In the hours following the mass shooting in Uvalde on May 24, four patients were rushed to a hospital in San Antonio. 

Those patients are improving and one has been released, “which brings us joy in this dark time,” said Dr. Ronald Stewart, chair of the department of surgery at University Hospital

But they have a long road to recovery, both physically and emotionally, he said.

Stewart gave that update Thursday in Washington, D.C., as the American College of Surgeons (ACS) called the growing number of mass shootings in the U.S. a public health crisis, not a political debate.

At a press conference in the wake of the shooting, Stewart and other members of the group, which represents 84,000 surgeons around the world, talked about their recommendations for reducing firearm violence and why they are taking a stand.

“Treatment is not enough,” Stewart said. “We have to effectively prevent these tragedies and they are preventable. They are preventable.”

Dr. Ronald Stewart, chair of the department of surgery at University Hospital, speaks during a press conference Thursday in Washington, D.C.
Dr. Ronald Stewart, chair of the department of surgery at University Hospital, speaks during a press conference Thursday in Washington, D.C. Credit: Courtesy / American College of Surgeons

The trauma surgeon has cared for victims of two of the largest mass shootings in modern history — the Sutherland Springs church shooting in 2018 and the Robb Elementary School incident in Uvalde last month that left 19 children and two adults dead and more injured. 

“These injuries, inflicted by high-velocity weapons used at both of these attacks, are horrific,” Stewart said. “A high-capacity, magazine-fed semi-automatic rifle such as the AR-15 causes extremely destructive tissue wounds. These wounds are horribly lethal at close range.”

Most victims do not survive long enough to make it to the hospital, he added. 

In 2018, the same year 112 people were killed in eight mass shootings in the U.S., according to Everytown for Gun Safety, the surgeons group formed a working group to examine gun violence, make recommendations to reduce it and help elected officials find common ground to address the crisis. 

All members of the group — 22 surgeons from 16 different states — had cared for children and adults with serious firearm injuries. The majority were gun owners.

But when it came to putting forth solutions to preventing firearm violence, as with the national debate on gun control, the group could not always agree, according to a Journal of the American College of Surgeons article published in 2019. 

In the end, the working group found some common ground and released a set of 10 principles and recommendations around obtaining guns, firearm registration and licensure, education, training and ownership responsibilities, mandatory reporting and risk mitigation, safety innovation and technology and research. 

“We recommend treating mass shootings as terrorism and support and encourage domestic law enforcement efforts and strategies to predict, detect and deter future mass firearm violence,” said Dr. Eileen Bulger, chief of trauma at Harborview Medical Center in Seattle and medical director of ACS trauma programs. 

The group also tackled issues related to “the culture of violence” and social isolation and mental health.

Specifically, the surgeons support accurate background checks for the purchase and transfer of firearms, a “permit to purchase” policy, and a formal reassessment of the firearms designated within each of the National Firearms Act classifications. 

“For instance, high-capacity, magazine-fed, semi-automatic rifles should be evaluated, and consideration given to reclassification as a National Firearms Act class III firearm or a new class designation,” stated the journal article. 

In addition, the surgeons promote a “see something, say something” approach to identifying warning signs of mental health crises. 

“Parents are not supposed to bury their children,” said pediatric surgeon Dr. Patrick Bailey, medical director for advocacy at ACS. Yet since 2020, the leading cause of death among children and adolescents is gun-related injuries, according to the Centers for Disease Control and Prevention.

Bailey is among those gun owners who seek to reduce the impact of firearm violence in the country, he said. “I do not believe that the steps recommended by the ACS FAST work group pose an undue burden on the rights of individual gun owners.”

Stewart said the group’s consensus on the set of recommendations proves that “people who hold very different views on firearms can and will harmoniously work together” to help reduce death and suffering as a result of firearm violence — and that the public expects the medical community to do that.

“And it is our fervent hope that legislation that incorporates [the recommendations] can pass at the federal and state levels,” he said. “We can save lives. We know we can do it and we must act.”

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Shari Biediger

Shari Biediger is the development beat reporter for the San Antonio Report.