10-6-17 8:26 AM EDT | Email Article

By Emma Court

'People say 'my thoughts and prayers'-- my thoughts and prayers, yes, but how many times are we going to say this?' Sakran asked

Dr. Joseph Sakran had a "relatively normal childhood," growing up in Fairfax Station, Virginia as the son of immigrant parents, attending high-school football games with his friends.

Then, after one of those games, while he and others were hanging out at a local elementary school playground, (https://www.washingtonpost.com/archive/local/1994/09/25/2-fairfax-teens-shot-watching-fight-at-playground/03e90e11-0126-45d8-a89e-e553a79b522d/?utm_term=.56b90c138280) Sakran was shot in the throat with a .38 caliber bullet.

"Most 17-year-olds don't realize that they're mortal," Sakran said. "When something like this happens, it changes your life, it's a 180. For me it really inspired me to figure out: How do I give people the same second chance I was given?"

The experience spurred Sakran to get into medicine, and then to become a trauma surgeon. Twenty-three years later, as a director of emergency general surgery at Baltimore-based Johns Hopkins Medicine, Sakran often operates on victims of gun violence, who come in as frequently as every week. He also works on research and public policy on the subject, co-authoring a study this week estimating that hospital costs for those with gun injuries approach $100,000 per patient (http://www.marketwatch.com/story/hospital-costs-for-those-with-gun-injuries-approach-100000-per-patient-2017-10-03).

"I've seen this from multiple sides, having been a victim then, now as a provider," he said. The experiences have motivated him to ask, "How do we work to effect change on a population level?"

Sakran's recent study also happened to be published the day after a gun massacre at an outdoor country-music concert in Las Vegas, which ranked as one of the deadliest mass shootings in modern U.S. history. (http://www.marketwatch.com/story/las-vegas-shooter-paddock-had-42-guns-and-a-device-enabling-firing-at-an-automatic-rate-2017-10-03)

Read: Hospital costs for those with gun injuries approach $100,000 per patient (http://www.marketwatch.com/story/hospital-costs-for-those-with-gun-injuries-approach-100000-per-patient-2017-10-03)

Sakran talked about first hearing about the Las Vegas massacre, his experience recovering from a shooting and the challenges of his job in a Wednesday interview with MarketWatch.

Below is an edited version of the conversation.

MarketWatch: How did you feel when you heard about what happened in Las Vegas?

Dr. Joseph Sakran: I happened to be driving from D.C. to Baltimore that morning. This was immediately the morning after. I woke up very early -- I had to be at the hospital at 7 a.m., so I was up at 4 and looked at my phone. At that point they were predicting 20 dead and over 200 injured.

Every time I hear about something like this my heart definitely starts racing. Here, yet again, we're having to witness yet another senseless tragedy. My prayers are obviously with the victims in Las Vegas and their families.

But what's unfortunate is that death and injury from firearms happens on a daily basis and it doesn't always get the media attention as what happened in Las Vegas. We need to promote more research and implement sound public policy, that's going to make our community safer.

People say 'my thoughts and prayers'-- my thoughts and prayers, yes, but how many times are we going to say this? It's really just heartbreaking every time this happens. And I just hope we can all come together, the way we did this week, but come together to implement sound policy.

Related: How cities could pay men with a history of gun violence $9,000 to clean up their lives (http://www.marketwatch.com/story/how-cities-could-pay-men-with-a-history-of-gun-violence-9000-to-clean-up-their-lives-2017-07-15)

And, by the way, our country is not the only country to deal with such tragedies. In Australia, in 1996, there was the Port Arthur massacre: 35 dead, 23 wounded, not even close to the numbers we had, but it was still a tragic event and a significant massacre. The prime minister at the time was John Howard, and 12 days after the massacre, they passed a national firearms agreement banning all semi-automatic rifles, making a firearm buyback program, a 28-day waiting period.

The point is if they can do it, we can do it. We have to be action oriented. This is not about taking away the Second Amendment. We want responsible gun owners. This is about implementing common sense gun policy.

MW: Lets talk about your study. The timing was interesting -- it came out right after Las Vegas. You mentioned before that gun violence happens every day, was that something you were hoping the study would show?

JS: When Las Vegas happened, we had known the study was going to be put out around Monday, that was our prior communication with Health Affairs. Obviously, as you know, publication of manuscripts take months. This is in no way, shape or form something that we obviously planned. I'll admit it's very coincidental.

Our goal was-- we used the [Nationwide Emergency Department Sample] database to report epidemiologic trends, to chronicle the human suffering but also the economic burden that's associated with firearm-related injuries.

See: Easy access drives gun violence? Less than half of Americans polled say yes (http://www.marketwatch.com/story/easy-access-drives-gun-violence-less-than-half-of-americans-polled-say-yes-2016-06-13)

Looking at the trends are very important, and the populations, because we're facing a public health crisis in America. If we're going to be able to make a difference, we have to tailor our interventions: suicides make up two-thirds of all deaths, homicides one-third. When you look at suicides, individuals that typically fall into that category are older white males. For homicides, you're talking about younger, minority males.

So you see here these populations are different. For all firearm-related deaths we've seen an overall decrease and then a leveling out. If you split that graph: for suicides, it was decreasing over time, then in 2007, the line curve started going up. Essentially the firearm death rate has been level over the last couple of years because those two kind of balance each other out, if that makes any sense.

When you talk about mental health in the setting of Las Vegas, there's this 'Oh, this person is crazy.' Well one of the things to remember is, of course anyone who commits an act like this, there's something that's not right. For the data that we have, only about 4% of violence is associated with a mental disorder, I'm talking about things like bipolar disorder, schizophrenia, depression. You find a higher correlation of mental health disorders with suicides.

MW: You mention in the study that research is limited because of the 1996 Dickey Amendment, which bars the Centers for Disease Control and Prevention from funding gun violence research. How did your study get funded then?

JS: We used resources within Johns Hopkins; there was no specific outside funding for this.

MW: Can you tell me about the process of recovering from a gun injury? What was your experience like?

JS: I think that question really depends on the type of injury that you have. There are people in Las Vegas who have already left the hospital and people who will be staying there for weeks or months. We have some tremendous health care personnel there who are really giving it everything they have. It is a tremendous number of patients to be able to take care of in short time span. They should really be given a lot of credit.

I was in the hospital for six weeks, and had a tracheostomy [which surgically creates a hole through the front of the neck to help with breathing] for six months. And multiple surgeries to remove scar tissue from the trachea, wind pipe. I was a senior in high school. When I got home, I still wasn't back to school, and had to be home-schooled in order to catch up. All these aspects patients are going to have to face as well as families.

Really having a strong social network is so important. I have the best family. They were so attentive and provided me with all the social support I could ask for, both from the physical and also mental standpoint.

I think about that a lot when I'm taking care of patients, especially when I go out to the waiting room to talk to families. It's probably the worst part of my job-- I see the faces of mothers, fathers, sisters. I often think that the news I'm going to tell them is going to change their lives. The memories of their faces are really kind of chiseled into my mind. I think about my own family and what they went through when the trauma surgeon went to talk to them that night.

Read: 13 charts on gun violence in America (http://www.marketwatch.com/story/oregon-mass-shooting-is-294th-this-year-and-more-data-on-gun-violence-2015-10-03)

(http://www.marketwatch.com/story/oregon-mass-shooting-is-294th-this-year-and-more-data-on-gun-violence-2015-10-03)

MW: Do you know if any other doctors have had an experience like yours with gun violence?

JS: In talking to a lot of people in medicine, there's a good proportion that have gone into it either because they were personally affected by something, not necessarily being shot, but something in the medical field.

For me it's having been shot, that's not relatively common. For others it's their father having cancer or having grown up with an illness. Perhaps in that sense, I'm not that unique. I think my story is relatively unique, having been a victim, and being able to see it at all these different levels. I know what it's like to go through such a traumatic event. It's not just taking care of the patient, it's also being able to relate to the families, the loved ones.

-Emma Court; 415-439-6400; AskNewswires@dowjones.com

 

(END) Dow Jones Newswires

10-06-17 0826ET

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