What getting shot taught me about practicing medicine in the US

How can doctors treat an epidemic if they don’t have the research?
How can doctors treat an epidemic if they don’t have the research?
Image: Reuters/Regis Duvignau
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When I heard the news of the back-to-back mass shootings in El Paso, Texas and Dayton, Ohio this August, I found myself flashing back to grim memories of my own encounter with gun violence.

It was late November of 2015. I was a fourth-year medical student at the time, and I was driving home from a shift at the hospital one night. Magazine Street in the Lower Garden District of New Orleans is usually a main thoroughfare bustling with visitors to art galleries, coffee shops, and restaurants. But at that hour, it felt like I was the only one on the road.

Out of the corner of my eye, I saw a man dragging a young woman by the side of the road. Without thinking about it too much, I stopped my car and got out to help her. I screamed at the man to leave her alone.

Instead, he pulled out a gun and shot me in the stomach.

Next, he aimed for my head. He pulled the trigger, but his gun jammed. It jammed three times in row.

I should have died. But someone working at a bar down the street called an ambulance, and I was rushed to the trauma bay at University Medical Center in New Orleans.

I woke up two days later, with no spleen and half of a pancreas. But fortunately, my family and friends were surrounding me and I got a second chance—my whole life ahead of me.

Being a doctor who was a victim of gun violence has given me a unique perspective on our society’s role in an environment full of violence. Having been the patient, I am more aware of the complex social system that health care plays a role in. In the hospital we have the ability to save lives and treat acute issues. But there are chronic public health issues that go on outside the operating room and hospital walls. And we as a society must find a cure. I’ve spent a lot of time reflecting on my near-death experience, asking: How could someone act with so much violence, with such ease?

In response to what happened that night, I and eight fellow Tulane graduates launched Strong City in 2016, a 501c3 organization that aims to empower underserved youth by partnering with community organizations in cities like New Orleans. We believe that focusing on our youth, the future leaders of our cities who need our guidance, brings us to the root of the problem.

As we continue to develop a strategy to make our cities stronger, what we really need are practical answers and real-time change.

A public health crisis

It’s time to think differently about gun violence. We see 109 gun-related deaths every day in this country—and that’s according to our most recent available numbers in 2017. It’s a public health crisis. We need to label it as such and use evidence-based practices to identify and track safer solutions.

If you have never considered gun violence to be a public health crisis, think about this: Imagine waking up one morning to discover reports that a common household chemical had become the third-leading cause of death overall among US children.

If evidence-based solutions to this crisis existed, would you not advocate for them?

Of course, that statistic is not about a deadly chemical, but actually represents those afflicted by gun violence. Along with my colleague Jeffrey Oestreicher, who’s a pediatric ER physician at Northwell Health hospital where I’m an orthopedic surgical resident, I’ve been working with the American Academy of Pediatrics to advocate for simple steps. These actions will not stop every firearm death. But can stop some.

Importantly, we have zero interest in a gun ban—we respect the Second Amendment and safe, responsible gun ownership. Americans didn’t ban household poisons; we made them less dangerous by assuring that they are stored safely and locked under the kitchen sink.

Similarly, evidence supports the conclusion that safe storage laws designed to keep guns out of the hands of children reduce firearm suicides and accidental shootings, although only 27 states in the US have any form of a Child Protection law.

When unexplained crib deaths (Sudden Infant Death Syndrome, or SIDS) reached epidemic numbers in the 1970’s, Congress allocated funds for aggressive research, which showed that the risk of death to babies placed to sleep on their stomachs was at least twice as high as those on their backs. With that discovery, the “Back to Sleep” campaign emerged and SIDS rates plummeted.

Data deadlock

Similar research campaigns produced life-saving interventions for lead poisoning and car accidents. Yet no research crusade has been directed at the epidemic of gun violence deaths. This is largely due to the 1996 Dickey Amendment, which has not just blocked the US Centers for Disease Control and Prevention (CDC) from funding researchers to examine this epidemic, but extended its far-reaching political chill on research to trickle down—even to hospitals like ours.

An amendment accompanying the nation’s comprehensive spending bill clarifies that the CDC can conduct research into gun violence—but cannot use government appropriation funds to do so. It was signed into law on March 2018. In 2017, again, for which we have the most recent available statistics, the country saw 39,773 gun-related deaths.

Oestreicher tried to study paramedic interventions in the pre-hospital setting for children who are shot to see if they led to increased pediatric survival. After a year of planning for the study, he was told by community organizations that it was “too political.” When he tried to pursue his study anyway, he found himself blocked from obtaining the data.

Like many other projects envisioned in trauma centers and medical schools around the country, his study was killed not by a lack of funding, but by fear—fear of the political consequences of doing as simple a thing as allowing people to study data.

Gun violence research of any kind has become intentionally conflated with advocacy, to the point where we can no longer objectively present life-saving facts. Federal research money is critical. But equally important is the strong message Congress would send by repealing the Dickey Amendment and allowing research to be carried out. This research would save the lives of Americans who have been shot without infringing on the rights of lawful gun owners.

We need to make sure fewer Americans become a victim of this crisis firsthand, like I did. Luckily, I survived. But every day, more than 100 people in this country don’t.

I think it’s time to join my fellow physicians in our call to finally develop a data-driven, evidence-based approach to gun violence prevention and immediately take meaningful and practical steps.