What keeps an ER doctor up at night: 'The sound a mother makes after her child dies.'
I completed my pediatrics residency in Boston before coming to Milwaukee for my emergency medicine fellowship. My first week in Milwaukee, in 2015, I saw more gunshot wounds in children than I did in all my three years in Boston. There may be a few reasons for this staggering difference, but the main reason is that Massachusetts has commonsense gun laws — laws that simply do not exist in Wisconsin.
During my fellowship training in Milwaukee, I grew accustomed to seeing bullet-riddled children. I remember the first time I sent a child home from the ER mere hours after he had been shot; it felt so wrong. “Someone fired a gun at you, a bullet pierced your leg, and you almost died. The exit is that way.” I remember the first time a mother cried to me about the safety of her neighborhood. “You can’t send us back to that house, that street. They shot him once, they’re going to shoot him again. Where do I hide my son?” I remember the first time I saw a child who came back again, for a different gunshot wound at a different site. “Do I have any prior medical history? Yeah, I just saw you here last month, when I had got shot in my belly. Remember that?”
The first few times witnessing these things are always the hardest. But then the shock fades. Now, I’m an attending physician, and gun violence has skyrocketed, especially in children. Guns are now the No. 1 cause of death in American children. Guns kill more children than cancer! Sometimes I have to say it out loud to believe it, to believe that this is our reality. This is America. Guns kill more children than cancer. There are telethons and penny drives and charity runs for kids with cancer. We send the kids with gunshot wounds home with gauze and an excuse to be absent from school.
I recently declared death on a child who had been shot. He came to the ER mostly dead, as they often do. We performed our medical machinations with needles and chest compressions — our secular last rites — and then we called the time of death.
Moms are not always present when their children die of gunshot wounds. Sometimes the mom doesn’t even know yet that her child has been shot. This time, the mom was in the corner of the Trauma Bay. She screamed and screamed as I announced that her son was dead. The screams of a mother after her child dies are not of this world. They are guttural, they are ghostly, and they will haunt you for the rest of your days. It is the ripping of the strongest tether, the cruelest injustice a human being could endure, the spectral response to George Floyd’s cries.
Ask any ER doctor about the sound that keeps them up at night, and they will all say, “The sound a mother makes after her child dies.”
After codes and traumas, we try to hold debriefs for the medical team. The debrief is a time for people to ask questions, offer suggestions, clarify the reason for a medical intervention or lack thereof. After one such death, I stood at the head of the bed in the Trauma Bay, and I talked to nurses and respiratory therapists and residents about the code. What could have gone better? What did we learn? What will we do next time? Because we all know there will be a next time.
Questions were asked, tears were shed. Gradually, people filed out of the Trauma Bay and back to work. The hospital chaplain lingered next to me, not moving. I don’t know his name. In my memory he is all angles: wiry frame, fresh haircut, black shirt with a crisp white collar. Once the Trauma Bay was empty save him and me, he turned to me and took both my hands in his. “I don’t know if you believe, but I want you to know that you are doing God’s work. You are a Soldier of God.”
Is it God’s work to hold mothers upright as their knees buckle, screaming and screaming, after their child dies because of a gun? Is it God’s work to see brain matter burst out of a bullet wound in a child’s skull after the pressure inside becomes too great? Is it God’s work to review a CT scan after a hollow-point bullet has shattered a hip, destroyed an iliac artery, and ripped through the colon, shackling the child to a wheelchair, a colostomy bag, a lifetime of PTSD?
If I am a Soldier of God, who am I fighting? Who is my enemy? Who is doing Satan’s work? Is it the National Rifle Association? Is it my senator — Ron Johnson — who has received $1.2 million in overall support from pro-gun groups? Is it my state senators, who have repeatedly refused to pass restrictions on magazine capacity, firearm registration laws and universal background checks? All these politicians and lobbyists have made it possible to buy semiautomatic weapons without a background check, without a waiting period, from a tent in a parking lot, before the purchaser is old enough to buy a beer or rent a car. These people are doing Satan’s work.
Bearing witness is a directive in most organized religions. In Christianity, a witness “calls attention to something other than himself … is called upon to give evidence of something.” In Islam, believers must “stand firm for justice as witnesses for Allah.” In Judaism, Elie Weisel describes bearing witness as a way to “sound the alarm,” to prevent future horrors. Weisel specifically declared the purpose of bearing witness to be for the sake of children, because “for the dead, it is too late… abandoned by God and betrayed by humanity.”
Believers seem to think that I am a Soldier of God. So I will bear witness. I am a pediatric emergency physician in a poor, segregated city in America, and I am calling attention to the No. 1 killer of children: guns. I am giving evidence of the gun violence epidemic in America. I am standing firm for justice and sounding the alarm that our children are not safe. Our children have been abandoned and betrayed by our elected representatives and all their useless thoughts and prayers. I am bearing witness to the fact that our elected representatives — through their cowardice and greed — have failed to protect the least among us.
Dr. Megan L. Schultz, MD, MA, is a pediatric emergency physician at Children’s Wisconsin.