Bullet Holes in America: Political or Medical Problem? A Trauma Surgeon's Perspective.

Life is often told and remembered in numbers. The age of your first kiss, how many years you have been married, what year you graduated from high school. These numbers are imprinted in your mind, and easily recalled. I have those same numbers that can be rattled off the tongue at a moment’s notice. But I have some numbers that can’t.

I don’t know how many bullet holes I have seen.

I don’t know how many hearts I have held in my hands, pumping and willing them back to life.

I don’t know how many mothers whom I have told their child was dead.

The numbers are too many, and I have lost count.

I have lost count of the number of times I entered a waiting room, forced myself to make eye contact, and given the words that destroyed so many hopes – of birthdays, graduations, anniversaries, children… a future.

Now, imagine you are on a boat. You, and five of your closest friends. It isn’t the biggest boat in the world, it isn’t a yacht, but you and your five friends fit comfortably. A small hole, the size of a nickel, gets punched into the boat. Water begins to pour in, but you are able to plug it with your thumb. Whew! You and your friends sigh in relief. But then suddenly comes another hole, the same size. Nothing too big, nothing you don’t know how to fix. Your second friend uses his thumb. But the holes keep coming, and despite their size, you and your friends realize there just aren’t enough thumbs or fingers to go around, and the ship is going to sink. Despite having the knowledge and skill you have to plug these holes individually, you aren’t able to handle this many holes, all at once, with the number of friends you have available. So you resign yourself to treading water instead of sailing.

If you can imagine this, then you now know what it feels like to be a trauma surgeon in the United States. There are too few of us, and too many bullet holes.

In this country, we have turned a medical problem into a political one. The conversations surrounding this issue are starting and ending with “gun control” and “anti-gun control”.

What would the conversation sound like if we only started and ended with “anti-bullet hole”?

Could we then actually focus on the victims of gun violence? If we began to think about the diagnosis of a bullet hole in the same way as the diagnosis of diabetes, could we then conduct research that has been prohibited? Could we then identify people at risk for bullet holes the same way we identify people at risk for diabetes? Could we then approach prevention of bullet holes the same we approach the prevention of diabetes?

Absolutely we could.

As surgeons, as physicians, as mothers, as fathers, as people – we have to try and change this. We have to research, to study W34.00XA (the medical code for gunshot injury) in the same manner we have researched and continue to study E11.9 (the medical code for Diabetes).

We control lice better in this country than gun violence, and it shows. Let’s treat this epidemic for what it truly is - a public health issue, one that is understudied, under-researched, and growing. Anti-gun or anti-gun control, I think we can all agree to become anti-bullet hole.

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