We can’t permit child gun deaths to be the status quo

Brianna Jackson stands behind Iheanyi Nwosu Jr. during a vigil for Breaunna Cormley, a 12-year-old girl who was recently shot to death. Karl Merton Ferron/Staff

In medical training, we learn strategies to deliver bad news. One strategy is called “the warning shot”: words you say to signal to patients and family members that you are about to share tragic news, to give them a moment to mentally prepare and brace themselves to hear that news. In our pediatric primary care clinic, an email subject title “Sad News” has become that too-frequent warning shot informing us that one of our patients has died. In the pediatric intensive care unit, we use the code words “Apples and Oranges” when we share such news.

Those words, “sad news” or “apples and oranges,” allow us to pause and decide whether we are in a safe emotional and physical space to read and process the message. Sometimes a death may be expected, perhaps following a prolonged hospitalization or a hard-fought battle against an unpreventable disease. But other times they come as a shock and take our breath away. All too often the sad news is a death due to gun violence. A preventable death. Another name added to Baltimore’s long list of victims. This time the name of an innocent child.

While we have the choice to decide whether or when to receive this “sad news,” our patients and their families are denied that opportunity. For them, the sad news of community violence is relentless and ongoing. No warning shot. A fatal shot. Just over halfway through the year, 114 lives have already been lost due to homicides in Baltimore City. Homicide is the leading cause of death among children and young people in Baltimore, most of which are by firearms. Firearms are also the leading cause of death in people ages 1 to 19 in the United States.

Last month, there was no warning shot, no “apples and oranges” subject line to let us decide whether to hear the sad news that yet another child in Baltimore had been killed. We saw the devastating news in local headlines. One of us mourned a loss to a community and a family and grieved that recent progress in reducing homicide in Baltimore wasn’t enough to save this young person’s life. Some of us read the victim’s name and felt a much more personal loss; the loss of a beloved patient who would no longer walk through the clinic doors.

We’ve devoted ourselves and our careers as pediatricians to preventing preventable harms and promoting the health and wellbeing of children. When the “sad news” email arrives in our inbox, how do we respond to honor our patient? How can we act to make sure that children stop dying preventable deaths and experiencing the relentless trauma of community violence?

We must redouble our efforts to implement strategies that prevent violence while also giving support to affected children and families in our community.

Perhaps the saddest news is that we know what works to prevent gun violence. If policymakers stood in our ICU and clinic and told parents that their child wouldn’t survive or heard children’s stories about parents shot outside their homes, cousins shot on the way home from church, a brother caught in crossfire in a park, and classmates dying by firearm suicide, maybe they could find the conviction to do more. As pediatricians, we feel the urgency of the problem as we treat the physical and emotional wounds it causes. As pediatricians, our job is to help children grow, be healthy and reach their full potential. Protecting them from gun violence is not something we can do alone. We are doing our part. We need policymakers to do theirs.

Rebecca Seltzer ([e-mail]), Katherine Hoops ([e-mail]) and Barry Solomon ([e-mail]) are pediatricians at the Johns Hopkins University School of Medicine. The views expressed by the authors are their own and are not the views of the Johns Hopkins School of Medicine.