Dr Selwyn Rogers Jr is a trauma surgeon at the University of Chicago. He sees, first-hand, the devastating impact of gun violence. He joined the board of Chicago CRED in 2023 and shared his story in a conversation with CRED Founder Arne Duncan and Senior Advisor Peter Cunningham. It has been lightly edited for length.
SR: I grew up in the Virgin Islands, specifically St. Croix. My journey took me to Cambridge where I graduated from Harvard and then to medical school because of my desire to marry my love for helping others and for science. I gravitated towards trauma surgery because I saw it as an equal opportunity problem; you can be young, you can be old, you can be white, Asian — but trauma is universal. What got me really intrigued about firearm related injuries was that that was not equal opportunity, at least in the city of Boston where I trained. Young men of color were disproportionally the victims of gun violence. In 1991, the year I trained, the Boston Globe had a story of the100 people killed in Boston by gun violence and all were black and brown, ages between 18 and 30. My journey, focusing on firearm-related injuries was largely started by that.
PC: As a trauma surgeon, talk a little bit about what you see coming into the hospital here in Chicago.
SR: Here in the City of Chicago, a great American city, unfortunately bullets find a way to peoples’ spinal cords, to their brains, to their chests to their abdomens and way too often it’s not one bullet but multiple bullets that ravage through peoples’ bodies and create damage to their blood vessels and to their bones. That’s the trauma that we see but we don’t see the long-standing impact on the patient’s social network, their own individual mental wellness, and sense of safety, sense of self but also the impact on the communities.
AD: Some of the decisions you had to make, how you go about setting up a trauma center that is not universally embraced here in Hyde Park, lots of folks that didn’t want it to come in and lots of resistance. Throwing two questions at you and you can take them in whatever order.
SR: Hurt people hurt people–so people who have been dramatically injured, hurt and or traumatized by discrimination, racism, structural violence are also apt to act out those hurts upon others. Chicago CRED takes the highest risk individuals and tries to wrap them around with services and opportunities to alter the trajectory of their lives. I’m informed by that because I truly believe in redemption and second chances.
As a trauma surgeon, I meet people on the worst days of their lives and, because of the therapeutic alliance, I learn a very different story. I learn about an 8-year-old who is lying in their bed and gets shot; I learn about a kid who hops off a bus and gets shot. I learned about a kid who has been shot who avoids ever walking outside during the day because they are fearful of being shot again. I hear about the non-physical harms of being a victim of gun violence where a rustle of leaves makes someone hyper vigilant for fear that someone is going to walk up on them and shoot them. I can’t imagine what that feels like given the fact that I walk around pretty much anywhere in the city feeling safe most of the time, but I can’t imagine if I was always surrounded by that fear.
So, I came to the University of Chicago 7 years ago because I didn’t frame it as building a trauma center Arne but framed it as a social justice problem. There’s a need for an adult trauma center that existed for almost 3 decades and the University of Chicago that I worked for chose to ignore that need, chose to devalue that need and made the arguments, some financial, some capacity, but none of them were based on social justice. So, for me, what brought me here was this idea that I was fixing a social justice wrong and hence, it was bigger than me.
I built a violence-based intervention program that I thought was pivotal to do two things; help the patients directly who were still in the hospital but help them in a way that made them more human to the staff, the nurses, the physical therapists, social workers who were taking care of them by having credible messengers to serve as translators.
The other thing that I am informed of, after twenty years of doing violence intervention work, is the power of community. There are so many community-based organizations doing great work but there are times when the challenge is connecting them to the people who need those services. So, informed by that, we also embedded a violence recovery program from the outside with the opening of the trauma center. As we matured at the trauma center providing high-quality, high-touch care, I’ve been able to step back a bit and be more in the primary prevention mode, secondary prevention mode which is informed by my public health training.
AD: Unfortunately, as you know, many of our guys end up at U of C, some of our staff has ended up there and I always ask what was the level of care, how were you treated and it is unbelievable to me that literally every single one say they were treated extraordinarily well by doctors, by nurses, by therapists and our guys, as you know, get treated so poorly everywhere. There is no doubt in my mind that some of the reduction in homicides and deaths from shootings are due to the fact that the trauma center exists.
SR: Depending on where you are shot, in terms of what is injured, minutes matter. So, if you are in hemorrhagic shock from a gunshot wound to a major blood vessel, every minute counts. We have opened for 5 ½ years going on 6 in May and we have treated over 22,000 trauma patients, 8000 of whom have been shot. It’s just a daunting number and as you know, if you go to a town hall of a hundred people in Englewood, half of them will say they personally know someone who has been shot. That is such an abnormal statistic that, to repeat it, you would have to go long and wide to places like Afghanistan or Kuwait during the war or maybe Ethiopia now.
AD: Selwyn, you invited me and some of our staff and participants to go and talk to his staff and if you can say why you did that.
SR: We do what we do because we love it — truly love taking chaos and making order out of it and that chaos comes in the form of broken bones, damaged brains, damaged colons and we use our technical skills, trainings and knowledge of anatomy, physiology and pathophysiology to repair people, at least repair them physically but we talk about vicarious trauma or secondary trauma and you can’t be surrounded by trauma and not feel it.
My worst day is having to go and tell a mother, a father, a brother or a sister or a friend that their loved one is dead. I don’t know how they are going to react, but I know I am going to have to absorb their grief. And the breadth of reactions has been silence to rage. I’ve had people say not true, wrong person. I’ve had people say just go back, try harder. And every time that experience happens it uncovers an old wound because I remember every one of these conversations because they are so profound, so individual and so personal from people I have never met, all people who I meet on the worst day of their life and it only gets worse because they succumb and I have to have the conversation with their family. I dread those days but I try to make it the best I can under the worst of circumstances. But if I never had to do that again, I’d be a happy man.
So, I reached out to Arne because I wanted them to see the other side, I wanted to see some people who actually make it out of the hospital, and have them share their experience on how, having been a victim, and/or perpetrator of gun violence, how that has transformed their lives and the faculty is still talking about ways to get broader engagement because I do think that it gives you a greater sense of purpose and meaning for the work we do beyond the technical proficiency that we have all amassed by this incredible assault on human beings.
PC: Do any of the victims ever come back and share stories of success with you of how they changed their life after being shot?
SR: At the Trauma Center? We get that a couple of different ways. Good and bad. People come back to the center, to the clinic and say…I will give you one concrete example of that. One guy was shot; he was with us in the hospital for almost 2 months, during that time he developed relationships with both our violence recovery teams and one particular trauma surgeon and then came back and said can I get a job at U of Chicago. I think he is now working at University of Chicago. Now that’s kind of a twisted story that getting you shot gets you employed but on a sadder note, there was a patient that I operated on who had a major abdominal bleed, lots of blood loss, touch and go, but survived, left the hospital and we were all applauding what a great save and isn’t that amazing, Selwyn is such a great surgeon, and that is just awesome and I am on call and there is a patient who arrested from a gunshot wound to the head and, as we are removing his clothing and he has staples and those staples are the ones I put in with my hands.
PC: In the last couple of minutes, talk about what makes you hopeful especially in relationship to Chicago CRED but more broadly INVC (Institute for Nonviolence Chicago) and the violence prevention network that has been built up here.
SR: I wouldn’t be doing this work as a trauma surgeon, as a public health advocate, violence interventionist, if I wasn’t pathologically optimistic; it’s a character flaw. On top of that, I am incredible encouraged, after having moments of sheer discouragement on why aren’t we not running out of bullets, why aren’t the things that we are trying collectively, big and small, mom and pop, NGO and Non-Violence Chicago and Chicago CRED and the READi program; why isn’t the collective of all those things, government, federal, why are all those things not having the impact that we all want it to have in a more accelerated way because we see they keep coming.
But we are hopeful because we have agency to make a difference. I’m hopeful, from the perch that I sit at and the tables I am invited at, that I see much more activities, interest, intentionality, and collaboration than I have ever seen before in Chicago.
I committed to this city and I sense that the business community, with scaling violence intervention work, the Civic Committee in general, philanthropy, the growth of INVC, Chicago CRED, the work that the READI program is doing, and lots of small mom and pop NGO’s that are trying to do work in the space too; I think the narrative is changing. It’s not about that bad people do bad things to bad people that deserve it but it’s about some broader issues that are long-standing that we need to think creatively about that, heretofore, we have not.
We need a different way of thinking to get to a different set of solutions that can have impact. So that brings me hope. We have the opportunity to do something different and the question that leaves me hopeful but also cautious is, can we scale, to the level that we need to and can we sustain before the next crisis/ distraction happens.
Photo Cred: U Chicago Medicine