Baltimore's Top Doctor: Why Aren't We Treating Gun Violence Like A Health Crisis?

Dr. Leana Wen, Baltimore’s health commissioner and an emergency room physician, wrote a moving op-ed last week after a gunman opened fire on a congressional baseball practice. In it, she highlighted the daily horror of gun violence the medical community faces.

Wen has long argued that gun violence is a public health issue ― a medical emergency without a prevention plan.

“Medical professionals are trained to stanch bleeding, stitch wounds and patch up broken bodies,” she wrote in her piece for The New York Times, titled “What Bullets Do To Bodies.” “We are good at our jobs; most gunshot victims survive their wounds. But every day, we are plagued by the question of how to prevent these injuries in the first place, when the damage is so extensive from weapons so readily available.”

Wen spoke to HuffPost on Monday about why she believes gun violence is a public health issue, and what Baltimore is doing to prevent it. 

The latest news about House Majority Whip Steve Scalise’s condition is that he has been upgraded from critical to serious, but he was at “imminent risk of death” when he arrived at the hospital. Why was this kind of single gunshot wound so life-threatening?

I don’t want to speculate on the tragic incident involving the congressman. I’ll say that in general what I’ve seen in the ER is that when you have an assault-style rifle or an injury or gunshot wound from an assault-style rifle ― such rifles tend to discharge at much higher velocities than handguns. And depending also on the type of bullet that’s used, it could be a type of bullet that causes fragmentation of the bullet and also causes something called cavitation, which is when it’s not just a single path. It’s not like a knife where there’s a single path of injuries ― there’s significant damage around that entry point as well.

As I talked about in the article, it’s not just the bullet itself that’s the problem ― it’s the injury caused by the bullet. And if the bullet then expands inside the body or if it’s shot at such a high velocity that it ends up damaging other vital organs and blood vessels and other structures, then that damage can be extremely dangerous and the wound can be such that it’s irreparable.

In your piece, you spoke about the aftermaths of gunshot wounds that go unnoticed after the blaring headlines about shootings. Can you elaborate on what happens after, when a patient begins the long road to recovery?

We think about gunshot wounds as death vs. survival, and yes, for my patients, even if they are to survive ― and there is a high rate of survival following gunshot wounds, thankfully, because of our medical advances ― we still have to consider the potential for lifelong consequences.

There could be lifelong consequences of spinal damage resulting in paralysis. I’ve seen many patients go through limb amputations. Because of the nature of the gunshot wound, it could be such that it fragmented their entire bone or because of blood loss. Many patients who have intestinal perforations and other irreparable wounds have to wear colonoscopy bags for a lifetime.

And so many of our patients end up getting addicted to opioid medications because of chronic pain and are also in and out of hospitals for a variety of physical, as well as mental, conditions. These are all the human aspects of survival that we have to consider when looking at the human cost of gunshot wounds. 

A HuffPost piece actually ran with the same title as your piece. It focused on Dr. Amy Goldberg, who is the chair of Temple University’s Department of Surgery in Philadelphia. She, too, has spoken out about the horrific aftershocks of gun violence and the shattered lives it leaves behind. Why do you think more medical professionals are chiming into the debate?

There is a hesitation from the medical community to get involved in issues that are potentially politically tinged. Anytime we talk about guns, there is an element of partisanship that unfortunately comes into the conversation, which is part of the reason why I wrote this article. This is not an article with a political bent. This is not an article with a partisan bent.

I wanted to share what it is that we see in the ER, because these are important lessons for everyone to know. It’s important for medical professionals to be aware of it, but it’s also important for people. I hope that individuals who own guns who are potentially at risk for a gun injury will also think about the potential consequences, including these life-changing, life-altering, life-threatening consequences.

What has the response been so far to your piece?

I’ve had a number of people write on all sides of the issue. People have posted a lot of comments on Facebook, Twitter, over email. A lot of people shared that they didn’t know exactly what happens, and that this piece was difficult to read. It was also difficult to write, because I had to relive many of these moments that, frankly, a lot of us would prefer to not think about ― the moments that patients died under our care.

These are the most difficult things that we have to face as physicians ― when patients die under our care despite our best efforts. People have written that they’re glad to read about it and learn about it, despite it being difficult to process.

Other people have commented on the cost implications, too. In our city ...
3 Published By - The Huffington Post - 2017.06.19. 23:21
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