GUN VIOLENCE PREVENTION IN NJ Understanding and addressing this deadly issue By Nancy Ruhling Nearly a decade ago, when trauma surgeon Stephanie Bonne, MD, was working for Washington University in St. Louis, she had to tell a mother that her 20-something son, a shooting victim, didn’t make it through his emergency operation.
Program with University Hospital, “is considered one of the up-andcoming leaders on this subject on a national level,” Livingston says. “There are several dozen such programs in the country. Our program is young, but it’s robust.”
She was used to being the bearer of bad news, so much so that she had stopped counting the bodies and putting a face on death.
Under the program, which has received some $650,000 in private and state grants since its inception in July 2017, caseworkers connected with the Newark community counsel and support victims of violence.
But this time was different. Perhaps it was because she had just given birth to her first child, a boy like the one who had died on the table. Or the case could have made an impression because few patients under her care suffered gunshot wounds. “I realized that the mother had witnessed her son coming into the world and now was watching him leave it,” says Bonne. “I wondered whether she was thinking of the whole arc of his life. I had seen lots of diseases take children away from their parents, but this didn’t have to happen.” That mother and son came to mind when she joined Rutgers New Jersey Medical School as an assistant professor of surgery in 2015. “For a long time, I had had an interest in researching injury prevention, which is what I was hired by Rutgers to do,” she says. “In Missouri, that had meant mostly train, motorcycle and car accidents, but when I came to New Jersey, I encountered many people who had all kinds of violent injuries.” Of those treated in the University Hospital’s level-one trauma unit, some 500 a year are victims of firearms violence, a statistic that David Livingston, MD, the Wesley J. Howe Professor and chief of the division of trauma and surgical critical care at the NJMS, says has remained constant for the last two decades. “Before Dr. Bonne joined us, we didn’t have a program to address this issue,” Livingston says. “We concentrated on pedestrian and pediatric injuries because it was unclear what impact we could have on firearms cases. A focus on gun injuries was sorely needed.” Bonne, who established the Hospital-Based Violence Intervention
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The caseworkers, who have helped 116 young adults so far, do far more than merely pointing patients to appropriate resources. “We provide what we call a warm hand-off,” Bonne says. “We know the social determinants that increase the risk of violence, so we do everything from encouraging people to earn high school diplomas to helping them find jobs and stable housing in a safer neighborhood. We help them navigate the system by making appointments for them and even sitting in the waiting room with them.” She says the program is a departure from traditional trauma-center approaches in which surgeons trying to quell gun violence merely talk with patients about avoiding high-risk factors. “It was not effective,” she says. “People hated it, and the take-away message was that this information should be conveyed not by the doctors but by someone from the community.” New Jersey has some of the stricter gun-control laws in the country, and when Gov. Phil Murphy announced in August 2018 that the state was taking proposals to create a $2-million center for gun violence research, Bonne took the lead on New Jersey Medical School’s winning application. When announcing the Rutgers designation in October 2018, Murphy said, “It is long past time to take a stand against the scourge of gun violence in our communities. Beginning today, New Jersey
