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Doctors are ready to share their stories from the frontlines of America’s gun violence crisis

Doctors are ready to share their stories from the frontlines of America’s gun violence crisis

Picture of Megan Ranney
[Photo: Scott Olson/Getty Images]

Many years ago, a young man was rushed by paramedics to my emergency department, where a trauma team was fast assembling. He had shot himself in the head. The moment he rolled through the door, I knew his injury was non-survivable. I was relatively inured to death thanks to my training, and a gunshot wound to the head is usually fatal, so the injury itself wasn’t shocking. What shook me to the core was the boy’s father. The father had thought his gun was safely stored. He didn’t know that his son knew where the key to the gun safe was. That father will live forever with the knowledge that his own weapon caused his son’s death.

This case is one of hundreds of gun injuries that I’ve treated in the emergency department over the last 14 years. Some, like suicide attempts and domestic violence homicides, rarely make it to the hospital. Others are blurry in my mind, because they are so similar to so many others: “Another young minority male lost in the prime of their life,” “another family torn apart.”

My patients’ stories are not unique. Each of the U.S. gun deaths and more than 80,000 gun-related injuries in 2016 were touched by someone in the health care system. As physicians, we are uniquely privileged to see these tragedies, and to give a human face to the legions of injured and dead.

For our own sake, doctors often wall off the details of these patients. We emotionally know that each of these tragedies is a person who should not have been hurt. But we wouldn’t be able to keep treating the patients who need us, if we were consumed by anger and sadness about the lost lives.

Most of the post-Parkland media coverage has focused on mass shootings. Some pieces talk about gang violence. A few discuss suicide, or evidence-based injury prevention. Largely lacking from the discussion is the wide, messy arc of havoc inflicted by guns on all aspects of our society.

We quickly quote statistics about gun violence: Over 38,000 Americans died from a firearm injury last year. Almost two-thirds of these deaths were suicides. Most suicide deaths are middle-aged white men. Most homicides are young, minority men. Most domestic violence homicides are shootings. Many of these deaths would be “preventable” if we were allowed to apply classic public health precepts to the problem. We urge research, and try to create evidence for prevention. We talk about gun violence in aggregate.

We also recognize that these statistics elide the true face of firearm injury.

Most of the post-Parkland media coverage has focused on mass shootings. Some pieces talk about gang violence. A few discuss suicide, or evidence-based injury prevention. Largely lacking from the discussion is the wide, messy arc of havoc inflicted by guns on all aspects of our society.

The #docs4gunsense hashtag arose from this realization that doctors have a privileged view of the true impact of guns — and that we therefore have an obligation to share the stories to which we have attended. In discussions with physician friends across the country (including Esther Choo, Dara Kass, and Gita Pensa), we discovered that each of us had our “most tragic” patient vignette. We also had dozens or thousands of other gun victim stories, stored somewhere in our psyche. We wondered what other doctors had seen and felt. We decided to ask.

I was overwhelmed by the response. Over the course of just two days in February, hundreds and hundreds of stories about doctors’ personal experiences from gun violence poured in. The stories were shared via Facebook, Twitter, and email. They came from every medical specialty, every state, and every training level. They came from doctors, but also from paramedics and nurses and physical therapists and community health workers.

Some stories were about the face of the shooting victim who was about to die. Some were about the families left behind, and the horrible job of having to tell a mother or father that their child was gone. Some were about the long-term consequences of gun injuries — the decades that a gun violence survivor spent in the nursing home, in a wheelchair, or in a vegetative state. Some were about their patients’ post-traumatic stress, substance abuse, and depression that followed a gun injury or death.

And many, many stories were personal. They talked about a co-worker, friend, or relative who had been shot and killed. About the burnout and depression and sadness that was caused by the accumulated burden of lost lives. About the attempts to keep going, in the face of horror.

To quote from one of the Twitter stories shared with me: “These patients are forgotten by our society.” The anecdotes are difficult to read, but they bear witness as no numbers can.

My hope is that these stories remind us that the struggle to stop gun violence is not a struggle between partisan sides. It is not about gun control versus Second Amendment rights. Nor is it about statistics. This struggle, and these stories, are about protecting our society from fear, from injury, from death, and from the incalculable long-term consequences of a bullet.

[Photo: Scott Olson/Getty Images]

Comments

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Try working in EMS where the GSW related suicides and MVAs are so bad that the doctors never see them because they are dead before we even get there. THAT is the ‘front line’ of the gun violence epidemic. Most physicians have no idea what it is like to see someone shoot themselves in the head in their home where family is left to cope with the aftermath. THAT is difficult.

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Dear Medic, Thank you so much. I absolutely recognize that my first responder & LEO colleagues see the worst of it - and that most GSWs never make it to the ED. Thank you for everything you do. I appreciate your sharing your voice.

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Doctor Ranney,

Thanks for your reply and your well written article. As an ER physician, you also see much worse than most of your other physician colleagues. Unfortunately, we carry this heavy burden that continually weighs on us. Part of me wonders if that is the bigger contributor to ER physician burnout than the other current proposed reasons.

As a current pre-medical student, I hope to combine my experience in EMS and my MPH degree once I enter medical school. I want to lobby for better mental health awareness for those of us who work in the realm of "emergency medicine." Most of the time, it can be the best job on Earth; other times, it can also be hell on Earth.

Warm regards,
Medic

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