Op-Ed: Saving Gun Violence Victims Begins Before the OR

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Like any teenager, I enjoyed attending high school football games and hanging out with friends. I did this routinely, just as my siblings did. But, like so many Americans, my life and the life of my family was changed forever when a fight broke out after a game and a stray bullet hit me in the throat nearly killing me. It took numerous operations and countless months of rehabilitation to recover, but the trauma of the event has reverberations that continue today for all of us. Ultimately, I got a second chance, and while sheer luck stood in the path of the bullet that day, it continued to fuel each next step of my life, shaping my own trajectory.

My second chance inspired me to pursue a career as a trauma surgeon. Every day, I am in the business of giving sick and injured people second chances. But when it comes to gun violence, my operating room really is a last resort, the last place of intervention before a bullet takes another life. There are so many opportunities for intervention before a patient ends up on my table, before I have to tell a family their loved one is gone forever. For that reason, I have been inspired to work on the issue of gun violence outside of the trauma center, at the nexus of medicine, public health, and public policy, where there are endless opportunities to stop bullets from being fired in the first place. Americans should not have to find themselves in that desperate position of fighting for a second chance.

The Gun Violence Archive reports that there were 611 mass shootings in 2020, up from 419 in 2019 and 337 in 2018. That is 611 incidents involving at least four victims. In other words, a minimum of 2,444 sons, daughters, mothers, and fathers. And that does not even begin to capture the thousands of injuries and deaths that do not qualify as mass shootings.

As a trauma surgeon, I often feel the weight of life and death. Not long ago, I walked up to the surgical ICU to speak to the mother of a 17-year old boy who had been shot in the head. Our team had spent the past hour making one critical decision after the other. We looked again at the scans, and discussed the case with all the members of our trauma team. But no amount of analysis could change the fact that this young man had a devastating injury that had shattered his skull and pulverized his brain. I began to feel that all-too-familiar heaviness on my chest: I would have to tell this child’s mother that her son would not survive.

Sitting at the nursing station, I did my best to gather my thoughts. I found myself lingering over his medical record, delaying the inevitable. As I gazed through the glass doors, I could see the mother grasping her son’s hand. While I could not see her features clearly, I know she was holding on to that last glimmer of hope. And I was about to shatter it.

As our team walked in, I could see the kindness in her face, the faith in her eyes, the fine lines gained over a lifetime of adversity as a single mom. She had done everything in her power to give her son a future she had never known. Looking into her tired, hopeful eyes, I took a deep breath and told her that her son would not survive. Then I waited.

Instead of collapsing into tears as so many mothers had before her, she began telling me about him. He had just graduated from high school, the first in their family, and he had his heart set on going to college. As she looked at our multidisciplinary trauma team, this devastated mother could see the desolation in our eyes. She walked over, placed a gentle hand on my shoulder, and asked, “Are you okay?”

I do not recall what I said in the moment, but reflecting on it now, the answer was no. I was not okay. I knew the best medical treatment for injuries like her son’s would not be found in the hospital; the solution starts long before, in the way we ensure responsible gun ownership, educate citizens, and fund communities. It starts with how we make and implement laws in this country, and with how we make sure those laws prioritize the lives of young people like that mother’s son.

Much can be done to stop the next shooting — and yet certain members of Congress continue to prioritize the profits of the gun industry more than they mourn the loss of life. In the meantime, more than 100 people die from gunshots every day.

For too long, the National Rifle Association (NRA), an inner circle of lobbyists, and the Republican politicians they support have purposefully stymied efforts to pass lifesaving laws. While the NRA mishandles philanthropic dollars in violation of U.S. law and Republican leaders look the other way, 40,000 people die every year in the U.S. from gunshot injuries. That’s forty thousand individuals who had their own communities and their own futures.

Access to firearms sits at the center of this problem. When young people attempt suicide or are unintentionally injured with a gun, three out of four times the gun comes from the home of the victim, a relative, or a friend. In other countries, initiatives like suicide prevention, safe gun storage, age limits, and firearm training have resulted in much lower rates of gun violence. The U.S. stands alone in our sky-high numbers of handgun injury and death, and the difference is our laws and our national leadership. The unwillingness to do the right thing, the dissemination of false narratives, and politicians controlled by the NRA have resulted in an unparalleled public health crisis.

I want to be crystal clear: the issue does not rest in the hands of responsible gun owners. In fact, the majority of Americans, including gun owners, support common sense measures like universal background checks, safe storage laws, assault weapon bans, appropriation of federal funding for gun violence research, and securing the firearms of people who are a risk to themselves or others.

Joe Biden made gun violence prevention a pillar of his campaign, and while the White House commitment is critical, alone, it’s not enough. Congress must come together to pass universal background checks, ban assault-style weapons, incentivize states to pass extreme risk protection orders, invest in community violence intervention programs, and codify the responsibility of gun owners to store and use their weapons safely.

The NRA once told us that, as healthcare professionals, we needed to stay in our lane. As long as we have to continue to tell mothers, fathers, brothers, and sisters, that their loved one has died at the hands of gun violence, this is our lane. And we will stay in it until the worst part of our jobs becomes a distant memory of a time when political courage failed us, and gun violence remained rampant.

Our members of Congress have a choice right now. The choice to put aside partisan politics and decide that they will no longer stand on the sidelines of history as communities continue to be decimated by this public health crisis. It’s too late for the victims of Boulder and Atlanta, but we can honor those victims and prevent further senseless tragedies by moving beyond thoughts and prayers. The number of lives we save in trauma centers across this country pales in comparison to what we can do by preventing these injuries from ever happening in the first place.

Joseph V. Sakran, MD, is director of emergency general surgery and a trauma surgeon at Johns Hopkins Hospital in Baltimore. He is also the founder of @ThisIsOurLane and board member at Brady United.

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