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Mr. Lucky

"Gunshot wound to the head," the medic call announced, and we geared up for the worst. They were bringing us a young store clerk who'd been shot in a robbery.

When the ambulance arrived, I was surprised to see the patient sitting up. He tried to talk but his speech gurgled as blood oozed from his mouth. The police told me his story. A robber had viciously put a gun to the clerk's mouth and pulled the trigger. Instead of killing him, the bullet shattered his lower jaw and exited his neck, without injuring a single major nerve or vessel.

"Damn, he was lucky," I thought. "Mr. Lucky." I think that was the moment I came to realize how bad things have really become. I used to think luck was winning the lottery, but it is the awful state of our society today that one feels lucky simply in not being a victim or merely to survive if one becomes a victim.

Violence has become such a problem that it has moved beyond being just a public safety issue and is now described as a health care issue. Gunshot wounds account for nearly forty thousand deaths a year and are our seventh-leading cause of death. Annually, there are more than 500,000 visits to ER's due to violent injuries with costs exceeding $5 billion.

Emergency physicians often come into contact with perpetrators of violence. Police bring us patients in custody, injured in the course of an arrest, often after committing some heinous crime. I have sometimes thought, why are we treating this scum. But usually these feelings are transient and soon become ambivalent. Often the perpetrators of violent crime are young. And often when they calm, or perhaps come down from drink or drugs, they can be very nice people - polite and grateful. Abstractly, it is easy to hate them. Up close, as I often come, you can feel as sorry for them as for their victims.

Everybody's on the bandwagon against crime today. Voters, usually reluctant to increase taxes, readily passed California's public safety law. Congress is throwing in more billions. More police will be hired, more prisons built, and remedial programs created. But I am skeptical any of those efforts will solve the problem. I have my own suggestions:

When a juvenile is sentenced, their parents should get some corresponding sentence as well. Not until you realize you're responsible for what you breed will you breed responsibly.

Within legal guidelines, victims or their families ought to hand down sentences, not judges. The feeling that justice has been done ought to be a part of the therapeutic regimen of every victim.

Members of the parole board should be elected or otherwise held accountable. And if a doctor can be sued because of an error in judgment, why can't members of the parole board be put under the same scrutiny.
Whatever solutions are tried, I won't believe we'll have a handle on this problem until the day comes when I can think again of the guy who wins the lottery as being "Mr. Lucky," and not some hapless victim who's been shot in the head.