If gun violence were a disease, the bullets would be the virus.
The symptoms include catastrophic soft tissue injuries, hemorrhaging, fractures, lifelong disability and death caused by high-velocity entry of those bullets, said Stephen Hargarten, M.D., director of the Comprehensive Injury Center at the Medical College of Wisconsin.
The root causes? Everything from childhood trauma to unsecured firearms, community instability, assault, mental health conditions and acute crises, Hargarten said.
“I want to frame this in a way that pulls in healthcare systems and pulls in healthcare leaders to talk about this in a meaningful way," Hargarten said, speaking at a small conference at the National Academy of Sciences on firearm injuries this week hosted by Kaiser Permanente and the American Hospital Association.
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Hargarten is among a small army of providers that is trying to mobilize U.S. healthcare systems around addressing gun violence the way they would if a new disease resulting in life-altering injuries and death swept the nation.
These healthcare providers have been emboldened in recent years by the steady tick of news reports of mass shootings and federal data showing a steady rise in suicides and have begun gaining more financial support for firearm injury research, such as a $2 million commitment from Kaiser earlier this year.
Even as providers mentioned the response of colleagues to events like the Parkland High School and Las Vegas shootings that have led some to call for gun control, they took special care to eschew any discussion of politics and policy questions. Instead, they said, they needed to apply a laser-focus to what they knew best: the science.
The event attracted emergency department physicians and trauma surgeons, as well as experts in injury prevention and public health. Speaking with the disciplined clinical vernacular found in medical lectures, they examined sometimes gruesome photos of injuries as they discussed the damage rendered by small pieces of lead. They tried to wrap their arms around how they might tangibly impact such an unwieldy public health problem in the same way healthcare once fought to convince a culture about the dangers of tobacco.
University of Pennsylvania School of Nursing Associate Dean for Research and Innovation Therese Richmond described the importance of research to identify where the risks lie by pointing to her work in a small "gun-toting" Pennsylvania town.
This community believed their gun problem was from outsiders trafficking drugs down the region's interstates. But the data showed most of their firearm injuries were from suicides and suicide attempts.
Lucas Neff, M.D., a pediatric surgeon from Wake Forest University Baptist Medical Center said he was stunned coming back from serving in Afghanistan to find himself treating kids in the U.S. with similar injuries.
Neff argued for more targeted community intervention programs for at-risk kids, identified through screening at primary care clinics and emergency departments, to help prevent injuries like the one that left one of his vibrant 16-year-old patients a paraplegic earlier this year after a car she was riding in was shot at.