Most doctors don’t spend much time treating gunshot injuries, emergency room physicians and surgeons excepted. My own experience with guns is confined to the quick occasional glimpse of a cop’s firearm, which, depending on your vantage point, can be viewed either as reassuring or menacing. My first and last encounter with a firearm was as a child and involved a BB gun I had for less than a day before my parents disappeared it from my life.
As a young physician, I took a temporary job in northern Minnesota that involved not only taking over a GP’s practice, but also acting as county coroner. During my time there, I dealt with one murder-suicide (a fisherman from Chicago shot a state trooper and then himself), one shotgun-to-mouth suicide, and one desperately sad and life-changing injury in which a hunter’s spine was severed by a bullet after his shooting partner mistook him for a deer.
My involvement with these gun-related incidents was minor, the job consisting mainly of preparing the paperwork on the deaths and sending the paraplegic hunter to Duluth for surgery and rehab.
Death by gun, injury by gun
It’s my sense that people tend to think more about gun deaths than gun injuries. Of course gun deaths are “cleaner” in a sense, a crisp tally that grows larger every day, each a deeply personal tragedy for the victims’ friends and family, and certainly for our larger society as well.
To date in the US there have been 13,092 firearm-related deaths, though the numbers change so quickly you’ll need to check with the Gun Violence Archive for today’s total. 543 of those deaths (probably more by now) occurred in Chicago. Then there are the 58 people massacred this year in La Vegas. Most recently, 26 people were shot to death in a small Texas town by a man with an assault rifle.
The front lines are populated by dedicated emergency medical technicians (EMTs), nurses, and doctors, all making their best efforts to save the lives of those wounded on our ghastly killing fields. Interestingly, the ratio of those killed to those wounded stays fairly stable at 1:2. In other words, two people are wounded for each person killed by a firearm.
Click back to the Gun Violence Archive to see this ratio holding surprisingly stable. In Las Vegas, where 58 died and more than 500 were injured, the ratio was skewed, probably because of the type of guns used by the shooter.
Guns destroy human bodies
I was first exposed to the damage a gun could do to a human during my surgical rotation at Cook County Hospital when I was in medical school. The owner of a bungalow caught an 18-year-old stealing his portable TV and shot the young man as he was making his getaway through a side window.
The bullet entered the kid’s right side, just below his bottom rib, traveling into his abdomen and ripping through his liver, gallbladder, spleen, and intestine before exiting on the left side.
As a med student, my job was to stand at the operating table in County’s overheated OR with the head attending surgeon, his first assistant (a resident), a second medical student, a scrub nurse, and an anesthesiologist. The med students’ job was to keep hold of the retractors, metal instruments with a nasty curve that pull open the patient’s abdomen so the surgeon has a clear field in which to operate. We pulled those retractors with all our strength to keep the operating field open, our upper arm muscles shaking with the tension of it, knowing that letting up would cause the abdominal area to close, limit the operating field, and place the surgeon in the position of operating blindly.
My med-school partner and I pulled on the retractors for the six hours it took the surgeon to complete his work. If we let up even a bit on the pressure, the surgeon first warned us verbally. A rap on the knuckles with the handle of whatever instrument he was holding at the time served as follow-up.
It’s only in films that nurses wipe the perspiring brow of the surgeon. In that steamy operating room, the surgeon and his first assistant wiped their brows on the medical students’ shoulders. After six hours of steady pressure on the retractors, I was sweat-drenched and my arms were throbbing, but that was nothing compared to the kid who took the bullet.
And the police were everywhere. A cop sat outside the operating room, I suppose thinking the kid might leap up and make an escape. Another policeman sat at the foot of the young man’s bed in the surgical intensive care unit for a week until the gunshot victim developed an infection. The cop stayed with him in the medical intensive care unit, too, until the boy died ten days later of an infection.
Everything changes when you’re shot
After my surgical rotations, I moonlighted in several emergency rooms, where I saw so-called “minor” gunshot wounds (GSWs for short). I helped extract small-caliber bullets from arms and legs, people with GSWs to the head, neck, chest, and trunk being immediately whisked to the OR.
If you’re ever shot (and the chances aren’t unreasonable since we’re the third most dangerous country after Mexico and El Salvador), chances are a trauma surgeon will operate on you, and these professionals really know what they’re doing.
But my point here is that it’s not just the immediate treatment of a GSW we should focus on. No individual is ever the same, physically or emotionally, after being shot. My father-in-law was a WW2 Ranger who landed at Normandy, endured severe back pain every day for his remaining 55 years, and battled post-traumatic stress disorder for decades.
Not a single one of the survivors of the Las Vegas massacre will ever be the same. Neither will the families of the Texas dead, aged 17 months to 77 years old.
A major public health issue
Every thinking physician–gun collectors and NRA members included–knows that gun violence is one of our greatest public health issues. Think about this: the number of people who will experience gun violence (fatal or not) is about the same as the number who will be diagnosed with pancreatic cancer. We spend enormous sums on cancer research, so why not devote some of our tax dollars to the health risks of guns?
The answer is straightforward. Just as the tobacco industry blocked medical research that might link lung cancer to cigarettes, the gun lobby pushed the infamous Dickey Amendment through Congress. This notorious amendment (introduced by former Rep. Jay Dickey, Republican from Arkansas, who now says he regrets it) was a provision inserted into the 1996 federal government spending bill that would determine how much money should be allocated to the Centers for Disease Control (CDC).
Some reasonable discussion about doing research on gun safety had already occurred. In 1993, in fact, one study showed that the mere presence of a gun at home increased the chances of a homicide occurring there. But research on gun deaths was halted because it could be interpreted as CDC advocating gun control, and the provisions of the amendment would be violated and CDC’s funding cut off.
It’s a bit like saying “Do all the research you want on cigarettes, but if you identify a link between lung cancer and tobacco you’re forbidden by law to say anything that might cause people to quit.”
Then, in October, 2015, 110 members of Congress (all Democrats) signed a letter asking Congress to reject the amendment and remove it from the spending bill. But since Congress is controlled by Republicans and members are significant recipients of NRA money, the Dickey Amendment remains solidly in place.
Automatic repeating (ARs) rifles, like one ones used by Stephen Paddock in Las Vegas, can shoot nine rounds per second. They can kill from a distance of five football fields away. They are seriously dangerous. But, then, virtually all guns are.
While laws forbid the CDC from telling you that being shot can be fatal or extremely painful and life-altering, I’m under no such ridiculous restriction. If you’re shot dead, your sudden death will affect more lives than you can possibly imagine. If you’re shot and survive, you’ll be physically and emotionally scarred for the rest of your life, as will your family and friends. It’s criminal that there are members of Congress who don’t want you to know this.
In a gruesome stroke of serendipity, in the 36 hours between the time I wrote this and its publication, a capable, loving teacher at the school my sons attended as children was murdered by gunfire in her own.
If you are a victim of Gun Violence, speak with a Personal injury lawyer attorney today to help yourself to a better mental, emotional, and physical recovery. You should also speak with a medical professional such as the Internal Medicine Specialist Chicago IL locals trust.
Thanks to author Paul Rubin at WholeHealth Chicago for extensive insight into Gun Violence.