What an AR-15 Does to a Child's Body: Why Surgeons Can't Look Away

Robert D. Glatter, MD; Joseph V. Sakran, MD, MPA, MPH; Andre Campbell, MD; Linda A. Dultz, MD, MPH


June 02, 2022

This discussion was recorded on May 27, 2022. This transcript has been edited for clarity.

Robert D. Glatter, MD: Hi. I'm Dr Robert Glatter, medical advisor for Medscape Emergency Medicine. Today we have a distinguished panel joining us to discuss the horrific mass shooting that occurred recently in Uvalde, Texas, at Robb Elementary School that killed 19 children, along with two teachers.

This is the 27th school shooting this year. An 18-year-old male armed with an AR-15 was able to enter a classroom, barricade himself for reportedly 40 minutes, and unleash unimaginable terror, forever destroying precious lives and families for generations to come.

Joining me to discuss the recent shooting is Dr Joseph Sakran, director of emergency general surgery at Johns Hopkins Hospital and a survivor of gun violence himself; Dr Linda Dultz, a trauma surgeon at UT Southwestern Medical Center; and finally, Dr Andre Campbell, attending trauma surgeon at Zuckerberg San Francisco General Hospital.

Thank you, everyone, for taking this time to join me on such an important topic. I really appreciate it.

Joseph V. Sakran, MD, MPA, MPH: Thanks for having us, Robert.

Andre Campbell, MD: Thank you.

Glatter: Let's talk about the mechanics of the AR-15 (ArmaLite AR-15) and how this compares with a typical 9-mm handgun (or even a standard rifle or shotgun, for that matter). Joe, can you talk about the injuries and what you see in the ED as opposed to the operating room?

Sakran: I just want to first say that I think I speak on behalf of all Americans when I say that we just woke up this past week, once again, feeling absolutely terrible after yet another horrific and senseless tragedy. We continue to wake up time and time again and hear about the slaughter of children in elementary schools and the slaughter of community members in grocery stores, at the synagogue, and at concerts.

I just refuse to believe that this is the best that we can do. I'm saddened and heartbroken, but I'm also angry. I know we're going to have time to discuss this, but I just can't start without underscoring the importance that we all have to play a role in ensuring that our communities are safer.

When you look at the mass shootings that happen and the use of the AR-15, a weapon of war and a military-style assault weapon, it is very clear that these weapons allow gunmen not only to fire numerous rounds quickly but also to create significant damage because they travel at more than 3000 feet per second. When that happens, a couple of different things take place. The first is you have what's called the permanent cavity that's dependent upon the size of the bullet. Then you have this temporary cavity that's created, which essentially is dependent on the velocity, or how fast this bullet is traveling.

If you think about a boat that's traveling, it has this wake that results behind it. That's the temporary cavity that is created. The faster the boat travels, the larger that wake is. The same thing is happening in the human body, where you get this energy that is dissipated across a path that then results in destruction. The destruction is very dependent upon whether you hit a main vessel, a bone, or a vital organ. It is very different than what we see with a handgun.

Glatter: You're essentially talking about the ability to survive a wound from an AR-15 vs a 9-mm handgun, for example. That really is what this comes down to. If you were shot with one of the two weapons, your chances of surviving would be quite different.

Dr Campbell, I want to hear about your experience with what you have seen from wounds from these assault weapons in San Francisco.

Campbell: Thank you, Dr Glatter, for having me on this morning. I just want to echo some of what my good friend and colleague, Dr Sakran, just said.

Our hearts are heavy over what has happened. It is just devastating. I think many of us who care for these patients all the time are sick and tired of being sick and tired. We have been through this, and it seems like it's just a bad dream that repeats itself, and the casualties are just catastrophic. You would think that 10 years after we had the tragedy at Sandy Hook, with 20 children and five teachers, now 19 children and two teachers [at Robb Elementary]… but there are other casualties, too.

I just want to highlight that the husband of one of the victims recently died because he was so overwhelmed. We're going to talk about the physics and the energy and dissipation of bullets, but these are people. The families are ruined. They're destroyed. And they will never be the same. I think that we should just sit there and ruminate on that first, on what is going on. We need to have a national reckoning, and we'll get into that later.

Extent of the Gunshot Injuries From Military-Style Rifles

Campbell: A little bit about bullets and what they do. The bigger bullets travel faster in AR-15s. When I first started surgeries way back when, we had "Saturday night specials," which were 22-caliber bullets, where people got shot, and depending on where you're shot, it could cause catastrophe. Then it became 40-mm, and AR-15, and AK-47, and Uzi submachine guns, and high-capacity rifles. The faster a bullet hits, the more destruction it has. It's traveling at 2000 or 3000 miles an hour. It's really fast; the bullets bounce and explode.

Just for the regular folks who may not be medically inclined, it causes an explosion in the human body where it hits bone, blood vessels, nerves, and skin. It's a devastating injury when that happens. We've all seen simulations of what these bullets can do. Certainly, you can get a shot with a 40-caliber pistol and have devastating injuries.

It's all about where you're shot, what happens after you get shot, whether it's a glancing blow or it's a full-on devastating explosion that happens in the human body — whether it's the thorax, the head, or extremities. If it's the extremities, you may have a shot at trying to save the patient, which is why we've promoted many things that we'll talk about later on. But it's just devastating, unbelievable destruction.

It's minutes before the patients bleed out, so you have to act fast. That's why at trauma centers — we work at level 1 trauma centers — we get the patients there early, we try to get them in the operating room, and our job is to find a way to stop bleeding. We've gotten pretty good at that. Now, we can save many people, but we can't save everybody.

We're out here every day trying to save people and get them back to their families because that's what we do as trauma surgeons. We come in, we save people's lives, and we work in concert with pre-hospital staff, our emergency physicians, and the trauma center to make things happen. I'll just start with that utter devastation, exploding, and the terrible things that happen to people when they are the target of these weapons of mass destruction.

Glatter: That's a very graphic and accurate description. Dr Dultz, if you do survive one of these types of injuries, there is the risk of complications, such as fistulas, wound infections, prolonged hospital stays, and the need for long-term care. You are an expert, working in the surgical ICU at your facility. These are the wounds of war that are in the ICU. These patients have prolonged stays. Can you comment about what you're seeing regarding healing, complications, and so forth?

Linda A. Dultz, MD, MPH: Thank you very much for allowing me to talk on this important topic. I greatly appreciate that. For us working in the trauma bay and in the ICU, we see these devastating injuries. Obviously, the more bullets, the type of bullet, the level of destruction, the more devastating of an injury that patient will have that will lead to their prolonged complication and ICU courses. I think the bigger picture is what we don't see, such as the long, drawn-out PTSD and the mental rehabilitation that comes from that.

It's not just a physical issue. It's emotional, and one that leads to a lower quality of life and long-term disability for these patients. That's where some of our research is focusing on as well — it's not just the physical aspect, because that's going to happen and we will get our patients through that and we will get them home, hopefully, and back to their families. That long-term effect, though, for most people, will never go away. We're focusing on that right now and a large amount of research is being put into that.

It's a Long Road to Recovery: Recidivism and Intervention Programs

Glatter: That's an important point you draw upon because as soon as a trauma develops in some institutions, there's a team approach involving crisis counselors and social workers right in the trauma bays, at least for some of my colleagues. It doesn't start once they hit the floor or after they've been out of the ICU - it's immediate.

Dr Sakran and Dr Campbell, is it an all-inclusive approach? It starts immediately that you engage the patient, the family, and resources that are available. This is going to be a long, drawn-out course.

Sakran: What Dr Dultz said was spot-on. For every death, you have about two to three people that are nonfatally injured — and those are conservative numbers.

Why is that important? Well, it's important for a variety of reasons. We know in urban cities across America, like Baltimore, San Francisco, and Dallas, the recidivism rate can be as high as 41% over a 5-year period, meaning we have an opportunity and a teachable moment to potentially prevent these individuals from being reinjured, which is why this comprehensive, holistic approach to how we manage patients that come through our trauma center is so critical.

I'll say that we do a pretty good job in general, when you think about healthcare systems across the country, of what happens within the four walls of the hospital. When patients are discharged, that's where I think there is much room for improvement, to not only think about the things that we heard Dr Dultz mention regarding both mental and emotional well-being, but also to understand how do these patients reintegrate back into life? What is their quality of life? Are they able to go back to work? Are they on a ventilator for the rest of their life?

The number-one cause of death in children between the ages of 1 and 19 is gun violence.

All those factors are so critical as we look at patient-reported outcome measures and how we can do a better job as an entire system to provide these patients with all the different things that they need to recover, and hopefully have a meaningful reintegration and get them as close to their baseline as possible.

Glatter: Is there actual research that is looking at the effect of these community intervention programs you're discussing?

Campbell: There are probably 40 or 50 hospital-based violence intervention programs throughout the country. Our program at San Francisco General is the Wraparound Project, but there are programs in Baltimore, Philadelphia, Dallas, Chicago, and all over the United States.

After the patient comes in, we do all our medical stuff, and we've gotten really good at saving people's lives over the years. We have techniques, use of blood products, things we do in the operating room. We've learned from the global war on terror; the Afghanistan and Iraq conflict taught us many ways to save people's lives.

Afterwards, what goes on integrating people — what Dr Sakran and Dr Dultz were just talking about — you want to make sure that people can go back to the world that they're in now. Sometimes, to tell you the honest truth, you can't send them back because they can be a victim of crime. We have evidence now in terms of recidivism rate. We have data at our place where recidivism went from the twenties to the single digits because of the implementation of our program.

We have data that it reduced recidivism, number one. It saved money, patients' lives, reduced injuries and reinjuries in folks so that this constant reentry pattern that we were seeing, we're able to interrupt it by the hospital-based violence intervention program.

It is very complex. It involves counselors; getting people to the healthcare they need; improving their mental health to deal with the PTSD, the physical issues that they're dealing with, and maybe the legal issues that they may be involved with too. We called ours the "wraparound program" because it doesn't just involve the medical stuff. It involves all the other things because you don't want to have to see them again.

I've been at my place for a long time, so when I walk in, the patients know who I am. One thing is that they know my voice. I've been taking care of families for a long time. They will say, "Dr Campbell is here. He saved my cousin, he saved my brother, he saved my son." Sometimes you can't do that. That's one of the hardest things to deal with.

We're very good at doing pre-hospital stuff, getting people on the gurney, into the hospital, the trauma bay, the operating room, the ICU, and into the interventional radiology for CT scan, whatever we have to do. But then we have to continue this afterwards. There are issues that are physical and some that are mental.

Maybe we should talk about this. All of us as trauma surgeons, we have our own PTSD that we have to deal with.

Trauma Staff Have Their Own Bouts of PTSD to Contend With

Glatter: I was just going to bring that up. It's a crisis among healthcare providers right now that we can't ignore after COVID-19. Healthcare providers are really showing the effects of everything at this point that we're seeing, from trauma incidents to just showing up to work. Taking care of ourselves and programs that are designed to do that are critical.

I wanted to ask you about each of your institutions.

Campbell: Dr Sakran took care of one of his colleagues who was shot just recently. I want him to highlight the power of the statements he made after that right now.

Sakran: As we're hearing both from Dr Campbell and Dr Dultz, it's hard to do what we do. Take that difficult job that we do on an everyday basis and imagine then that it's your colleague, someone that you work with, someone who also happens to be a trauma surgeon and taking care of injured patients.

That's what happened a couple of months ago when I came on call one morning and I got the message that one of my partners was being brought in after they were shot. I don't want to get into this person's story because that's for them to tell.

What I will say is this: As I sat there in disbelief as to what I had just heard, I asked myself whether or not I was going to be able to separate the emotion from the moment, to be able to make one methodical decision after the other. It was a tough moment because I didn't know at the time what type of injuries he had. Many things went through my mind. Of course, even afterwards, thinking about the fact that, thankfully, he physically survived, things could have been different.

Now, we're all dealing with the mental and emotional trauma and what has been coined as the "second victim" — a fact that I know Dr Dultz probably remembers from her time at Hopkins, where the people who are impacted are not only the patients that we're taking care of, but they're also us as a multidisciplinary team of healthcare professionals.

Glatter: What exactly, as surgeons, do you do? Dr Dultz, I'll bring you into this. In other words, after seeing these horrific scenes day after day and managing these cases and then going home at night, what do you do personally? Do you have some approach that you use that keeps you mentally in a frame of mind that allows you to reenter the situation again?

Dultz: It's a great question. Like Dr Sakran was saying, in the media, we hear about these mass shootings or these crimes and we see the pictures for a few days, then it goes away in the news. It goes to the back of people's minds and they continue with their day.

For us as trauma surgeons, that is challenging because we see it every day. It doesn't have to be a mass shooting. It could just be one. It could just be that one patient that comes in that you can't save, and you have to be the person to tell their family that they're not coming home. It's hard and gets emotional.

As trauma surgeons, we're a very tight-knit community — at least that's how I feel. I feel very supported by my colleagues and my coworkers. We have our own support staff at Parkland that is also helpful for us as physicians that we can turn to.

As trauma surgeons, it's important for us to check in with our teams at all points. We're team leaders, and so it's always important that we debrief after challenging events like this and talk to our team and make sure our team is okay. Going from there, I talk to my colleagues all the time about these things, reflect, go home to my family, and hug my kids.

Sakran: If I can just add to that. At Johns Hopkins, we have the RISE (Resilience in Stressful Events) program — a caring-for-the-caregiver program. It's a hospital program that's set up to provide and deliver psychological first aid and emotional support to healthcare professionals. There are probably a variety of these programs that exist at other institutes.

I would just say that for a long time — and maybe Dr Campbell can speak to this experience — we often thought, Oh, we're tough. Nothing bothers us. We didn't want to talk about it. The reality is that it does impact us in a very tremendous way. Listening to Dr Dultz talk about how we have to tell moms and dads that their child who left that morning is never coming home again, that never gets easier. I think we have to recognize our own need for the type of support that is so critical to allow us to do our job effectively.

Campbell: Dr Dultz and Dr Sakran are really talking about something that hits home with every one of us who cares for these patients and their families all the time. Going in that room — we call it the quiet room — where we basically sit down and we dispense really tragic information to people, no matter how you do it or how long you do it, it still hurts. It hurts every time. If it doesn't hurt, then you're in the wrong business. We may not cry in the room, but we may go home and cry, and cry with our families. We have to process this and we have to deal with it.

I've been doing this long enough now where when I walk into a room, it's almost like in the back of my mind I'm watching a movie and I know how the movie's going to end. I know that somehow, I'm going to be able to make the movie and it's going to be successful. Most of the time, because we've gotten much better doing things, we save people, but sometimes you just don't, and you have to be prepared to deal with that.

We talk often about resilience and coping strategies and what to do, but you need to go to the place, whether that's your faith, your family, the people you love, or talking to your friends. When things happen, I'm always sending messages back and forth to Dr Sakran because we go back a while and we help each other get through this. When something bad happens, asking, "Are you okay?" is something that's important. Dr Dultz — I know I trained one of the people who trained her. We go back and forth with things. These little messages help us get through the day because sometimes it's hard to get through the day.

In the US, the Leading Cause of Death in Children Is Gun Violence

Glatter: Absolutely. No one should suffer in silence. It's the same in emergency medicine. Check-ins, asking "Are you okay?", or saying "We need to talk."

What this brings up to me is that the number-one cause of death in children between the ages of 1 and 19 is gun violence. That statistic, when I read it in NEJM the other day, just made me cringe.


Sakran: That is a striking statistic and it's the first time that I'm aware of in 40 years that gun violence has become the leading cause, surpassing motor vehicle crashes. When you look at what has happened over the complexity of this public health problem, we have several different opportunities to intervene because there is no single solution for this issue. It really requires a multifactorial, multisector approach.

If you're talking about suicides, in general, it's a different demographic and different intervention vs unintentional injury vs homicide and so forth. I think we have to move away from trying to focus simply on human behavior, which we know in and of itself is not cost-effective, to really developing a system that allows us to ensure that fewer people are injured.

Campbell: The fact that children are being killed at such a high rate is just devastating for all of us. When we hear about these events, it's just absolutely tragic. I agree that it's complex and there are many answers, but there are different groups that are being affected. Dr Sakran just highlighted that. Suicide has a different demographic.

With respect to where I live in San Francisco, 4% of the population is African American and 30% are Latino, but about 80% of people who are shot are African American and Latino. That's just the fact of the demographics we deal with. African Americans are 13% of the population, but half the homicides in the United States are African American. This is a problem that is devastating certain parts of the community.

As we begin to unravel the problem and to dissect it, we have to look at the demographic profile of folks. Suicide, which is the silent epidemic that we have, is typically more White patients who take their lives as opposed to Black patients. Just understanding about trying to get around that is something that we are really going to have to grapple with as a society. Because we say this is a uniquely American problem — and it is — we're going to have to have a uniquely American solution to this because we're a different place than many places around the world. We're going to have to work this out together.

Can We Classify Gun Violence as a Public Health Emergency?

Glatter: Reframing this instead of a public health crisis as a public health emergency is something that was brought up. Also having the surgeon general jump in and do a report on gun violence, elevating this to a moonshot level about gun violence and putting this on the forefront. This last event is the tipping point. It may not be something that's going to happen in our lifetimes, but it's something that needs to start now.

Sakran: I thought the tipping point was going to be Sandy Hook 10 years ago. Clearly, I was wrong. I think that we have a moral obligation to think about this from a comprehensive, holistic way. I understand how, when you look at what's happening right now in America, it's very easy to be hopeless because we haven't seen any federal action.

I continue to remind folks that most governing happens at the local and state level. We've seen hundreds of pieces of commonsense legislation passed in states across America. The problem is that we live in a country that has porous borders, and so we have to be able to shore up those borders by passing commonsense legislation.

I think there's a variety of things that we can do. Some of the stuff that you mentioned, Dr Glatter, we have been requesting for a while. President Biden can commission a surgeon general's report on gun violence prevention, the likes of which we have never seen, and that would be a huge statement as we think about tackling this public health issue. You can also direct the secretary of Health and Human Services to declare gun violence a public health emergency, which opens up a whole slew of resources and different ways that we can continue to tackle this. This has been done in the opioid crisis, as an example.

Last but not least, you mentioned the war on gun violence. We have seen President Biden, when he was Vice President Biden, do this with the cancer moonshot. I think being able to apply all the different options that the administration has while we continue to work on congressional action at the federal level, and of course, continuing the fight and the effort that's happening at the local state level, is going to be critical.

Glatter: Dr Campbell, any thoughts to add to Joe's comment?

Campbell: I agree with what he said. Thinking about this as a public health crisis and emergency is really the best way to look at it. If we continue to do things around the edges, that's not really the way we're going to get things done. We need to have more of a centralized effort. I agree that on the state level, there have been some things that have gone on, and that's really where the action has been. If we can't agree on simple things, we're not going to make any progress. I think a Surgeon General's Commission report would be a way of starting to do that and opening up other funds for this type of work to make sure that we can then stop this.

We're still reeling from what happened in Buffalo, then there was an incident in Southern California, and then on the heels of that, this incident now in Uvalde, Texas. This is something, as a country, where we're going to have to wake up and say that we need to change the way we're doing business and we need to make some big steps forward because we've been stuck in one place for a long time. That has not been the way that we're going to get anything done. Taking big steps, we're going to have to think boldly and maybe out of the box because there's a fair amount of paralysis in Washington, DC.

Trying to get past that, how can we do things that that will make a difference so that we don't have to keep going into those quiet rooms and we don't have to address those families? We don't have to be saying thoughts and prayers, because I think we're all tired of doing thoughts and prayers. We're just tired of that. We want something to happen.

Dultz: The other things that we can do as providers are to continue our education, our outreach, our hospital-based violence intervention programs. We can advocate for funding in those areas that we know we can make an impact on.

Right now, the CDC has finally allowed us to do research again in gun violence. I think that's really important because we can have the objective data of what we're dealing with and bring that out to the public and say, "These are the statistics." I think advocating for that funding is just so important.

Research on Gun Violence: Progress Made, More Needed

Glatter: Is there a national database created for gun violence at this point? We have it for motor vehicle collisions, smoking, and domestic violence. Is there any action toward that effect?

Dultz: There is the National Violent Death Reporting System that you can use, but there are several of us who are advocating that that be expanded substantially, that it be more robust, so that we can actually do better research in that area and also bring that to individual state levels as well. I don't know if Dr Sakran or Dr Campbell has anything else to add.

Campbell: There was actually some legislation written in the late 1990s that said we could not fund research in gun violence at all, and it wasn't until just recently that money started to be released. In order for us to understand a problem, we have to study it. The fact that we're now getting money from NIH and the CDC, that money is being dedicated and there are institutes that have been funded that now could study this problem and give us concrete solutions — that work is something that cannot be overstated. We have to make sure that any time these things come out that we embrace it, study it, and publish the data that we find related to this, because that's the only way we're going to change this.

Sakran: In the last cycle, Congress finally appropriated $25 million, half of which went to the CDC and half of which went to the NIH.

While that was historic, I think we should also recognize that when you look at the burden of disease as it relates to gun violence and you compare it with other disease processes like sepsis, it really is a drop in the bucket. We need to continue to push for extensive gun violence prevention resources to be able to look at these evidence-based practices in a way that is thoughtful and comprehensive.

Campbell: The American College of Surgeons Committee on Trauma, about 5 years ago after the Southern shooting, under the leadership of Dr Ronald Stewart and Dr Eileen Bulger, who followed him, organized multiple meetings and discussions with all the stakeholders in medicine and outside of medicine to talk about things that can happen. They came up with a plan, and we can explore some of that if you want. It was something that required a lot of hard work. It's published now and it's out.

It refers to sensible ways to deal with this problem from the public health point of view, and that includes the background-check issues and red-flag warnings; safe storage; making sure that people who are mentally ill don't get a hold of weapons, capacity magazines, and things like that. There are many things that are built in there that we don't have time to go into, but this is a sensible way to deal with this that is not controversial.

Dultz: The other thing that the American College of Surgeons Committee on Trauma has really pushed in the last several years is the Stop the Bleed program. That's been a huge thing for us as trauma surgeons in terms of education and getting the word out. It's not primary prevention, but it's how do we engage citizens and civilians in the area to say, if these events occur, what can you do to quickly stop the bleed, get a tourniquet on, control hemorrhage, and get that patient to the nearest trauma center so that we can take care of them. Here in Texas, we actually have pushed that legislation through, which is fantastic. We're pushing Stop the Bleed kits in every school.

Glatter: There was a young girl who covered herself in blood and tried to protect herself from getting shot. I'm not sure if you've heard about this, but she knew enough that maybe this would prevent the shooter from actually trying to hurt her.

Sakran: You have a child that covers herself up with blood in order to potentially make a perpetrator think that she's already dead. Is this really the best that we can do? I'm sorry. I just can't accept that. I don't think anyone else should either.

Campbell: That's not a skill that we want to teach our kids. We want to make sure that when they go to school that they're protected, that they're safe, that they're being nurtured and not doing drills. The school that we're talking about had gone through drills. The reason some of those kids survived is because they've actually done active-shooter drills before.

When I was growing up, we would do air-raid drills— jump under a table and do all the stuff for nuclear war. Now, it's like you have to protect yourself in this situation, and it's just criminal that we have to put our kids through it.

I'll be political just for a second and say that the problem is that there are too many guns. There are 300 million people and 400 million guns. We don't want to take away anyone's guns, but we want to understand that part of the heart of this is going to be gun safety also. I'll just go out on a limb and say that. I think that this is about gun safety and making sure that people understand that we can't keep doing the things that we're doing, and we must change.

Sakran: The data and science are incredibly important, but the reality is just that the data and science don't change the hearts and minds of people.

One of the reasons that This Is Our Lane, I think, was so impactful is because healthcare professionals from not only across the country but also across the world came together to tell their stories, and in some instances, to share their pictures. For the first time, American people got a chance to see what we, as healthcare professionals, are seeing on a daily basis in our trauma centers and in our operating rooms.

We have to do a better job of illustrating that and not sanitizing the shootings that continue to happen. Again, like we've talked about, it's not only the mass shootings but also the everyday injuries and deaths that happen across America.

Glatter: I agree completely. I want to thank everyone for your time to discuss this sensitive topic. It's been so helpful, and thank you for your expertise in addressing this public health emergency.

Robert D. Glatter, MD, is assistant professor of emergency medicine at Lenox Hill Hospital in New York City and at Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York. He is an editorial advisor and hosts the Hot Topics in EM series on Medscape. He is also a medical contributor for Forbes.

Joseph V. Sakran, MD, MPA, MPH, is a director of emergency general surgery and assistant professor of surgery at Johns Hopkins University in Baltimore, Maryland. Sakran's interest in medicine stems partly from having nearly lost his life after a gunshot wound to the throat during his senior year of high school, and he has subsequently dedicated his life to making a social impact to curb gun deaths.

Andre Campbell, MD, is a professor of surgery at the University of California, San Francisco, School of Medicine and an attending trauma surgeon at Zuckerberg San Francisco General Hospital and Trauma Center. He is also vice chair for Diversity, Equity, and Inclusion in the Department of Surgery.

Linda A. Dultz, MD, MPH, is a trauma surgeon and assistant professor in the Department of Surgery at UT Southwestern Medical Center. She serves as program director of UT Southwestern's surgical critical care fellowship and medical director of Parkland Hospital's surgical intensive care unit (SICU). Her areas of clinical expertise are general surgery, wound management, trauma, and surgical critical care.

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