An eye surgeon and former Navy SEAL who helped transform battlefield medicine is on the front line of a national push to save the lives of civilians targeted in mass shootings and terror attacks.

Frank Butler, 67, of Pensacola was the command surgeon for U.S. special operations when American forces entered Afghanistan after the 9/11 terrorist attacks. Because of his work, all American soldiers deployed in war zones today carry tourniquets as part of their standard-issue equipment — a move credited with saving hundreds of lives.

It was mid-afternoon, on the first day of deer season and Chief Joe Tuckey of the Tecumseh, MIch., Fire Department was multitasking, furiously, in his office.

In one week last month, paramedics responded to 494 suspected drug overdoses in Greater Vancouver, including 271 in the Downtown Eastside and 81 in Surrey. These numbers are not just alarming, but becoming alarmingly routine.

That was just one week in an ongoing opioid epidemic that has killed unknown thousands across North America this year. Even the U.S. Centers for Disease Control can’t offer a national estimate for 2015 or 2016; it says “Opioids were involved in 28,647 deaths in 2014 and opioid overdoses have quadrupled since 2000.”

There are two clocks running from the moment an active shooter begins; the shooter’s clock and the victim’s clock. One clock is concerned with living; one clock is concerned with dying. The shooter has to shoot as many people as possible before he’s stopped. The victim (casualty) has a period of time, depending on their trauma, where they can still be treated and live. The idea behind rescue task forces is to start working on the victim’s clock.