Trauma surgeons tell what it is really like to try to repair such devastating injuries. “Bones are exploded, soft tissue is absolutely destroyed,” one said.
Perhaps no one knows the devastating wounds inflicted by assault-style rifles better than the trauma surgeons who struggle to repair them. The doctors say they are haunted by their experiences confronting injuries so dire they struggle to find words to describe them.
At a high school in Parkland, Fla., 17 people were recently killed with just such a weapon — a semiautomatic AR-15. It was legal there for Nikolas Cruz, 19, the suspect in the shooting, to buy a civilian version of the military’s standard rifle, while he would have had to be 21 to buy a less powerful and accurate handgun.
Many factors determine the severity of a wound, including a bullet’s mass, velocity and composition, and where it strikes. The AR-15, like the M4 and M16 rifles issued to American soldiers, shoots lightweight, high-speed bullets that can cause grievous bone and soft tissue wounds, in part by turning sideways, or “yawing,” when they hit a person. Surgeons say the weapons produce the same sort of horrific injuries seen on battlefields.
Civilian owners of miliary-style weapons can also buy soft-nosed or hollow-point ammunition, often used for hunting, that lacks a full metal jacket and can expand and fragment on impact. Such bullets, which can cause wider wound channels, are proscribed in most military use.
A radiologist at the hospital that treated victims of the Parkland attack wrote in The Atlantic about a surgeon there who “opened a young victim in the operating room and found only shreds of the organ that had been hit.”
What follows are the recollections of five trauma surgeons. Three of them served in the military, and they emphasized that their opinions are their own and do not represent those of the armed forces. One has treated civilian victims of such weapons in American cities. And a pediatric surgeon treated victims of a Texas church shooting last year.
“The tissue destruction is almost unimaginable. Bones are exploded, soft tissue is absolutely destroyed. The injuries to the chest or abdomen — it’s like a bomb went off.” If a bullet hits an arm or a leg, he said, the limb often hangs at an unnatural angle. Such victims can need a dozen surgeries over months. “Some eventually decide to undergo an amputation if there is severe pain in the limb and it is dysfunctional,” he said.
“Bystanders are traumatized just seeing the victims. It’s awful, terrible. It’s just a ghastly thing to see.”
Dr. Cannon recalled the aphorism by José Narosky, the Argentine writer: “In war, there are no unwounded soldiers.”