Experience Treating So Many Bullet Wounds Has This Surgeon Exploring The Root Causes Of Gun Violence   

A case that began with what sounded like a funny announcement in the Emergency Department—“GSW to butt, ETA 5 minutes”—has forever changed Dr. Robert Winfield.

An Associate Professor of Surgery, Division Chief and Director of Trauma Research at the University of Kansas Medical Center, Dr. Winfield writes about his experience treating gunshot wounds and how he is now willing “to speak to anyone, anywhere, at any time, who wants to talk about gun violence and its root causes.”

We consider his first-person account a must-read, but be warned that it does include graphic details that some might find disturbing:

I remember the day that my perspective on gun violence changed forever.

I was the trauma surgeon on call at Barnes-Jewish Hospital in St. Louis. I was making my way through the labyrinthine hallway to the emergency department to see a patient who had been in a car crash, when I was stopped by a nurse who asked, “Dr. Winfield, did you take care of that kid who got shot in the butt yesterday?”

The case had taken place less than 24 hours prior, but was already among the more memorable of the surgeries I had performed in my life. 

The patient was a teenager; one of a steady stream of young, primarily African-American, males I have cared for following gunshot wounds (GSW) in St. Louis and Kansas City. The trauma page had people laughing prior to his arrival, because all it said was “GSW to butt, ETA 5 minutes.” It didn’t take long for the laughter to subside once he arrived though, because he was visibly in shock from blood loss: pale, clammy, a dazed look on his face. My heart sank when we saw that the patient had indeed been shot in the left butt cheek, but the bullet had left his body through the right groin. 

He hardly spoke, but asked weakly where his “mama” was, and the ambulance team relayed to us that she was a drug addict and thought that she was on her way. We started transfusing blood and had him in the operating room inside of 10 minutes, so that we could explore his abdomen and pelvis for injuries. When we sliced into his belly, we released torrential bleeding, making him profoundly unstable. I tried everything to stop the bleeding. I called for backup from another trauma surgeon as well as a vascular specialist. It was the vascular surgeon who finally said, “There’s nothing else that we can do”, and we declared a time of death. 

The bullet had shredded bone, arteries, and veins to an unsalvageable degree as it passed through the body. 

At moments like that, I have to remind myself that although I failed, the patient would have certainly died without me and I gave him a chance—it was the bullet that ultimately killed him, not me. This is a reality of my job, and although it doesn’t always work (over the long term, I constantly question whether I did the right thing when an outcome is poor), it usually quiets my self-doubt enough over the short term to move on and help the next patient, which is what had to happen that day, since my relief didn’t arrive for another couple of hours.

Mentally, I had somewhat moved on by the next day, when the nurse stopped me. I told her, “Yeah, he died on the operating table. It was awful.” What was worse than awful was what she said next: “His mother is here.”

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