Emergency response

Emergency physicians fight on the front lines of responding to gun violence

Fact verified by Shannon Sparks

When someone is shot in Chicago, the effects reverberate beyond the wounded person. They envelop a person's family and friends, first responders at the scene, and the doctors and medical teams treating them at the hospital.

Nearly 80% of the 2,880 shooting victims in Chicago survived in 2023, thanks in large part to emergency rooms in the city's hospitals. Here, we dive in with emergency medicine doctors who are on the front lines of the gun violence epidemic, facing the horrific consequences of gun injuries. Together with their clinical teams, they navigate a landscape where quick, decisive action can mean the difference between life and death.

These medical professionals are not only healers, they are also first responders to a public health crisis, confronting the stark realities of trauma every day. Their experiences treating gunshot victims reveal a deep commitment to patient care, resilience in the face of repeated tragedy, and a comprehensive understanding of gun violence as a symptom of larger societal issues. Their stories highlight the urgent need for comprehensive solutions and support systems to address the pervasive impact of gun violence on individuals and communities.

Fernando Orellana, MD, is an emergency medicine physician at Sinai Chicago

Juan Rodriguez, MD, a trauma and burn surgeon at John H. Stroger Jr., Cook County Health

Elena Chen, MD, a pediatric emergency medicine fellow at the Ann and Robert H. Lurie Children's of Chicago

Janet Lin, MD, emergency department physician at UI Health

What prompted you to specialize in emergency medicine?

Juan Rodriguez: I wanted to be able to make a difference by serving patients on what was likely their worst day. In the Trauma Unit, you are able to make an impact on many people across the entire humanitarian spectrum. I'm originally from Chicago. During my residency at the Rural Trauma Center, I knew I wanted to serve patients in my city.

Elena Chen: I wanted to take care of all children regardless of the circumstances. As a health care safety net, the Emergency Department provides me with the opportunity to care for every child and family that comes through our doors.

How often do you typically treat gunshot victims?

Fernando Orellana: I have seen approximately 50,000 patients in my career so far. Victims of armed violence – more than 5,000 patients. This includes victims and their families.

Rodriguez: Last year we cared for 771 patients with firearm injuries in Stroger Hospital's trauma unit.

Chen: Over the course of five years of training in general pediatrics and pediatric emergency medicine, I cared for approximately 50 children who were victims of firearm injuries.

Is this what you expected when you walked in? Emergency medicine?

Orellana: When I entered emergency medicine, I was very aware of the victims of trauma and gun violence that I would be caring for. I just couldn't imagine the amount. The actual daily care of these victims also puts reality front and center.

Chen: As a pediatric resident, I never expected to care for so many children injured by firearms. Based on the cases of children I have cared for, and knowing the impact of gun violence on children's health, I am resigned to the fact that I will likely continue to care for children who are victims of gun violence, whether to treat acute injuries or the long-term physical and mental health consequences of those injuries.

Janet Lynn: To some extent yes. However, gun violence is not as prevalent in our society. When I see young, innocent bystanders victimized by gun violence, it is heartbreaking.

What is a particularly poignant case involving a victim of gun violence that sticks out with you?

Orellana: A father committed gun violence on his two children to get revenge on his ex-wife. The children arrived with gunshot wounds to the head. They did not survive. Everyone in our department did everything they could, and yet we felt like failure. There was no dry eye in the house. This experience haunted employees for months.

Chen: I took care of a child who was caught in the crossfire during a shooting. A few months later, they returned to the emergency department. The mother thanked me for taking care of her daughter when she was injured. When I asked her about their conditions, she told me that it was difficult, but that she was grateful for her child’s life. This stayed with me. In an instant, the bullet left her child with a severe, lifelong disability. It changed the course of life not only for the child but for the entire family.

Lynn: One of the first patients I cared for had a gunshot wound. He had attempted to commit suicide by shooting himself in the face under the jaw. Because of the force of the gun's recoil, it was forced His head was thrown back and he survived. However, his face was partially shot. Nothing vital was injured, but he needed extensive plastic surgery to repair his face. I had the opportunity to see him several weeks later in the clinic after he was discharged from the hospital. He was glad he survived. But he left me thinking about the ease with which he (obtained) the weapon.

How has your experience treating gunshot victims changed your perspective on gun violence over time?

RODRIGUEZ: I've realized that as much as we hear about gun violence, a lot of people don't fully understand it. We cannot be satisfied with seeing statistics or reading the news and moving on. Gun violence is a symptom of much larger societal drivers and inequalities that need to be addressed comprehensively. I also think that many people have preconceived notions about individuals injured by a firearm. What they don't realize is that many patients injured by firearms are unwitting targets or had a relatively routine interaction that unexpectedly escalated into violence. We need to do more to raise awareness about the complex effects of gun violence and how it affects not only the patient and their family, but our entire community.

Chen: We know that there are some preventable scenarios that can change a child's life immediately and permanently. In my opinion, these are drownings, car accidents, and other incidents such as accidental ingestion and household accidents. Now I have to include random gun violence on this list. For most of these other scenarios, we have evidence-based research on how to reduce these events and laws or policies in place to prevent the events (e.g., seat belts, speed limits, car seats). But for gun violence, there is only limited research available on how to prevent these events, and many policy opportunities to prevent child firearm injuries have yet to be operationalized.

In what ways do you think that Current health care system Well-equipped or ill-equipped to handle armed violence situations?

Orellana: I think that in the United States, we have the best medical technology and the best trained staff, and in that way we are well equipped to care for victims of gun violence. We're not doing a good job on the mental health front — the mental health of the victims and the staff (who) treat those victims.

Rodriguez: Approximately 25% of the traumatic injuries we see in our unit are penetrating trauma resulting from gunshot or knife wounds. Most other hospitals around the country see 12% to 14% of traumas penetrating. Because we see such a wide range of casualties, we were chosen to be a US Navy medical training site. Surgeons, nurses and Navy personnel rotate at the hospital to get training in treating penetrating trauma and other injuries before they deploy. What has become an increasing challenge is the proliferation of high-capacity ammunition magazines, automatic firearms modifications, and bullets containing explosive components. They are in fact weapons of war, causing widespread and immediate destruction. It doesn't matter If you put the patient on the operating table in seconds; The damage can be catastrophic.

What needs to change in health care Or a medication to better respond to bullet victims?

Rodriguez: A public health approach must be applied to gun violence in the United States if we, as a society, hope to reduce gun-related morbidity and mortality. The US Surgeon General's recent declaration that gun violence is a public health crisis is an important first step in this effort.

Chen: I believe resources should be allocated to better support patients and their families after the initial event, including resources to support physical health, mental health, and social support. These resources aid in recovery and can prevent re-injury, because unfortunately a number of gunshot victims suffer additional gunshot injuries.

Lynn: In the emergency department, we deal with the downstream, treating the lead victim. We must do more to address the source: the root causes of gunshot casualties. This is multifactorial and must be addressed at multiple levels.

What keeps you going?

Oriana: Teaching and properly passing the torch to the next generation of providers. Unfortunately, we will still need flexible and caring providers to care for these types of victims.

Rodriguez: I return to my Christian faith for a sense of purpose and a life of service; My family for their support You have provided me over the years. And my colleagues who work alongside me, Because I won't be able to do my job Without them.

Chen: The families I care for and my amazing colleagues in the emergency department.

Lynn: I hope that all of us, together, can make a difference.

Photo above by Jim Vondruska
Originally published in Fall 2024/Winter 2025 Printing issue.