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Friday, Oct 19, 2018
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Column: Demand changes to reduce gun violence

It was 1:40 p.m., and our team was gathering in the Trauma Resuscitation Unit at University of Florida Health Jacksonville after receiving the page for a Level 1 gunshot wound to the torso. Within minutes, we began hearing reports of a mass shooting at Jacksonville Landing, a nearby shopping and entertainment complex, and immediately began to prepare our trauma bays, emergency room and staff for a mass casualty incident.

In less than 30 minutes, six patients arrived, four of them with multiple gunshot wounds to the chest and abdomen. Bullets in these regions are extremely dangerous and potentially life-threatening because of the risk of injury to the heart, major arteries and veins, lungs and intestines. Two other patients sustained potentially limb-threatening injuries to their extremities.

Fortunately, all of these individuals survived and are doing well, thanks to the amazing work of the first responders and our trauma center's 35 years of experience in trauma care and disaster preparedness. Two other victims died at the scene.

Our patients' physical and emotional scars may last a lifetime.

As a trauma surgeon, a professor of surgery and a public health researcher, I have been concerned about gun violence in America for more than 20 years. I have cared for thousands of victims and treated their injuries. I have lost many. The toll this takes on our families and communities is oppressive. More than 30,000 people die of firearm related injuries every year; that means since 1968, more Americans have died of civilian firearm injuries than U.S. soldiers in combat since the beginning of our nation. This is the equivalent of a jet airliner slamming to the ground every day.

I find it simply unconscionable that trying to research and implement solutions to a health problem of this magnitude meets active resistance. It is easy to feel hopeless in the face of such staggering numbers and the daily death toll of shootings. For communities to feel safe, law enforcement and government have responded by making more arrests, but this has led to the crisis of mass incarceration and has likely widened distrust between law enforcement and disadvantaged communities. In a 20-year study of children shot in Jacksonville that is due to be published later this year, we found that while the number of shootings varied by year, the neighborhoods where these incidents occurred did not change, indicating that these disadvantaged communities remain at risk despite best police efforts.

But we can do more to combat violence than rely on law enforcement; there are absolutely evidence-based solutions that we can employ to save lives from gun violence.

We know that sensible licensing and purchase requirements decrease not only firearm-related suicides and homicides, but also overall deaths, indicating that impulsivity, easy availability of guns and lethality of means are clearly part of the problem. We also know that supporting affected communities by addressing urban blight, investing in children, and community based violence prevention programs can reduce shootings as well as change attitudes about violence.

The Jacksonville Landing shooting happened in August, and it has for many likely become a faint memory, eclipsed by more recent shootings. That is true even for providers here at UF, because caring for injured patients, frequently six or more at a time, is what we do every day. I am fortunate to work in such a seasoned trauma center with experienced and capable colleagues. Our collective skills save many lives that would otherwise be lost due to gun violence.

But why is this necessary? I call on our leaders in government and my fellow voters to demand change. Work toward sensible licensing and purchase requirements of firearms, and work collectively to address the issues of poverty and injustice that are associated with gun violence.

Not one of us in the trauma community would complain if we never saw another 2-year-old dead of a gunshot wound.

Dr. Marie Crandall is a professor of surgery and associate chair for research for the Department of Surgery at the University of Florida College of Medicine-Jacksonville.

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