A shoot­ing sur­vivor is now striv­ing to aid gun vic­tims

Hop­kins trauma sur­geon is in fore­front of physi­cians’ move­ment to end violence

Baltimore Sun - - FRONT PAGE - By Justin Ge­orge

Joseph Sakran re­mem­bers the day in 1994 when an er­rant bul­let changed the tra­jec­tory of his life.

Then a se­nior at Lake Brad­dock Sec­ondary School in Burke, Va., he re­mem­bers the flash from the gun fired dur­ing a fight af­ter a foot­ball game, peo­ple dis­pers­ing and blood gush­ing over his clothes. He had been shot in the throat.

Over the next six months, Sakran had a tra­cheostomy and un­der­went mul­ti­ple surg­eries to help him breathe and speak. The 17-year-old also re­solved to be­come a physi­cian. He be­lieved his des­tiny was “to give oth­ers that sec­ond chance I’ve been given.”

Now 39 and a trauma sur­geon at Johns Hop­kins Hos­pi­tal, Sakran is on the fore­front of a move­ment among med­i­cal pro­fes­sion­als grow­ing more vo­cal about a surge in gun violence in Bal­ti­more, a city where more than 240 peo­ple have been shot to death this year, and across the coun­try. His med­i­cal ad­vo­cacy group is join­ing forces with an­other physi­cians or­ga­ni­za­tion, and he hopes to launch more in-depth re­search into shoot­ings and vic­tim out­comes.

Sakran says he is mo­ti­vated by his ex­pe­ri­ence as a sur­vivor and his ex­pe­ri­ence per­form­ing emer­gency surg­eries on gun­shot vic­tims. He said he re­calls the looks on his par­ents’ faces two decades ago when talk­ing to the par­ents of shoot­ing vic­tims he is try­ing Sakran

to save.

“Their faces are chis­eled in my mind,” he said. “I imag­ine what they had been go­ing through — and not al­ways does some­one sur­vive.”

In Bal­ti­more, one out of three peo­ple shot last year died, mak­ing the city one of the most lethal of Amer­ica’s largest cities, ac­cord­ing to a year­long Bal­ti­more Sun in­ves­ti­ga­tion. The odds for gun­shot vic­tims wors­ened last year in at least 10 of those cities, in­clud­ing Bal­ti­more, Chicago and Mil­wau­kee, The Sun found.

While med­i­cal ad­vances and prac­tices have dra­mat­i­cally im­proved the sur­vival rate of most trauma pa­tients, stud­ies by hos­pi­tals in­clud­ing Johns Hop­kins have shown the chances of sur­vival for gun­shot vic­tims have de­creased. At the same time, a num­ber of deadly trends have taken root, such as crim­i­nals us­ing higher-cal­iber guns with large-ca­pac­ity mag­a­zines, leav­ing mul­ti­ple-gun­shot vic­tims to bleed out more quickly.

Po­lit­i­cal im­passes over univer­sal back­ground checks for gun pur­chasers and in­creas­ing fed­eral fund­ing for gun violence re­search was among the rea­sons Sakran started the group Doc­tors for Hil­lary two years ago. The group sup­ported Demo­cratic pres­i­den­tial nom­i­nee Hil­lary Clin­ton, who made gun con­trol a cen­tral tenet of her cam­paign. Sakran said his group in­cludes a few hun­dred core mem­bers and 65,000 fol­low­ers on Face­book.

In the wake of Don­ald Trump’s win over Clin­ton, Sakran plans to merge his group with Doc­tors for Amer­ica, a po­lit­i­cal ad­vo­cacy group of health pro­fes­sion­als that pushed for health care re­form and has made in­creased fed­eral fund­ing for gun violence re­search a top goal.

Sakran hopes to con­tinue push­ing for univer­sal back­ground checks, clos­ing loop­holes that al­low cus­tomers at gun shows to by­pass back­ground checks, pre­vent­ing “straw” pur­chasers from legally buy­ing guns for peo­ple with crim­i­nal records, and greater re­stric­tions on “mil­i­tary-style weapons.”

“More than ever it’s go­ing to be im­por­tant for us to re­ally take a con­certed ef­fort to say that this is not a Demo­cratic is­sue, not a Repub­li­can is­sue. This is an Amer­i­can is­sue,” he said.

Trump has op­posed lim­its on gun own­er­ship, and any gun-con­trol mea­sure is likely to meet stiff re­sis­tance in a Repub­li­can-con­trolled Congress. Trump, a Repub­li­can, has said he would ap­point Supreme Court jus­tices who up­hold the con­sti­tu­tional right to bear arms and that he would seek to ex­pand men­tal health treat­ment pro­grams in the wake of mass shoot­ings by men­tally ill peo­ple in re­cent years.

Doc­tors for Amer­ica Ex­ec­u­tive Di­rec­tor Alice Chen, an in­ter­nal medicine physi­cian and as­sis­tant pro­fes­sor at Ge­orge Wash­ing­ton Univer­sity and the David Gef­fen School of Medicine at UCLA, said com­mon ground can be found on is­sues such as pre­vent­ing sui­cides and child in­juries by firearms.

“All of us have a re­spon­si­bil­ity to be more civi­cally en­gaged,” Chen said. “Cer­tainly we have to think about what are the like­li­est things that we can get passed in the new po­lit­i­cal en­vi­ron­ment. … But the ur­gency to do some­thing does not change.”

Sakran said seek­ing re­forms on a stateby-state ba­sis may be an­other route for doc­tors to pur­sue.

While Mary­land al­ready has some of the strictest gun laws in the na­tion, Bal­ti­more Po­lice Com­mis­sioner Kevin Davis plans to step up ef­forts to lobby law­mak­ers in the Gen­eral Assem­bly ses­sion that be­gins in Jan­uary for manda­tory prison time for peo­ple ar­rested with il­le­gal hand­guns and high-ca­pac­ity gun mag­a­zines. Other pro­pos­als leg­is­la­tors plan to push in­clude bills to ban guns from col­lege cam­puses and pre­vent peo­ple on fed­eral ter­ror­ist watch lists from buy­ing them.

S. Rob Todd, chief of gen­eral surgery at Ben Taub Hos­pi­tal in Houston and a mem­ber of Sakran’s group, said sur­geons need to con­tinue to make the public and politi­cians aware of the wors­en­ing con­di­tions in which many gun­shot vic­tims ar­rive at hos­pi­tals. Todd, also a pro­fes­sor at the Bay­lor Col­lege of Medicine, said the per­cent­age of gun­shot vic­tims dy­ing in the emer­gency room has in­creased sig­nif­i­cantly since 2000.

“At some point, we have to stop be­ing quiet and we have to start speak­ing up,” he said. “We can talk about the grav­ity of the sit­u­a­tion. We can talk about what we see.”

Sakran said he also wants to study the de­gree to which gun violence has be­come more in­tense na­tion­ally us­ing data from med­i­cal ex­am­in­ers’ records and the Na­tional Trauma Data Bank, which gath­ers statis­tics from hos­pi­tals.

He also wants to study Johns Hop­kins pa­tients who have been shot on more than one oc­ca­sion to de­ter­mine fac­tors that put peo­ple at a greater risk of be­ing vic­tim­ized.

Sakran has vivid mem­o­ries of his own shoot­ing. He re­mem­bers turn­ing his head to­ward two peo­ple who were ar­gu­ing when some­one fired a .38-cal­iber gun into the crowd of high-school­ers, striking him and an­other stu­dent, who also sur­vived. He re­mem­bers chok­ing on his blood as paramedics tried to place him flat in a medevac, and a trauma sur­geon tak­ing charge amid chaos, wheel­ing him into an op­er­at­ing room.

Sakran’s tra­chea was rup­tured and his left carotid artery, which pro­vides blood flow to his brain, was sev­ered. One of his vo­cal cords was par­a­lyzed, as was a phrenic nerve, which helps with speak­ing and breath­ing.

Sakran un­der­went mul­ti­ple op­er­a­tions at Inova Fairfax Hos­pi­tal, where he was born and, years later, where he would do his res­i­dency.

In a per­ma­nent, slightly hoarse tone with a vol­ume about half of what it should be, Sakran speaks ad­mir­ingly about the trauma sur­geon and vas­cu­lar sur­geon who saved his life and taught him as a young res­i­dent.

“I was re­ally in­spired to give oth­ers the op­por­tu­nity I had been given,” he said.

The bul­let that struck Sakran was sur­gi­cally re­moved weeks later. He keeps it in a con­tainer on his dresser, and takes it out to ex­am­ine ev­ery once in a while as a re­minder of his near-fa­tal shoot­ing and his mis­sion to save oth­ers.

“This is not a Demo­cratic is­sue, not a Repub­li­can is­sue. This is an Amer­i­can is­sue.” Dr. Joseph Sakran

ALGERINA PERNA/BAL­TI­MORE SUN

City Coun­cil­man Bran­don Scott holds a mu­nic­i­pal ID card his leg­is­la­tion is in­tro­duc­ing. A fi­nal vote on the doc­u­ments is sched­uled for next week.

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