Standing up to the NRA, American physicians demand voice in gun control debate
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Standing up to the NRA, American physicians demand voice in gun control debate

Four doctors share their experiences treating gunshot victims and warn of the lethal combination of rampant hate and easily accessible weapons

Renee Ghert-Zand is a reporter and feature writer for The Times of Israel.

Following the February shooting at a high school in Parkland, Fla., several hundred students rally on the West Lawn of the Capitol to call for an end to gun violence in schools, in Washington, Friday, April 20, 2018. (AP/J. Scott Applewhite)
Following the February shooting at a high school in Parkland, Fla., several hundred students rally on the West Lawn of the Capitol to call for an end to gun violence in schools, in Washington, Friday, April 20, 2018. (AP/J. Scott Applewhite)

In recent weeks social media has been awash in bloody hospital scenes. Grouped under the #ThisIsOurLane hashtag, the photos and videos are posted by American physicians and nurses who want the public to see the aftermath of treating victims of gun violence.

These images are gruesome, but they are not being shared gratuitously, rather as a way in which healthcare professionals are raising awareness about firearm safety. It is a grassroots online protest movement by those on the front lines of treating the carnage against the National Rifle Association and other organizations which want to exclude the medical community from the national gun control debate.

The tipping point for the health professionals was a November 7 tweet from the NRA responding to the publication of the American College of Physicians’ updated gun safety guidelines.

The NRA admonished the doctors’ group, saying, “Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves.”

While international headlines do reflect major gun violence events, such as the synagogue massacre of 11 worshipers on October 27 at the Tree of Life – Or L’Simcha Congregation in Pittsburgh, a mass shooting is actually defined as a shooting with three or more fatalities. There have been 320 mass shootings in the United States this year so far — roughly one a day.

In this October 29, 2018, photo, a makeshift memorial stands outside the Tree of Life synagogue in the aftermath of a deadly shooting in Pittsburgh. (AP/Matt Rourke)

The US has the highest rate of gun ownership in the world, with 41% of adults owning at least one gun or living in a household where another person owns a gun. One in three American homes with children have firearms.

According to the Gun Violence Archive, 2017 saw 15,649 people killed and 31,254 injured in 61,890 shooting incidents — homicides, suicides or accidental deaths. As of late November of this year, there have been 38,511 deaths and injuries caused be gun violence. In 3,142 cases, the victims were children or teenagers.

Every day (on average for the last five years) 342 people in America are shot in murders, assaults, suicides and suicide attempts, unintentional shootings, and police intervention, according to the Brady Campaign to Prevent Gun Violence. Suicide accounts for approximately two-thirds of deaths by firearm, according to a 2016 Centers for Disease Control report.

Parents wait for news after reports of a shooting at Marjory Stoneman Douglas High School in Parkland, Florida., on February 14, 2018. (AP Photo/Joel Auerbach)

The NRA did not respond to a request for comment on the #ThisIsOurLane campaign.

The Times of Israel asked four American physicians about their experiences treating gunshot victims and their families, their activism, and what they would like to see done to prevent future gun violence. We also asked for their thoughts on the documented increase in hate and anti-Semitic crimes in an environment where guns are so widely and easily available.

Dr. Judy Melinek, Forensic Pathologist

‘I see all the gunshot cases, not just the ones that make it to the hospital’

Dr. Judy Melinek (Doug Zimmerman)

In the last 17 years, Dr. Judy Melinek has autopsied the bodies of 300 gunshot wound victims. The week the NRA tweeted that physicians should “stay in their lane,” she had two gunshot cases.

Melinek responded with a tweet of “Do you have any idea how many bullets I pull out of corpses weekly? This isn’t just my lane. It’s my f— highway.” It became a rallying cry for physicians and other healthcare professionals around the country.

Melinek, who was born in Israel and moved to the US with her parents at age five, is a forensic pathologist in the San Francisco Bay Area. She performs autopsies in cases of sudden, unexpected or violent deaths. Of the 300 gun violence cases she has dealt with, half were homicides and half suicides. In one case she performed autopsies in a mass shooting incident: a man had shot his wife, three children, and himself. In an autopsy of a man who was shot by the police after pointing his gun at them, she examined and documented 43 gunshot trajectories. That postmortem took her four days.

Until her November 9 tweet, Melinek, 49, had not been particularly outspoken about gun violence. Her only previous activism was attending a gun control rally in Los Angeles in 2000.

“I was a new mother, and I remember holding my baby son in a snuggly. I went because I cared about my baby,” she told The Times of Israel.

In responding to the NRA’s tweet, Melinek said she decided to break the culture of confidentiality in the medical community among physicians who work for or are contracted to government agencies. She knew she was taking a risk in taking a public stand, but she felt relatively confident for several reasons, one of which was her experience having dealt with the media following the 2014 publication of her medical memoir “Working Stiff.”

“I’m not an activist, but I have been thrust into the spotlight,” said Melinek, who has given media interviews and published articles on gun violence from her perspective in the last month.

Ammunition from Dr. Judy Melinek’s teaching files for instructing other doctors about what they might recover from bodies. (Leah Mitchell)

According to Melinek, gunshot cases — especially homicides —  are different from others in that the forensic pathologist needs to understand the ballistics involved and to be able to answer related legal questions that come up.

“It’s more than just pulling out bullets,” she said.

It is Melinek’s job to be dispassionate in the morgue, but it can be challenging in some cases, especially with suicides. “My father died by suicide, so this makes me particularly sensitive,” she said.

And as the granddaughter of Holocaust survivors, Melinek is especially concerned about the recent increase in expressions of anti-Semitism and anti-Semitic crimes in the US.

“Guns have always been scary, and now there is a lot of hateful rhetoric out there and certain segments in society feel emboldened. Any time there is a gun, antagonistic situations become more lethal,” she said.

Melinek does autopsies related to deaths that occur in many different manners. However, gun violence stands out in one crucial way.

“A gun is a guaranteed lethal means,” Melinek said.

Dr. Joseph Sakran, Emergency General Surgeon

‘The worst part of my job is going into waiting rooms to tell the families’

Dr. Joseph Sakran (courtesy)

“As I approach the waiting room, I look at the families through the window and know that what I am about to do will completely change their life,” said Dr. Joseph Sakran, director of emergency general surgery at Johns Hopkins in Baltimore.

Sakran’s own parents were similarly waiting anxiously at a hospital in Virginia on a Friday night in 1994 when a 17-year-old Sakran had been hit by a stray bullet while standing on a playground after a football game. The errant shot ruptured Sakran’s trachea, severed his carotid artery and paralyzed his vocal chords. Fortunately, surgeons were able to not only save Sakran’s life, but also his ability to speak.

As Sakran recovered from his wounds, he decided he wanted to go from victim to healer. Sakran, who is Catholic, received his initial medical education at Ben-Gurion University’s Medical School for International Health, which is affiliated with Columbia University’s College of Physicians and Surgeons. His areas of practice now include trauma, emergency general surgery and surgical critical care.

“We see a high level of gun violence in Baltimore, and much of it affects untold black victims,” Sakran said. “Between the two Level 1 trauma centers in the city, we see at least one gunshot victim a day.”

Sakran, 41, said that it wasn’t until his fellowship in trauma medicine at the University of Pennsylvania that he understood the impact his own personal story could have in terms of changing the hearts and minds of others.

He recalled a program that brought local high school students — mainly African Americans — to tour the trauma center.

“Teens don’t always pay full attention, but when I told them my story, all eyeballs were on me. I asked how many of them, their families and friends were affected by gun violence, and almost all of them raised their hands,” Sakran said.

“It was at that moment that I realized that I turned from just someone in a white coat to someone with credibility with them,” he said.

Sakran, who has long been active in gun violence prevention work, recently became a Brady Campaign board member. Building on the #ThisIsOurLane hashtag, Sakran established an @ThisIsOurLane Twitter account, which garnered 15,000 follows in less than a week.

The fact that people are scared to send their kids to school, attend services at houses of worship, or venture going out into public spaces is unacceptable to Sakran. However, when asked whether he thought the US should emulate Israel in terms of security measures to deter and prevent killings, Sakran said he didn’t want to go down that road quite yet.

“We can learn a lot from other countries, but I don’t want to see searches and screenings like in Israel. There are other options before we get to that,” he said.

Sakran wants to see all stakeholders work together to move beyond the status quo. He warns people not to be complacent.

“Complacency is the enemy of preparedness. The next hashtag could be your community,” he said.

Dr. Shoshana Ungerleider, Internist

‘There are many ways to prevent bullet holes in people’

Dr. Shoshana Ungerleider (Mike Boland)

Dr. Shoshana Ungerleider also believes it’s time for physicians to forgo their silence on gun violence and stop fearing possible backlash.

“You can either speak up or be part of the problem,” said the internist and palliative care activist, who has family ties to Israel.

Ungerleider, 38, usually spends a quarter of her time in clinical practice at California Pacific Medical Center in San Francisco, and the rest running her foundation for consumer education and advocacy around end of life issues. However, in March 2018, she unexpectedly put much of her work on hold to organize San Francisco’s March For Our Lives following the February 14 mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida, in which a gunman killed 17 students and staff members and injured many others.

“My husband and I were visiting New York on February 14, and when we turned out the TV that evening, we saw the [surviving] Parkland students and were so inspired by them. We got online to see if there was a March 24 event scheduled for San Francisco, and there wasn’t,” Ungerleider recalled.

So the couple created an Facebook event and invited their personal friends. The invite went viral and the next morning they woke up to find that 5,000 people has responded that they would attend. Within three days, the number was up to 25,000.

People arrive for the March For Our Lives rally against gun violence in Washington, DC on March 24, 2018. (AFP PHOTO / Alex Edelman)

Ungerleider took it upon herself to plan and organize the San Francisco march and rally. Six Jewish moms from the Bay Area volunteered to help her. Some 75,000 showed up on March 24, many of them students, parents, teachers and healthcare professionals.

Ungerleider said she asks her patients about guns in their homes. She doesn’t want them or their loved ones to end up like a teenager she saw rushed into the emergency room during her medical school trauma medicine rotation. That boy had been caught in crossfire, and a bullet had pierced his heart.

“There was no time to get him to surgery. I watched as they had to crack his chest and massage his heart to try to dislodge the bullet and get his heart going again. I was running around trying to get enough blood to replace the huge amounts he had lost,” Ungerleider said.

The boy never made it off the gurney.

“Those #ThisIsOurLane photos?… They’re real,” she said.

Dr. Michelle Sandberg, Pediatrician

‘One in three households with children has a gun, and many are loaded and unlocked’

Dr. Michelle Sandberg (courtesy)

Dr. Michelle Sandberg isn’t on Twitter, but the NRA’s message telling doctors to butt out quickly reached her.

“My reaction was that it was preposterous and completely nonsensical when doctors are on the front lines treating gunshot victims,” Sandberg said.

“Gunshot wounds are among the worst things physicians see. The photos tweeted in response to the NRA were mild in comparison to what it really looks like,” she said.

Sandberg, 45, practices general pediatrics at Santa Clara Valley Medical Center in San Jose, California. She is also an affiliated medical instructor at Stanford University.

“I went to medical school in Baltimore and saw a lot of gunshot injuries during my training. Almost all doctors in the United States treat gunshot victims at some point during their career or training,” she said.

Sandberg was on the founding board of Moms Demand Action, which is now, along with Mayors Against Illegal Guns, Students Demand Action and the Everytown Survivor Network, part of Everytown for Gun Safety. She  also joined the advisory board of SAFE: Scrubs Addressing The Firearm Epidemic, an organization of physicians, nurses and healthcare professionals acting to reduce gun violence through research, education and evidence-based policy.

Sandberg publishes articles about the the role that pediatricians can play in preventing gun violence in homes with children, and she takes every opportunity to educate her patients and colleagues.

“I’ve done a lot of speaking and writing about the gun violence epidemic, including pediatrics Grand Rounds lectures. Teaching doctors how to educate patients about gun safety is critical,” Sandberg said.

This March 14, 2018 file photo shows students at Roosevelt High School in Seattle taking part in a protest against gun violence. (AP Photo/Manuel Valdes, File)

To prevent injuries and deaths, as well as suicides, among children and adolescents, Sandberg urges all pediatricians to ask patients’ parents whether there is a gun in the house, and to follow up with a gun safety discussion. If a teenager has mental health issues, then removal of the gun should be recommended, she said.

Sandberg pointed to the American Academy of Pediatrics’ cooperation with The Brady Center to Prevent Gun Violence on the annual National ASK (Asking Saves Kids) Day. The ASK Campaign reminds parents and caregivers to inquire if there are unlocked guns in the homes where their children play.

Pediatricians need to ask, too. Even if they don’t want to get publicly involved in the gun violence debate, Sandberg would like to see that at the very least they make gun safety issues part of their regular interactions with patients.

“Asking about guns should be part of anticipatory guidance for all pediatricians,” she said.

In speaking with The Times of Israel following the Pittsburgh synagogue shooting, Sandberg called the easy access to firearms joined with the spread of hate, conspiracy theories and a disregard for facts and truth under and within the Trump administration “absolutely dangerous.”

“American Jews should not be in denial about this combination of hate and firearms,” she said.

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