“They weren’t the first victims of a mass shooting the Florida radiologist had seen—but their wounds were radically different,” observed radiologist Heather Sher in The Atlantic.
“As I opened the CT scan last week to read the next case, I was baffled. The history simply read ‘gunshot wound.’ I have been a radiologist in one of the busiest trauma centers in the nation for 13 years, and have diagnosed thousands of handgun injuries to the brain, lung, liver, spleen, bowel, and other vital organs. I thought that I knew all that I needed to know about gunshot wounds, but the specific pattern of injury on my computer screen was one that I had seen only once before.
“In a typical handgun injury that I diagnose almost daily, a bullet leaves a laceration through an organ like the liver. To a radiologist, it appears as a linear, thin, grey bullet track through the organ. There may be bleeding and some bullet fragments.
“I was looking at a CT scan of one of the victims of the shooting at Marjory Stoneman Douglas High School, who had been brought to the trauma center during my call shift. The organ looked like an overripe melon smashed by a sledgehammer, with extensive bleeding. How could a gunshot wound have caused this much damage?
“The reaction in the emergency room was the same. One of the trauma surgeons opened a young victim in the operating room, and found only shreds of the organ that had been hit by a bullet from an AR-15, a semi-automatic rifle which delivers a devastatingly lethal, high-velocity bullet to the victim. There was nothing left to repair, and utterly, devastatingly, nothing that could be done to fix the problem. The injury was fatal.
“With an AR-15, the shooter does not have to be particularly accurate. The victim does not have to be unlucky. If a victim takes a direct hit to the liver from an AR-15, the damage is far graver than that of a simple handgun shot injury. Handgun injuries to the liver are generally survivable unless the bullet hits the main blood supply to the liver. An AR-15 bullet wound to the middle of the liver would cause so much bleeding that the patient would likely never make it to a trauma center to receive our care.
“One of my ER colleagues was waiting nervously for his own children outside the school. While the shooting was still in progress, the first responders were gathering up victims whenever they could and carrying them outside the building. Even as a physician trained in trauma situations, though, there was nothing he could do at the scene to help to save the victims who had been shot with an AR-15. Most of them died on the spot, with no fighting chance at life.
“As a doctor, I feel I have a duty to inform the public of what I have learned as I have observed these wounds and cared for these patients. It’s clear to me that AR-15 or other high-velocity weapons, especially when outfitted with a high-capacity magazine, have no place in a civilian’s gun cabinet.
“I have friends who own AR-15 rifles; they enjoy shooting them at target practice for sport, and fervently defend their right to own them. But I cannot accept that their right to enjoy their hobby supersedes my right to send my own children to school, to a movie theater, or to a concert and to know that they are safe. Can the answer really be to subject our school children to active shooter drills—to learn to hide under desks, turn off the lights, lock the door and be silent—instead of addressing the root cause of the problem and passing legislation to take AR-15-style weapons out of the hands of civilians?
“But in the aftermath of this shooting, in the face of specific questioning, our government leaders did not want to discuss gun control even when asked directly about these issues. Florida Senator Marco Rubio warned not to ‘jump to conclusions that there’s some law we could have passed that could have prevented it.’ A reporter asked House Speaker Paul Ryan about gun control, and he replied, ‘As you know, mental health is often a big problem underlying these tragedies.’ And on Tuesday, Florida’s state legislature voted against considering a ban on AR-15-type rifles, 71 to 36.
“As a radiologist, I have now seen high velocity AR-15 gunshot wounds firsthand, an experience that most radiologists in our country will never have. I pray that these are the last such wounds I have to see, and that AR-15-style weapons and high-capacity magazines are banned for use by civilians in the United States, once and for all.”
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