Fatalities are but one tragedy of shootings

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Media reports of our frequent mass shootings tend to focus on how many victims were killed at the scene. The number of persons "hurt" or "injured" is provided as something of an afterthought, and we rarely read about the long-term impacts on those survivors and their families. But fatalities are just the tip of the iceberg.

While loss of life is unquestionably the most immediate tragedy, it is important for the public to understand that an "injury" from a gunshot wound — especially a high-caliber, hollow-point or military round — is not like a sprained ankle or a broken wrist. Gunshots commonly cause extensive destruction of essential body parts, both within and outside the direct path of the projectile. When bullet hits bone, for example, it does not usually cause a clean break, but a deep, complex, contaminated wound containing fragments of bone, clothing and other debris. These wounds are difficult to treat and often heal poorly or not at all. A gunshot wound to the abdomen can result in damage to important internal organs. Treatment may require multiple major surgeries and result in the need for a colostomy.

No matter where the entrance wound is, bullets commonly travel through the body doing damage to structures along the way, such as the spinal cord. Injuries to the spinal cord cause permanent paralysis and inability to walk and/or move the arms. And the survivors of a gunshot wound to the head will often suffer the extreme disabilities we associate with strokes and other major brain injuries, in many cases requiring round-the-clock care and assistance for the rest of their lives.

As an attempt to trivialize the significance of gunshot injuries, it is sometimes pointed out that knives and baseball bats can also cause serious injury. While this is true, the injury-causing capabilities of these weapons are limited by factors such as the length of a blade or the strength of an attacker. Firearms suffer neither of these limitations. Today's offensive weapons are not the single-shot rifles James Madison would have known, but tools well-designed to inflict the maximum amount of injury to multiple human beings in the least amount of time. So in both scope and consequences, modern gun violence really is different from other types of violent trauma.

In addition to the physical and psychological suffering of individuals and families, the cost of these injuries to our economy through lost productivity, medical expenses and the need for ongoing care is enormous. This cost is borne by all of us through our taxes and insurance premiums. It is the price tag for a level of gun availability far above any other nation.

Now is the time for health care providers, journalists and gun violence survivors to speak out so that legislators and the public can get a more complete picture of the extensive human and economic cost of this particular type of violent injury.

Dr. Todd Grant, of Golden Valley, is a retired emergency physician. Dr. John Twomey, of Tucson, Ariz., and formerly of Minneapolis, is a retired trauma and general surgeon.