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What the AR-15 Does to a Child's Body
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As I mentioned yesterday, I’m away, visiting my grandkids in France. So, for the next few weeks, I’ll be offering encores of some of most notable Morning Shots of the Year. This one is from June 1, 2022.
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People visit a memorial in the town square for victims of Tuesday's mass shooting at Robb Elementary School on May 26, 2022 in Uvalde, Texas(Photo by Eric Thayer/Getty Images)
What if we saw the pictures?
At the moment, the question is academic, since no one can really bear the thought of seeing them. But what if we saw the pictures of children blown apart by America’s most popular gun?
Journalism professor Susie Linfield writes in The New York Times:
Photographic images can bring us close to the experience of suffering — and, in particular, to the physical torment that violence creates — in ways that words do not. What does the destruction of a human being, of a human body — frail and vulnerable (all human bodies are frail and vulnerable) — look like? What can we know of another’s suffering? Is such knowledge forbidden — or, alternately, necessary? And if we obtain it, what then?
The idea of showing pictures of dead kids was floated by film maker Michael Moore after Sandy Hook, and more recently by Jeh Johnson, the former secretary of Homeland Security.
Maybe it’s naïve to think that even the most graphic pictures would really make a difference. But they have in the past. Think about the impact of the photo of Emmett Till lying in his open casket, a victim of racist violence; or the picture of a naked Vietnamese girl fleeing a napalm attack. The picture of a drowned Syrian three-year-old boy shocked the world into addressing the migrant crisis. After WWII, German citizens were forced to witness the horrors of the concentration camps, and the images of the atrocities still haunt our collective conscience.
But showing the children may simply be too much. And it’s certainly too much to ask the families of those children.
Some journalists have instead suggested showing the scenes of carnage rather than the victims. After Taliban “fighters” attacked a school in Peshawar, Pakistan and killed at least 134 schoolchildren, pictures of bloody classrooms were published by some wire services.
But journalists are usually denied access to crime scenes here, so we are left with the descriptions of what we cannot—and most likely will never—see.
***WARNING … GRAPHIC CONTENT***
“The AR-15 is America’s most popular rifle,” the magazine wrote six years ago. “It has also been the weapon of choice in mass shootings from Sandy Hook to Aurora to San Bernardino. In Orlando, the shooter used a Sig Sauer MCX, an AR-15 style rifle originally developed for special ops, to kill 49 people in the Pulse nightclub.”
May 24, 2022: Shooting at Robb Elementary School in Uvalde, Texas. 21 dead.
May 14, 2022: Shooting at Tops Friendly Market in Buffalo, NY. 10 dead.
August 31, 2019: Shooting in Midland, Texas. 7 dead.
August 4, 2019: AR-15-style pistol used in shooting at Ned Peppers Bar in Dayton, Ohio. 9 dead.
August 3, 2019: AK-47-style rifle used in shooting at a Walmart in El Paso, Texas. 23 dead.
Feb. 14, 2018: Shooting at Marjory Stoneman Douglas High School in Parkland, Florida. 17 dead.
Nov. 5, 2017: Shooting at First Baptist Church in Sutherland Springs, Texas. 26 dead.
Oct. 1, 2017: Shooting at the Route 91 Harvest music festival in Las Vegas, Nevada. 58 dead.
But this is abstract. Impersonal. A series of numbers, rather than images of the reality that none of us could bear.
The bullet from an AR-15 does an entirely different kind of violence to the human body. It’s relatively small, but it leaves the muzzle at three times the speed of a handgun bullet. It has so much energy that it can disintegrate three inches of leg bone. “It would just turn it to dust,” says Donald Jenkins, a trauma surgeon at University of Texas Health Science Center at San Antonio. If it hits the liver, “the liver looks like a jello mold that’s been dropped on the floor.” And the exit wound can be a nasty, jagged hole the size of an orange.
These high-velocity bullets can damage flesh inches away from their path, either because they fragment or because they cause something called cavitation. When you trail your fingers through water, the water ripples and curls. When a high-velocity bullet pierces the body, human tissues ripples as well---but much more violently. The bullet from an AR-15 might miss the femoral artery in the leg, but cavitation may burst the artery anyway, causing death by blood loss. A swath of stretched and torn tissue around the wound may die. That’s why, says Rhee, a handgun wound might require only one surgery but an AR-15 bullet wound might require three to ten.
During the Vietnam War, the U.S. conducted a survey into the impact of the AR-15 and its use on the battlefield. To put it bluntly, the survey found that the weapon, chambered with same .223 caliber rounds that Ramos used in Uvalde, was exceedingly good at killing human beings…. Viet Cong fighters hit with the weapon were frequently decapitated and dismembered, many looking as though they had “exploded.” A field report documented how an AR-15 had blown up a man’s head and turned another’s torso into “one big hole.” The weapon was lauded by soldiers on the battlefield for its effectiveness at killing adversaries and even cutting through dense jungle forest.
In a typical handgun injury, which I diagnose almost daily, a bullet leaves a laceration through an organ such as the liver. To a radiologist, it appears as a linear, thin, gray bullet track through the organ. There may be bleeding and some bullet fragments.
I was looking at a CT scan of one of the mass-shooting victims from Marjory Stoneman Douglas High School, who had been brought to the trauma center during my call shift. The organ looked like an overripe melon smashed by a sledgehammer, and was bleeding extensively. How could a gunshot wound have caused this much damage?
The reaction in the emergency room was the same. One of the trauma surgeons opened a young victim in the operating room, and found only shreds of the organ that had been hit by a bullet from an AR-15, a semiautomatic rifle that delivers a devastatingly lethal, high-velocity bullet to the victim. Nothing was left to repair—and utterly, devastatingly, nothing could be done to fix the problem. The injury was fatal.
Once again, the point needs to be emphasized: Wounds from AR-15s are dramatically different from other types of gunshots.
Routine handgun injuries leave entry and exit wounds and linear tracks through the victim’s body that are roughly the size of the bullet. If the bullet does not directly hit something crucial like the heart or the aorta, and the victim does not bleed to death before being transported to our care at the trauma center, chances are that we can save him.
The bullets fired by an AR-15 are different: They travel at a higher velocity and are far more lethal than routine bullets fired from a handgun. The damage they cause is a function of the energy they impart as they pass through the body. A typical AR-15 bullet leaves the barrel traveling almost three times faster than—and imparting more than three times the energy of—a typical 9mm bullet from a handgun. An AR-15 rifle outfitted with a magazine with 50 rounds allows many more lethal bullets to be delivered quickly without reloading.
I have seen a handful of AR-15 injuries in my career. Years ago I saw one from a man shot in the back by a swat team. The injury along the path of the bullet from an AR-15 is vastly different from a low-velocity handgun injury. The bullet from an AR-15 passes through the body like a cigarette boat traveling at maximum speed through a tiny canal. The tissue next to the bullet is elastic—moving away from the bullet like waves of water displaced by the boat—and then returns and settles back. This process is called cavitation; it leaves the displaced tissue damaged or killed. The high-velocity bullet causes a swath of tissue damage that extends several inches from its path. It does not have to actually hit an artery to damage it and cause catastrophic bleeding. Exit wounds can be the size of an orange.
Exit take: Here’s a modest suggestion. Rather than publish the pictures, we should force legislators to look at them in closed sessions before voting on gun safety measures.
Despite the very real dangers of exploitation and misuse that disclosure of the Uvalde photographs would pose, I myself would like politicians to view them: to look — really look — at the shattered face of what was previously a child and to then contemplate the bewildered terror of her last moments on earth.
Would that make a difference? Sadly, probably not, because our capacity for indifference and rationalization is apparently infinite. And the gun issue has become entangled in our larger culture war.