homeaboutarchives + tagsshopmembership!

kottke.org posts about Leana Wen

What bullets do to bodies

posted by Jason Kottke   Jun 16, 2017

Emergency room doctor Leana Wen writes in the NY Times about what bullets do to human bodies.

Early in my medical training, I learned that it is not the bullet that kills you, but the damage from the bullet. A handgun bullet enters the body in a straight line. Like a knife, it damages the organs and tissues directly in its path, and then it either exits the body or is stopped by bone, tissue or skin.

This is in contrast to bullets from an assault rifle. They are three times the speed of handgun bullets. Once they enter the body, they fragment and explode, pulverizing bones, tearing blood vessels and liquefying organs.

Earlier this year, Jason Fagone wrote a much longer piece on the same topic for HuffPost.

“As a country,” Goldberg said, “we lost our teachable moment.” She started talking about the 2012 murder of 20 schoolchildren and six adults at Sandy Hook Elementary School. Goldberg said that if people had been shown the autopsy photos of the kids, the gun debate would have been transformed. “The fact that not a single one of those kids was able to be transported to a hospital, tells me that they were not just dead, but really really really really dead. Ten-year-old kids, riddled with bullets, dead as doornails.” Her voice rose. She said people have to confront the physical reality of gun violence without the polite filters. “The country won’t be ready for it, but that’s what needs to happen. That’s the only chance at all for this to ever be reversed.”

She dropped back into a softer register. “Nobody gives two shits about the black people in North Philadelphia if nobody gives two craps about the white kids in Sandy Hook. … I thought white little kids getting shot would make people care. Nope. They didn’t care. Anderson Cooper was up there. They set up shop. And then the public outrage fades.”

I think about this tweet all the time:

In retrospect Sandy Hook marked the end of the US gun control debate. Once America decided killing children was bearable, it was over.

Update: Radiologist Heather Sher was on duty at a Florida trauma center when victims from the shooting at Marjory Stoneman Douglas High School were coming in. In this piece for The Atlantic, she explains how drastically different the wounds are from the AR-15 than from other guns.

In a typical handgun injury that I diagnose almost daily, a bullet leaves a laceration through an organ like the liver. To a radiologist, it appears as a linear, thin, grey bullet track through the organ. There may be bleeding and some bullet fragments.

I was looking at a CT scan of one of the victims of the shooting at Marjory Stoneman Douglas High School, who had been brought to the trauma center during my call shift. The organ looked like an overripe melon smashed by a sledgehammer, with extensive bleeding. How could a gunshot wound have caused this much damage?

The reaction in the emergency room was the same. One of the trauma surgeons opened a young victim in the operating room, and found only shreds of the organ that had been hit by a bullet from an AR-15, a semi-automatic rifle which delivers a devastatingly lethal, high-velocity bullet to the victim. There was nothing left to repair, and utterly, devastatingly, nothing that could be done to fix the problem. The injury was fatal.

In addition to the obvious horrorshow of carnage caused by AR-15-propelled bullets, what gets me is the phrase “a typical handgun injury that I diagnose almost daily”. In other countries, daily gunshot wounds would be an alarming situation in need of immediate response, but the in the US, it’s just a prelude to even greater horrors.