This is my lane: Advocating against gun violence is part of a doctor’s job
As I rushed into the intensive care unit, the description I overheardwas terse and chilling: “13-year-old, no past medical history, GSWto head— neurosurgery following.”
I entered the child’s room to find hisweepingmother taping something on thewall behind his bed. The lightswere low. The undulating hum of the ventilator and the lowpitch of the drains protruding fromher son’s misshapen skull filled the room with sounds familiar to those of uswho knowwhat a “GSW”— gunshot wound— to the head really means.
Since his birth, I have cared for this child at our pediatric clinic, situated in one of the most concentrated areas of poverty, and of early mortality, in America. Violence is not unusual here in North Philadelphia. But no one ever gets used to it.
I could not give this mother what shewanted— to turn back time. Time before her happy, bright boy jumped into his cousin’s car, excited about getting a haircut. Time before a bullet, aimed at someone else, struck her child’s head at the temple and exited through the top of his skull, shattering bone and brain. Time when her boy’s only physical problemwas the thumb-sucking that made his teeth protrude.
What I could dowas hold her hand and silently keepwatch with her. With each ventilator-directed breath, the side of his head billowed out like a sail, lacking the protective temporal bone that had to be removed to relieve pressure on his injured brain. We looked together at his swollen face, at the plastic oxygen tube pushing against his teeth as his thumb once did.
Thiswas not the first timemy pager had summonedme to the intensive care unit to see a child and a family shattered by bullets. Therewas the 18-year-old, headed home after a hard-fought basketball game, stopped by three bullets to the back. The 12-year-old who took a bone-destroying bullet to the leg whilewalking home fromschool. The 3-year-old, playingwith Barbie dolls on the porch, struck through the neck. The 17-year-old, a star football player whose once-muscled legs are nowatrophied fromparaplegia. He had justwalked out of a corner store, clutching a bag filled with treats for his younger brother, when a bullet struck his spine.
I ama primary care doctor, not a trauma surgeon. Butmothers ask for me. Theywantme to explain the complex care that their children are receiving, which I gladly do. Theywantme to offer them hope, though so often I cannot.
Theywant a witness in a white coat to make sure that the ICU team knows their child is so much more than theGSWinRoom7, Room3, Room1. That their child was entirely perfect until they were in the wrong place, at the wrong time, in a citywheremore than 140 children have been shot so far this year.
Back inRoom7, the mother sits with her knees curled up, her hand on her abdomen just where she first felt her baby boy kick and hiccup.
She told me what had been explained to her, that in the rush to save her boy, the piece of skull thatwas removedwas not placed inside his abdomen— the usual procedure to preserve the bone so it might be replaced. I imagined the bloody bone, discarded in a metal bucket next to the operating bay that saved his life.
“Nowthey are going to have to make one to fit his head once the swelling goes down,” she said. This is what shewanted to talk about, so I listened silently, knowing fullwell that no medical technology could replace what her child had lost.
Imade sure that she had food, which she refused. Then I looked at thewall abovemy young patient’s head and noticed what his mother had been doing when I arrived. Like nearly every mother I have visited over the years in the ICU, she had been putting up photos. Her beloved son in his football uniform. In his grade-school graduation cap and gown. With his little sister. As a baby.
TheNational Rifle Association recently tweeted something about doctors staying “in their lane” when it comes to advocating against gun violence.
Visitingmy once healthy, happy patients in the ICUafter their lives are altered or ended by a stray bullet ismy lane.
And fromthat lane, I ask all of our elected leaders: Look at your own children’s pictures that you keep in your home, at your desk, on your phone. Nowimagine those photos taped above the bed in ICURoom7. Imagine.
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Daniel R. Taylor is an associate professor at DrexelUniversity College ofMedicine and director of community pediatrics and child advocacy at St. Christopher’sHospital for Children in Philadelphia.