As I examined the strength in my patient’s legs, I noticed some scar-like indentations on his right thigh. Pausing, I asked Rob how he’d gotten them. “I got shot,” he responded

I nodded calmly, while I summoned up Rob’s medical history. I recalled that he was on medications for PTSD. As my mind connected these dots, I asked, “What happened?”

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Missed Shot

“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.


“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.

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Memories of Columbine

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.

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A Routine Clinic Session

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.

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Guns Beget Guns

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.

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She Loved Her Baby

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.

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Beyond the Number


The number alone is staggering. Twenty-four thousand five hundred and seventy-six deaths due to homicide in the United States in 2020, per the CDC estimate. This number, however, leaves out much of the toll of violence, a reality that became clear to me after an experience in clinic one afternoon.

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When I entered elementary school in the 1950s, I practiced hiding under my wooden desk in case a Soviet bomb was dropped on my school. By the time I took early retirement as a teacher in 2003, I was leaving a middle school with a locked-door policy; the principal told us if we ever heard over the loudspeaker that “Mr. Lock” had entered the building, we should immediately lock our classroom doors and gather our students on the floor, away from the windows.

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June More Voices: Gun Violence

Dear Pulse readers,

A few years after my father passed away, my mother was visited at her New Jersey condominium by one of her favorite nephews, who drove down to visit from Canada.

Something happened–as I recall, it was a misunderstanding over a condominium parking space that my cousin was using. In trying to sort this out, the son of a friend of my mother’s became enraged and suddenly, without warning, punched my cousin in the face, knocking him down.

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