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Long Before I Was a Doctor, I was Just a Teen Whose Cousin Was Shot Dead

— An excerpt from Dark's new book, Under the Gun

MedpageToday
A photo of the cover of the book Under the Gun next to the author Cedric Dark, MD, MPH.
Dark is an emergency medicine physician and professor.

Long before I was an emergency physician and a medical educator with an alphabet soup of letters after my name, I was a nerdy, four-eyed teenager whose cousin was shot dead.

I didn't know much about trauma then. I knew about SATs and MCATs, the Baltimore Orioles, and the Washington Bullets, the latter a team whose moniker would change in the mid-1990s so the flurry of gun violence penetrating the community where I lived wouldn't be glorified in the nickname of a sports franchise.

I didn't grow up in North Carolina, where most of my family lived. My parents, who both grew up in the small city of Winston-Salem, had long ago moved out to stake a life of their own, settling in the relative peace of Maryland's Prince George's County -- known as the richest predominantly Black county in the nation by the time I was born. I spent my weekdays at a magnet school for techies and my weekends either at my house or a friend's house, writing short stories, playing video games, and eating ramen noodles. I dreamt of the years ahead of me and prepared for a life filled with science, microscopes, and medicines -- thinking I would one day cure cancer, the disease that had taken one of my favorite aunts from me.

Robbie's death ruptured the peace. It ricocheted through my teenaged mind, reverberated through my growing body like an alarm clock. Subconsciously -- although it's sometimes hard to trace our decisions to their exact roots -- I think my cousin's death launched me into a career of confronting trauma, of looking it right in the eyes. I wasn't particularly close to Robbie -- he lived two states away -- but Robbie was my blood. I didn't attend the funeral. I hate funerals. And I hate death. Maybe that's why I joined a profession and a specialty that constantly battles against mortality.

When my mother returned from the funeral, she told me about the white gloves Robbie was wearing in his casket. The gloves were there to cover up the wounds on his hands that would never have the chance to heal, she said. I have never stopped thinking about that and imagining those never-healing wounds in my mind's eye. As a physician, I have seen countless similar injuries.

After high school, I left the Maryland suburbs for college in Georgia and then went to New York City for medical school and public health training. I carried with me that vicarious memory of Robbie lying in his casket and my family's silent, impenetrable grief.

Then, another crisis, another trauma introduced me to the emergency department soon after I began medical school. One morning from my perch on the roof of New York University's Rubin Hall on East 30th Street in Manhattan, I watched the Twin Towers burn in an act of violence so severe that it prompted a war. That day, September 11, 2001, I chose to dedicate my life to emergency medicine so I could learn how to piece together broken things: memories, bones, lives. Life is filled with crisis, I thought. I wanted to be useful in that moment when everything else was falling apart.

When I was fully qualified, after completing a 4-year residency training program in emergency medicine and another 3 years practicing independently at Saint Agnes Hospital in West Baltimore, I moved to Houston to work as an attending emergency physician at the city's top trauma center. Our hospital is ranked as one of the best in the nation when it comes to saving the lives of trauma victims. Day and night, I grapple with death, grief, and often guns. I see people who remind me of my cousin Robbie every day; other people's cousins, brothers and sisters, sons and daughters, grandchildren writhing in the trauma bay, their breath slipping away beneath my gloved fingertips. On average, 14 gunshot victims are wheeled into my hospital each week. Every month, six people die from a bullet wound in my emergency department. In 2020, when all the numbers were tallied across every community in the U.S., the total was who died from a bullet that year. are the tens of thousands of Americans who suffer gun injuries and whose lives are robbed of peace, freedom, health, and joy. Provisional estimates from the CDC indicate that the continues to climb.

I am sure that you have heard these numbers before. Americans own , more than enough for every single man, woman, and child in the country. In India, which ranks second on the global list of gun ownership, there is one gun for every 20 people. To me, it makes more sense to compare American civilians to global militaries. Tallying all the firearms in the hands of American civilians, our guns outnumber the guns in the possession of every military of every other country across the globe. Because American citizens own more firearms than the rest of the world's professional militaries combined, it is no surprise that over 120,000 of us are wounded or killed by firearms each year.

But this is not a book about statistics; this is a book about stories. Starting with my own and including the stories of my patients and my colleagues who have become too intimately acquainted with gun violence, this book is an investigation of how we got into this mess and how we can get out.

While some numbers will help us make sense of what we're up against, you can find the statistical reports elsewhere. I want to go beyond the datasets, death certificates, and medical reports, into the lives of ordinary Americans whose lives have been forever changed by gun violence and the doctors, like me, who come face-to-face with violence every day. In my work as a physician-advocate, I have learned that numbers might grab someone's attention, but it is stories that stick and provide hope for change.

We all make assumptions, whether we think we know the politics and personalities of gun owners or the people who want to see guns banned. This book interrogates those misconceptions. Beginning with me.

is an emergency medicine physician, and an associate professor in the at Baylor College of Medicine in Houston. He is the co-author, with Seema Yasmin, MD, of , from which this piece was excerpted. Copyright 2024. Published with permission of Johns Hopkins University Press.