How Hospitalists See the Forgotten Victims of #GunViolence: #NeverAgain #Docs4GunSense

By  |  March 7, 2018 | 

I am angry. Perhaps, you are too. As a physician, it is heart-wrenching to watch people unnecessarily die from gun violence. As a mom, it strikes fear in my heart to know that our nation’s children are not safe in our schools. I vividly remember being a resident on call in the ICU when I paused to look at SWAT teams on the TV in the middle of the night and thought I was hallucinating. Columbine was not a dream. 20 years later, we are in a nightmare. I won’t bore you with the statistics on mass shootings and gun violence; there are some really good papers to do that. No one talks about the fear and paranoia we have normalized.

This past December, I was excited to see Star Wars on Christmas Eve. Unfortunately, I could not focus. For a brief moment, I saw someone come into the theater from the corner of my eye, and I became afraid. I started to question my decision to see a blockbuster movie on a holiday at a major theater in Chicago. I got up and moved to the emergency exit and visually rehearsed how I would get out or hide if I needed to. I made it through the movie, but anytime anyone moved, I got nervous. Maybe, I am paranoid I thought. When I recently got the nerve to share my fear with a friend, they told me this is why they don’t go to the movies in the city anymore. Maybe, we are both paranoid. Then I told a third friend, and they told me they don’t go to see movies anymore period.

Of course, mass shootings get a lot of attention and cause a lot of fear, but we must remember that death from guns is more likely to take other forms of harm, such as suicide. As a hospitalist in Chicago, I have certainly seen my personal share of gunshot victims from violent crime. However, they are not ones that you hear about – not the freshly operated on ones by trauma surgery or the victims that died shortly thereafter memorialized on the nightly news and in the days after. Instead, I see the forgotten victims of gun violence. They are the long-term survivors of gunshot wounds…the ones who have “GSW” as the first thing in their past medical history followed by their permanent disability which is often in rendering them paralyzed and immobile. They suffer from chronic sacral wounds due to sitting on hard wheelchairs or in beds, from frequent urinary tract infections due to the presence of an indwelling Foley or the need to straight cath and from depression due to all of the above. As hospitalists, we see the hidden victims of gun violence who never really recover and enter a never-ending vicious cycle of health and social ailments.

I will see more gunshot victims in the near future. My hospital is about to open a Level 1 trauma center on the South Side of Chicago. We have built a new ER and hired some great trauma surgeons to lead this effort. The leader of this effort, Dr. Selwyn Rogers, is the first to acknowledge that a trauma center is not a “magical solution,” and upstream solutions are needed. As he says, “We should not allow one more American to die or be permanently disabled from gun violence without taking action.”

So what action can we take? First and foremost, we can use our platform to ask our patients about guns and educate ourselves on how to have a discussion about gun safety (even if you live in Florida). While this is not something that is often included in medical training, editors of prominent medical journals agree that it needs to be. Here, hospitalists can lead in training current and future healthcare professionals.  At last year’s Pediatric Hospital Medicine meeting, the 5L’s of gun safety were reviewed (Locked, Loaded, Little Children, feeling Low, owner Learned?). The University of Michigan has also created an easy to read graphic handout on gun safety.

It is also important to use our medical platform and voice to highlight that gun violence is a public health epidemic. We can share papers and policy papers and data to interject a scientific voice into this debate. However, because numbers often fail to capture the hearts and minds of our people and politicians, we can share our stories. Emergency medicine physician and researcher @MeganRanney is collecting stories of why gun violence is a public health issue. They have already been shared thousands of times.

As hospitalists, our stories may not be those of immediate death from ricocheting bullets in the body, but they are still worth telling. They are of the able-bodied lives ruined by gun violence and the disability and harm that follows. Hospital costs from gunshot wounds do not even reflect the long-term costs of the care that we provide to the survivors. We can give money to organizations like Everytown and Moms Demand Action. We can vote with our ballots and with our pocketbooks. We can also march. Most of all, we can amplify. We can amplify the voices of the brave young people that are fighting to reduce the risk of dying in our nation’s schools – not to mention hospitals, movie theaters, parks, concerts and any other public area. As members of the scientific community, we can also advocate for more research. We do not ban cars as vehicles of death, but instead we mandate seatbelts. Likewise, research on measures that can make guns safer and reduce deaths from gun violence can save lives.

The students from Marjory Stoneman Douglas have certainly learned to channel our nation’s failure to protect them into action. Maybe some of them did see The Last Jedi too and recall the eloquent Master Yoda saying, “The greatest teacher, failure is.” Let’s not fail them this time. #NeverAgain

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About the Author: Vineet Arora

Vineet Arora MD, MPP is Director of GME Clinical Learning Environment and Assistant Dean for Scholarship and Discovery at the University of Chicago Pritzker School of Medicine. Dr. Arora’s scholarly work has focused on resident duty hours, patient handoffs, sleep, and quality and safety of hospital care. She is the recipient of the SHM Excellence in Hospital Medicine Research Award in 2007. Her work has appeared in numerous journals, including JAMA and the Annals of Internal Medicine, and has received coverage from the New York Times, CNN, and US News & World Report. She was selected as ACP Hospitalist Magazine’s Top Hospitalist in 2009 and by HealthLeaders Magazine as one of 20 who make healthcare better in 2011. She has testified to the Institute of Medicine on resident duty hours and to Congress about increasing medical student debt and the primary care crisis. As an academic hospitalist, she supervises medical residents and students caring for hospitalized patients. Dr. Arora is an avid social media user, and serves as Deputy Social Media Editor to the Jounral of Hospital Medicine, helping to maintain its Twitter feed and Facebook presence. She blogs about her experiences at http://www.FutureDocsblog.com and actively tweets at @futuredocs.

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