HOW HAS GUN VIOLENCE AFFECTED YOU?
Medical Student
RESIDENT PHYSICIAN
EMERGENCY MEDICINE PHYSICIAN
Students from Temple Medical School, including the author of this Our Story, Izaak Tobin
The safety notifications at Temple Medical School in North Philadelphia were initially just background noise—alerts about areas to avoid. These notifications became painfully real the summer following my M1 year during a clinical internship in the emergency department. Minutes after receiving a shooting alert, I would find myself in the trauma bay watching the medical team provide lifesaving care for the patient in the trauma bay. Witnessing firsthand the devastation gun violence inflicts on our community transformed my perspective.
This urgency led me to found Student Doctors Against Gun Violence (SDAGV). Our mission is to address gun violence through community engagement and education. We’ve distributed gun locks at community events and through door-to-door outreach in neighborhoods affected by gun violence. We've also organized Stop the Bleed training sessions and developed a curriculum to help medical students incorporate firearm safety discussions into patient care. The support from fellow students and faculty has been overwhelming, reinforcing the importance of this work and desire for this education.
Discovering Scrubs Against the Firearm Epidemic (SAFE) felt like the next important step for our organization to continue to expand our work. SAFE has offered to provide the guidance and resources we needed to focus our efforts and expand our reach. Their collaborative approach will empower us to tailor evidence-based strategies to our community, amplifying our impact. SAFE has not only been a resource but also a reminder that we’re part of a larger movement fighting to reduce the harm caused by gun violence."
Since i last saw you your heart has beat 20 million times. Your lungs have taken 5 million breaths. Your eyes have been open for thousands of hours.
When we went into your room every morning on rounds nobody talked much. There wasn't much to say. Not much changed from day to day. Yyou weren't getting better but you weren't getting worse. We watched your heart beating on the monitor over your left shoulder. We listened to the ventilator humming in the background, watched your chest rise and fall rhythmically with it.
Your family asked about the plan every day as we left the pediatric ICU. Visitors weren't allowed in the unit. Your dad wanted to know specific lab values, how your sodium trended overnight, how high your lactate was, if you were still on pressers. Your mom just wanted to know if you'd opened your eyes yet. Your little sister asked if she'd ever be able to hug her older brother again.
A few days after your admission i saw your parents meeting with the organ donation team. They'd had the conversation we'd all been thinking about since you were first admitted to the hospital. It was the direction we knew things were going in but there was a certain finality seeing them sitting there after being stuck in limbo for so long. Your parents were the ones to request the meeting. The medical team hadn't brought it up yet. They asked about who is eligible to become a donor, they asked if the gunshot wound would prevent you from becoming a donor, they asked about what organs you'd be able to donate, and they asked if they would ever be able to meet the recipients.
The organ procurement happened a couple days later and was successful. your heart, both lungs, your corneas, as well as your liver, kidneys, and small intestines have new homes.
Since i last saw you your heart has beat 20 million times, your lungs have taken 5 million breaths, your eyes have been open for thousands of hours. But you will never feel your heart beat against your chest again. You will never catch your breath when you step outside and breathe in cold winter's air. You'll never see another sunset.
In medicine, we are far too familiar with stories that don't have happy endings - where the ends don't justify the means. We put everything we have on the table and still get beat. Sometimes we do everything right and we still lose. Other times there's nothing left to do because the game is already over. We expect stories that don't have happy endings as part of the game.
Since i last saw you, I've been thinking about the silver lining in your story. Even though it was the worst day of your parents lives, other families got the call that after months or years of waiting their kid was finally going to get a new heart, a new lung a new kidney. By choosing in that time of immeasurable grief and heartbreak to share your heart with strangers, they kept your story going. Your story did not end that day. Every one of those 20 million heartbeats is physical evidence of that. I can't tell you that your story had a happy ending. I can't tell you that since i last saw you we've put a stop to gun violence because since I last saw you almost 900 other children have been killed by guns in the US. I can't tell you that we've finally woken up to the fact that even living in a home with a gun triples one's risk of dying by one and that those who buy firearms for safety are often doing more harm than good. Because since I last saw you five million more homes have guns in them.
I can't tell you that your story had a happy ending but i can tell you that your story isn't over yet.
He was 3 months old, beautiful, crying, and had a through-and-through gunshot wound to his head. It was around midnight on an overnight shift, and suddenly a police officer drove over the curb at our emergency ambulance drop-off, got out of his car, and ran in while cradling a baby in his arms. He immediately yelled in a broken voice, "I need help! There's a baby with a GSW to the head!" The emergency department's charge nurse simultaneously over-head paged a critical trauma and pointed him to the trauma bay where he ran in, setting the baby down on the gurney. I was an emergency medicine attending just 2-3 years after residency graduation. My senior resident, my co-attending, and 2 nurses run into the trauma bay and see what will forever be embedded in our hearts and minds: a beautiful baby boy dressed in a decorative onesie, crying and whimpering in pain with his eyes closed, his head and shoulders wrapped in a towel that was covered in blood - - the innocent victim of a senseless act of gun violence while in his carseat at his aunt's home where several others were shot from bullets of a gun fired outside of the house. The emergency physicians in the room quickly started the resuscitative efforts with my colleague at the foot of the gurney leading the resuscitation. Soon, the trauma team arrived, then the pediatric ICU team, then the pediatric neurosurgeon. I placed the central line, hung the blood for transfusion, reported back to my colleague as we do during any resuscitation to the trauma lead. Each person had a role, and each didnt give up. We usually know if someone will survive within 30 minutes or so into ourefforts, and we knew he would not - given the extent of his gunshot wound. But, we kept at it...for 2 hours. We kept fighting, we kept trying, We wouldnt, couldnt, stop. Finally, the trauma attending said it was done, that there was nothing more that we could do. We all looked at each other, stepped back from the gurney, and put our heads down - in sadness, in anger, in prayer. I realize now that we were fighting not only for his life, but for much more. We didn't want this epidemic of gun violence to win - not on our watch, not with this adorable baby. Although true that there was nothing more that we could do for him, there is so much that we could do to open everyone's eyes to this horrific, devastating, and heart-breaking effect of gun violence. I walked out of the trauma bay tired, defeated, my eyes filled with tears that I didnt want to have show. Im supposed to be strong, Im an emergency physician after all. In the hallway outside of the trauma bay I heard crying - a mother's gut-wrenching tears. I found out she was also in the emergency department with a non-life threatening injury. So was her cousin. She knew... She knew what happened to her son. And, when my colleague who led the resuscitative efforts went to tell her that he died, I waited in that hallway outside of her room, my head remained low, and I tried to prepare for the vocal sounds that only come out a person after they are told their loved one has died. It came, I heard it in my core, and it has never left me. The built up tears came, and my heart hurt. I stood there and thought : "Im so sorry. Im sorry I couldnt save your son. Im sorry for your emptiness that you will forever feel. Im sorry this country allows for anyone to own a gun. Im sorry I havent done more to change the system. Im just so sorry." It's been 10 years since that happened, and it hasnt gotten any easier to deal with as a healthcare provider - not in the least. Since then, more and more doctors and nurses have put out gun control statements, stood in the rain in protest, and yelled how we must change the system. God, I hope it changes soon. There's too many victims - too many. Today and everyday, I will speak about how gun control must exist, how we as a society must care, and that we can no longer deny that this epidemic of gun violence doesnt exist, shouldnt be spoken about, or cannot be studied. When I left that hallway and entered back into caring for the other patients that were in our emergency department, I promised that for that beautiful 3-month old baby (and all the victims before and after) I will always advocate for better gun laws, show up at every gun control event, and stand for what is so long overdue: a cure. Today, as I hold my now 3-month old adorable baby in my arms, I continue to Stand SAFE for you.
Pediatrician
In residency, I cared for a teenager who was shot while walking to a nearby convenience store to buy birthday candles for her brother's cake. She was caught in the crossfire of a grudge between two warring gangs. She made it back to outside her house, where she bled out in her mother's arms and arrived to the hospital in cardiac arrest. The surgeons had to rip her chest open, massage her heart and pump her back full of blood. They saved her life, and miraculously, she had very few neurological deficits from the cardiac arrest. Although she survived the tragedy, she faced a long recovery from the emotional and physical trauma of such a scarring event. I watched each day for the month while she was there--first in a coma while her family kept vigil, terrified to take their eyes off of her should she be gone in the moment when they dared close their eyes for sleep. After she came out of the coma, she became more guarded each day as she processed the events. She would jump or startle with any loud sounds or sudden movements, her emotions swung wildly between being detached and distant to become enraged at her family members. Children like her are at high risk for depression, anxiety, and post-traumatic stress and she will return to living in a neighborhood where gun violence is unfortunately all too commonplace due to wide availability and easy access to guns. No child should ever fear being shot when walking to the store in broad daylight. By passing common sense gun reform laws, we can ensure those who own guns are responsible and law-abiding citizens and prevent tragedies such as this in the future.
ED PEDIATRICIAN
As a pediatrician working in the emergency department, I expect to see ear infections and colds, sprained ankles and broken bones. But in the back of my mind, I know that at any time a child or adolescent could come with a gunshot wound. I was reminded of this when on a previously quiet night shift, a young adolescent boy came in with a bullet in his leg. He was pale, and initially had the kind of fast heart rate and dropping blood pressure that makes us as doctors concerned for significant blood loss. When we lifted his thigh, we saw the back of it covered with congealing blood. At first, he didn't even know where he was, and he didn't have a family member there with him. When he finally became more oriented and we had finished doing a thorough exam to look for other mortal wounds, the first thing he asked for was someone to hold his hand. The second, a phone to call his parents. Though I was not able to prevent this trauma from happening to this boy, I could meet these asks. So I stood there, simply holding his hand, reassuring him that we'd get his parents over to the hospital somehow and that everything would be all right. This is the kind of moment that brings one down to earth, that cuts through the political rhetoric and gridlock to expose in its most most raw and vulnerable form what's at stake - the lives of kids.
I was called a couple of weeks ago by a buddy who does a lot of good work supporting our local veterans community. He had just been contacted by the grieving father of a young Marine combat veteran who had been struggling with PTSD. Sadly his son bought a weapon and ended his life, alone, in a cheap motel room. The Marine's last wish was to have his body donated to our medical school as an anatomical gift. This brought back a flood of memories from serving as Commander of our USAF combat hospital in Baghdad during the surge, where one of my duties was to go to Mortuary Affairs almost every night to unzip body bags and sign death certificates on brave Americans who died the previous day in combat, before their remains were shipped back to Dover AFB in a flag-covered transfer case. I usually suppressed my tears while in the presence of the Mortuary Affairs Soldiers, but I always cried when the following morning we would stand at attention on the flight line and slowly salute as the transfer cases were loaded on the C-130 and the chaplain would recite the 23rd Psalm. While the combat deaths were heartbreaking, almost worse was having to pronounce a Soldier or Marine who committed suicide downrange. In almost all of these suicides this was an impulsive act that would not have happened without instant access to a firearm. I'd like us all to come together to come up with ways to make it harder for both veterans (and civilians) back here in the US who are struggling with psychiatric issues to access a weapon.
Retired USAF Colonel, flight surgeon and hospital commander
Pediatrician (and parent)
I have cared for too many victims of gun violence in the pediatric ICU. One of my earlier cases was a young boy who was accidentally shot by his older brother. He lived, but was in the ICU and hospital for many months and has permanent severe disability. Over the past year, I have had several epiphanies as a researcher and a parent that have led me to want to be more involved on this front. I learned about Parkland as I was editing a paper focusing on reducing lab testing in the hospital, and I distinctly remembering having the thought: "As important as all this work on overuse is, it just seems so inconsequential when juxtaposed to what is happening right now with gun violence". And then a few months later, Sante Fe, TX happened, and my thought was "If one of my own children gets shot, I will have to live with the fact that I could have done more about the gun violence problem in this country, but didn't."
Currently, there is a huge disconnect between the major health threats to our children (i.e. gun violence, climate change, opioids) and the things we are focusing on and studying in the academic setting. I want to help change that.
I am primary care pediatrician. One of the reasons I chose this field of medicine is to prevent shootings like my sister's. My sister was shot on her 16th birthday at a high school party in suburban Maryland, DC suburbs. She was the unintentional target in a gang related shooting. She survived but continues to live with PTSD, anxiety, etc. and her shooting was 28 years ago! As a pediatrician, I work very hard to prevent children from getting into the path that will lead to gangs. Untreated educational disabilities and untreated behavioral health problems (many from childhood trauma) contribute to school failure, dropout, gang involvement. I am a tireless advocate for educational and mental health advocacy for my patients. It all goes back to my sister's shooting.