“What brings you in today?” I asked my new patient, a healthy appearing clean cut thirty five year old married man with kids.
“Check me out, doc.” (STD check? chronic disease screen?) “My brother was just diagnosed with diabetes, I want to make sure I’m okay.” (okay, easy—sugar and cholesterol check)
No prior medical problems for him.
Prior surgeries? At this question, he paused.
“I was shot in the leg last summer leaving work,” he said. “I lost a lot of blood. I spent three months in the hospital learning to walk again.”
He had been a home health aid. He was leaving the wrong home at the wrong time, and got caught in crossfire.
“Now I’m afraid to leave my home,” he said. “I used to like to walk in the park. No way now. (Great way to develop diabetes.) I just get home, close the windows, watch television and eat in the dark. (Diabetes, obesity, depression.) Everything scares me. I’m terrified to step out the door. (Mental health issues too, with post-traumatic stress.) My kids cry and don’t want me to go. (family impact.) I’m jumpy all the time, snap at them. I can’t go on like this.”
His workplace related injury turned his world upside down. He no longer works in other peoples’ homes, helping them get well. Instead he works at Burger King, and sips soda all day (The sugar releasing natural feel good chemicals, while also setting him up for weight gain, diabesity, future joint pain). It feels safer than going into strangers’ homes, and feeling vulnerable to gun violence.
Earlier this winter, I was annoyed when home health workers refused to go to the home of my patient with a gunshot wound.
I have more sympathy now. Gun violence is an epidemic. It’s catching. If you’re in a social network with gun violence you’re way more likely to get shot. And you carry around more than just the bullet wounds, if you’re one of the two out of three people who survive a shooting. Your mind and your life have scars. Those scars can cause future health problems.
The gun violence epidemic is a traumatic injury epidemic of bullet wounds, ruptured flesh and shattered bone and life bleeding out on the sidewalk. It is also a mental health epidemic of fear and distrust, unresolved grief and post traumatic stress disorder. It is a physical health epidemic of obesity and diabetes, when lifestyles are curtailed by the physical and mental limits of recovery fro a gun shot wound.
No more walks in the park. Staying inside in the dark watching television and sipping soda. Pushing away loved ones. The sequelae of his gunshot wound is a limp, mental scars, social isolation, and a lifestyle that will bring on the diabetes he fears.