Xavier Lesaffre, an emergency doctor on the November night in 2015 when terrorists unleashed mayhem on Paris, collects his thoughts carefully before recalling the sequence of events that led him from a dinner party with friends to the epicentre of the carnage at the Bataclan concert venue. A decade on, he says he still asks himself why the attacks happened and what has changed since.
"What worries me is all the dissension that we feel in our society," he told RFI. "I think that's been something the attacks have contributed to ... more violence and more tension in our society."
Lesaffre had finished his shift as a physician at the Menilmontant fire station in northern Paris on 13 November 2015.
Walking past Le Petit Cambodge in the 10th arrondissement on his way to his dinner date, he paused to watch a fire brigade crew from the Parmentier station helping an elderly woman near the restaurant.
"I had been working with a team from that fire station that day and I wanted to give them some information on a patient that we had treated together, but it was not the same team so I continued," Lesaffre recalls.
Minutes later, terrorists attacked Le Petit Cambodge and the bar Le Carillon opposite, killing 13 and wounding 10. The rampage around Paris left 137 people dead and more than 400 injured.
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First moments
"About an hour later, I started to receive messages and calls that something was happening in Paris," Lesaffre says. "And right after that I received a call from my fire station asking me to come back to work because of what was happening."
Retreading his footsteps past Le Petit Cambodge, he saw colleagues from his fire station treating people on the terraces.
He found a taxi whose driver took him to Menilmontant for free. From there he was teamed up with a nurse and a driver and sent to the Bataclan.
As he sits by the blazing log fire in the living room of his home on the southern outskirts of Paris, his account radiates grace under pressure.
Victims were being rushed out of the concert hall into the street. The plan was to split them into two groups. "The most urgent ones were supposed to go into one courtyard and the less urgent ones in another courtyard," Lesaffre explains.
But the flow was such that rescue teams used anything they could find on the streets to carry victims and deposit them in either area.
Triage under pressure
"We started treating them and stabilising them," Lesaffre says. "Usually the role of the physician is to organise the flow, so you don't do much medically in the initial phase. You leave that to the nurses."
He worked in a courtyard with another physician. Together they organised care in one area and evacuation to hospitals in another.
In the immediate aftermath of the attacks, Lesaffre told friends the story of a judgment made too soon.
"A nurse asked me what she had to do about one particular patient," he recounts. "She had been doing everything she could ... like putting in adrenaline, but the woman had severe bullet wounds and she was going down despite all that the nurse had been doing.
"I remember it well because what I said was: 'OK, now we're going to have to organise a mortuary zone.'"
He says he pointed to a spot as the patient opened her eyes.
"I will never know if she heard me or not but it was really not a good move on my side to speak like that in front of her," he says. "But when you have a rush of victims like that, you have to prioritise and focus on those you think you can save.
"And effectively, we couldn't do more than what we had done for her except send her to a surgeon. And that's what was done once we had more teams on site."
Lesaffre smiles wryly. "I know she survived."
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Lessons learned
Two of Lesaffre's five children were eight and seven at the time of the attack.
“The first thing was to try and make sure they did not feel unsafe or threatened,” he says. "I explained that I did my work, which was to try and rescue people."
Following the assaults, Lesaffre spent 18 months travelling in Europe and Asia to lead seminars on how French emergency services responded that night to attacks on the Bataclan, cafes and restaurants in Paris and the Stade de France in Saint-Denis.
"What I tried to deliver to other medical teams was a fair account of all the things that were helpful in the way we were organised, but also our shortcomings and where we failed," he says.
"And it was also a chance for me to see how other services abroad were organised and to bring back some ideas and some training systems as well."
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Choosing life
Trying to implement some innovations in training and at the emergency call centres, says Lesaffre, proved too onerous and ultimately led to him stepping away from his role.
"My impression was that everybody knew that some changes were needed but at the same time they would not let it happen," he says without bitterness.
He also had a co-operative housing project underway. "It soon became clear that there was a need to be more involved in that," Lesaffre says.
Two boys and a girl, all born since he stopped life as a full-time doctor five years ago, further occupy his time.
"I've never been doing anything special or trying to not commemorate 13 November," Lesaffre says.
"It's rather been a point not to alter the course of my life because of these attacks otherwise I'd have the impression of conceding some kind of victory to the perpetrators who want to hurt us.
"It seems to me the more we go back to normal, the more strength somehow we build."
