggling with PTSD. His expertise was helpful and the information he provided was excellent, but were like placing a Band-Aid on a gaping wound–too little, too late.

PTSD Symptoms
Ross and Susan continued to suffer daily with PTSD symptoms. Some of the most common of those symptoms are:



Nausea or frequent gastrointestinal upset

Severe abdominal pain

Loss of energy, drive, or motivation

Restlessness or periods of irritability (being easily annoyed)

Severe depression

Sleep disturbances, including insomnia, nightmares, abrupt awakening, and inability to return to sleep

Loss of appetite

Loss of sexual desire

Memory loss and forgetfulness

Reduced ability to concentrate

Sudden unexplainable outbursts of anger and/or hostile behavior

Periods of uncontrollable crying

Chronic pain, often in the joints, back or head

Pains in chest area, often mistaken for heart disease

Muscle weakness in various parts of the body

Muscle soreness

Hot or cold spells

Numbing or tingling, especially in the hands, feet and face

Lump in the throat and occasional difficulty swallowing

Hyperventilation or shortness of breath

If post-trauma sufferers are aware, through timely education, that these symptoms are normal, the duration and intensity of most symptoms tend to decrease rapidly. However, if sufferers do not know what to expect, as is usually the case, fear and worry increase and symptoms tend to escalate.

Woolley’s Credentials
Notwithstanding their collective expertise and involvement in the community, they could find no effective response to their mushrooming needs. Susan had an impressive career of experience in nursing, management, and supervision to her credit. Ross held prestigious awards and certificates as a scholar and professor of public health with training in psychology. He had taught numerous physicians-in-training as a faculty member at several colleges and universities. He is a research scientist, an author, and has been reviewer for the Journals of Preventive Medicine, Social Science and Medicine, and Computers and Medicine. Grants for research that he has authored total over $23 million. Dr. Woolley was a Special Officer of the University of Utah Police Department and had formal training as a hostage and barricade negotiator. With his wife’s life on the line, no wonder Ross was frustrated at being incarcerated in the fire house during the hostage-siege negotiations.

Continuing Side-Effects of Trauma
But traumatic stress does not respect credentials. Susan was unable to return to work for several years. Ross’s professional pursuits were severely disrupted. Hounded by the media, discredited by the prosecuting attorney in the Worthington murder trial, Susan’s sanity and marriage were strained to the breaking point. Ross reports that at one point the only reason he stayed in the marriage was that he felt it was the “right things to do.” And then there was Susan’s desperate thought of ending it all by stepping out into the path of an oncoming car when she and Ross were visiting Los Angeles. They both looked “fine.” But outward appearances can be deceiving. Inside, emotional wounds were festering into severe psychological abscesses.

The final insult came right after Richard Worthington was found guilty and sentenced to prison. One official said, “Well now it is all over and we can put this incident behind us.” Oblivious to reality, it is easy for bystanders to go on with their lives wholly unaware of victims’ emotional wounds. Too easy. And the consequences?

Eventually, these two invaluable members of the health care community learned many things–at a painful and almost fatal cost. No one intended it; certainly no one expected the extent and duration of their suffering. But given the absence of any specific information or individual attention to their deep emotional wounds, the consequences were predictable–especially when we take into account all that is known today about trauma and its aftermath. How could any right-thinking person assume that anyone could undergo eighteen hours of terrifying hostage trauma that included a witnessed murder and continual threats to life and not need the most extensive and well-qualified expertise available to deal with its impact?

With all that is known about the normal side effects that follow life-change events, why would anyone have to wait until they break down or have serious consequences before they receive help? Why were Ross and Susan and the other survivors sent home from a cursory evaluation without any specific directions about what to expect and how to prevent further complications?


Part 2 of this article will explore the Woolley’s quest for healing and their serendipitous acquaintance with pioneer traumatologist Barry M. Richards. This association resulted in joint efforts to promote Richards’s revolutionary principles for the healing of emotional wounds to the health care community and the creation of the book Sudden Trauma. The article will outline the basic principles that underlie Richards’s unique approach and give readers the information most essential for maximizing emotional recovery in the aftermath of trauma. Readers will be given invaluable Dos and Don’ts for survivors and for those who care the most about them.


2001 Meridian Magazine.  All Rights Reserved.