At the end of an otherwise quiet night, we were paged to the emergency department for a stat trauma. A man with multiple gunshot wounds was wheeled by paramedics into the trauma bay, his blood pressure perilously low. The surgeons searched his body for blood. They cut off his clothes and rolled his body onto its side. Using an ultrasound probe, they looked in the cavities and potential spaces where blood can hide: the abdomen, the chest, the sack around the heart. They palpated his thighs for a massive hematoma. This coordinated, frantic search revealed no source of hemorrhage. Oddly, though the patient’s blood pressure was still dangerously low, his heart beat slowly. Had he been bleeding out, his heart should have been frenetically pumping whatever blood remained in his circulation into his aorta and pulmonary arteries.
“Has anyone seen him move his feet?” the attending barked. “Has anyone seen him move his feet?” The pack of residents said nothing. With each millisecond of silence, the possibility that this man’s spinal cord had been severed by a bullet, and that his low blood pressure was the response of a stunned nervous system, seemed to increase exponentially. The attending shouted the question a third time while a resident aggressively scratched along the bottom of the man’s feet. But his legs did not so much as twitch. It had barely been ten minutes since he arrived in the emergency room and we all knew this man would never walk again.
Like so much of what I witnessed in my third year of medical school—my first year in the hospital—this scene was buried somewhere in my memory. But this week, while drinking my morning coffee and reading the New York Times, it barreled into the foreground of my mind.
An article published in the aftermath of the shooting at Umpqua Community College in Oregon reported recent comments by Dr. Ben Carson, the retired pediatric neurosurgeon and Republican presidential candidate. In an October 5th Facebook post Dr. Carson wrote:
“As a Doctor, I spent many a night pulling bullets out of bodies. There is no doubt that this senseless violence is breathtaking—but I never saw a body with bullet holes that was more devastating than taking the right to arm ourselves away.”
His words—a body with bullet holes—transported me back to the trauma bay. But as the scene replayed in my mind’s eye, I was no longer standing timidly against the wall of the emergency department, unsure if I should get warm blankets for the patient or gloves for the surgeons. Instead, I was crying, holding my head in my hands, and screaming at this enormous tragedy, screaming at the violence in my country and in my city, screaming desperately and unnoticed.
It wasn’t just this reference to gunned bodies that pulled this scene from the recesses of my mind and forced it into painful view. It wasn’t the mere thought of handguns and bullets that rendered this nightmarish replaying of my memory. It was that Dr. Carson, as a physician who has witnessed scenes like this and worse, would argue that the devastation of this man’s body was an acceptable price to pay for gun ownership.
What I have found in talking with classmates about our most painful moments in the hospital is that while patients’ suffering and premature deaths can be heartbreaking, acts of callousness in the face of suffering are often more distressing and more difficult to make sense of. The sincerity of Dr. Carson’s words is not clear to me—he may be telling his own truth, but it’s also entirely possible he’s just playing the political game. But regardless of his sincerity, he wrote what he wrote. Despite many differences, Dr. Carson and I both chose to enter the medical profession and we have both seen bodies with bullet holes. And it is in acknowledging what we share that his expression of callous indifference is so deeply disturbing to me.
The media typically refers to Ben Carson as Mr. Carson. I choose to call him Dr. Carson as reminder of his past career in a profession that, at its best, bears witness to suffering, provides care and healing, and upholds the preciousness of human life. But when it falls short, medicine is also a profession in which physical mutilation, suffering, and premature death are so common that the tragedies of others become minimized, mere blips in a hectic day. Dr. Carson would do well to stand on the nobler side of this profession.
Colleen Farrell is a fourth year student at Harvard Medical School.