The Invisible Bullets: A Medical Student’s Journey With Tragedy, Healing, and Advocacy

By Jasmanpreet Kaur

I walk past the same sign in the Michigan State University Secchia Center that reads "Spartan Strong" and often wonder how these two words carry so much hope but also so much pain.

On the night of February 13, 2023, three students were murdered at Michigan State University. Another five were critically injured. And the entire Spartan community was left traumatized.

I worked a 10-hour shift in the emergency department earlier that day and was wrapping up a research meeting when I looked down at my phone and saw the words, "Run, Hide, Fight." My eyes widened, and I felt sick to my stomach. Heart racing, hands trembling, dry mouth — I felt my body getting ready to "run, hide, and fight." I wanted to move, but I could not. The flight or fight response I learned about during my first year of medical school failed me — I instead became paralyzed with fear.

When a bullet shears through the human body, the damage is instantaneous. Our job as doctors is to determine the bullet's location, assess its damage, repair the injuries, and not cause further harm. During my surgery rotation, I learned sometimes it's best to leave behind the retained bullet.

I carry four of these invisible bullets with me.

After the World Trade Center attack, my Sikh community became a target of hate crimes. Our turbans, a religious article of our faith, were viewed as dangerous. Balbir Singh Sodhi was the first Sikh man murdered by a gunman four days after 9/11. Unfortunately, this wasn't an isolated event. A gunman next targeted a Sikh temple in Wisconsin, killing six members of my community.

I carry the third, invisible bullet from a gunman who targeted a chapter of my Alpha Phi community and killed seven students in Isle Vista, California. I carry my fourth (hopefully last) bullet from the gunman who killed three MSU Spartans and injured another five students at Michigan State University.

As a future emergency medicine physician, I often worry about the safety of my patients. Firearms are the number one killer of American children and teens. In 2023 alone, 448 children and teens (ages 0-17) died from firearms, and another 1,072 were injured. That is 30 school buses full of dead and injured children. To make matters worse, these deaths are entirely preventable.

During my family medicine rotation, one of my patients presented with worsening depression — she had one previous suicide attempt, she no longer played sports, saw her friends, or enjoyed school. Call it my (future) "doctor's gut feeling," but I felt compelled to ask about firearms in the home. There were three — all easily accessible and not securely locked. I counseled her mom that day, and together my attending physician and I know we saved her life. My attending took me aside and told me he rarely asked patients about access to firearms — he was grateful that I did.

The research meeting I attended before receiving news of the MSU mass shooting was about my passion project — incorporating firearm violence prevention and education into medical education. Since that night, I’ve often wondered if this was a coincidence or if mass shootings are just that prevalent in our society. I received my answer one month later, in March, after I presented this project in Nashville, Tennessee. A few days later, in the middle of a conversation with a patient, I received a notification on my watch that a gunman had murdered six people at The Covenant School in Nashville. My heart rate did not increase this time. My hands did not shake. Instead, I proceeded with my physical exam and finished my patient encounter. As I left my patient's room, and a few tears roll down my cheeks, I thought of those children and families. I thought of the dreams they had for themselves. I thought of the little kids who may have wanted to become doctors one day. And then I thought about the next patient I needed to evaluate — I only had a few moments to process my grief and collect my thoughts.

Firearm violence is no longer about protecting our freedoms but rather about protecting our children. I do not want our children growing up and keeping track of their invisible bullets as I have done. No child, caregiver, or person, for that matter, deserves to carry the psychological or physical trauma of firearm violence.

I call upon our community to speak out on behalf of the individuals we have lost to firearm violence and no longer have a voice.

Next, I call upon our medical community to address firearm violence for what it is — a preventable disease. I ask our medical community to:

• Develop a standardized curriculum that addresses firearm safety education, firearm violence epidemiology, risk factors for firearm-related injuries and death, and firearm safety counseling

• Advocate for passing gun-sense laws, such as Extreme Risk Protection Orders (ERPOs), that allow physicians to file for a temporary transfer of firearms from patients at risk to themselves or others.

• Include accreditation requirements for all U.S. medical schools, including MD and DO programs to include firearm education and injury prevention in medical education

• Include accreditation requirements for all residency programs to provide their trainees with firearm education and injury prevention

• To build up post-trauma resources for residency programs.

About The Authors

Jasmanpreet Kaur is a thirdyear medical student at the Michigan State University College of Human Medicine. She plans to pursue a career in emergency medicine and continue her advocacy in firearm injury prevention. She is an SAEM Foundation research grantee and has presented FIP research and multiple conferences. @jaskMS3