‘You’re not going to die today’

Sometime around 6:30 that evening as the sun slid from view and the hospital’s emergency room staff was in the midst of a shift change, a call came in announcing the arrival of two patients with multiple gunshot wounds.

For two long years, Janet Paulsen had feared this day.

She knew if she ever got the courage to divorce her husband, there would be a price to pay. She began scanning documents like Social Security cards, birth certificates, insurance policies, deeds to the house, anything she thought she would need should she and her twin sons have to leave in a hurry. She put them on a flash drive and hid them at her parents’ home.

“If anything ever happens, get it,” she told her father, “but promise me you won’t look at it unless something happens.”

Scott Bland, who arrived at Kennestone first, had pumped six bullets into this wife, then turned the gun on himself, shooting into the center of his chest and taking out his entire left lung.

To buy enough time to figure out where all his injuries were, Dr. McGann opened his chest and put a clamp across his aorta to keep blood going to his heart and lungs.

Scott died shortly after surgery.

Numbers tell horrifying truth

According to a 2018 United Nations report, domestic violence is the leading killer of women worldwide.

In 2017 alone, 87,000 women were murdered globally, and over half of them were killed by intimate partners or family members. This means that six women are killed every hour by someone they know; usually their husband, boyfriend or ex.

In that same year in the United States, there were 2,237 intimate partner homicides, primarily the result of gun violence and primarily women, according to research conducted by Northeastern University.

In Georgia, on average 130 residents lose their lives to domestic violence every year, according to the Georgia Coalition Against Domestic Violence. Most of them are killed by a current or former intimate partner, but the number also includes children, family members, and alleged perpetrators, who like Scott Bland, died by suicide after killing or attempting to kill their victims.

What's more, Georgia consistently ranks in the top 25 states for the rate at which men kill women. In recent years, it's often ranked in the top 10. And since the current coronavirus outbreak, state health officials have noted an additional increase in domestic violence incidents.

Between 2010 and 2015, the year things came to a head for Janet and Scott, there were 529 domestic violence shooting deaths in Georgia.

Would Janet Paulsen follow her husband?

Bliss, then ‘Dr. Jekyll-Mr. Hyde situation’

Neither seemed likely candidates for such an ominous tally when the couple met in 1995 at TGI Fridays on a blind date.

Janet was an assistant marketing director at Carter & Associates, the same company where Scott worked as an electrician. A mutual friend suggested he ask her out and he did.

He made a good first impression. He was a hard worker, and at just 27 years of age, he seemed unusually stable. He owned his own home and was easy to talk to.

When they parted that night, she was sure she’d see him again. Over the next few months, they grew closer, often talking about marriage. They even shopped for a ring, and early in 1999, they purchased a home together in Acworth.

They were there with both sets of their parents for Thanksgiving dinner that year when Scott announced he and Janet had decided to marry.

On March 18 the following year, at the Magnolia House in Powder Springs, they pledged their love for each other before 100 guests, then embarked on a cruise to Cozumel and Grand Cayman Island.

Five days later, they returned to Acworth, settling back into their work and marriage.

Life was good, Janet said.

January 2002 brought with it good tidings: Janet was pregnant.

But just 20 weeks in, doctors discovered her hormone levels were high. There might be a problem with the baby’s brainstem. They needed a high-resolution sonogram to take a look.

Have you had a sonogram before? the technician asked her.

Janet had indeed had a sonogram, but she was in no mood for small talk.

Just tell me what's wrong, she pleaded.

Honey, there's nothing wrong, the technician told her. There are two babies. Boys.

When she shared the news with Scott, he was “crazy happy.”

Credit: Contributed

Credit: Contributed

Janet could only think of how much she didn’t know about caring for twins. There would be double everything.

How were they going to do it all?

The hand-wringing was for naught. When the boys arrived the evening of Sept. 18, 2002, Scott “dove right in.”

“When I went back to work, he took them to day care every day and he picked them up,” Janet said. “He changed diapers. At night, he helped make their bottles, all 18 that went with them to day care. He really did the lion’s share of the work.”

Partly because Janet worked an hour away in Rome. Partly because his schedule was more flexible. Mostly because “those were his boys.”

Credit: Contributed

Credit: Contributed

It was the same way as they grew older. Wherever his boys were, Scott was there also. He even coached their youth baseball team.

By their eighth birthday in 2010, though, the peaceful life they’d known was becoming more and more chaotic.

At the slightest irritation, Scott lashed out, often threatening to harm his target. His slow and downward spiral in many ways mirrored what happens to Alzheimer’s patients.

“Scott was never physically abusive with me,” she said, searching. “It was verbal, emotional and sexual. He suffered from unpredictable fits of anger.”

By 2012, he was adding alcohol to the mix. The more he drank, the more unpredictable he became. The more he changed.

The guy who would give the shirt off his back to a stranger suddenly seemed at war with those he loved most.

Janet did what she could to intervene, suggesting he see a therapist, but nothing worked. He just got worse.

“It was a Dr. Jekyll-Mr. Hyde situation,” she remembered recently. “I never knew what I was going to get.”

Tension turns into threats

Over the next five years, what Janet didn’t know, what she dreaded was coming into full view.

Scott had taken to leaving his empty Miller Lite beer cans in their shower, crushed in the console of his car or exploded in the freezer. He was getting into shouting matches with the neighbors, once brandishing a gun at one.

“He obviously wasn’t happy and I was miserable,” Janet recalled.

For two years, she’d been pleading with him to get it together. Instead of taking responsibility for his actions, Scott blamed her. Janet grew more afraid. She had to let him go.

“I told him I wanted a divorce, that it didn’t have to be a big thing, we could split custody of the boys.”

Scott looked at her.

Why don't you go upstairs and get the boys, he told her, and see what happens to you.

He leaned back in the chair and repeated himself.

Scott, you’re scaring me, Janet told him. Please don’t threaten me.

You need to leave, he told her.

In the end, Scott left then called her parents.

If she thinks she's going to divorce me, she's got another thing coming, he told her father. I will kill her.

Seeking help from police

It was Oct. 25, 2015.

The following day, Janet was waiting in the car at the twins’ school when Scott called.

Tell you what, I’m going to make you a deal. I’m going to give you $500,000 in cash. You’re going to take that money and disappear.

Janet felt sick to her stomach.

I will never speak to you again, she told him and hung up.

Scott called right back.

I'm going to sweeten the pot, he told her. I'm going to throw in the river house. That's probably worth $300,000. You're going to be rich. Call your attorney and he's going to tell you that's a really good deal. But you are going to go away. I may let you see the boys every now and then.

Janet didn’t speak. She hung up and called a girlfriend.

I need you to take the boys, she told her. I need to go to the police department.

She then called another friend and asked her to meet her there. For her own protection, she needed to file a complaint.

She always figured Scott would do all he could to make her life a living hell, that he’d harass her, maybe drag out the divorce or file for bankruptcy.

“I never imagined he would try to kill me,” she’d say later.

Instead of going home that night, Janet and the twins checked into a nearby hotel with only the clothes on their backs.

Both her attorney and Acworth police advised her to seek a temporary protective order. The next day, armed with photos of Scott’s massive firearms collection, she headed to Cobb County family court, where abusers are required to surrender all their firearms on the protective order.

The judge granted the temporary protective order on Oct. 30. Scott Bland couldn’t come within 1,000 yards of his wife or children. Hours later, while Janet and her friends waited at the police department, sheriff’s deputies arrived to serve the order, confiscate the weapons and move Scott from their home.

Of his 74 weapons, one remained in Scott’s truck. A deputy said they couldn’t take it.

Running out of time

Less than 24 hours later on Oct. 31, Janet received an alert on her cellphone. Scott was tracking her and the twins and knew their location.

Janet freaked out. She was still in the midst of changing the locks on their home. She took screenshots of the messages and went back to court to request a felony temporary protective order violation, which meant Scott would be in jail until the court date on the order.

Janet hoped that would buy her some time, that maybe Scott would sober up and get help.

Unwilling to believe the text was from Scott, the judge issued a misdemeanor instead. Scott prearranged for bail, put down a $2,500 retainer at an attorney’s office and turned himself in. He was out before the sun went down.

Meanwhile, acting on the advice of her local police department, Janet applied for a concealed carry permit then headed to her attorney’s office, where she signed divorce papers before going to the grocery store and joining her parents at North Cobb High, where the couple’s 13-year-old twins had football practice.

Sometime around 6 p.m., Janet left practice to return home and put the groceries away. She was pulling into the garage when the door suddenly jerked.

A final confrontation

Scott, who’d parked his truck a mile away and trudged through the woods behind the house, down a ravine and over a creek, stood at the rear of the vehicle.

Just as she was about to exit her car, Janet spotted him in her sideview mirror, gun cocked and loaded.

Calm down, he’s here to scare you, she told herself. Get out of the garage or you’re dead.

“I put the car in reverse and hit the gas as hard as I could,” she recalled.

As her car smashed through the closing garage door and landed against a tree in the neighbor’s yard, Scott approached with his gun still pointed at her.

Janet hit the gas again and careened into the woods. When she stopped, Scott was just feet from her window. She ducked, tumbled from the passenger side and took out running through the woods, thinking the trees would give her some cover.

Pop. Pop. Pop.

She felt stinging in her torso. The fear of dropping in the woods and dying there propelled her forward. She turned back toward a neighbor’s home. There was more stinging, this time in her leg. Janet fell in the driveway. Scott shot her again as she lay there, then twice more.

The last one hit her L2 vertebrae. An electric jolt traversed her entire body.

“I knew instantly I was paralyzed,” she said.

By then, Scott stood directly over her. Janet held up her hand.

Don’t shoot me any more, she begged him. I’m dying.

Scott cocked the gun one final time, put it to his head and pulled the trigger. Click.

Startled, he ran back to the side of the house where he had hidden an extra box of ammunition and reloaded.

Janet could hear a neighbor yelling, then sirens.

She told herself to hold on, she was not going to die. Just hang on. She heard another voice giving her permission to close her eyes. You will be OK.

She heard footsteps approaching, then saw Scott coming back down the driveway toward her.

Click.

Looking for a miracle

Janet Paulsen was dead on arrival.

“Her heart had already stopped and she didn’t have a pulse,” McGann said. “She was as bad as it gets.”

In addition to training at Grady, McGann had worked at a level-one trauma hospital in Ohio before returning here in 2011. He’d seen a lot of patients like that.

He opened Janet’s chest, put a clamp on the aorta so blood could get to her brain and lungs. He pumped her heart with his hands, then injected epinephrine to stimulate the organ.

Janet regained a pulse and was taken to the operating room.

For penetrating traumas like Janet had, there is only a 5% survival rate.

“You see it fail 99 out of a hundred times,” McGann said. “Survival varies patient to patient, and it always helps when you’re in good condition.”

Janet Paulsen, who just 24 hours earlier had received a statewide volunteer award from the Georgia Recreation and Park Association for her work with the Acworth Baseball Association and Acworth Parks and Recreation, happened to be in tiptop shape. She taught trampoline aerobics two to three times a week, climbed Kennesaw Mountain and had just run the Savage Race, coming in first in her age group (45).

On the days she’d climb to the top of Kennesaw Mountain, she’d look down on the hospital complex, not knowing one day she’d be there fighting for her life.

It wasn’t all that surprising, though, to Dr. McGann. Although ER doctors see many more, McGann had seen enough that he’d grown concerned about the impact of domestic violence on women.

“Whether it’s an assault or rape, the threat that women are under is scary,” he said. “As the father of a daughter, I worry about it a lot.”

He recalled seeing two women who’d been stabbed by their spouses during his first few years at Kennestone. One of them had 27 stab wounds, but she walked out of there. The other one had been stabbed and pushed down stairs. She was really tough. She walked out, too.

And he remembered a 15-year-old kid whose father shot him because he ate all the mac and cheese.

“People can be brutal,” he said.

Not all of them make it to Dr. McGann because it has to be a gunshot or stab wound before he gets involved.

Janet Paulsen had six gunshot wounds — one bullet to her left knee, one went through her back and out the other side, one through her upper thigh, another shattered inside her right femur, one into her right lung and a final one to her spine.

Appropriately caffeinated, McGann launched into the algorithm he’d learned while in residency at Columbus, Ohio’s Riverside Methodist Hospital, the fifth-busiest ER in America.

“You don’t have to create a care plan,” he said. “If you see X, you do Y.”

In Janet’s case, he saw a pulseless gunshot victim and proceeded to perform an emergency thoracotomy, cutting her from sternum to back over the rib cage and placing a rib spreader inside so he could see her heart. After a clamp was placed on her aorta, she was taken to the operating room.

It was clear she had a big injury to her right lung.

McGann removed the part that was bleeding, then gave her about eight units of blood, the equivalent of a can of Coke per unit. He closed her up and took her to the ICU, where she was put in an induced coma and put on a breathing machine to keep her comfortable.

Over his 10-year career, he’d performed or witnessed the procedure on patients perhaps 100 times.

Only a handful had survived. Janet Paulsen was one of them.

“This was a Hail Mary,” McGann said. “It’s always amazing when it works. It’s miraculous.”

A long journey ahead

Janet Paulsen would lie in a medically induced coma for the next three and a half weeks.

She was unrecognizable. She was so swollen, her eyelids were turned inside out. Her left leg looked like a hot dog when it bursts in a microwave. She experienced wicked hallucinations.

While her parents kept vigil at her bedside, her community rallied, picking up the twins and taking them to school, bringing them to the hospital for visits.

When you hear people talk about ripple effects from domestic violence, this is what it looks like, experts say. The impact reverberates far beyond the perpetrators and victims.

When Janet finally woke up the day before Thanksgiving, her parents sat at her bedside.

Janet couldn’t move her legs. The respirator had been in her throat so long she could barely speak above a whisper.

With Janet paralyzed from the waist down, doctors warned her she might have brain damage and would never walk again or have control of her bodily functions. She thought about her life in a wheelchair. She was grateful and very hungry.

A cup of microwaved pudding or ice chips tasted like dinner at the Ritz-Carlton.

No big deal, she told herself. You’re still alive.

Two weeks later on Dec. 4, she was transferred to the Shepherd Center.

A strong will to walk

Janet was scared out of her wits. This wasn’t supposed to happen to people like her. University of Georgia graduate. White. Middle class.

That’s precisely why domestic violence is a public safety issue. It doesn’t just happen in trailer parks and among people of low income. It happens to women and men of all ages, races, religions and economic backgrounds.

Janet was experiencing flashbacks, prompted by fire alarms, sirens or hospital personnel announcing codes.

With each one, she whispered a prayer. Please God, let them be OK.

At Shepherd, her goal was to get out of the hospital wheelchair and into the one she could propel herself.

She drew motivation from within: You willed yourself to live. Now, will yourself to walk; #jpstrong, she scribbled on a whiteboard in her room.

After two days of sitting there in excruciating pain, Janet willed herself to pull her wounded legs back as hard as she could, slide into the other chair and wheel herself out of her room. It was the first time in three months.

“It was like being in school,” she said. “I had different classes throughout the day: one to learn to use the bathroom again; one to learn to transfer from the bed or commode, take a shower, how to put on her clothes; one to learn how to drive again.

“They’d take me out to the parking deck to a Ford sedan, then showed me how to slide into it on a board,” she said.

But first, she had to take the wheels from the chair, collapse it, then lift the chair across her body and into the passenger side seat.

“When I could do it under 30 seconds, they taught me how to drive with hand controls,” she said.

If coming to Shepherd was scary, it was equally terrifying when Janet finally left just days before Valentine’s Day 2016.

“There you’re in a bubble of safety and security. Everybody there is in a wheelchair because they’ve experienced something traumatic. I didn’t know how I was going to get into the house. My wheelchair wouldn’t fit in my commode closet, I had to install a potty chair. It was like taking baby steps and then I started to get a little bit more movement back.”

With the nearly $50,000 left in a GoFundMe account, Janet enrolled in Beyond Therapy, the Shepherd Center’s top-tier outpatient physical therapy program. It was enough to pay for six hours of therapy a week over two years.

For the next year, she received $25,000 from the Georgia Crime Victims Compensation Program, a little-known state-run program administered by the Criminal Justice Coordinating Council.

“If it weren’t for that program, I’d still be in a wheelchair full time,” she said.

‘It could’ve been so much worse’

Janet Paulsen is what medical experts refer to as a hemiplegic, which means paralysis in one quadrant of the body. For her, the paralysis extends from the right hip to right toe. In addition to not being able to move her ankle or toes, only about 40% of the muscle in her right leg works.

“When I first arrived at Shepherd and had X-rays done,” she said, “I was told I’d probably be able to walk again but not without assistance and not more than 1,000 steps a day.”

She has a permanent bruise to the spinal cord that is blocking the signal to her right leg. With crutches, she can get mail from the mailbox, but to get to her kids’ game or to the grocery store, she has to use her wheelchair.

“The pain is excruciating but I’ll take it,” she said. “It could’ve been so much worse.”

Looking back, so many things worked in Janet’s favor.

The first was leaving her sons’ football practice that night alone. The second was the airbags in her car failed to go off. If they had, she would not have been able to get out of the car. Third, the sheer will to live. And fourth, the skill of the first responders and trauma team at Kennestone.

“I could feel myself slipping away, but I kept telling myself no,” she said. “You’re not going to die today.”

A life with pain but new purpose

On Nov. 5, 2015, the morning of the shooting, Janet Paulsen applied for a concealed carry permit. She was in a coma, fighting for her life, when it arrived in the mail six days later.

She was in the Shepherd Center gift shop one day when a bit of clarity revealed itself on a plaque: Someday This Will All Make Sense.

Janet understood how lucky she was because she knew most women don’t make it to the other side of the hell she’d been through.

She still tires easily and experiences chronic pain from nerve damage in her right leg. She still suffers from post-traumatic stress syndrome, but it isn’t nearly as bad as it once was.

Two to three times a week, she takes bungee classes for physical therapy, but she isn’t trudging up and down Kennesaw Mountain anymore, and it takes four times as long to do anything, including everyday tasks like unloading groceries and laundry. The boys, now 17 years old, are a big help.

“There are days when I wake up and just pull the covers up over my head because I can’t deal as well as I used to,” she said. “But most days, I wake up and say I got another day.”

On many of those days, she shares her story with local civic groups, domestic nonprofit functions, and first responder meetings, advocating for domestic violence victims, educating whoever will listen so her lot never again falls to anyone else.

This is her purpose, she said, the substance of the plaque she remembers often from a visit to the hospital gift shop:

Someday This Will All Make Sense.

“We have a serious problem in Georgia,” she said. “We’re not going to stop this 100%, but we sure can do a lot better job than we’re doing now.”

Today, you will find Janet at every Stop Violence Against Women Day held at the state Capitol. She testified last year in front of a Georgia Senate committee, advocating for Senate Bill 150, which would prohibit convicted domestic abusers or anyone who is under a "family violence protective order" from possessing firearms. And had it not been for the coronavirus, she would've made yet another plea this year.

Had the law been in place in Georgia in 2015, Janet told members of the Senate Judiciary Committee in 2019, she might still have the ability to walk.

Doing such work, she said, puts her in the driver’s seat.

“I get to take control and do something good with what happened,” she said. “I remember that plaque in the little gift shop. Doing this is what makes sense to me.”

IF YOU NEED HELP

Georgia Coalition Against Domestic Violence, 114 New St., Suite B, Decatur. 404-209-0280, GCADV.org.

24-hour statewide hotline: 1-800-334-2836