The Current

Gun violence takes a heavy toll on families of victims, says trauma surgeon

As part of One Bullet, The Current's series on gun violence, we speak to two trauma surgeons who are faced with the reality of what bullets do to bodies.

'Most people don't get to rehearse their reaction to a catastrophic event,' says Dr. Bernard Lawless

Dr. Bernard Lawless, a trauma surgeon at St. Michael's Hospital in Toronto, says frightened families of gunshot victims often look to him for information about the crime. (Sinisa Jolic/CBC)
This story is part of CBC's One Bullet series. Each instalment takes a close look at a shooting from somewhere in Canada — who was hurt or killed; who was held accountable; and how did the fallout impact friends, family and first responders.

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Originally published Jan. 17, 2019.

For Dr. Bernard Lawless, helping families process that a loved one has been shot can be as difficult as treating the gunshot wounds themselves.

"Most people don't get to rehearse their reaction to a catastrophic event, and so I think that's why you get to see that range of how to cope … where they direct their anger, their disbelief," he told The Current's Anna Maria Tremonti.

Lawless' role is to explain the patient's prognosis, and lay out the "rocky trajectory" to recovery. But he said families often want answers about the shooting itself, or will fixate on certain details.

Seeing families struggle to make sense of the situation will often "rest with me the most, even sometimes beyond the impact that it might have on the actual victim," he said.

Two people died and multiple people were injured in a shooting in the Danforth neighbourhood of Toronto in July 2018. (Mark Blinch/The Canadian Press)

Statistics Canada reported that there were 266 victims killed by a firearm in 2017, 43 more than in 2016. Handguns accounted for about 60 per cent of those deaths.

The overall rate of violent firearm offences increased seven per cent between 2016 and 2017, from 2,534 to 2,734. It was the third year in a row that there was a rise. The types of offences ranged from shooting a gun "with intent," to pointing one at someone, to having a gun on your person while committing another offence.

According to Statistics Canada, Toronto accounted for the most firearms-related homicides of all cities in 2017.

Lawless was on call the night of a mass shooting in Toronto's Danforth neighbourhood last July that killed an 18-year-old woman and a 10-year-old girl and injured 13 others. As the victims began to arrive at St. Michael's Hospital, he worked to make sure his team was coordinated and could quickly assess where care was most needed.

"The last thing you want in those situations is even extra chaos," he said.

"It seems very sterile and separated ... but I think at the end of the day, you know, we're human, and you can't divorce yourself from seeing the impact that it has on patients and families."

"You have to be careful about how much of that weighs on you from a day-to-day basis, or else it can be a bit crippling, and then you can't function the way that you need to in the moment."

Should surgeons 'stay in their lane?'

Dr. Paola Fata, a trauma surgeon at the Montreal General Hospital, says gun violence is a public health issue.

"We need to look at it carefully, and have … a proper perspective of how and where the violence is happening, in order to inform what we do next," she said.

In 2017, there were 14,542 gun-related homicides in the U.S., according to the Centers for Disease Control and Prevention. In October, the American College of Physicians published a position paper, recommending a series of gun violence prevention measures.

Responding on Twitter, the National Rifle Association wrote: "Someone should tell self-important anti-gun doctors to stay in their lane."

"Treating patients, treating victims of gun violence is what I do, and what I've always done, so I consider it my lane," said Fata.

Lawless says that previous public education programs — such as those about wearing seatbelts, or not drinking and driving — could be applied to learning about gun safety.

"There is a very clear role, I think, for trauma surgeons ... in highlighting what some of those issues are, and advocating for a public health perspective."

According to Statistics Canada, Toronto accounted for the most firearms-related homicides of all cities in 2017. (John Sandeman/CBC)

He said, however, that no "single soundbite" will capture the nuances of the issue.

"It begs a more thoughtful discussion … with thoughtful decision-makers, political parties, legislators, looking at what are some of the real things that can be done," he said.

"We need to maybe search out ways of having an equal amount of energy … looking at the things that we might be able to do different, or address those elements I think that contribute to violence in our society."

Written by Padraig Moran. Produced by Jesscia Linzey and Joan Webber as part of The Current's One Bullet series.  



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