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ORLANDO, Fla. – The flashback hit nearly three weeks after Joshua Stephany and his staff carried dozens of bodies in bags out of the Pulse nightclub in Orlando.
The Orange County chief medical examiner thought he was ready to return to normal life, to socialize, to have dinner in public for the first time since the June 12 rampage that left 49 victims and the shooter dead. But when he met his friends, the restaurant's lights and sounds brought back images of the carnage at Pulse — traumatic scenes even for a man who constantly works around death.
"When you see people drinking at a bar, you get a flashback ... you know the scene where there's drinks on the bar, a tip jar, there's receipts, there's hors d'oeuvres, food," he said. "And then ... take all those people away."
Stephany, 41, and his staff are still coming to terms with the work they did that night. Stephany walked into a nightclub where drinks were still on the bar, tabs unpaid. But the walls were pockmarked by bullet holes and the floor littered with bodies.
"When we heard the term 'biggest domestic mass shooting in U.S. history,' then people started to get it," Stephany said. "Because we've all lived through the other ones: Columbine, Aurora, Sandy Hook, San Bernardino. We've all seen those from afar. But to be in it ... people are talking to us about possible grief that's going to happen. We don't know what's going to happen."
It is the job of a medical examiner to determine, scientifically, the cause and manner of death. He presents the findings to prosecutors, who decide whether a crime has occurred. Stephany says all the bodies in the Pulse case had the same manner and cause of death — gunshots — but the office is still putting together final reports for the FBI.
The onslaught of death that Stephany and his staff experienced that week in Orlando was unusual by any standards.
This was the same city where, just about 24 hours before, pop singer and former Voice contestant Christina Grimmie was shot by a gunman who later killed himself. When Stephany got the call about the Pulse shooting, he was still bleary-eyed from working late on the autopsies for Grimmie and the shooter. Later in the week, the office would receive the body of a 2-year-old boy dragged to his death by an alligator at Disney.
Stephany said he arrived at the Pulse scene around 7:30 a.m. and found chaos. Even though the shooter was dead, law enforcement was trying to determine whether shooter Omar Mateen had planted bombs, so Stephany couldn't access the club. Two bodies lay in the open near a bagel shop across the street, and others were at hospitals. Stephany focused first on those.
But he realized the numbers would be higher than anything he'd ever seen and that he'd be under intense scrutiny. He told himself: "Just don't mess up."
Around 7 or 8 p.m., he was able to start removing the bodies from Pulse.
The first body out was Mateen's. Stephany put his body in the morgue's "decomp room," a separate facility for a few older bodies — "the smelly ones," in the gallows humor of the office. Stephany wanted to keep the body away from the dozens of victims, a gesture that later drew much appreciation from their families.
By 11:30 p.m., all 49 victims were in his office being cleaned and identified.
At first, the task of documenting, bagging and identifying the bodies was its own kind of salve. It kept everyone busy. Stephany's crew finished the autopsies by that Tuesday evening — within 72 hours of the shooting — in a hangar with hoses and electrical cords hanging from the ceiling. This allowed families to start burying loved ones four days after the attack.
When the busy work was over, reality set in.
Days later, Stephany saw celebrities on TV reading biographies of the victims. Usually, he likes learning about those who've come through his morgue. This time, he turned the TV off.
"That would personalize it too much for me right now, and I'm still too close to it. I think that's going to have to be a slow process," he said, sipping from a mug emblazoned with a skull and crossbones.
Even people who are mostly accustomed to seeing the dead experience trauma from extraordinary events such as the Pulse shooting, said Dr. A.J. Marsden, a former U.S. Army surgical nurse and a psychologist at Florida's Beacon College. She said it may be several months before the flashbacks and nightmares stop for Stephany and others.
"Normally, in the first 36 to 48 hours after the event, people are focused and can get the work done. They go through the motions. It's the following week when they sit down and have to think about what they saw and went through," she said. "The Pulse shooting was so tragic, no one can ever get used to something like that."
Orange County has made grief counselors and comfort animals available to first responders and the medical examiner's staff, spokeswoman Carrie Proudfit said. Stephany also has found comfort in his two golden retrievers, Kennedy and Gronk.
In the end, Stephany takes pride in knowing his staff rose to a challenge. Now, he hopes to help other offices.
"This can happen anywhere," Stephany said. "If my experiences can help other offices prepare for the inevitable, I want to help."