“Trauma surgeons,” says Stephanie Bonne, “see everything.”

Yet amid the stabbings, falls, burns, and car wrecks, the gunshot wounds are  the worst, she says. The New Jersey Trauma Center at University Hospital in Newark—where Bonne has been since 2015—sees about 500 gunshot victims  a year, with most between the ages of 18 and 40. Bonne, an assistant professor of surgery at New Jersey Medical School, has treated her share, here and elsewhere. She lost count long ago. 

“Probably somewhere around 1,500,” she guesses, “from graze wounds to people shot 30 times and bleeding to death.” Much is “gang violence, street violence, and domestic violence.” Others are accidents—kids who fooled around with loaded guns that they found in the house.

“So many are so young,” says Bonne, “and it’s so preventable.”

Michael Ostermann, codirector Center on Gun Violence Research

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“Our job is to provide objective, unbiased scientific data, ultimately leading to intervention strategies, like programs and policy recommendations.”  

—Michael Ostermann, codirector
Center on Gun Violence Researc
h

Photography: 
Nick Romanenko

Now, there is New Jersey’s Center on Gun Violence Research, co-led by the School of Public Health and the School of Criminal Justice at Rutgers. The center, endorsed by New Jersey governor Phil Murphy and funded by the state legislature, is charged with finding ways to stop the carnage. It will draw on the expertise at Rutgers University–New Brunswick, Rutgers Biomedical and Health Sciences, Rutgers University–Newark, and Rutgers University–Camden in fields such as psychology, sociology, medicine, law, social work, public policy, and engineering. The center is only the second of its kind in the nation (California’s was first).

“Our job,” says Michael Ostermann, one of the center’s codirectors and an associate professor at the School of Criminal Justice, “is to provide objective, unbiased scientific data.” Collecting, comprehending, and coupling gun violence data is clearly a start, if not a solution. “I’m not suggesting that’s the be-all and end-all,” says Paul Boxer, the center’s director of research and a psychology professor at the School of Arts and Sciences–Newark, “but it’s a way to start identifying those things we can do better.”

The data that is available is grim and alarming. More than 100 people are killed with guns daily in the United States. Nearly 40,000 Americans died at the end of a gun in 2017, a record high. New Jersey had 69 shooting victims in March 2019 alone (nine died). “But there’s so much that we don’t know,” says Elizabeth Sloan-Power, the center’s director of training and education and an associate  professor of social work at the School of Arts and Sciences–Newark. Data, at the moment, is the missing link.

Bernadette Hohl, codirector  Center on Gun Violence Research

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“Gun owners are stakeholders in this process. We could get answers that might surprise some people. That’s why you do the science.”

— Bernadette Hohl, codirector  
Center on Gun Violence Research

Photography: 
Nick Romanenko

“There has not been a consistent and ongoing ability to collect data around gun violence,” says Bernadette Hohl, the center’s other codirector and an assistant professor of epidemiology at the School of Public Health. “There’s a lack of interest at the federal level on gun violence research. Sometimes it has even become obstructionary.”

Conversely, plenty of data exists on state and local levels—where gun crimes happen, how they happen, the kinds of guns used, who owns them. “There’s public health data, census data, housing data, criminal justice data,” says Michael Gusmano, the center’s director of outreach and an associate professor at the School of Public Health. “But the data was never designed to speak to each other.”

Fixing that, says Bonne, who is the center’s director of surveillance, is “extraordinarily challenging.” But it’s crucial because isolated data sets won’t help much. Making connections—between police and hospital records, for instance—becomes problematic. “You can’t say, ‘This person who committed suicide was someone also recently in the hospital for depression,’” says Hohl. “We have to piece it together from all of these different places. It’s difficult to come up with anything meaningful.”

Examples abound. Data that might explain criminal pathways—how some juvenile offenders evolve into adult criminals—isn’t yet available. There’s little on the demographics of victims—their age, race, and neighborhood. No one is even certain just how many people are injured by guns each year. “Deaths, we know,” says Hohl. “But we don’t know how many people are shot.”

Data assembly may sound dry; some might consider it dull. And the process takes months, sometimes years. But without it, the center can’t “even begin to say what’s evidence-based,” says Bonne. “How is data going to stop a kid from getting killed? When you have data—and when you understand who’s being shot and who’s at risk—you can develop programs to address the problem.”

 

Stephanie Bonne, director of surveillance  Center on Gun Violence Research

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“Having to talk to mothers after I became a parent myself—a mother going to tell another mother that her kid is dead—is the worst thing ever. I always think of how unnatural it is.” 

—Stephanie Bonne, director of surveillance  
Center on Gun Violence Research

Photography: 
Nick Romanenko

Mass shootings, for all their notoriety, account for less than 400 deaths each year nationwide, or 1 percent. “They redirect the attention,” says Hohl, “from the other issues we have.” Home invasions kill more than six times as many; about half of U.S. women killed by guns were murdered by a spouse, partner, or family member. Moreover, the availability of a gun during a domestic dispute increases the risk of homicide for U.S. women by 500 percent.

More than half of gun deaths are the result of suicides, about 60 a day or 22,000 every year. Over the last 10 years, suicides among children and teenagers by firearm nationwide are up 60 percent and 19 percent in the general population. And suicide rates are higher in states where gun ownership is higher. “But in the national conversation, we don’t hear much about suicide,” says Boxer. “Yeah, we want to prevent school shootings, but they’re rare. And suicide isn’t. Suicide is a much clearer and more present danger than school shootings.”

Disentangling all the data will ultimately lead to “intervention strategies,” says Ostermann SCJ’07, GSN’09, “like programs and policy recommendations.” Those proposals may not come down for a couple of years. Gun advocates may already be bristling; researchers are bracing for blowback. But looking at ways to decrease gun deaths, says  Hohl, does not necessarily translate into taking away guns:  “I don’t think we’re suggesting that. Gun owners are stakeholders in this process. We could get answers that might surprise some people. That’s why you do the science.”

—	Paul Boxer, director of research Center on Gun Violence Research

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“We may be funded by the current legislature and the current governor, but no one’s putting a specific agenda on us.”  

—Paul Boxer, director of research
Center on Gun Violence Research

Photography: 
Nick Romanenko

Some possible recommendations are obvious—and relatively noncontroversial. Promoting safe storage to gun owners, particularly those with children, might be one. And having an ongoing discussion among all those who have a stake in the crisis is another. “We’re not going to be censoring anyone,” says Gusmano. “And we’re going to be including groups that are very much pro-gun rights.”

Talking tours sponsored by the center will soon take place throughout New Jersey; results from two statewide surveys are due sometime this year. “I’m looking forward to the focus groups,” says Sloan-Power. “I want to listen to other viewpoints. Once we begin talking to one another, we can actively work on problem solving together.”

Boxer and Gusmano underscore the importance of addressing the issue of gun violence with no preconceptions, letting the data accumulated through research point the way. “We may be funded by the current legislature and the current governor,” acknowledges Boxer, “but no one’s putting a specific agenda on us.” Says Gusmano, “We’re not an advocacy group or a political party or an agency of government. We are an independent academic research institution.”

 

The blood of gunshot victims often covers the gloves and gowns of the physicians and nurses at the New Jersey Trauma Center. “Oh, yeah,” says Bonne. “I’ve had it all the way soaked through, where I had to take a shower.” One haunting case—“devastating,” she says—was a wound from an AR-15 semi-automatic rifle. “It hit the liver,” she says. “I’ve never seen such horrible damage to an organ. It was in pieces. I couldn’t make heads or tails of any of the anatomy.”

—	Elizabeth Sloan-Power, director of training and education   Center on Gun

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“I’m looking forward to the focus groups; I want to listen to other viewpoints. Once we begin talking to one another, we can work on problem solving together.”  

—  Elizabeth Sloan-Power, director of training and education   
Center on Gun Violence Research

Photography: 
Nick Romanenko

Yet in the operating room, it’s “all adrenalin,” she says. The hard part is later, should the victim not survive. “When it’s all over, you sit back and look at the patient’s face,” she says. “Then you have to go meet their family for the first time. And you’re about to give them the worst news they’re ever going to get in their lives.”

When that happens, Bonne has a routine. In a nearby waiting room, across from the sofa where the family is sitting, she goes to the blue chair. “The chair,” she says, “is where I tell parents their kids are dead. I used to give this very long, ‘we did this, then we did that, but unfortunately they didn’t make it.’ But, I’ve learned over time, they’re not going to hear anything you said about what you did. They just want to know if their loved one is alive or dead.”

When they find out, the reactions are “always different,” she says. They cry or curse; sometimes, there’s silence. Bonne, out of medical school 13 years and a trauma surgeon for six, says the meetings have become harder. “Having to talk to mothers after I became a parent myself—a mother going to tell another mother that her kid is dead—is the worst thing ever. I always think of how unnatural it is,” she says. “Parents aren’t supposed to bury their children.”

 

The leaders of New Jersey’s Center on Gun Violence Research unveiled their plans to the Rutgers community and the public during a well-attended symposium held on April 23 at the Douglass Student Center at Rutgers–New Brunswick.

Michael Gusmano, director of outreach Center on Gun Violence Research

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“There’s public health data, census data, housing data, criminal justice data. But the data was never designed to speak to each other.” 

— Michael Gusmano, director of outreach
Center on Gun Violence Research

Photography: 
Nick Romanenko

The daylong event—“Preventing Gun Violence in New Jersey: A Call to Action”—was prefaced by impassioned  remarks from longtime advocates for gun safety: Governor Murphy, U.S. representative Frank Pallone CLAW’78, and majority leader of the New Jersey General Assembly Louis Greenwald.

As the governor put it: “The fight against gun violence isn’t about violence, and, in many ways, it isn’t about guns. It’s about reaching for change in public policy. It’s about how we support victims of gun violence through recovery, and how we work together with community groups and law enforcement to create trust to prevent problems before they occur rather than after.” •