Surgeon on the firing line

There are a number of practical concerns to consider when attempting to save the life of a gunshot victim, according to retired surgeon John Barrett of Oak Park.

First you have to figure out how many times the person’s been shot. With multiple gunshot wounds, which is more common at trauma centers these days, you have to determine the entrance and exit wounds, and are there any bullets still lodged in the body. Was the intestine hit by a bullet, leading to bleeding into the abdomen, causing the potential for infection?

“It makes management [of the situation] more difficult,” he said.

Barrett, 71, has unique insight into the work it takes to save the lives of gunshot victims. Now retired, he worked for 22 years at Cook County Hospital’s Trauma Unit, 20 years as the director of trauma services.

Barrett’s exposure to Chicago’s gun violence epidemic has inspired him to assume the mantle of gun control advocate.

Green beginning

Barrett, who hails from Cork City, Ireland, said he became interested in treating gunshot trauma patients as a medical student in the late 1960s.

But in spite of “The Troubles” in his homeland, he knew the real action was across the Atlantic in the United States.

“I needed to come to America and a big city if I wanted to see a lot of gunshot wound victims,” he recalled.

His original intent was to take his training back to Ireland, but, “as the years passed, it became clear there was not enough gun violence in Ireland to specialize as a surgeon in the management of gunshot victims.”

Naturally, he took his skills to one of the epicenters of gunshot violence — the city of Chicago.

He started out at Cook County in 1980 and within two years was promoted to director of trauma services for the city’s first trauma unit. “There was never a period of time in Chicago that this was not a major problem,” he noted.

New weapons, greater damage

Barrett said gunshot victims reached epidemic proportions in Chicago in the 1980s, but the severity of the wounds intensified in the ’90s as high-powered semi-automatic handguns became more popular.

In the ’80s, the .22-caliber revolver, sometimes referred to as the “Saturday Night Special,” was the most common gun used in Chicago shootings. “With a .22-caliber revolver, you squeeze and the case revolves around and you fire a second round,” he said, noting that the time it took for the revolver to reload substantially limited the number of times most victims were shot.

In the ’80s, practically all gunshot victims that came to the trauma unit were shot only once. About 5 percent were struck with more than one bullet, he said.

That changed in the ’90s, when semi-automatic guns allowed shooters to fire more rounds per second. By the 1990s, about a quarter of all gunshot victims at Cook County had been struck by multiple bullets.

The velocity of the bullets also increased, making gunshots more deadly and destructive, Barrett said, describing them as similar to the kind of gunshots you’d see from a war zone. The methods used to manage such wounds were the same as those surgeons used with soldiers wounded in Vietnam.

The multiple shots made it more difficult for surgeons to administer life-saving care.

From surgeon to advocate

Barrett’s exposure to Chicago’s gun violence made him start thinking of the problem as a “recurrent disease” because so many of his young victims would return to the streets to again be subjected to violence.

“It’s a disease worse than cancer because if you go back into the same situation, you’ll be shot again,” he said. “I thought, ‘Something needs to be done.'”

In medical-speak, he said, the agent used to spread a disease is known as the “vector.” That’s how Barrett sees guns.

“The gun is the vector of violence; it’s the way the violence is spread.”

Barrett has advocated for decades for stronger gun control laws and was instrumental in helping organize a group of Oak Parkers in 2013 made up of both gun control and gun rights advocates.

The so-called Gun Rights and Responsibilities Group met for 11 months, but, “to make a long story short, it didn’t work,” he said.

The group ultimately couldn’t agree on support for universal background checks.

Oak Parker Ray Simpson, a gun rights advocate who met with the group, said criminals don’t care which laws you pass and more regulations just place an undue burden on law-abiding gun owners. He said the group generally agreed on denying gun ownership to felons and those suffering from mental illness, but they could not reach consensus on universal background checks.

Since then, Barrett, former village attorney Ray Heise, and approximately 10 others have formed Gun Responsibility Advocates (GRA), which states that great responsibilities must accompany gun rights.  

Currently, licensed gun dealers are required to perform background checks on those purchasing guns in Illinois and other states, but not all states have background checks and a loophole allows unlicensed dealers to sell at gun shows and online without performing background checks on buyers.

Barrett said Oak Parkers overwhelmingly support universal background checks, noting that 92 percent of residents voted for it in an advisory referendum placed on the ballot in 2014.

Continuing the struggle

Barrett said he and a handful of others in Oak Park have continued the uphill battle of bringing about common-sense gun legislation, but their numbers are slim and successes incremental.

One of the GRA’s initiatives is encouraging local businesses to place stickers in their windows forbidding concealed weapons.

“What we’re saying is if you put up the sign, you’re making a value statement,” he said. “The solution to gun violence is not more gun violence.”

He said his group convinced the Oak Park Board of Trustees to approve a resolution in June 2015 in support of universal background checks. They also partner with groups at the state level, such as the Illinois Coalition Against Handgun Violence, to educate lawmakers and other elected officials about the need for tighter regulations.

Oak Parker Harlene Ellen, an organizer with the Oak Park branch of gun control group Moms Demand Action, praised Barrett’s efforts and noted that recent events, such as the mass shooting at an Orlando nightclub in June that left 49 people dead and 53 wounded, makes such efforts imperative.

She said the Moms group has about 12 active members, and the commitment from residents like Barrett is critical for making a change.

“There are people who are standing up to the [National Rifle Association]; they’ve run roughshod while we were all asleep,” she said. “Now it’s time to get more people awake and fighting back.”

CONTACT: tim@oakpark.com