An E.R. doctor's call to action: Treat gun violence as an epidemic we can conquer

It was an unusually quiet evening at the emergency department of Cooper University Hospital in Camden. Doctors and nurses reveled in the chance to spend a few extra moments with their patients, rather than having to rush off to the next bedside.

Hallway beds lay empty, made up with crisply folded white sheets. Machines and monitors beeped their reassuring tones.

Suddenly, the radios crackled to life with the unmistakable sounds of an emergency — a child had been shot.

With no time to wait for an ambulance, the little girl was scooped from her yard where she had been playing, and rushed to us for help, squealing tires and the frantic radio traffic heralding her arrival. She was limp, so badly injured by a bullet meant for someone else, we could see right away that she was dying.

Nonetheless, our team moved swiftly and smoothly into action, doing all the things we know to do to try and save someone so badly injured. But on the table before us, her life drained away.

This tragic drama from just about a year ago plays out all too often in trauma centers and on street corners all over our the Philadelphia area. In 2016, nearly 230 people were cut down by gunfire in the City of Brotherly Love, and an additional 44 fell on Camden's streets.

The firestorm comes in bursts and waves, and it's our friends and families, our students, our teachers, our coworkers, and our neighbors who are dying. The violence has become a terrible norm, one that seems to gain the spotlight only in an event like the Las Vegas massacre when the circumstances seem remarkable, and the one-day toll is so extraordinary.

Gun violence is among the greatest public health threats of the 21^st century. Until last year, firearms eclipsed opioids in lives stolen, despite a 200 percent increase in the latter. In Pennsylvania, guns killed more people than car accidents.

Every day in our hospitals and on our city streets, an anything-but-silent disease is killing Americans—more than AIDS, asthma, and flu combined–and yet a coordinated public health effort has remained conspicuously absent.

Indeed, a study published earlier this year in JAMA Internal Medicine identified a curious disparity between the burden of gun violence in our country and the funding available for its study and solution. Despite more people dying from guns than AIDS, hepatitis, house fires, and asthma combined, gun violence research receives only a fraction of the funding of even one of them.

The JAMA authors offered a possible explanation for this incongruence: a 1996 congressional hamstring stipulating that none of the funding earmarked for injury prevention at the U.S. Centers for Disease Control and Prevention be used to advocate for or promote gun control—a legislative muzzle that has effectively muted gun violence research in the United States.

Dr. Joshua Hazelton, trauma surgeon and Director of Trauma Research at Cooper University Hospital, lives this reality every day. "This issue extends far beyond gun control laws," he told me, "and encompasses mental health, firearm education, trauma center outreach, and early intervention programs." He is among the many physicians calling for a comprehensive and concerted public health approach to gun violence, a sentiment echoed by the American Medical Association, American Academy of Pediatrics, American Public Health Association, and American College of Emergency Physicians.

While politicians, pundits, and social-media proselytizers debate gun control, constitutional quandaries, and an uncertain future, there's little question that injury prevention research and a public health approach to the epidemic of gun violence can help improve the safety and health of every American.

The scientific method, applied as it is meant to be, ennobles us. Free from the constraints of political rancor, it tells us where we are and where we must go. Epidemiologic research, prevention efforts, and evidence-driven interventions rooted in scientific inquiry and objective analysis can provide the long-sought answers to the questions that nag at our collective soul.

The shooting in Las Vegas has again revealed the heartbreak our nation experiences with each tragedy, a recurring sorrow that we share with the families of gun-violence victims every day in the ER, and every night on the evening news. It's long past time that we moved past the vitriol and polarization of political discourse and treated this never-ending national nightmare as the health crisis we have long known it to be.

Rick Pescatore, D.O., is assistant director of research, Department of Emergency Medicine, at Inspira Health Network in Vineland. He recently completed his residency in emergency medicine at Cooper University Healthcare in Camden, where he served as chief resident.