Epidemiology of Firearms injuries in the US
I gained Knowledge on the Columbian Drug war as soon as I joined the Yale-New-Haven Program at Bridgeport and New-Haven in the state of Connecticut. In a short time, I faced the reality of a population at war, a phenomenon that many large cities share, nowadays. It did not take me long after leaving my faculty position at Meharry Medical School to settle in Trumbull CT and assume my responsibility as Chief of Orthopedic Trauma and responsible of the Orthopaedic clinics. I joined the Yale-New Haven trauma system in November 1990. I never knew that I was reaching a battlefield in a non-conventional war. I packed my belongings with wife and kids (2 boys) and headed to the New England area, happy to leave the Mid-West (Murfreesboro and Nashville in TN). My wife was pregnant with our fourth child, a year after we had a stillborn boy following complications associated to an amniosynthese.
I needed a change in my life. Moving to work at a Level One Trauma Unit, was definitively a challenge that I was ready to take but I did not really understand what was waiting for me in Bridgeport Hospital. It did not take me long to realize that I was in a drug infested area and that I was the only treating physician for a large underprivileged community. The majority of my patients were victims of gunshot wounds related to the diffusion of drugs. The Police, the FBI and all other authorities were questioning on the details of their injuries. In little time, I found myself in the middle of a battlefield where each rival gang member wanted to protect me because I became the only physician taking care of them. Indeed, the only black physician in the Trauma center, capable of handling such injuries. I was told by many that “my back was protected “which mean that, if in the middle of the night, I wanted to have a sandwich or a drink between cases, I was able to do so, walk downtown Bridgeport and be protected. All police officers knew me as the orthopedic surgeon of the community. I felt safe when my kids and wife were home.
It was a time where most gunshot wounds to the extremities needed to be admitted and treated in longitudinal skeletal traction followed by long leg casting or Spica casting once the fracture site showed sufficient callus formation. Soon after, we opted to be more aggressive and learned how to fix them avoiding a long hospitalization with Intramedullary (IM) Rods or external fixators or plate fixation. I was often in the operating room, morning and evening taking care of anybody involved in the fatalities. I became the one to whom all will turn to for information and care of the victims. The gang members would easily announce the way they would always protect me because I become the only individual physician taking care of their injuries. I was in a certain way in charge of the orthopedic traumatized patients once they become hospitalized or involved in the clinic looking for subsequent care. I will refrain myself for discussing many of the anecdotal tales dating of the time I served as a Traumatologist at the Bridgeport-Yale Health in Connecticut.
High velocity Gunshot wounds with a comminuted fracture of the humerus ready for emergency treatment in the Operating room with Irrigation, debridement and application if an external fixator.