Gun Trauma: a Los Angeles Physician's Plea

Editor's Note: Peter Ureste, MD, is a third-year psychiatry resident at Los Angeles County + University of Southern California Medical Center and a regional vice president of the Committee of Interns and Residents/SEIU Healthcare union (Photo is of memorial to shooting victims in June 17, 2015 mass murder in Charleston, SC).

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Where will you be during the next mass shooting? I can tell you where I was on the morning of December 2: waiting at a hospital in San Bernardino County while my 61 year old mother underwent knee replacement surgery.

I remember sitting in the lobby filled with concerned family members of other patients all intensely glued to the television that broadcasted the mass shooting in San Bernardino.

The two assailants had opened fire at a public health training event and holiday party at Inland Regional Center killing 14 and injuring 21 county workers. A day later I learned that my younger sister knew one of the victims, 52-year-old Nicholas Thalasinos, who was her store’s health inspector for the last 3 years. She described him as friendly, always smiling, and laughing. Her heart was heavy after learning about his murder, especially since she last saw Nick less than a week before. He talked with her about his recent surgery and felt blessed for making it through.

I am also a county worker, a resident physician in Los Angeles at one of the largest public hospitals in the country. Every day I am reminded when I go to work that gun violence is alive and real. As I enter the lobby of LAC+USC Medical Center I pass the metal detectors that were installed after our own tragic shooting in 1993. A patient reportedly suffering from severe pain had presented to the emergency room seeking pain medication. After getting frustrated from his long wait, he shot and injured three physicians and barricaded himself in an X-ray room with two hostages for about five hours before finally turning himself into police.

Three years after LAC+USC doctors were shot and hostages held, the federal government passed the Dickey Amendment effectively banning any federal research on gun violence. This legislation, supported by the National Rifle Association, was renewed by Congress this past summer. This was a missed opportunity to improve public safety.

At the end of 2015, I was hopeful that the congressional budget would include a rider removing the ban on federal research on gun violence, but our elected leaders again failed to remove this restriction.

The federal government and law enforcement agencies could learn about gun violence through research, just as we have done with motor vehicle accidents over the last two decades. Billions of dollars have been spent to better understand car accident deaths and how to reduce their fatality. This has resulted in legislative change and technology innovation in the form of seat belt laws and air bag installment in cars leading to a dramatic drop in motor vehicle deaths.

Based on current trends, it is estimated that death by guns will surpass death by motor vehicle accidents. More than 89 Americans die every day from gun violence - clearly this is a serious epidemic and public health concern.

How long will we wait? Will we begin to find solutions to this crisis before there is another gun massacre? Before it is your patient or neighbor who is massacred? It could be your mother undergoing surgery, but instead of a knee replacement it may be to repair hemorrhaging organs due to bullet wounds - a nightmare scenario for any of us.

Mere hours before the terrorist attack on county workers in San Bernadino, several physician organizations from across the country stood together at a press conference at the Capitol in Washington, DC. They represented thousands of doctors who have petitioned and called their representatives to urge them to end the ban. The urgency of the issue could not be more clear to me and my colleagues.

As physicians, we have a responsibility to our patients and communities to support legislation to reduce death and dying. As a physician myself, I know that thoughts and prayers are rarely enough to heal our sicknesses. After a senseless tragedy like the shooting in San Bernardino, and the attack on a Colorado Planned Parenthood clinic, along with the traumas that come into our emergency rooms every day from gun violence, everybody asks why it happened and how we can prevent it. It is time for our research dollars and our policies to align with our values and the kind of society we aspire to be.