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Scenes from the front line: What gun violence looks like to one emergency physician


I’m an emergency physician. There are tens of thousands of doctors like me in this country. Here are just a few of the people I’ve seen who have been shot.

* * *

He was in his 20s, in a uniform, the driver of an armored van. He’d been ambushed outside of town, in the desert, by men with rifles. They’d fled before they got the money.

The top of his skull was gone. His brain had a delicate pink hue, and a strange bright beauty to it, like a jellyfish unfolding in the water.

We learned the story from the police.

She was 17, getting off the school bus, and caught in the crossfire between two gang members. At first we could not find the wound, because it was a small caliber handgun, but she lay dead on the gurney anyway, and finally we rolled her and saw it — a tiny blue hole, the size of a pencil eraser, high in the nape of her neck, covered by her long dark hair.

We learned the story from the paramedics.

He died quickly, and he was unlucky, because it was only a .22, and it hit him in the right side, right above the belt line, and went through his aorta. He had been running for his life up the ramps of a parking garage. His assailant shot him through the gap from the level below.

They were sisters, 9 and 10, lying beside one another on adjacent gurneys in the trauma room.

Someone had mistaken their house for another, and fired blindly from a car with an assault rifle. The girls were sleeping together in the same bed upstairs.

My girl had a perfect red crease through her earlobe from the bullet, but that was all. She lay quietly and looked up at me, and didn’t cry.

Her sister beside her, on the other side of the curtain, was dead.

We learned the story from the papers.

He was in his 30s, and came by helicopter, and his heart was still beating. Someone had called an ambulance from the house in a little town on the Arizona border. He had two small caliber holes in his forehead, placed very closely together, wounds that radiated experience and lethal calculation.

Meth, they said. A professional killing. We learned the story from the flight crew.

He was in his teens from the reservation and someone in his family shot him six times in the head with a .22 rifle, and everyone was drunk, and no one really knew what the story was, but the flight crew said it was a domestic dispute. He was alive, but his face was swollen and bruised and distorted, his lips puffy and his pink tongue protruding a little around the endotracheal tube.

She was clutching her belly and fading in and out, ashen and dreamy. The wound was low, beneath her belly button.

The surgeons saved her by a whisker. The police didn’t know the story — only that she was in a car, in a parking lot, with the motor running. Someone had seen a man near the car.

His son frightened him, and he was trying to get him out of the house, and when he told him he had to go the boy fired a single shot from a pistol into his chest.

He came in almost alive, still moving a little, and what I remember most was his startled, staring blue eyes and the way he kept opening and closing his mouth and flicking out his tongue like a snake. I haven’t seen this before or since.

They opened his chest in the trauma room but it was too late. We learned the story from the police.

He was drunk, and harmless, but he tried to get into the wrong house, the next house over, because the houses look alike there. He kept banging on the windows, and then he started kicking the front door. The father met him in the threshold with a shotgun.

12 gauge, right through the chest, just below the heart, and just above the belly, and I thought that he had no chance with a wound like that, from that close, with that kind of weapon, but he made it to the OR alive and defied us all and somehow the surgeons saved him. No charges were filed.

He was a cop alone at night, and he pulled over the car when the plate lit up as stolen. When he approached, the driver opened the door and came out firing in the dark. He was hit twice in the belly, and once in the leg. The vest saved him. But his femur was shattered. He lay there on the gurney and stared furiously at the ceiling, tight-lipped and disciplined, crying out only when we moved him.

Later, I walked out into the hall to a sea of blue uniforms.

They were kids in a party house all night, and he owed another boy $60, and told him in the morning that he didn’t have it. The boy shot him through the chest with a 9mm handgun. Then everyone was awake, and panicking, and they didn’t know what to do.

They carried him outside, to the park, and left him beneath a tree, and though it was early in the morning, someone saw him under the tree, and called an ambulance.

I never found out how long he was beneath the tree.

She was an old woman, with a sign around her neck with her name and phone number in case she wandered, and her husband had shot her through the temple before killing himself, because, as we learned later, he was sick also and could no longer care for her.

She lay there, blinded by the wound, with the sign, muttering incoherently, with frail papery skin, and perhaps she weighed 85 pounds.

I can’t remember how we learned the story, because it was a long time ago. But I remember her because of the sign.

He lay beneath me, a young man in his 30s, in office clothes, and looked directly up at me as I stood over him in my gown and mask. He told me his wife’s cell phone number, that he was allergic to penicillin, and that he was going to die. He said all three things calmly, in the same tone.

He’d gone to work on an ordinary day. Another man had come into the offices, firing indiscriminately before shooting himself as the sirens grew nearer.

It was breaking news, and even then the story was on TV, but I didn’t know any of that.

I told him we’d take care of him. I told him we would save him, because I always do. But he was right. When they say that there, in the trauma room, in that tone, they are speaking with an animal’s authority.

Huyler is an emergency physician in Albuquerque. This is an excerpt from his newest book, “White Hot Light,” to be published next year. Some details have been changed to protect confidentiality.