‘There’s Nothing to Fix’: Assault Weapon Injury Emergency Documents

Last Tuesday, Christopher Colwell, MD, chief of emergency medicine at Zuckerberg San Francisco General Hospital and Trauma Center, looked forward to a rare dinner attended by his entire family of five.

He’d finished his ER shift and headed straight home, listening to music in the car rather than the news. But when he arrived, he knew something terrible had happened. His wife, his daughter, who is in high school, and his two sons, who are in college, were sitting on the couch waiting for him. They had heard about the horrific mass shooting in Uvalde, Texas that killed 19 children and two teachers. And they knew the emotional impact it would have on Colwell, who reacted to the scene at Columbine High School 23 years ago.

In fact, since the mass shooting in Columbine that killed 12 students and a teacher, Colwell has also witnessed the brutal aftermath of two other similar tragedies — the Aurora Theater shooting in 2012, which killed 12 people and dozens of others wounded, and the 2017 San Francisco UPS shooting that killed three workers and wounded several others.

“I’ve gone through different iterations of it,” Colwell said MedPage today. “It felt kind of lonely in 1999. There weren’t that many medical professionals who had dealt with mass shootings. You just haven’t seen events like Columbine. At that point, it felt relatively unique. To experience any of that again is painful every time and gets even more so when you know you’re not lonely anymore.”

The medical professionals who lived through the aftermath of the two most recent mass shootings — in Uvalde and the killing of 10 black, mostly elderly people, at a supermarket in Buffalo, New York — will have to live with the rest of their careers, he said.

Colwell and other doctors said that one reason the US is seeing more, and deadlier, mass shootings is because of the proliferation and accessibility of AR-15 style guns. Now the nation is in a “much, much worse place” than it was in 1999, when there was a federal ban on assault weapons, Colwell noted.

“You have to see the damage these guns do to really respect and understand how dangerous these guns are,” he said, adding that he doesn’t argue that a .22 pistol can’t end a life, but does there’s a reason you wear them I don’t see them in mass shootings anymore.

“There’s no way to cause the kind of havoc these people want to wreak without some of the power and speed of an offensive weapon,” he continued. “Assault weapons are specifically designed to eject bullets faster, and the power they have and the speed they have is unquestionable…most of the devastating injuries occur in the first few minutes of the event.”

Colwell went to Columbine High after the horrific events in hopes of finding someone alive. However, all the carnage had happened almost immediately.

“The main way you can do that kind of damage this time is with a gun that shoots as fast as ballistics,” he pointed out. “Again and again, what are they using? I’ve never seen the number of devastating wounds unless you’re dealing with offensive weapons – the number of casualties and the number of wounds.”

Colwell’s memories of the young victims at Columbine remain with him.

“I vividly remember seeing one of the victims at Columbine [who] had a textbook I had in high school,” he recalled. “It really brought me back to our high school library.”

“They hardly had a chance to hide,” he added.

There’s no way a shooter could have done that with a handgun or non-semi-automatic weapon, he said. Looking at the wounds, the expressions on the victims’ faces and the way they lay at the scene, the emotional impact lasts forever, he noted.

William Begg, MD, vice president of medical affairs at Vassar Brothers Medical Center in Poughkeepsie, New York, and emergency physician at Danbury Hospital in Connecticut, has also seen the horror of mass shootings firsthand.

He cared for young patients after the 2012 shooting at Sandy Hook Elementary School in Newtown, Connecticut County, which killed 20 children and six adults. That it happened again in Uvalde hit him particularly hard.

“The more closely a mass casualty is related to one you’ve already been involved in … the more affected you are,” Begg said MedPage today. “This tragedy in Uvalde has affected my institution and I disproportionately compared to all the other mass shootings over the years because we have been able to identify so much with the pain, sadness and anger that these healthcare workers are currently going through struggle.”

Although hospitals and communities across the country experience other disasters, natural disasters like hurricanes and tornadoes are not self-inflicted, he said.

“This was a self-inflicted hurt by our country’s culture,” he noted. “And it was preventable.”

“It’s a public health issue unique to the United States,” he added. “If you look at all other developed countries … no country in the world has anywhere near the number of mass shootings. When you have a public health crisis, you have options to respond. And we in our country haven’t done all the answers.”

Begg said the use of assault weapons by those who aren’t military or law enforcement is entirely unnecessary, as is allowing high-capacity magazines. Not having background checks related to gun purchases is also a mistake.

If you have a kid that gets hit by three to 11 high-power bullets that explode inside their body, “it’s not a survivable event,” he noted. “That’s why all these kids died at the scene.”

Normal pistol bullets come out one at a time, he pointed out. With the lower speed, the survival rate is significantly higher, for both children and adults. And that is why there is little data on those who are shot with assault weapons – because most of the time no one survives.

The only survivors from Sandy Hook were those shot in the arms or legs, he said, as opposed to those shot in the head, neck, abdomen or pelvis. Sadly and similarly, those in Uvalde who were shot multiple times in the midsection did not survive.

In previous testimonies before Congress, Begg recalled using simulation video to show the difference between the damage done by a regular bullet and an assault weapon bullet. The normal bullet went in and out of an artificial block representing a human body. However, the bullet from the assault weapon passed through organs such as the liver or heart and blew them apart completely.

Without prevention efforts, Begg predicts there will be “more and more shooters” in the US who are “getting bolder.”

There comes a point where great trauma and resuscitation infrastructure has already been developed, he added. “The greatest opportunity is prevention.”

Mark Kline, MD, chief medical officer and attending physician at Children’s Hospital New Orleans agreed.

“I’ve worked in children’s hospitals and pediatric trauma centers long enough to have seen a lot of the physical damage — there’s too much of it, and it took a long time,” Kline said MedPage today. “It’s really reached epidemic proportions, I think. It’s not just mass shootings… it’s accidental indoor shootings, it’s kids caught in the crossfire. There are just too damn many guns out there, and it just seems to me that the least we can While discussing the role of mental health issues, gang violence, and video games, we’re trying to limit access to the high-powered guns that hold large magazines , which can fire any number of rounds per minute and do the kind of damage we saw at Uvalde.”

“These are weapons of war,” he added of offensive weapons. “They really have no purpose in civil society.”

The explosive power and speed of the projectiles “destroys organs” and “there is nothing to fix,” he added.

The people of Uvalde will never be the same, from the families who lost children, to the children who witnessed the horrific event, to the entire community and first responders, Kline said.

For Colwell, he believes speaking out is the only way to make a difference.

“As a medical community, we need to make our political leaders as uncomfortable or even more uncomfortable confronting us as gun lobbyists,” he said. “I think that needs to change.”

“We can continue to talk about how to prepare for these things,” he added. “But there’s no way you’re going to prepare for something that my family has in the living room waiting for 23 years later. Until our voices are heard…these events will not only continue to happen, they will become more frequent. “

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    Jennifer Henderson joined MedPage Today in January 2021 as a corporate and investigative writer. She has covered the NYC healthcare industry, life sciences and business law, among others.

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