Citation

Rogers SOJ. New Engl. J. Med. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Massachusetts Medical Society)

DOI

10.1056/NEJMp2214971

PMID

36648074

Abstract

As a trauma surgeon on the South Side of Chicago, I too often have to tell a parent, a child, a sibling, or a best friend that a bullet killed their loved one. In a sterile, eggshell-colored box of a room, I crowd in a chaplain, sometimes one of our violence-recovery specialists, and always a security officer, with no more than two family members or close friends. Why the security officer? We've learned that sometimes grief-stricken people become enraged and lunge at us or try to throw something -- anything -- maybe a chair. For that reason, the only furniture in the quiet room is four chairs; we have entertained the option of bolting them to the floor. Why only two relatives or friends? We've found that the intensity of the grief is difficult enough to manage with two people, never mind a large clan.

Other times, a distraught mother or sister will let out the unmistakable shriek of despair, drop to her knees, and pound her fist into the concrete floor. One of the more surreal responses I get is silence: just a faraway stare, as if the person is looking past me. I have just told them in clear, succinct language that their son, daughter, father, mother, or friend is dead. I ask if there are any questions, and they mumble "no." Then they get up and walk out of the quiet room, and I never see them again.

Remarkably and fortunately, much more often than sharing the news of someone's death, I am informing people that their loved one was struck by bullets and suffered damage to organs, arms, or legs but will survive. I try to explain the anatomy of the liver or the small or large bowel. I explain what an ostomy is or how we fix a broken femur with a nail down its long axis. Sometimes I have to explain the nature of critical illness or how a ventilator works. In these interactions, I use every ounce of my skills and intuition to communicate clearly and to judge what the family's response is.

Language: en