Louisville Medicine Volume 66, Issue 3 | Page 8

VIOLENCE
GUNSHOT
David Seligson, MD
Andy Warhol, Gun, 1981
© 2018 The Andy Warhol Foundation for the Visual Arts, Inc. / Artists Right Society (ARS), New York and DACS, London
T
he short man in the green hat in the
door of the bar lowered his gun and
shot. Since he was short, the pa-
trons all took rounds at the knees:
the St. Patrick’s Day shootout. The
leprechaun moved on to look for his pot of
gold at the end of the rainbow. EMS took the
victims to University Hospital. As an ortho-
pedic traumatologist, I take care of patients with broken bones. At
University, the ortho trauma services are treating about one new
gunshot fracture a week. Gunshot injuries are the third leading
cause of injury in the Emergency Room after motor vehicle acci-
dents and falls.
Bullets break long bones, shatter joints and come to rest in awk-
ward places in the skeleton. Simple fractures in the long bones are
straightforward to repair with intramedullary nails; complex joint
injuries are more challenging. The harm to individuals is incalcu-
lable. The two basic patterns are people whom other people shoot,
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LOUISVILLE MEDICINE
and people who shoot themselves. The patients from the bar are in
the first category – someone shot them.
In Louisville, there is relatively little overt gang-style combat.
When I came to town, there was the Standard Gravure massacre.
There was none of this in Vermont. In my new practice in Louisville,
I took care of one Gravure patient with a femur fracture for years
– she never really recovered from the loss to her wellbeing of this
random crime. Another common story is “I was minding my own
business when I got shot.” Minding one’s own business and getting
shot for it may occur when strolling along an unlighted path by
the river, or just standing on the corner of Second and Oak doing
nothing in particular.
Some people get shot because they are not liked or not loved.
These wounded patients may have guards at the door of their hospi-
tal rooms. Hospital administration helps them hide from potential
assailants by giving them color-based pseudonyms in their paper
and computer records.