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.
In my current work as a palliative care and hospice physician, I assist patients and families who are navigating serious and terminal illnesses. I often describe the work as walking into the worst day of someone’s life. This is especially true in the trauma ICU. I have cared for patients whose lives were impacted by gun injuries—with paralysis or traumatic brain injuries changing their lives forever. For me personally, I find the hardest situations are the incompleted suicides, often attempted with a gun. The patients arrive with devastating, often disfiguring injuries. Assisting the families in decision-making when they are in the midst of a nightmare is heart-wrenching. The families must contend with the knowledge that the patient found their quality of life unacceptable. Should we continue aggressive lifesaving measures that might commit the patient to a lifetime of disability? It is a nearly impossible situation.
Our national crisis of gun violence spills over into so many areas. The families that lose loved ones are forever broken, those who survive often live with serious injuries and emotional scars. First responders and medical providers and communities are all traumatized by what they have witnessed. The work of palliative care includes supporting our colleagues, who suffer vicarious trauma, the result of continuous exposure to patients impacted by violence. The wounds people inflict on each other are the hardest to bear. This work takes a toll on us all.
Today, we have reached the point where gun violence is the leading cause of death for our youth, an unfathomable reality and a serious public health crisis. Mental health comes up frequently in discussions. I wonder about the impact of active shooter drills in the schools, of children growing up in a climate of fear and anxiety. Surely, they must realize, the adults cannot agree on how to stop this: how much does that contribute to our mental health crisis?