Outside the operating room, hunched over the scrub sink feeling exhausted, demoralized, and with a sense of utter failure, we begin to wash off the blood that has seeped through our surgical gowns. And the worst part of it all is that we have yet to do what many of us consider to be the most difficult and heart-wrenching part of our job—explaining to a family that their loved one who left that morning to school or work will never be coming home.
As trauma surgeons who see what bullets do to people’s bodies, we have started asking ourselves if it is time to pull back the curtain and give Americans a look at the consequences of firearm violence—the damage done to the human body resulting in injuries too severe to repair, the despair of families torn apart, and the shattering of communities. These are injuries we know all too well. Every day, in hospitals and trauma centers across the nation, healthcare professionals are on the frontlines of this uniquely American public health problem.
Firearm injury is a public health epidemic that’s so prevalent Americans have become desensitized to its impact. Annually we see over 48,000 deaths and at least two to three non-fatal injuries per death. Over recent years, there has been a significant rise in the number of mass casualty shootings. In fact, in America, firearm violence is the number one cause of death in children. It is not car crashes. It is not poisoning. It is not cancer. It is bullet-related injury.
These tragedies often dominate the news cycle, but the sheer number of them, over 100 so far this year, has led to a normalization and desensitization to their horror. Just as concerning is the silent epidemic of firearm violence happening across the country where rarely a day goes by without someone being shot, whether it’s an unintentional injury, or assault, or someone that dies by suicide.
Additionally, the way that firearm violence is portrayed in media, particularly in movies and video games, also contributes to desensitization. These forms of entertainment often depict firearms and violence in an exciting or glamorous way, which can make it seem less shocking when we encounter them in real life.
These factors promulgate a culture where firearm violence starts to feel normal, or even unavoidable.
Working on the frontline of firearm violence feels different. It’s neither glamorous nor exciting: for medics, law enforcement officers, healthcare professionals, survivors, and, too often, family of victims. Firearm violence is traumatizing. And we’ve had enough.
In the operating room, we often treat children who are shot because of a firearm not stored securely. We’ve had to emergently deliver babies from their dead or dying mothers. We comfort parents whose children’s bodies are so unrecognizable that DNA samples are necessary for identification. We care for high school students bleeding to death before prom. And we’ve treated the students who smear blood across their limbs so that the gunman in their school thinks that they’re already dead.
These are not hypothetical situations. This is not a scene from a video game or the latest blockbuster movie. These are real people, injured or killed from unnecessary violence in a society that should know better. These are stories that have played out in the national news media and are daily occurrences at your local trauma center.
Healthcare workers, systems, and organizations are stepping up in a real way to be a part of the solution to this complex public health problem. Earlier this year Kaiser Permanente established a Center for Gun Violence Research and Education committing $25 million to the firearm violence prevention. Northwell Health’s Gun Violence Prevention Forum followed by launching a National Health Care CEO Council, including 50 of the nation’s largest health systems. And on March 6, 2023, 46 major medical organizations released the proceedings of the Second Summit on Firearm Injury Prevention with actionable next steps to create the Healthcare Coalition for Firearm Injury Prevention, which will leverage talent from across organizations to focus on addressing this public health problem in communities around the nation.
We took the Hippocratic oath, a solemn pledge to first do no harm. To honor our oath, we feel an obligation to speak out on behalf of our nation’s citizens, both children and adults. The epidemic of bullets in bodies needs to stop. Secure gun storage (known as Ethan’s Law), expanded background checks, implementation of extreme risk protection orders, and regulations of high-capacity magazines and assault weapons are common sense approaches to begin to decrease the death and disability from firearm violence.
If you saw the wreckage of firearm violence inflicted on people every day like we do, we suspect you’d feel the same.
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