Should Gunshot Wounds Be Treated Like a Disease?

BY Jason Kane  March 26, 2013 at 9:01 AM EST

Havilah Phillips, a sister of a 15-year-old shooting victim in Newark, is comforted during his memorial service in 2011. Photo by Aristide Economopoulos/The Star-Ledger.

NEWARK, N.J. | The floor of the trauma bay was slippery with blood the day Dr. Sampson Davis looked into a gunshot victim’s face and did a double take.

In too many ways, the bullet-riddled man on that stretcher looked like Davis himself — a 20-something man with an eerily similar face, “the same muscular medium build, the same honey-colored complexion, and the same neat, short haircut,” he wrote in his new book, “Living and Dying in Brick City.”

As Davis cut away the man’s shirt, cracked open his chest and attempted to plug up a hole near the heart, he couldn’t shake the feeling that it easily could have been him dying on that stretcher. If Davis hadn’t walked away from drug dealing and crime as teenager, his own vital organs might have been the ones torn apart by several rounds of high-caliber bullets in a Newark turf war. And his own death might have become part of the statistic — just one of 2,366 homicides between 1982 and 2008.

“Far too many,” he said. And while Davis shares the outrage that shook the U.S. after the murder of 26 children and adults were murdered at Sandy Hook Elementary School in Newtow, Ct., in December, he also points out that inner-city gun violence occurs daily on a much wider scale — and almost entirely unnoticed by the general public.

On a typical summer night at Newark’s University Hospital, as many as 35 people will walk into the E.R. “shot, stabbed or beaten,” he said. And that’s just at one of Newark’s major hospitals.

Davis sat down with Ray Suarez last week to explore why living in America’s roughest neighborhoods can negatively impact health. Their discussion continues below with a closer look at one of the most pressing reasons: gun violence.


Join our live chat with Dr. Sampson Davis at 1 p.m. ET on Tuesday, March 26. See below for details.


The mass bloodshed doesn’t just mean chaos for hospitals and heartache for families. It also translates to huge health care costs for federal and state governments.

On average, treatment for a victim of an inflicted gunshot wound costs about $322,000, Davis said. If as many as 35 wounded patients are hauled into an E.R. in one night, “you’re looking at millions and millions and millions of dollars spent, by tax-payers, in order to take care of them,” Davis said.

One recent study estimated that nationwide, gun-related court proceedings, insurance costs and hospitalizations cost taxpayers $12 billion each year. The Centers for Disease Control and Prevention reported in 2010 that the medical and work loss costs from firearms death and injury totaled more than $68 billion.

It’s why Dr. Davis believes now is the time to start treating inner-city violence with the urgency of a disease. Because in some ways it is, he said “especially in the sense that 35,000 young people lose their lives a year through gun violence.”

The theory was taken one step further in a recent study in which Newark’s murders were tracked with equipment previously used to keep tabs on public health threats like the flu and certain types of cancer.

Just like a disease, homicides usually have a source, a mode of transmission and a susceptible population, according to one of the study authors, Jesenia Pizarro — who is also a native of Newark and associate professor at Michigan State University’s School of Criminal Justice.

In large cities like Newark, “sources” often include areas with drug markets, gangs and a high availability of firearms, Pizarro said. Violence is “transmitted” by gang retaliation, common crime and a population feeling the need to “arm up” and respond violently when threatened. The “susceptible population” often includes those at an economic disadvantage, she said.

By tracking the homicides that occurred in Newark between 1982 to 2008, Pizarro and her team saw the original cluster of violence — which, at first, was mostly contained to the central part of the city — spread west and southward as the public housing projects were demolished and gang activity spread.

Continuing with the disease analogy, Pizarro said that tracking homicides in this way may help “inoculate” at-risk populations in the future by giving officials the opportunity to increase services or interventions in a given neighborhood. And they may be able to do that “more effectively because they’ll know exactly where the violence is and where it’s likely to go,” she said.

Dr. Davis shares his own thoughts on the theory of viewing “gunshot wounds as a disease” in the video below:

As Davis sees it, there’s nothing “inherently wrong” with the inner-city youth caught up in violence.

“Children growing up in poor urban neighborhoods aren’t programmed by their DNA to run around with guns, killing one another,” he wrote in “Brick City.” “Violence is a learned behavior. And I know from my own experience that the negative lessons learned in an environment saturated by drugs and violence can be unlearned.”

He also knows from his own experiences that hope and success — both powerful weapons against drugs and violence — are things that can be demonstrated and taught. His proof: Dr. Arabia Mollette.

Mollette grew up in the projects of the South Bronx, raised by a family “where drugs, alcohol and crime” were nothing unusual. Gunshots rang out so frequently in her part of town that Mollette would barely flinch when a gun was fired. “If I was sitting outside and I heard one, sometimes I wouldn’t even run,” she said. “Because it’s just like, ‘Oh, here we go again.’ I became desensitized by it.”

But as far back as she can remember, Mollette dreamed of bigger things.

She would sometimes cut out paper dolls and play hospital and would always care for the sick around her. And when she was a little older, she questioned hospital employees about the medical explanations behind the tragedies in her life — like when her four-month-old baby boy was beaten by his father and ended up dying of the wounds. Or when her sister was shot and killed while riding in a friend’s car. Everyone told her she should become a doctor and help put that passion to work.

“But I didn’t have any money for medical school,” she said. “The opportunity was unrealistic.”

At least that’s the way it seemed until the young woman met Dr. Davis at a film festival and realized their stories were nearly identical — the poverty, the obstacles, the desire for change. She bought his first book to find out more, and “I remember I kept reading it over and over and over again because I felt that my life story was pretty much laid out in that book,” she said.

When Mollete contacted Davis again, he saw the similarities, too, and became her mentor. He advised her broadly on things like how to fund her education, and also talked to her about the nitty gritty, like how to study for tests and manage time.

Nearly a decade later, Mollette is an emergency medicine resident at Newark Beth Israel Medical Center — the same place Dr. Davis started his career. When her days get tough, she remembers why Davis said that despite the obstacles, people from disadvantaged backgrounds are extremely qualified to succeed in medicine.

“He told me, ‘You are a fighter and you will make it. And just understand that it is hard but always know that you are cut out for this, you are made for this,’” Mollette said. “Still today, he’ll repeat it to me: ‘You got this far and you will get even further.’”

After all she’s been through, Mollete can see his point.


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