Pediatric Trauma Surgeon Says Most Firearm Incidents Don’t Happen at School, but in the Home

As we have all heard this year, gun violence is the leading cause of death among children in the United States. According to the Centers for Disease Control and Prevention, firearms accounted for nearly 19% of deaths in children ages 1 to 18 in 2021—that’s about five children lost for every 100,000 children in the U.S. The American Academy of Pediatrics warns that gun violence also carries long-term physical and mental health consequences.

The data does not surprise Stephanie Chao, MD, pediatric surgeon and trauma medical director at Lucile Packard Children’s Hospital Stanford and assistant professor of the Surgery Division of Pediatric Surgery at Stanford Medicine. She recently appeared on A Little More Conversation with news podcaster Ben O’Hara-Byrne to discuss what it’s like for pediatric surgeons to treat young victims of gun violence.

In the podcast, Dr. Chao says that firearm injuries in young patients are not generally from school or gang-related shootings, but from incidents in the home. In a 2021 Stanford study, she found that the most common cause of pediatric gun injuries is when children “accidentally” discharge firearms they find and handle without their parents’ knowledge, followed by being intentionally shot due to domestic violence incidents in the home. But it is the rise of suicide by firearms that also has physicians worried.

“Suicide is the most common mechanism of death by firearms [in kids and teens]. It’s incredibly deadly. Some patients make it to our hospital, but a lot of times they don’t.”

Dr. Chao, who specializes in trauma and pediatric general surgery, adds that the children who show up in emergency rooms with gunshot wounds have a better chance for survival. “Firearms compared to any other weapons are so incredibly deadly. And so many young patients never make it to the ER.”

Many emergency room and trauma physicians, like Dr. Chao, who are treating a young patient with a gunshot wound are forced to compartmentalize their emotions to focus solely on aiding the patient. “Then we go home, and you reflect on what just happened. That is why a lot of us feel so passionate about gun education and safety polices, because so few people have seen a firearm injury up close. We see firsthand the devastation that it causes.”

The mother of two says it’s never easy to talk to kids and teens about the violence they see and hear about on TV or online, but it’s important to acknowledge that it happens and to focus on the reassurance of safety.

“That is why a lot of us feel so passionate about gun education and safety polices, because so few people have seen a firearm injury up close. We see firsthand the devastation that it causes.”

While Dr. Chao acknowledges that there is no single cure-all in protecting kids from gun violence, she points to research showing that the more states that have gun policy laws and strategies for harm reduction for pediatric firearm injuries, like safer firearm storage, counseling for at-risk youth, and having hospital-and community-based violence intervention programs, the fewer pediatric gun injuries and deaths.

“All of us want to protect our kids. All of us want to see our kids grow up, and anything that we can do to protect our children, I can’t imagine anyone trying to prevent that from happening.”

You can listen to the full interview with Dr. Chao here.