Triggered

I nervously tapped my foot as pediatric residents filled the seats in front of me. Normally, this would be our educational conference time—residents grabbing lunch, the room abuzz with chatter before settling in for a lecture. Instead, weighted silence, bowed heads, and solemn stares replaced the usual boisterous conversation as the horrors of the previous day sank in. Less than 24 hours prior, our community joined the long list of those devastated by a mass shooting when 3 adults and 3 children were murdered in an elementary school. On that day, instead of learning about traditional pediatric content, we debriefed about the number one killer of children: gun violence. Flanked by a social worker and gun safety advocate, I listened to story after story of how these residents had been impacted by gun violence. It was clear that not only were they angry about the present, but they were also reliving traumatic past experiences. In that moment, it became abundantly clear that their world views and mine are inherently different.

I strode through the early summer morning. Remnants of the celebration last night scattered the street—firework debris interspersed with bullet casings. It was always difficult for me to tell the difference between the 2 in the cacophony of an Independence Day celebration. I saw my parents’ car parked along the side of the street. No new bullet holes this year.

Loud bangs throughout the evening were common on any holiday or football gameday. Every “Go Vols” was accompanied by a barrage of fireworks and a shower of bullets. While my family tried to guess if each bang was a firework or gunshot, I quietly found the corner of the room with the most protection between myself and the street. I kept the tiny ember of fear hidden, visible only by a slight tremor at each explosion.

After a shooting at my sister’s high school, my future school, that ember was stoked to flames. There was one casualty, a teenager, shot in the cafeteria just before the first bell. That day my sister happened to be sick at home. There remained an empty seat behind her for the remainder of the year. Then: an obsessed lover murdering a cheerleader, a sad teen whose hope ran out long ago, a kid walking home in the wrong color. I fear the rising inferno in my community.

Growing up in a war zone, I experienced the horrors of gun violence ravaging my homeland. The sounds of gunfire were a familiar soundtrack to our lives. We lived in constant fear for our safety. The streets were always filled with chaos and despair. Families shattered, communities torn apart by grief and trauma, everlasting scars on my psyche. Bullets showed no mercy. I never thought gun violence would haunt me after fleeing my home country. US gun violence turns schools into war zones where children are caught in the crossfire. Now a parent, I fear for my child’s life after this school shooting so close to home.

BOOM. The first gunshot I remember is from middle school. My uncle died by suicide after suffering an injury at work and a breakup. They found his body in shreds, tearing a wound in our family just as deep. BOOM. I remember the second gunshot from high school. Another uncle died of a gunshot wound. Everyone in the family whispered about him for as long as I could remember, calling him “odd.” They danced around a term that fit more accurately—“mental illness.” He wore gloves everywhere, refused to be around me since I was adopted from Vietnam, and feared my germs. He had gone out with a gun planning to take his life. Surrounded by police, he raised the gun and was shot by the police. BOOM. The third gunshot I remember was in college. My teenage cousin was cleaning his gun and accidentally shot his hand, unaware that the gun was loaded. Each gunshot pierced not just my uncles and cousins, but my family and me.

I was a student at the University of Connecticut during the Sandy Hook massacre. My best friend worked in the daycare center down the street from the elementary school; listening to her recount that day still feels like yesterday. Ambulances and police cars pooling in the parking lot. Lines of children filing to safety. Shielding their kids from the windows, the daycare staff drew the blinds when stricken parents came to collect children. With each passing year, the list of close calls just gets longer. Now a resident, I watched 3 kids and 3 adults roll into my emergency department. Children are dying every day. Adults are dying every day. By others’ hands and by their own. How is it that there are people in this country that do not feel the desperation that I do?

I had just arrived at the library to study for my pathology final exam. I opened my computer and immediately saw the headlines—my high school, Marjory Stoneman Douglas, had an active shooter on campus. My face turned white; my heart pounded through my chest; the room fell silent; time stood still. Texts and phone calls poured in. My thoughts raced. Was my sister at school? My neighbors? Who was accounted for? What building was the shooter in? Do we know any victims? I pictured helpless, scared, vulnerable school children. I remained in a daze, motionless on my couch. Among those who had been killed, my sister’s best friend, a 14-year-old girl, full of potential, whom I had coached in soccer and still called me “Coach Logan.” How would I go on? How could I go on? Life has never been the same. My high school—a memorial. My community—a burial ground. Every subsequent shooting—a trigger for grief.

One hundred and fifty-five days, or 223 200 minutes, or 13 392 000 seconds. Hundreds of IVs, 21 different medications, 7 CT scans, 10 x-rays. Eight surgeries, 700 hospital notes, 106 different doctors. One home lost, one custody battle lost, one mother lost. One patient, 0 function in 2 legs.

I will never forget his vacant stare, painted on his face like a mask. My second patient during residency. Just one bullet to rip away an entire childhood.

I stand over you, damp inside my flimsy blue plastic gown, trying to meet my 120 beats-per-minute and 2 inches of depth. The skin had been peeled off your mandible. The burgundy found in the center of your chest makes my gloved hands slick with every compression. You and your brother were playing a children’s make-believe game. In 10 minutes, we will declare what was true half an hour ago. My eyes are stinging with what I assume is sweat; your eyes are fixed and dilated. The 2 of you had listened to the message that our society had clearly sent: that these weapons of death are toys. You look so small on the gurney. I’m so sorry this happened. I’m sorry that we are always, all the time, letting you down.

Growing up in an era marred by gun violence has shaped this new generation. May the next generation of medical trainees have different stories to tell, stories not pierced by gun violence. May they one day no longer be triggered.