or more specifically, What Bullets Do to Bodies. Leana Wen, who authors that piece for today’s New York Times, is an emergency physician and the Health Commissioner of Baltimore City (a city in which there has been far too much gun violence). In her service in the emergency room she has seen the impact on the human body from handguns and from high-powered rifles, whose projectiles travel at three times those of handguns and — more importantly, cause far more damage upon impact. As she writes,
Once they enter the body, they fragment and explode, pulverizing bones, tearing blood vessels and liquefying organs.
There is also the impact of the shock wave they produce upon the body. Wen describes two shooting victims who were treated in her emergency room. The one shot with a handgun had a wound that went straight, it could be treated, and her survived. The other was shot with what we call an assault rifle. When he heart stopped, they opened up his chest to try to revive him.
Blood poured out of his chest cavity. The bullet had disintegrated his spleen and torn his aorta. Four ribs had essentially turned to dust. The damage was far too extensive. He died in our E.R. He was 15.
As Steve Scalise continues to be treated, we read of the multiple surgeries he has undergone. Wen describes her experience with a similar pelvic wound from a similar weapon:
The bullet shattered the hipbone into hundreds of pieces. It shredded the femoral artery, causing life-threatening bleeding and destroyed whole portions of the bowel and bladder.
Wen notes the number of our mass shooting with such weapons,whether Pulse, Sandy Hook, San Bernadino, and Aurora, and how doctors who treat the victims and the medical examiners who examine the bodies
all commented on the unbelievable devastation resulting from the bullet wounds. Indeed, this is the intended consequence of assault rifles. They are designed to be weapons of war. The bullets they discharge don’t follow a straight line through the body; they fragment and explode, destroying as much living tissue as possible.
All of this is in a sense preface. There are three remaining paragraphs, which need to be read in the entirety. The first, and longest, of these, describes in detail the impact, even upon those who survive wounds from such weapons:
There are estimates that the annual society cost of gun violence exceeds $229 billion. What I see are the human costs, not only of death but also of survival. Because of spinal damage, my patients become paralyzed, unable to walk and sometimes unable to move anything from the neck down. Because of blood loss and infections, they have their leg bones removed and undergo limb amputations. Because of intestinal perforations, they wear colostomy bags to reroute feces to a bag over their skin. Many require multiple surgeries, followed by a lifetime of hospitalizations from antibiotic-resistant infections and chronic, unremitting pain. Some become addicted to painkillers; they face a downward spiral of unemployment and poverty, homelessness and hopelessness.
Thinks of that cost on both levels. The cost of gun violence is not just by assault weapons, but the cost of treating someone shot by such a weapon is far greater than someone shot by most handguns. Not what Wen rights about the human cost of survival. Scalise may not face the downward spiral described at the end of the paragraph, but reading the medical impact should have a sobering impact upon us as we consider what he faces should he survive, as we all hope and pray.
In describing the impact of such weapons, Wen does not in any way mean to minimize the damage that can be done by handguns. After all, Gabby Giffords’ head wound came from a handgun. But wounds at different points of the body are far more difficult to treat if inflicted by high velocity projectives from assault-style weapons than those by the lower velocity projectiles from handguns.
I will conclude this post by offering the final two paragraphs of Wen’s piece without subsequent commentary from me. Let me only note this: even those of us who are not medical professionals know the impact of such weapons. That we have not yet as a society chosen to address this, even when we have been told multiple times by military professionals like Mike Mullen and Stan McChrystal that they do not belong in civilian hands, is a sad commentary, one that to my mind is the kind of American Exceptionalism of which we should by all rights be ashamed.
But let me allow Wen to have the final words:
Medical professionals are trained to stanch bleeding, stitch wounds and patch up broken 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.
Two years ago, a group of doctors wrote in the Annals of Internal Medicine: “It does not matter whether we believe that guns kill people or that people kill people with guns — the result is the same: a public health crisis.” In the war zone of the E.R., we don’t see partisanship or politics. We see the devastation that happens when our society normalizes tools of total bodily destruction.