June 2022

“You’d better sit down,” says the neighbor of a friend, a voice I hardly recognize over the phone. On automatic pilot, I grab the nearest chair.

“Okay.”

“S. shot herself.”

“What?” Shock throws me off balance, even with four legs and a wooden seat under me.

“S. bought a gun and shot herself last night on the patio outside the kitchen, leaving a trail of notes for B. to find while he was out walking the dog.”

I can’t keep up with all this information.

Every school shooting takes me back to April 1999.

I was a medical student in Denver, Colorado, when the Columbine High School shooting occurred very nearby. The recurrent media coverage of mass shootings continually reignites the horror and shock of that day; several of my classmates had graduated from Columbine, others cared for the wounded.

With every school shooting since, I wonder, how is it we can’t move forward? My mind replays the scenes from Columbine—a student dangling from a window, the terror of those running from the scene, the memorial of white crosses on a hill.

I open the door, belt out a “hello,” and peer at the patient seated in the exam room I’ve just entered. My gaze is drawn to a homemade button pinned to their jacket and then to their T-shirt. Both depict a photo of their loved one who was a victim of gun violence. The victim’s dates of birth and death are imprinted below the photo. A quick mental subtraction reveals a life ended far too soon.

Joanna has always been more dramatic than my other patients, but this time she seemed so much more distressed and fidgety than before. I had to ask, “How are things at home?” That was her cue to ask me to bring in my medical assistant, who has now become her friend, to help with translation. She did not want me to misinterpret anything she told me, in her broken English. And so we switched to Spanish.

I was a second-year ob-gyn resident, back in the mid-1980s, when I met her in the clinic. She stood out because she could speak English—Queen’s English, to boot. She was friendly and happy. She anticipated her delivery with joy. I saw her several times in the clinic and again in the labor room, when we celebrated her son’s birth.

But here’s what she didn’t tell me: She had been a sex worker.