The trauma of gun violence

Dr. Edward E. Cornwell III, trauma chief at Johns Hopkins Hospital, describes gunshot wounds as "more and more a juvenile disease."

March 12, 2000|By MIKE ADAMS

A .357 MAGNUM handgun can fire a bullet with a muzzle velocity of 1,500 foot pounds. Baffled by muzzle velocity and foot pounds? Well, consider this: That bullet has enough energy to bore through the trunk of a big, boxy Lincoln Towncar and continue through the back seat and the front seat and kill the driver. It's an awesome weapon, and it's just one of many types of high-powered handguns that can be found on Baltimore's streets, all too often, in the hands of teen-age drug dealers.

So what happens when the human body meets the gun industry's deadliest creations? It's not pretty. Ask Dr. "Eddie" Cornwell, the trauma chief at Johns Hopkins Hospital. During the 16 years he has been a trauma surgeon, Cornwell has saved his share of gunshot-wound victims, and he has watched many others go to the medical examiner for autopsies.

Now, as a board member of Baltimore's Police Athletic League, Cornwell is on a mission to save kids before they wind up on the operating table. Periodically, he visits a PAL after-school center in East Baltimore and gives a slide presentation showing ghastly bullet wounds. During his "Rap with Doc" sessions with boys from 11 to 17, he talks about the harsh realities of gun violence. To drive home his point, he arranges for the boys to visit the hospital to meet gunshot victims and to look at the hideous holes in their bodies. It's Cornwell's version of "Scared Straight."

Edward E. Cornwell III, 43, realizes that only a quirk of fate separates him from the African-American youths he is trying to save. He says his parents made the difference. His father was a surgeon on the faculty at Howard University Medical Center, and his mother was a school teacher before she became a Realtor.

Cornwell graduated from Sidwell Friends School in Washington in 1974 and moved on to Brown University and the Howard University School of Medicine. Next came an internship and residency in general surgery at Los Angeles County General Hospital, followed by a fellowship at Maryland Shock Trauma Center in Baltimore. He moved on to faculty positions at Howard and L.A. County General before Hopkins recruited him to head its adult trauma unit about two years ago.

Cornwell has strong opinions about gun violence. Recently, he shared his thoughts with Perspective Editor Mike Adams.

How many gunshot wounds does Hopkins treat annually?

It's been slowly increasing. We had about 365 in 1997, about 380-some in 1998 and 390 last year. Baltimore actually stands out a bit, apart from the national trend. From the early to the late 1990s, in Boston, New York Los Angeles, Miami, Washington, the numbers of penetrating trauma, gunshot wounds and stabbings, have gone down. Baltimore is different, and I don't have a complete explanation for it. But, in the neighborhood around Hopkins, about 80 percent of the crime is centered around trying to obtain or sell illegal drugs.

While the good news is, nationally, the gunshot wound rate is down, the bad news is that we have more kids in school who are entering what's called their "crime-prone" years. And these kids have spent more hours watching violence on television, are more likely to see violence in their immediate surroundings, and are less likely to have a nonviolent role model in the home and have more access to guns than any generation in American history.

Basically, [street] crime in America has become the domain of males from 14 to 34. And in many cities, like Los Angeles, where I was before I came here, we see 35 to 40 percent of our gunshot wounds happening to people 21 years old or younger. It's becoming more and more a juvenile disease.

How would you describe the typical gunshot wound victim treated here at Hopkins based on age, race and economic background?

Simply put, young black males. The typical patient would be in his late teens or early 20s, someone from the surrounding neighborhoood. As I said before, in 1999, we had about 390 gunshot cases, and those patients from the narrow age of 15 to 20 years old represent close to 60 percent of our gunshot wounds and close to two-thirds of all of our deaths.

What's the societal cost of these gunshot cases? Who's paying the bill?

You and I are paying the bill. The taxpayers are paying the bill. That's the sad truth throughout the country. To be a Level 1 Trauma Center as we are, we need to be open, ready and available 24 hours a day. That means the lights are on, the CAT scan is ready, the operating room is ready to go, the blood bank is available, people are in-house who are specialists in certain areas and prepared to take care of these patients whether they show up or not. And then, when the patients show up, they may or may not be able to pay. Many of my patients are Male X, Male Y, Male P, for hours before we even know a name.

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