I’ve taken care of more children with gunshot wounds than appendicitis.
I’m a pediatric intern at Harbor-UCLA Medical Center, a safety-net hospital in Los Angeles County. When I decided to go into pediatrics, I pictured helping children and their families with broken bones, asthma and ear infections, as well as some chronic diseases, such as diabetes. I never imagined how often I would take care of children trying to heal from the physical and mental trauma of being shot.
Nor did I expect to see kids die from gun violence. But I have.
The heartbreaking reality is that firearm-related injuries are the leading cause of death in children and adolescents in the United States, according to the Centers for Disease Control and Prevention. More than 5,000 children, teens and adults younger than 25 perished from gun-related homicide, suicide and unintentional injuries in 2020.
That’s equal to 70 school buses of kids who don’t come home.
An incomprehensible addition to those numbers are the 19 children in Ulvade, Texas, murdered by an 18-year-old at their elementary school in May.
Across all ages, more than 45,000 Americans died in 2020 due to firearms, the most ever reported in the U.S. In Los Angeles, gun deaths hit a 15-year high in 2021, with nearly 400 fatalities.
As tragic as mass shootings are, they are a fraction of the “everyday” shooting deaths in the U.S., which occur at a rate unlike any other nation. The violence that children in this country — especially in disenfranchised communities like where I work — are exposed to is real and often has devastating consequences.
I worry about the kids I’ve seen.
A little girl, age 10, with a curly ponytail and a bullet wound in her back is the youngest gunshot victim that I’ve had as a patient. I was on duty in the emergency room the night that she and another boy were rushed into the trauma room. My little patient and the 13-year-old boy had been shot playing at the playground outside her school. The boy died shortly after arriving in the ER. Both were innocent bystanders in a drive-by shooting, likely targeting an adult nearby.
What I remember most about this little girl, however, wasn’t that night. It’s that she came back months later unable to sleep. She was terrified about the bullet still lodged near her spine and that she could die. As a survivor of gun violence, she is 51 percent more likely to be diagnosed with a psychiatric disorder, and 85 percent more likely to struggle with substance use, compared to her unwounded peers.
I also remember two teenage boys, not quite 18, who were shot in separate, presumed gang-related incidents. They should’ve been planning their futures, getting jobs or going to school. Instead, each teen spent months in the hospital, undergoing surgeries, dealing with the pain and recovering from the complications of multiple physical injuries. That doesn’t even include addressing the mental trauma of being shot or why their lives led them to be involved in a gang.
The fear caused by gun violence, from mass murders to shootings, hurts everyone in the community. Exposure to gun violence is common in urban settings in the U.S., affecting nearly 1 in 4 people, and disproportionately impacting young people, especially Black, Latinx and low-income residents. Even living near a shooting can have negative psychological effects. Researchers found that people living within a few blocks of a shooting were almost twice as likely to visit an ER for psychiatric reasons in the two weeks following the incident.
In addition, the monetary costs of firearm-related injuries are incredible. Hospital costs alone for initial gun injury care exceeded $1 billion annually in 2016 and 2017, according to the federal government accounting office. The estimated average cost for a patient hospitalized for a gunshot wound was $92,151 in a 2019 study. This number doesn’t take into account the time my patients lost in their young lives, their risk for future disability or the mental toll of their injuries and hospitalization.
Many of these children’s stories are too relatable for my comfort. I recall one very distressed mom chastising her teen son, who had been shot, for placing himself in a dangerous situation. He was just hanging out at the mall. It was the same mall I used to go to with my friends when I was a teenager. After that shooting, I’m sure a lot of kids and their parents no longer considered the mall, a typical teen hangout, as safe.
The same must be true for schools.
I’ve learned a lot in my internship year about how to manage bullet wounds, how to talk to kids and their families after a shooting, and how to find mental health resources for the children. I’m thankful to be in a place where dedicated doctors, nurses, therapists, social workers and so many others work every day to help the kids heal.
But we, as health care providers, can only do so much.
Gun violence is a major public health issue that’s happening all the time, even when it’s not in the news. My hope is that these tragedies lead to solutions — and the political resolve — to end gun violence.
Dr. Adriana Mellor, a native of South Los Angeles County, is completing her pediatric training at Harbor-UCLA Medical Center.