The Relative Value of Life

Every day, 100 Americans are killed with guns and hundreds more are shot and injured (Source:  This article was written by Dr. Jacques Mather, a trauma surgeon at the University of Maryland Prince George’s Hospital Center and the R. Adams Cowley Shock Trauma Center.  Jack is also a close friend, whom was a colleague with me at The Johns Hopkins Bloomberg School of Public Health in Baltimore.  He wrote this as an Op-Ed in The Washington Post.

Originally published November 13, 2018 by Jacques Mather

To the mother whose son I couldn’t save:

I wish that I possessed some combination of words that could heal the wound in your heart, some turn of phrase that could end your sorrow. But I have no such words. You will live the rest of your life with an unfillable void and the simple question “why?” forever unanswered.

We read all too frequently about mass shootings. But your son’s story was never in the news. There were no news conferences, cameras or reporters. The day your son was shot, he was one of five gunshot victims brought to our trauma center — all unrelated. Nowadays, five individuals gunned down separately is not newsworthy. Some, in fact, might consider it socially acceptable — the price of doing business in a country where gun violence is the norm.

The National Rifle Association recently told doctors who stray into the gun debate to “stay in their lane.” But we trauma surgeons are the direct witnesses and final chroniclers of gun violence. As I was with your son, I am too frequently the last person who speaks to loved ones. A stranger in mask and gown, their newest friend and their final companion. I want to tell you that their final words are something heartfelt, something special. In truth, the words are often sterile. Answers to questions such as “Do you have any allergies?” or “Have you ever had surgery?” We are, after all, professional. And I think — no, I hope — that is also what you want from us.

Nonetheless, it still feels callous. I know not everyone can be saved. But I ignore that logic and treat every single person who arrives before me as I would a member of my own family. I did not give up on your son until I exhausted every ounce of my training and every thread of my soul. In doing so, your son became like family to me. I will never understand the pain you are feeling, yet I find that anytime I lose a patient, I feel as if I lost someone close to me.

When a life is saved, I cautiously tell the family how lucky their child was, how a millimeter to the left or a millimeter to the right would have provoked a different conversation. When a life is lost, I alone must corral parents and siblings into a private room to inflict the last salvo. The bullet destroyed your son’s life; my words will destroy yours.

Our gazes locked together in that private room, and I watched the hope disappear from your eyes as your son’s demise became your new reality. The sadness filled the shrinking room as though I were watching an explosion with the sound muted. You sat still while others in the room yelled and cried. And then you said something under your breath — a whisper in the mayhem: “How many more?” The last three words were left unsaid: “have to die.” These words are what prompted this letter.

Despite their bravado, politicians and gun rights groups probably would not have the stomach for this conversation — they “steel” themselves by waiting for the dust to settle. They play on their stage with the sharpest words they can find yet keep themselves at a generous distance from the actual war. Never have I walked from that small room hoping for more guns on the streets.

My visceral response to the violence I see every day is not a pleasant one, but I want to share it with you. In fact, I have two responses. Both are childish and not particularly useful, but they characterize my immediate emotion after opening yet another child’s chest as if it were the hood of an overheating car. The first: I throw my hands in the air and say, “I give up. I no longer care if people die. As a society we have decided that the feel of a gun in our hands is more important than a human life. So be it.” My second response is better tempered: “We have two choices. We can either greatly restrict the use of guns in this country, or we can simply decide that we are morally and ethically okay with people needlessly dying from gun violence.”

I fear that our society has chosen the latter response. We treat the Second Amendment as a constitutional scapegoat, as if it were a loophole to the “Thou shalt not kill” commandment. But so long as there are guns, innocent people will fall victim to them. Refusing to acknowledge this is tantamount to acquiescence. But we seem okay with this. After all, none of my patients — not even your son — made the evening news.

I cannot bring your son back. But you shouldn’t feel alone in your struggle or pain. There are many who share your agony and your frustrations. Extremes in frustration threaten to breed hopelessness and, worse, a sense of apathy. I can occasionally be charged with the former, but I hope never to be guilty of the latter.

There are no easy solutions, but we can start by creating a unified voice. Those who advocate for unrestricted and unregulated access to guns are implicitly advocating gun violence. This group is a minority, but it speaks with a unified voice. The majority are too silent and too fractured. I am not advocating the wholesale extinction of guns. Nor am I against the use of guns for legitimate purposes. But removing certain types of guns and regulating the use of others will go a long way toward reducing the number of last words we have to hear in the trauma bay.

We need to coalesce — come together and unite. Our voice will be louder and our passion stronger. I will be there with you every step of the way.

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