“Am I going to die?”
That’s all she said as my team hurriedly undressed her to assess for injuries. The emergency room teaching is to complete a full assessment – head to toe – when one’s natural tendency is to focus on the obvious, a gunshot wound to the forehead in her case. Her jeans were cut off in seconds, an intravenous line secured, and a blood pressure cuff struggled to get a read. I searched every square inch of her body. “No other entrance wounds,” I yell out. Clear. We finally have a blood pressure to record and then it’s back to staring at her one injury, the gunshot wound to her forehead.
“Am I going to die?”, she says again.
At least she’s talking. Moving her limbs. I figure maybe she’s got a fighter’s chance. My job in the trauma room is done for now, and as I hustle back to hand off my other patients to the oncoming doctors at shift change, I hear her again.
“Am I going to die?”
I pray and hope not. It’s the third gunshot wound to the head in two days. If yesterday’s patterns hold, she will soon be brain dead. The answer to her question, then, will be a tragic yes. I’m sure she didn’t imagine this would happen when she awoke this morning. Or that our paths would cross early afternoon and that she would end up under my care and “in my lane.”
Last week, the National Rifle Association sent a tweet telling me and fellow physicians to “stay in their lane” when it comes to gun control. The American College of Physicians had just released a position paper plainly stating what is obvious to many of us in the ER: that “Firearm violence continues to be a public health crisis in the United States that requires the nation’s immediate attention.” Upon hearing the NRA, my physician colleagues quickly revolted and shot back via social media — #thisismylane. And they’re right.
Because it’s in my lane to answer the radio and take incoming ambulance calls when a person is shot and coming to my ER. It’s in my lane to assemble the entire trauma team in a moment’s notice and prepare for the unexpected. Call for more blood at the bedside. Stay calm in a room full of chaos. Put a chest tube in someone’s lung to evacuate the blood not allowing their heart to beat. And it’s in my lane to tell another mother that her son lost his life to a preventable cause.
As physicians, surgeons, and frontline providers, we are well within our right to advocate for stricter regulations on guns and greater funding for trauma services. In fact, it is our responsibility and duty to patients, many of whose lives are affected daily by gun violence.
In no other developed country has gun violence taken such a toll. Every day, close to 100 people are killed by guns while hundreds more are shot: a raging public health epidemic with no end in sight. And while we pride ourselves in Massachusetts when it comes to gun control, my experience as an ER physician at Boston Medical Center — New England’s largest trauma center — is a stark reminder of how much more prevention and intervention is needed, particularly in communities of color.
I will be swearing in to my new role as Massachusetts State Representative the first week of January. The State House has been a national leader when it comes to gun control. However, if my future colleagues want to address the root cause of gun violence and the associated mental and emotional trauma, we need to tackle the economic, educational, and environmental injustice that breeds such violence. What I’ve come to learn as a physician is that the ER is where the failures of public policy present themselves in their most crude, violent, and visceral form. Yes, we must have strong gun control laws on the books, but we must also address the conditions that allow violence to foster and create a situation where a young woman can be shot in the head during daylight hours.
And while I don’t know yet how her story ends, I thank her for the privilege of being able to care for her and bear witness to her struggle, and for the greater lesson she has taught me. Her life and the few moments we shared in the trauma room on that sunny afternoon will not be in vain. Her story and those of countless others will stay with me as I make my way to the Massachusetts State House this January.
State Rep.-elect Jon Santiago is an emergency room physician at Boston Medical Center.
