An NYPD surgeon learns the random nature of wounds

I expected to see more gunshot wounds when I became a police surgeon for the NYPD three years ago. I had seen my first one as an intern decades earlier -- a suspect injured during a robbery had been brought into the emergency room -- and I still recalled the jagged, deep crater left by the bullet. The image had left its mark on me, not only by its appearance but also because it had been inflicted by another human being.

I was braced for the sight of other such disturbing wounds, but I was surprised to find that many injuries resulted from trips, stumbles and mishaps that occurred off duty. Among these were a detective who had grasped a glass that shattered, lacerating her hand and severing tendons and nerves supporting her thumb, and a sergeant building a deck on his home who had fallen through it, breaking several ribs. At first I thought this odd, that members of the police department, empowered by the law, would be as vulnerable as the rest of society.

But soon I was to learn that these men and women were vulnerable to dual risks: the ordinary dangers that all of us encounter from time to time -- and the kind created by the violent society in which we live.

And sometimes, I was to find, the most difficult-to-treat wounds weren’t to the body.

A shout, then shots

The first incident to drive this point home involved an officer who had been riding in a van with seven other members of the New York Police Department about to be deployed for parade security. The van had stopped at a traffic light, and the officer heard shouting. He saw a group of men and women standing on the sidewalk only a few feet away -- and a man nearby brandishing what appeared to be a handgun at them. Before the officer could react, the gunman walked a few steps closer to the group on the sidewalk and fired, killing one of the men.

The officer later described the noise: “It was a .45, and it sounded like a cannon. I had never been that close to a gun firing without my ears being covered.”

The group in the van took cover, but the gunman had seen the NYPD logo and began to shoot. Three bullets struck the vehicle as the driver pulled away, stopping a half block up the street, where the officers disembarked, weapons drawn. No one inside the van had been hit, but at the street corner, the gunman was still firing. Another man fell. The officer who had witnessed the first shooting returned fire with his colleagues, one of whom hit the gunman. In a few seconds, all shooting stopped.

As the officer recounted: “My head was pounding, and my ears were ringing. I could feel my heart beating.”

Sirens of other police vehicles and paramedics gradually became louder as the vehicles descended on the scene. All of the officers involved were taken to the nearest emergency room. Once released, they spent the remainder of the day and night answering questions regarding the shooting.

The officer whose head ached and ears rang was placed on medical leave and instructed to see his district police surgeon -- me. Police surgeons supervise the care of injured officers and decide when they can return to duty, and I’ve found that it’s impossible not to form relationships with these men and women.

Lingering effects

In this case, the officer told me that in the 24 hours since the shooting, his headache had become less severe. And although the ringing in his ears was softer, his hearing was off. He had been on the force for four years and had never previously fired his weapon in the line of duty.

I arranged for him to have his hearing checked and asked him to come back in a week. If his headaches were still a problem, I would refer him to a neurologist. When he returned, I could see from the seriousness of his expression that he was still disturbed by what had happened. The incident’s impact had nothing to do with his physical complaints. “It happened so suddenly,” he said. “I know that there are a lot of sick individuals out there.”

He had been forced to confront both his vulnerability and a police officer’s capability to inflict deadly force. This was a much different wound from what a bullet or knife would make and one with which I was not yet familiar.

I knew that the officer would undergo counseling required by the department and return to work once this had been completed. His expression seemed to brighten as we talked about returning to duty. “I really want to get back to work,” he said, and I sensed that resuming his routine would be the best therapy I could recommend.

As for my role as a police surgeon, I was beginning to realize that I would need to deal with many types of injuries as well as the violence that produced them. I did not know which would be harder.

Adams is a pulmonologist in New York City and the author of “The Asthma Sourcebook” and “Healing Through Empathy.”