gun violence

Before and After Route 91

A year after she was shot in the face at the Las Vegas massacre, Natalie Grumet is still reconstructing her life.

Photo: Courtesy of Natalie Grumet
Photo: Courtesy of Natalie Grumet
Photo: Courtesy of Natalie Grumet

On October 1, 2017, Natalie Grumet was swaying along to Jason Aldean’s love song “When She Says Baby” at the Route 91 Harvest music festival in Las Vegas, when she felt her face explode. Aldean’s set was the last of the night, and Natalie and her friends were preparing to leave the large field next to the Vegas Strip when, high above the ground on the 32nd floor of the Mandalay Bay Hotel, Stephen Paddock began to spray the crowd of 22,000 people with bullets. One of those bullets struck Natalie’s jaw, fracturing the 37-year-old ultrasound technician’s chin and pulverizing her left jaw bone into hundreds of tiny fragments. Within a second, it shattered the architectural scaffolding of her face and blew out her motor and sensory nerves. At the end of Paddock’s 11 minutes of carnage, 58 people were dead and hundreds of others were injured. According to several medical professionals, many of those people, like Natalie, had head and facial wounds, the result of Paddock’s shots coming from above.

It has been exactly one year since Natalie Grumet was a victim of the Las Vegas massacre, the worst mass shooting in modern American history. Since that night, doctors at two hospitals have worked to rebuild her face, stretching the limits of biology in the process. She’s had eight surgeries, with one still to come, and has documented every step of her recovery on her ‘I Am A Warrior’ Facebook page. Her body has been retrofitted in new and surprising ways; plastic surgeons used a flap of skin and tissue from her neck to cover up the hole in her jaw. Bone marrow from her hip was placed into a 3-D mold of her jaw in order to reconstruct the missing bone. Two nerves were taken from her feet and put back into her face in order to try to return function to her lower left lip. After weaning off gastrointestinal and tracheotomy tubes, she learned to eat, talk, and breathe on her own again.

Ahead of the anniversary of the Vegas massacre, I met Natalie and her husband Jason at their home in Orange County, across the street from the Pacific Ocean, to find out more about her year of recovery. Here is Natalie’s story of survival, told in her own words.

Jason Aldean was several songs into his set when we heard some really loud noises. I remember one of my friends said fireworks. The next thing I knew, it felt like there was an explosion in my face and that my face was on fire. It kind of just hit me: Okay, you’ve just been shot in the face, and there’s still gunshots going on. This isn’t over.

We got down on the ground. It was chaos, 22,000 people crying and screaming, not knowing what to do. I was standing stage right, which is where the magnitude of injuries and deaths were. There was a stranger behind me who took her tank-top shirt off to hold it to my face. I could definitely tell there was something missing in my face. I thought I had lost all my teeth, because I felt so much stuff in my mouth, and I thought, Oh my God, my face has obviously been shattered into pieces and all my teeth have been blown off. Later they explained to me that what I had been feeling was all the bullet fragments and bone fragments that were stuck in my mouth. It was weird because when I touched my face I didn’t really feel anything and I didn’t understand it, but later we learned it was because the sensory nerve had been completely obliterated so I couldn’t feel the touch there, but from the explosion I could feel the pain.

I remember laying on the ground being like: Okay, you can breathe, you can control your extremities, so you have to stay calm and try and get out of here. I knew that I was having problems moving my mouth and communicating and that my left side was partially paralyzed. My left hand also felt like it was on fire and I kept looking and trying to figure out what was wrong with it. Later it turned out I had multiple pieces of shrapnel in there.

There was this naïve part of me that wanted to believe that we were all going to be okay. And when I got up I knew that wasn’t the case. We started running, I was pressing this stranger’s tank top to my face, and we were passing people on the ground and we just knew that they were dead. It was so hard to keep going because I just didn’t want to leave these people on the ground. I realized that they were never going to return home, and that they were somebody’s son or daughter or mom or wife or husband. I knew that because of the wound on my face and mouth, that even if I wanted to I couldn’t give CPR. It was horrible to not be able to help people. Eventually, I made it to the Tropicana Hotel where they were triaging people in the basement. I was bleeding a lot but I didn’t know the extent till later when Jason told me I’d lost a third of my blood supply.

Once I got in the ambulance, there was this guy with me that had been shot in the leg but wanted to help, and so one of the drivers said: Hold pressure on her face, we gotta stop her bleeding. So this guy who had been shot himself, the whole way there, talked to me and kept me calm. I remember feeling like my bones were being crushed when that person applied pressure, because I could literally feel my bones moving. I didn’t realize at the time how extensive my bone injury was. My doctor said it was like if you’d taken a china plate and dropped it on the ground and it had shattered. You’d find little ground-up bits and you’d find big chunks of bone. I still have bullet fragments and shrapnel in my face and neck that just don’t make sense to try and dig out. To this day when I have a CT scan you can still see the bullet fragments.

Courtesy of Natalie Grumet.
Courtesy of Natalie Grumet.

At Sunrise Hospital in Las Vegas, doctors performed an initial surgery to stabilize Natalie and reset her jaw. They performed a tracheotomy and inserted a feeding tube. When Jason arrived at the hospital, Natalie was covered in blood, and the side of her face was completely blown off. He recognized her only by the little braid in her hair.

I didn’t wake up again until September 4th, three days after the shooting. I have some vivid first memories of coming to in the hospital. I remember Jason being by my side and crying and telling me that he was sorry he wasn’t with me when it happened and that he loved me. I was trying to tell him, “I’m okay. It’s okay.” That was pretty emotional. My jaw was wired shut and I had a tube inserted in my throat so I couldn’t communicate very well. When I was finally able to talk a little bit, I asked him to tell me the story of how he found me — how he ran towards the venue to look for me while everyone else was trying to leave. I made him repeat that over and over. It brought me a lot of comfort.

I also remember being with my dad, and asking him to tell me the details of what happened. It was frustrating because I wasn’t able to really speak or write at that point, so I made the signal of a gun with my hand, and he understood what I wanted to know. I saw how hard it was for him to have to tell me what happened. My family was careful with how much information they gave me at a time.

Jason wanted to get me out of Vegas and to Mission Hospital, near our house. I don’t remember the flight back to Orange County. I don’t remember landing or getting into an ambulance. I was heavily medicated. I was pretty much in and out of consciousness and medically sedated over the next couple days.

Arriving at Mission Hospital on October 5, Natalie had significant skin, soft tissue, bone and nerve injury. Doctors removed the bone and metal debris from her jaw and fitted a temporary titanium plate to stabilize her jaw and chin. Plastic surgeons tried unsuccessfully to close her facial wound, but too much tissue had been destroyed; they ended up using transplanted tissue and skin from her neck. An unexpected fourth emergency surgery was needed to address the fact that Natalie was bleeding uncontrollably into her neck.

After my third surgery to finish closing the wound on my face, they were actually getting ready to release me and I started having really abnormal pressure on my left side, and they discovered I had a blood clot. It really scared me because it made me realize even in this safe medical setting with everything being planned, great physicians, there’s just uncertainty. I was worried about aspirating, I was worried about bleeding. And then as I got more comfortable and stable, I started to wonder: Am I ever going to eat an apple again? Will I ever feel safe at a concert again? Will I ever just enjoy being somewhere without being scared about what’s around me?

One day, I decided I was ready to find out more about the shooting. I looked on my phone and 58 names and pictures came up. That made it really real, to have names and pictures of them, to learn about who they were, their ages and what they did for a living, how many kids they had, what they were going to school for. I had a really hard time with guilt. I hated the unfairness of it — why I survived and they didn’t. I was also having all these flashbacks and memories of being under fire. It was a really hard time.

On October 21, Natalie came home from the hospital. Her jaw was wired shut and she had a feeding tube. She had been gone for 23 days.

When I came home from the hospital, my jaw was wired shut for eight weeks. I couldn’t gargle, because it would just spew out of the left side of my mouth. I couldn’t even blow out a two-wick candle. It was so frustrating to get my lips to cooperate to move together. It’s little things like that, that you don’t even think about, where you have to retrain your muscles and lips, and pay a little bit more attention and work a little bit harder. Trying to communicate was also really challenging. My mouth wasn’t moving a lot so I’d mumble a lot and get frustrated and feel self conscious. I had this writing board that I’d bring everywhere with me as my safety blanket.

At that point, we were going to doctor’s appointments two or three times a week. Just leaving the house was a challenge. I felt really alone at times, because I would just look around and wonder what would come next. At the same time, I also didn’t want to let my injury take over my life. I had to find a way to rebuild my life.

I also went through Thanksgiving with my jaw wired shut. We had to blend up turkey in a blender and it was hard for me to be around a lot of food. The smells and sights and everything made me really kind of nauseous and overwhelmed. I remember I was sitting outside of my aunt’s house, and I had this mug of blended up turkey. For a moment I had a little bit of pity for myself. I could hear my family inside, and talking and joking and laughing, and I knew they were having this great traditional Thanksgiving meal. Still, Thanksgiving is about gratefulness. I was grateful to be alive.

Photo: Jake Stangel

As Natalie continued in her healing, she often found the psychological symptoms were harder to navigate than the physical ones.

I had my first public meltdown December at the Marriott spa. We were getting massages for Jason’s birthday. We were in separate areas, like the men and women’s locker room, and there was all this construction going on. They had this jackhammer that was really loud. I was alone, and I tried to tell myself that it was construction and to stay calm, but the sound was just so loud and it really sounded like gunfire. I just started shaking, and I couldn’t help it. I ran out of there, and started crying, and looking for Jason in my robe hysterically crying. It was scary to realize how something so simple could bring me back to such an awful place.

It’s definitely changed that part of me. Now everywhere we go I’m just constantly evaluating in my head, “Is this a place that somebody would try to come and do something bad? Would someone try to do a mass shooting here?” I have all these weird habits. Like I’ll sit in my car when I’m alone for like sometimes a couple minutes before I get out, just to look around. I fixate on where the exits are. It’s hard for me to even just leave the sliding glass door open at night. I set up these booby traps, like I’ll move stuff in front of the door, so if someone tried to come in I’d wake up and hear them. I have been formally diagnosed with PTSD, though I don’t want to use it as an excuse. It just is what it is right now, and I know it’s not forever. Sounds can be really bad trigger points. Noises, helicopters, ambulances.

Gradually, Natalie started going outside, taking walks on the beach outside their house. In November, she went back to Las Vegas for the first time.

The first time we really did anything kind of big outside the house was about a week after I’d been released from the hospital. I realized that the crosses that had been put up at the ‘Welcome to Las Vegas’ sign were going to be removed and taken to the Las Vegas museum. I knew right away that I had to go pay my respects to each of them and their families, and that it would be a huge part of my healing.

I went, and I still had my g-tube in, I had a tube hanging out of my shirt. And my trach was still healing so I had a huge bandage over my throat and left side of my face. People looked and stared. But my purpose was bigger than that and I think that it gave me the confidence to say, like: I survived this, I’m going out and doing what I need to do to heal. That was really important to me and I think that it kind of led to other times leaving the house. I knew people looked at me and wondered what happened, but most were really kind. We’ve also built a whole new network of family and friends through the Route 91 group. We get together monthly and it brings me a lot of joy to see us all moving forward. We’ve been back to Vegas four times. We eloped there when I was 22 and for our 15-year anniversary, in June, we went and renewed our vows. I felt really compelled to not let that change that special memory and moment that we had that connection to, and not let that fear and negativity overrun our life. I did put parameters on some things, mind you. Like, “Okay, we’ll go, but we’re not staying on the Strip. We’re not staying at certain locations. We’re not driving down this street.” I find the healing garden to be really therapeutic. I think it’s a peaceful place to kind of pay respect to the victims, and I thought that they did a nice job putting that together.

On the third week of March, Natalie had her biggest surgery yet — a bone graft, in which bone marrow was taken from her hip to be placed in a 3-D mold of her jaw, where it was combined with protein with the goal of regrowing her jaw bone. She also had a nerve graft, transplanting a nerve from her left angle to her face in order to hopefully regain feeling in the lower left side of her mouth.

Photo: Jake Stangel

I was really looking forward to getting the bone graft done, because I knew that was a huge thing that was kind of weighing over me. I just wanted to get that step completed and check that box. It was definitely my biggest surgery so far, because not only was my jaw wired shut again, and obviously all my neck, and chin incisions reopened, but also it was hard to walk. My left side was just really weak from the bone marrow from my hip, and then also from my ankle where they took the nerve. I just took it slow. Gave my body a chance to heal.

I feel like I was very blessed to have skilled surgeons, and plastic surgeons. I think that the medical community and physicians recognized that there’s a huge part of emotional and mental healing that comes with aesthetically repairing somebody, and they made it a priority. I’m grateful for that. I was really lucky that they worked very hard to get my face as close to what it was. They were conscious enough to move everything to my jawline, so it does kind of hide the scars a lot.

My face obviously feels very different. When I talk, or when I move it’s very tight, and I can’t feel things the same. Every day I’m reminded physically that something’s different about my body. I definitely remember looking at myself when I came home from the hospital in the mirror for the first time, and my face was so disfigured and asymmetrical on my left side. It was hard to see, because that’s the first thing people see, and I couldn’t even really move my mouth to make a smile. It looked very odd. It’s hard to balance those feelings. You don’t want to be superficial, and ungrateful to be alive. So part of me was saying, “Who cares? You’re alive. Be grateful for that.” Then there’s the part of you that’s like, “But I’ve had this loss too.” I had to kind of acknowledge grieving that my face is different — that somebody did this to me, and disfigured my face. It is a daily reminder when I look at myself that I’m different. Some people will say like, “I can’t even tell. I don’t even notice.” But, I notice, and I feel it, and I see it.

One thing I catch myself doing it all the time is I’ll start at the top behind my ear, and kind of trace my scar down my chin. It feels very like hard and firm, because I lost all of like the normal muscle and soft tissue there when I got shot, so it’s just kind of like bone and mesh plate. It became a habit; I would just kind of trace it down through my chin, and then back up. It’s surreal to feel that on my face. As I was doing I’d replay why they were there, and how they got there, and what happened.

In July, Natalie had a second nerve graft, taking a nerve from her right ankle to replace her motor nerve to hopefully regain movement in her lower left lip. She’s still waiting to see what the results will be, although she has started to feel cold sensations which could indicate the first nerve graft starting to work.

The nerve grafts are considered unpredictable outcomes, so they don’t really guarantee you success. Still, it was important for me to try everything I could to get back to as normal as I could. We did the other nerve graft surgery in July, and that turned out to be a harder surgery than we anticipated. They thought it would be maybe like a three to four hour surgery, and it was six hours. Since then I’ve had more issues with my right side, for whatever reason, so I’ll have to have another surgery to correct that. They don’t know why. There’s no medical reason. It’s just how it happens sometimes. That has been frustrating.

I think I haven’t really been able to like give myself permission to start healing all the way until I was done with my surgeries. It’s hard to move forward when you know you’re just going to have surgery again, and it’s just going to kind of pull you backward. I feel like Humpty Dumpty; they just like keep piecing me back together. But I feel like just recently I’ve started to feel like: okay like I’m seeing that light at the end of the tunnel even more.

The anniversary of the shooting is today. In October, Natalie will have the last surgery to ease pain that has started forming in the right side of her face. She still wakes up in pain every day.

It’s super frustrating when people don’t realize how much hard work it is to get better. Sometimes it felt like the world was just moving forward, and I was just stuck in time. People see your life on social media and they’ll be like, “Oh wow, you’re really getting out. You did this, and that.” They have no idea how much work it took to get to that point. How much work it is to just sometimes get out of bed in the morning. It can be exhausting. And there’s the little things. Sometimes if a cup is too wide or broad, it can be really hard for me to make that complete connection with the surface of it, and I can’t always feel when something runs down the left side of my face, so it can be embarrassing or frustrating. But, just being able to grab a cup of water now and take a drink is something that I couldn’t do 11 months ago, so it’s improvement and process.

I think it’s going to definitely be interesting to get through the one year mark and then see where we go from there. I feel like I’ve had more good days than bad days lately. That’s a good start for healing. I’m so different, physically and emotionally that it’s hard to find that new person. I want to get to a point where I can go back to my job. I love working with my patients, and I love my co-workers. I miss them. I’m excited to put that back into my life. Jason’s brother is getting married in May in Maui. My life is very much divided before Route 91, after Route 91. This whole last year, I’ve spent so much time in the hospital, and surgeries, healing, recovering, that it’s really impacted my life. I can’t deny that loss. Sometimes it can be really depressing, and I think it’s almost like you have to grieve this person that you used to be, this life that you used to have. I don’t know if I’ll ever be free of physical pain. I don’t know if I’ll ever have movement of the left portions of my face again, if I’ll ever have sensation and feeling there. So, I think that I have to grieve that sadness, and I don’t know if I’ll ever be as carefree and nonchalant to be in a place and just enjoy it.

I feel like sharing my story has connected me with people that have gone through similar traumatic things, and it makes me feel less alone, and it makes them feel less alone. I try to find the positives in that. I just hope that when people read this, that they realize that there is always hope to get through whatever you’re going through. I think that there are always times in our life that we’re going to be given these trials and tribulations to go through, and we don’t get to pick them. We don’t see them coming. We don’t even understand them. But, there is a power that comes with finding inner strength and courage to move forward with grace and dignity.

Before and After Route 91