CHAPTER

5     Fighting the Root Cause

THE GOOD DOCTOR

JOSEPH SAKRAN WAS EXHAUSTED. It was the evening of November 7, 2018, and the 41-year-old trauma surgeon had just gotten home after a long day in the operating room at Johns Hopkins. He was unwinding by sitting on the couch in his living room, eating dinner, and like so many of his generation, simultaneously taking in information from a variety of sources. While the television played in the background, he scanned magazines and medical journals, and periodically looked at his iPhone to see what was new on Twitter.

Then he saw something on Twitter that gave him pause. Someone had written that the National Rifle Association (NRA) had tweeted a comment about how doctors should not take positions on gun control and that they should “stay in their lane.”

Sakran had seen plenty on Twitter with no basis in fact, so he went to the NRA’s Twitter messages. The NRA had indeed sent out a tweet at 2:43 p.m. that afternoon that said, “Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted no one but themselves.”

The NRA tweet was in response to a series of articles that had just been published in the highly respected medical journal Annals of Internal Medicine. The articles had documented the relationship between stringent gun laws and lower firearm death rates, and included an editorial calling for physicians to speak out on gun violence as a public health issue. Sakran didn’t expect the NRA to like the idea of a medical journal adding its voice to the coalition pushing for gun control, but something about the phrase “stay in their lane” got to him.

Sakran is director of emergency general surgery at Johns Hopkins Hospital, which sits on the edge of the neighborhoods featured in the television show The Wire. As a result, Sakran sees gunshot victims all the time; many he helps save, but some he cannot. It’s emotionally draining work, the kind that causes burnout in many doctors and nurses. The idea that someone should say physicians like him were “self-important” and tell them, basically, to shut up. . . .

“I was incensed,” he said.

He immediately tweeted back: “As a Trauma Surgeon and survivor of #GunViolence I cannot believe the audacity of the @NRA to make such a divisive statement. We take care of these patients every day. Where are you when I’m having to tell all those families their loved one has died. @DocsDemand #Docs4GunSense.”

As events would soon show, the NRA tweet could not have come at a worse time. Only a few hours later, 13 people were killed in yet another mass shooting at the Borderline Bar and Grill, a country-and-western bar that was a favorite hangout of college students in Thousand Oaks, California. The NRA tweet led to more than 22,000 comments, most of them critical, many from physicians who, like Sakran, saw the NRA tweet as adding an outrageous insult to horrible injuries.

In the days that followed, Sakran could not put the NRA tweet out of his mind. He created a Twitter platform with the “handle” @ThisIsOurLane. Its description is “Medical Professionals who care for #GunViolence Victims. We are ‘in our lane’ when we propose solutions to prevent Firearm Injury and Death. #ThisIsOurLane.”

He added in a tweet “Since the @NRA is incapable of understanding the important role we the medical community have in this fight against #GunViolence, we have created this handle just for you!”

He glanced a few hours later and saw that there were already 500 followers. The next day, he saw there were 7,000, and soon @ThisIsOurLane had gone viral. As of April 2019, there are more than 29,000 followers. Physicians, nurse, and other healthcare professionals sent in stories and photos of blood on the floors and walls of the trauma bays and operating rooms after frantic efforts to save gunshot wound victims. A resident physician sent in a photo of his bloodstained scrubs, and wrote “First patient, first day of residency: gunshot wound to the head. Tried saving him as his mother cried into my shoulder pleading for us to save him. He didn’t make it. He wasn’t the last one either. #ThisIsMyLane #ThisIsOurLane #NRA.”

Another physician wrote: “Single GSW [gun shot wound] to the head as a drive-by. Surprising little blood, but plenty of blood-curdling screams from this middle schooler’s mother when we told her that her baby was dead. Tell me @NRA how do I get her screams out of my head 4 years later? #ThisIsMyLane #GunControlNow.”

Yet another showed his blood-soaked pants legs, and wrote “Can’t post a patient photo . . . so this is a selfie. This is what it looks like to #stayinmylane. @NRA @JosephSakran.”

#ThisIsOurLane had caught on. Sakran had sounded just the right note of indignation, with the voice of experience of a clinician who actually cared for gunshot victims and consoled their families. The media starting writing stories about Sakran and the movement he had helped set in motion. The New York Times ran a front page story. The New England Journal of Medicine ran a perspective piece at the front of an issue, saying in part: “#ThisIsOurLane calls attention to the role of physicians from many walks of medical life—trauma surgery, emergency medicine, radiology, anesthesiology, surgery, physical medicine, rehabilitation, psychiatry, and forensic pathology. It encompasses our colleagues as well: paramedics who face carnage in the field, nurses who provide massive transfusions, housekeeping staff who clean blood-soaked floors, pharmacists who assist with intensive care unit (ICU) medication dosing, and everyone who helps survivors piece their lives back together and helps families recover from loss. This is their lane, too.”⁸

The Washington Post ran a long story on Sakran on November 14. National Public Radio’s legendary interviewer Terry Gross broadcast a 37-minute interview with Sakran on November 28.

The flurry of attention made Sakran something of a celebrity. FierceHealthcare named him one of five physicians to watch in the year ahead. He was seen as akin to the news anchor who becomes unhinged in the movie Network and starts a movement by yelling, “We’re mad as hell, and we’re not going to take it.” Sakran was asked to speak around the country and write essays for magazines.

Asked about this public response, Sakran shrugged and said that he was just a physician taking care of patients who were all too often victims of gun violence. It was reasonable to assume that almost any doctor or other healthcare personnel would have been upset, he said, and he pointed out repeatedly that many of the followers of @ThisIsOurLane are gun owners as well as healthcare providers.

But the fact is that Sakran had more reason to care about gun violence than most physicians or other healthcare personnel. When he was 17, he was shot in the throat in a random act of gun violence. He nearly died and had a tracheostomy for six months.

At an age when most teenagers are enjoying the last gasps of adolescence, he had what might have been his last gasps. That ordeal influenced his journey into medicine and how he feels about his work today—including those moments when he has to tell family members that one of their own has been gravely injured.

* * *

When asked where he is from, Joseph Sakran pauses, takes a deep breath, and says, “It’s complicated.” He starts with his parents, but quickly goes a generation further back. He explains that both of his parents are Lebanese, but they grew up in Israel and emigrated to the United States in the early 1970s. His family background explains why he speaks both Arabic and Hebrew, and has something to do with why he became a doctor, a trauma surgeon, and ultimately a leader in the campaign against gun violence.

Sakran’s father, Victor Sakran, was born in Nazareth, where his Greek Orthodox ancestors lived long before it became part of Israel. Sakran’s grandfather owned a small store in the center of town, right near “Mary’s Well” (the site of the Annunciation, where, according to Catholic tradition, the Angel Gabriel appeared to Mary and told her that she would bear the son of God).

Sakran never knew this grandfather, but countless stories made his grandfather something of a role model. His grandfather had an enormous family (11 children, some of whom died in infancy) and an even larger circle of friends. He was not wealthy, but he was a religious man with a reputation for welcoming anyone into their home.

“I heard over and over growing up that my grandfather stood for selfless service,” Sakran says. “He really tried to make the community better. I’ve been back to visit, and all the information I have is that he was someone who led by example. He was the same even when no one was looking. My parents gave me a very clear message as I grew up that behaving this way was part of what it meant to be in our family.”

Sakran’s father came to the United States in the early 1960s, following an older brother who had moved to Miami. “My dad came with just a quarter in his pocket—literally, nothing,” Sakran says. “But he worked hard and put himself through school. He was living in the basement of his brother’s home. He wanted to become a doctor, but he didn’t have the means or opportunity. But he became an aerodynamic engineer and ended up working for Cessna focusing on both commercial and military projects.”

Victor Sakran’s work took him to Wichita, Kansas, but then he was recruited for a position in the US Department of Commerce and moved to northern Virginia, just outside Washington, DC. Meanwhile, he had met the young woman by the name of Nuhad, who would become his wife. Nuhad was a friend of his sister, the only child of a Syrian-Lebanese-Catholic couple that had decided to move to Haifa, Israel, and run a small store. Nuhad and Victor met, they married, and they moved to the United States.

In 1977, they had the first of three children, Joseph, who was born on August 3, 1977, at Inova Fairfax Hospital in Falls Church, Virginia. Two years later, a daughter, Jennifer, was born. And two years after that, they had a third child, another son named Mark.

* * *

For the first 17 years of Joe Sakran’s life, his family’s experience was a classic American immigrant success story. He remembers his father getting up every day at 5 a.m. to go to work, and his mother staying home to take care of the children, but then going back to work as a teacher. “They faced their share of adversity,” he says. “They had accents, and people were always asking where they were from. I think back then it was more the lack of diversity that existed rather than hatred. But it wasn’t easy.

“I would say that my parents were really involved in our upbringing,” he says. “They felt that nothing was more important than education—that it was the path to success. So we played sports, we played musical instruments, we had friends—but nothing was more important than our educations. In the summer, we didn’t just bolt out the door and play the whole day. We had to read book chapters and then summarize what we had read.”

Joe Sakran did not seek his first job until he was 17. “My father always said that his job as a parent was to go to work and make ends meet,” he recalls. “My job was to get educated. That was my responsibility.”

It was only when he began his senior year at the local public school, Lake Braddock Secondary School in Burke, Virginia, that he signed on for part-time work at a pet store. He was supposed to start on Saturday, September 24, 1994, at noon.

He never got there. At that moment, he was regaining consciousness in the ICU of the hospital in which he had been born.

* * *

The evening before, Sakran and almost everyone else he knew had gone to the first football game of the season for his high school. He had had a busy afternoon, going from school to an SAT preparation class that his parents had enrolled him in. He got home from that class, and one of his friends was already waiting for him. He barely had time to drop his things off and change. “My parents were trying to ask me how my class had been,” he remembers. “I said, ‘I’ll tell you later, I have to go.’ And I ran out of the house.”

He went to the game, and afterward, Sakran joined a group of his friends. “We were just chatting it up,” he says. “But at a nearby park, a fight had broken out between two individuals. One pulled out a gun and started firing. I got hit by a random bullet.

“The experience is still very clear in my mind, but it’s also very fuzzy in the sense that it happened so quickly,” he says. “I remember that I heard people yell, and I remember turning to my right and seeing flashes. Then I felt numb. I wasn’t sure what had happened, but I knew something wasn’t right. It seemed like the group around me was disbursing in slow motion.”

At this point, Sakran was still on his feet, and he walked to the curb of street. He could not talk. A .38 caliber bullet had entered the front side of his throat, ruptured his trachea (windpipe), nicked his left carotid artery, exited his neck, and lodged in his left shoulder. Blood was streaming from the artery. He could only mouth words and nod his head to answer yes or no.

“I was wearing a white shirt, and I was just drenched in blood,” he says. “A couple of my friends saw me, and they were trying to figure out where I had been shot. They tried to lay me down, and when they did, I started choking on blood.”

Someone stopped a car, and asked the driver to call 911. The police medevac helicopter arrived before conventional ground ambulances, but Sakran could not be transported by air. The small chopper could only accommodate patients who could lie supine, and he could not, because his airway quickly would fill with blood. Within minutes an ambulance arrived. Emergency medical technicians (EMTs) started an intravenous line and took him to Inova Fairfax Hospital.

In the trauma center at Inova Fairfax Hospital, Sakran was surrounded by the trauma team of physicians, nurses, and other staff. The trauma surgeon had not arrived yet. Sakran could tell that there was disagreement among the team about what to do next. He even overheard a discussion between the emergency department physician and the trauma resident: “I’m not going to get sued if we lose him.”

At that point, the trauma surgeon, Robert Ahmed, arrived, noticed the chaos, and immediately took charge. Sakran’s memory is that Ahmed said, “What in the fuck are you all doing?” Ahmed said Sakran had to go the operating room immediately, unlocked the gurney, and began wheeling him toward the operating room. Once there, Ahmed laid Sakran flat—a challenge, because Sakran was still choking on his blood when he leaned backward. Ahmed looked down at Sakran and said, “I’m sorry, but I have to do this to save your life.” That was the last thing Sakran remembers before passing out.

Ahmed and the surgical team did an emergency tracheostomy and explorations of both sides of his neck. During the explorations they found significant damage to the left carotid artery. Dipankar Mukherjee, the vascular surgeon on call, took a piece of Sakran’s saphenous vein (from his leg) and created a patch to repair the hole in the artery. An ear, nose, and throat specialist, Timothy McBride, worked on reconstructing his trachea.

Sakran woke up the next day in the ICU. He could not talk or really move. For the next two days, his breathing was performed by a ventilator connected to his lungs through his tracheostomy. He stared straight ahead and saw a clock on the wall. When he woke up it was almost noon—the time that he was supposed to start his new job, his first job, at the pet store. He remembers thinking, “Oh, shit! I’m going to be late.”

And then he saw his family around him. Both of his parents were there, along with his sister, his brother, and his mother’s father, who was living with them at the time. They were horrified. “I could see from the looks on their faces that what had happened was really bad,” he says. “They had worried so much about me and my brother and sister, but I don’t think they could have ever imagined that something like this might happen.”

Sakran often thinks about what his family went through that day. “Now when parents or other family members get called to come to the hospital because their loved one has been hurt, it’s hard not to see my own family in their place,” he says. “Sometimes, when I go out to talk to families, I tell them that things can turn out fine—my own story is proof of that. But that’s not always the case. Sometimes, I look at these families, and I have to tell them that their loved one is never coming home again. And their lives are never the same.”

* * *

Sakran’s road to recovery was a long one. He was in the hospital for a little over a month and went home with his tracheostomy tube, which stayed in place for six months. During that period, he had several follow-up operations to remove scar tissue that resulted from his body’s attempt to repair the damage. They were necessary to prevent the narrowing of his trachea. He had a paralyzed left vocal cord, and to this day, his voice gets hoarse when he is tired. He also lost function of his left phrenic nerve, the nerve that tells the diaphragm (the sheet of muscle between the lungs and abdomen) to contract, and thus enlarge the chest and pull air into the lungs. His chest x-ray today shows his left diaphragm frozen high in his chest.

He was damaged, but he wasn’t dead—and he was still a high school student who wanted to graduate with his classmates. His school and local county government rose to the occasion and provided home schooling, which enabled him to catch up and then keep up with his classmates. In the spring, he returned to school. He graduated with his class.

But before that graduation, before his tracheostomy came out, there was a defining moment. He was standing in the bathroom, looking in the mirror, taking in all the scars and other vestiges of his ordeal. He was down. “This is horrible,” he remembers thinking. “What did I do to deserve this?”

At that moment, his father walked by. He could see the expression on his son’s face in the mirror, and understood what was happening.

“Listen,” his father said. “What happened to you is terrible. But you have a couple of options. One is that you can feel sorry for yourself. The other is that you can take this terrible tragedy, turn it into something positive, and use it to make a difference in the lives of other people.”

“It was an ‘uh-huh’ moment,” Sakran says. “I thought to myself, ‘He’s right. This sucks. But I have the possibility to do the best that I can to positively impact the lives of others.’”

* * *

Sakran started to think about becoming a doctor. He cannot really remember what he imagined himself doing before he was shot, but afterward he says, “I asked myself, ‘What can I do that will allow me to give other people the same second chance I was given?’” He decided that he would try to go to medical school. Before long, he started to picture himself as a surgeon—a trauma surgeon operating on patients with injuries like the one he had had.

He wanted to stay close to home as his recovery continued, and applied to only one school—nearby George Mason University. He did really well academically in college—better than he had in high school before being shot. And he picked up some new skills that would enhance his ability to help people in danger. He became an EMT and a firefighter. He spent six months training as a firefighter, which occupied every Tuesday and Thursday evening and every weekend. Then he started responding to alarms and putting out fires.

“I loved it,” he says. “It was exhilarating—it really is not like movies like Backdraft. It is so hot in those rooms that it is hard to describe. And when you walk out of there, there’s a feeling that is hard to describe. You feel like you have really done something. My parents were really worried at one point that I loved being a firefighter so much that I wasn’t going to go to medical school.”

* * *

He did go to medical school, but not close to home—at least, not literally. Sakran went to Ben-Gurion University in Israel, his parents’ home country. His parents had often talked about what an amazing place Israel was to live and go to school, and Ben-Gurion had a unique relationship with Columbia University. So the Medical School for International Health provided an ideal chance to get a medical education, get to know his extended family, learn a new language, and learn about life—all at the same time.

The experience was all he had hoped for. He learned medicine, came to know his relatives, and lived in a society at the nexus of Christianity, Judaism, and Islam. “Living in Jerusalem was just mind-blowing,” he says. “I think I really developed as a person there.”

He also learned how easily tolerance can give way to hate. He moved to Israel in the summer of 2000, and that fall, Ariel Sharon made his controversial visit to the Temple Mount—a provocative act that led to a period of Israeli-Palestinian violence known as the Second Intifada. As a student, he helped treat victims of suicide bombers in Jerusalem. “To hear some of the hatred that existed among both sides was hard,” Sakran says. “But it’s not the majority of what I heard. What you see on television is not representative of how people behave. For the most part, the Arabs and the Jews in Israel actually get along pretty well. You see that in a lot of different cities, like Jaffa and Haifa.

“Is there an analogy to tensions with the NRA?” he wonders. “I can’t help but think that on a whole lot of issues, not just firearms, a problem in this country is that we just don’t listen to each other. I guess I have had one useful lesson in life from my gunshot wound—I learned to deal with adversity. But another comes from living in the Middle East. I know we have to be willing to listen to each other in order to make progress on issues that affect our communities.”

* * *

When it came time to apply for residency, Sakran’s first choice was Inova Fairfax Hospital. Inova has a good general surgery training program, but not a famous one, and Sakran’s friends asked him why he didn’t rank other more traditional academic institutions, like Columbia, number one. Sakran had no ambivalence about the decision. He had been living overseas, and he wanted to come home for the next five years of his life, which could be difficult ones.

Inova was home. He had been born at Inova. He had nearly died at Inova. When he worked as an EMT during college, he had been based at Inova. He had rotated at Inova as a medical student. The two surgeons who played critical roles in treating him the night of his gunshot wound, Bob Ahmed and Dipankar Mukherjee, still worked there.

“I said to myself, what could be more inspiring than going back to Inova and training with the people who had saved my life?” he recalls.

“It was a tremendous experience. It was just wonderful to be physically close to my family” Sakran says. “Inova has a very comprehensive general surgical program that allowed me to develop my focus, and to develop the necessary skills to become a surgeon in the presence of the physicians and nurses who had saved my life. Sometimes, my hands would shake because I was so anxious to be the best I could be for them. I wanted to make them proud.”

After surgical residency he spent two years at the Trauma Center at Penn Presbyterian Medical Center, part of the Hospital of University of Pennsylvania, doing a fellowship in traumatology and surgical critical care. Aside from deepening his expertise with the cardiovascular, infectious, and metabolic issues that often determine whether a traumatized patient recovers or dies after surgery, he had his first experiences as a teacher—one who would use his own story to bring insight to others.

The Trauma Center at Penn brought in high school students from underserved areas in the surrounding community. The program faculty asked Sakran to talk to them about gun violence and take them through the trauma center. They were primarily 14- to 15-year-old African American youths. Sakran would walk them through the facilities, and as would be expected of teenagers, many of the students would be distracted, giving Sakran less than their full attention.

But when he sat them in a room and told them the story of his gunshot wound—what it took to save him, and his long, difficult recovery—“all of their eyeballs would be completely focused on me,” he says.

“I hadn’t expected that,” he says. “I said to myself, ‘My gosh, what just happened?’ And that’s when I realized the power of my story. Until then, I had really thought, ‘Who cares that I got shot?’”

Sakran always asked those students how many of them had been personally affected or knew someone who had been a victim of gun violence. Almost every hand would shoot up in answer. When Sakran told his story, he felt he was transitioning from just one more white guy in a white coat to someone who had insight into what they had been living with and fearing in their own communities.

His medical training and the work he did gave him credibility. But his history of being shot and surviving gave him relatability. He had gotten a glimpse of the power of telling one’s story.

It was at this point that Sakran began to wonder, “I if I’m to follow the tradition of my grandfather in Nazareth—the one who did all he could for his community—should I try to do good on a larger scale?” He knew he wanted to be a trauma surgeon. He loved the work. He had a bit of the meticulousness and artistry he saw in his father, the engineer, and he could express those traits in the operating room. And just as he had felt when he worked as a firefighter or an EMT, as a surgeon he felt like he had done something real on a regular basis.

He decided that the logical next step in his career was to stop being a trainee and start being a real grown-up surgeon. An opportunity came up at the Medical University of South Carolina, where Dr. Samir Fakhry, former chief of trauma surgery at Inova Fairfax Hospital, had taken a new role as division chief and recruited Sakran. When Sakran visited, he found Charleston beautiful and realized that it was just an hour flight away from his family. He took the job in 2012 and spent almost four years there.

It is clear in retrospect that well before Sakran arrived in Charleston, he had broader agendas on his mind. During medical school, he had taken a year off to get a masters of public health at Johns Hopkins, so he already had had some formal, big-picture education about health and healthcare. During medical school in Israel, he had helped take care of Bedouins in the desert and Black Hebrews from Dimona. After the Indian Ocean tsunami in 2004, he helped organize relief for the damaged city of Pondicherry, India, and in 2010 after the earthquake in Haiti, he also helped set up clinic services there. During his residency, he continued to work on developing healthcare interventions in low- and middle-income countries.

So it was no surprise that when he arrived in Charleston, he was made director of Global Disaster Preparedness for the Department of Surgery. And no surprise that after a few years, he sought permission to go to Harvard’s Kennedy School of Government to get a masters of public administration to learn how to effect change on a larger scale. He took a large cut in his salary to sit in classrooms again, learning how political leaders think and exert influence. He learned about the power of social media and started a Doctors for Hillary grassroots movement. He became active on Facebook and Twitter.

It was also no surprise that by the end of his Kennedy School fellowship, he was offered other opportunities. Sakran didn’t feel like he was an expert in public policy who had all the answers for what should happen. “What I realized was that I was a doctor, I really knew about issues that mattered to patients, and I was learning how to help patients by building relationships, bringing people together, and developing partnerships,” he says. “I never wanted to stop being a trauma surgeon. I love that rush of taking care of patients, the way I loved the rush of being a firefighter. But I can’t help but want to help patients on a larger scale, too. To me, it’s the same work.”

* * *

Sakran was recruited to be director of Emergency General Surgery and associate chief of the Division of Acute Care Surgery at Johns Hopkins Hospital. The job was attractive in so many ways, including being a short driving distance from his family. He has an elective general surgery practice, in which he performs routine general surgery (e.g., hernia, gallbladder, and colon surgery), often using robotic techniques. But he also takes care of trauma patients and cares for patients in the surgical critical care unit. Right before our first conversation, he had been in the operating room performing an emergency operation on a patient with a very low white blood count due to chemotherapy (“neutropenia”) who had developed a perforation of the large intestine.

November 7, 2018, had also been an operating-room day for Sakran—a long day of being on his feet and concentrating for hours in a row. When he read the NRA tweet, his passionate response was spontaneous, visceral. “It’s not like I took a long time to think about what I was going to say,” he says. “I just responded back as someone who was online and taking care of his patients.”

One of the details of the NRA tweet that bothered Sakran was the implication that physicians like himself had not tried to engage with the NRA in the past. He is, after all, an Arab-American who went to medical school in Israel and strongly believes that the world would be better if everyone would listen to the voices of those on the other side. Sakran notes that leadership from the American College of Surgeons had actually met with NRA leadership in January 2017, and expresses irritation that the NRA suggests that physician leadership has not attempted to find a reasonable middle ground.

In fact, just one week after the NRA tweet, a working group from the American College of Surgeons issued “middle ground” recommendations for gun-safety recommendations that included robust background checks, enhanced gun-safety training, mandatory reporting requirements for people considered being a threat to themselves or others, and use of innovative technologies to prevent accidental firing. The American College of Surgeons working group consisted of 22 authors, of whom 18 were gunowners.

But indignation over an inaccuracy in the NRA tweet was not what made Sakran’s Twitter response resonate with so many clinicians. It was the implication that medical personnel had no role in attempting to reduce gun violence

“The worse part of my job is having to speak to families of patients who have been critically injured,” he says. “We’re able to save a lot of people, but we’re not able to save everyone. Sometimes, when I go out to those waiting rooms, I look at those mothers and those fathers, and I realize that what I’m about to do is going to change their lives. I’m about to go out there and tell them that their loved one is never coming home again.

“That never gets easier,” he says. “I often look at those faces, and I wonder what my parents thought when that surgeon came out to talk to them.”

* * *

Starting #ThisIsOurLane was an effort by Sakran to give a strong voice to clinicians like himself and to help create a community for them. It was a blend of his experience as a clinician, what he learned at Harvard’s Kennedy School of Government, and the zillion hours of his youth playing around on social media.

“My goal was to provide a platform to unite healthcare professionals, to have one strong voice in this fight to end gun violence in America,” he says. “To my surprise, it exploded overnight. I think it showed that people were waiting to have this type of platform where they could express what they’re seeing day in and day out within healthcare.”

#ThisIsOurLane brought him a flurry of attention, invitations to speak, and even suggestions that he should consider running for public office. He sees public policy roles as natural outgrowths of being a clinician. “Being in the operating room and making one life-saving decision after another is incredibly gratifying,” he says. “But when you do that day after day, you realize that you have both the possibility and the responsibility to work beyond the trauma center, beyond the operating room. There are clinicians across the spectrum who are so moved by what is taking place and want to be part of the solution as well. Frankly, a lot of the times, the best thing we can do in healthcare is prevention, and that is especially true for those of us who treat critically injured patients.”

His personal story has made him an effective advocate for initiatives to reduce gun violence. But he says, “Being able to take care of patients is something that keeps me grounded and reminds me every day of what is important. Keeping patients in the center of the equation—that’s a good principle to live by.”

* * *

“Have I suffered burnout? Absolutely,” he says. “But I have always had a very strong supportive network that allows me to deal with those low moments, when you’re just completely exhausted physically and emotionally, and you don’t have anything else to give.

“When I get to those points, I realize, OK, it’s time to take a little bit of a break and spend a day or two doing nothing, or go on vacation. But I think I’m basically an optimistic person, and I always try to come to work with a cup-half-full perspective. I might be having the worst day personally, but I don’t bring that to my work environment.”

While not immune to burnout, Sakran thinks his near-death experience at 17 gives him a unique perspective.

“I was 17,” he says. “Most 17-year-olds have no idea what they want to do for the rest of their lives. Most 17-year-olds don’t realize that they are mortal. And most 17-year-olds don’t appreciate the people that they have in their lives.

“When I got shot, it really opened my eyes, and the whole experience made me realize that I had been given a second chance,” he continues. “To be able to provide other people with that same opportunity—that is what inspired my path into medicine. That moment when my father walked in as I was looking in the mirror feeling sorry for myself—when he told me I could feel sorry for myself or take the opportunity to try to make a difference for other people—that was a defining moment. It led me down this path, and inspired me to go into medicine, to become a trauma surgeon, and to work at the intersection of medicine, public health, and public policy.”

The fragment of the bullet that came to rest in his left shoulder still sits on his dresser. He says, “I keep it there as a reminder of how lucky I am to be here, and how much I don’t want to waste this second chance I have of life.”