Seeing My First Gun Shot Victim

?My First Gun Shot Patient:

The call came over the emergency room’s (ER) loudspeaker: ‘Trauma Activation. EMS is bringing in a Gun Shot Victim. 4 minutes out. 22-year-old female. Trauma team to the ER STAT.’

I had just earned a spot on the trauma team, having had to take many courses and certifications. Up until that evening shift, I had never seen anyone who had been shot. I was like you: the uninitiated, the na?ve, the shielded.

People You Never Met

Then 4 minutes later, in came the paramedics with a person who just became ‘our patient.’ Waiting in the trauma bay were three nurses, two doctors, a lab tech and radiology. The patient had been shot in the face with a small caliber handgun. I remember this clearly because she was talking, which I couldn’t believe, since she was indeed shot in the face. To my knowledge, she survived.

The next gunshot victim (later that same shift) was shot in the abdomen with a large caliber weapon which ripped the patient’s chest open. This patient was intubated, two large-bore IV’s were running wide-open and CPR was being conducted while the paramedics were wheeling the patient into the trauma bay. That patient died right then and there.

Almost every shift the staff treated one or more ‘trauma activations.’ Most were horrific, bloody cases, and many of these patients died right there in the trauma bay. As far as we could make out, most of these cases were pointless killings. Some were outright depraved—like the man who shot his girlfriend in front of their 6-year-old son.

Gun Violence After The News Stops Filming

In our society, news networks don’t show what it looks like when victims of gun violence become patients in the ERs. When these victims become patients, the terribleness of the crime continues because these ‘new patients’ are subjected to harsh and emergent medical treatment. This treatment often includes inserting big IV’s put into each arm, putting tubes into every opening, being intubated, taking x-rays, drawing blood for labs, probing the chest or gut or arm or leg or head to find the bullet(s). All of this is done in the hopes of ‘stopping the bleed’ so we can keep the patient alive long enough to get them to surgery.

If the patient makes it to surgery, this type of emergency surgery is called ‘unplanned surgery,’ and is the riskiest surgery there is because—as the name suggests—it is not planned. No one has prepared for this patient, so the surgical team is, almost, going-in blind. And then, if the patient makes it out of surgery, the recovery starts.

The Pathway of Victimization After the Shooting

This whole pathway of victimhood is important to know about since the crime and horrors of gun violence is not just the shooting itself, it is the aftermath of surviving the physical injury. And of course, dealing with psychological injuries too.

Why Talk About This?

As doctors and nurses we are duty-bound to talk about the horrors of violent crime because the harm and injustice must be kept in the public view. It should not be ‘routine’ for an ER nurse to expect to treat 3 or 4 gunshot victims every shift.

?The intensity of these types of injuries should not be shielded from the public view.

According to the CDC, in 2020, firearm-related injuries were among the 5 leading causes of death for people ages 1-44 in the United States. About 125 people die each day from guns. ?The American Medical Association—not known for their progressive views—state that ‘Firearms violence is “pervasive, it's systemic” and requires a public health response.’

So, What Did I Learned About Guns and Emergency Rooms?

I learned that gun violence is usually—if not always—senseless. It is a demeaning way to die. It is an expensive way to die.

I learned that, while we have a lot of gun violence in our society, and while we see it often on the news, and even though we see the horror on parents’ faces with school shootings, and even though we see the horror on citizens’ faces when daily errands turn deadly, we do very little to stop this epidemic of terrorism and death.

Gun Violence Guts the Soul of Clinicians

It is the job of the nurses and doctors to advocate on behalf of their patients and family. Consistently and uniformly all clinicians feel that gun violence is irrational, destructive and sad beyond anything you can imagine.

Some doctors and nurses say that ‘if only people could see what we see in the ER, then there would be less violence.’ Perhaps.

Why don’t clinicians and hospital administrators invite the public to see what it looks like when a trauma team starts ‘working on’ a patient—and how messy, manic and dicey it all is. And how, despite a whole roomful of experienced clinicians’ efforts, good people die.

Is it Irrational to Imagine a Safe World?

It is (past) time to realize that gun violence is a ‘whole cycle of despair’ and, hardens our collective souls.

It sounds almost irrational to imagine a world where it is safe to do the simplest of things like being comfortable walking to your car at night, or going shopping, or dropping kids off at school. But imagine if this were true--that it was safe from harm to do these simple, daily activities. Imagine how amazing it could be.

In fact, it is so simple that it could be attainable. Let us not lose sight of ‘the possible.’ This is possible. ‘Safe’ is possible. Let’s make ‘safe’ possible.

Ms. Kliger is an independent consultant whose firm, The Altos Group, LLC specializes in health-technology growth, real-world implementation, and ROI measures, metrics and clinical outcomes. She can be reached at [email protected].