Finding core solutions for gun homicide crisis

Brian H. Williams would love to put himself out of a job so he never has to tell another mother their child has died due to gun violence.

Williams, a Black, Harvard-trained trauma surgeon, was the keynote speaker for the third edition of the “Beyond the Knife” endowed lecture series. The series was established by the Department of Surgery “to engage in difficult conversations surrounding racism and health care in the United States.”

More than 800 students, faculty and community members attended the Feb. 2 event, including about 400 people in person in the M&T Lecture Hall in the Jacobs School of Medicine and Biomedical Sciences. Severe weather conditions in Dallas prevented Williams from traveling to Buffalo, so he took part in the event via videoconference.

Williams, who currently is professor of trauma and acute care surgery at University of Chicago Medicine, opened his keynote address, “Racism, Gun Violence & How We Heal: Dispatches from a Black Trauma Surgeon,” by recalling a phone call he received from his mother informing him that his cousin had been shot and killed by her intimate partner in front of her three young children.

“I share that story because for me, gun violence — it is personal,” he said.

“I am a trauma surgeon; that is the life I chose,” he said, noting he still remembers encountering his first gunshot victim during his third year of medical school at the University of South Florida in Tampa. “I was watching the team go all out to save this patient. It looked like chaos, but it was organized chaos. I said, ‘that is what I want to do.’ I was attracted to the speed, the adrenaline, making quick decisions, trying to save patients that were at death’s door.

“But there has been one constant ever since that night that still troubles me,” Williams said. “From Tampa to Boston to Atlanta to Dallas to Chicago — it’s that most of my patients — gun violence victims —have been young Black males.”

Williams asserted that “gun homicide is a Black male problem.”

“When you pronounce that many deaths of people who look like me, and after you console families that look like mine — that changes you; it slowly eats away at you,” he said. “We must talk about the role systemic racism plays in certain communities.

“Here’s what we don’t really talk about. For many, many years, gun violence was the number one cause of death for Black children,” Williams said. “But it did not become front page news until a couple of years ago when a study showed it was the number one cause of death for all children. We cannot separate race and gun violence. There is always a racial element.”

Williams made note of the May 14, 2022, mass shooting at a Tops Market in Buffalo.

“I also think about communities that are traumatized by gun violence, like yours. And how one young man with a gun came in and transformed your community,” he said. “We are all impacted by that, and I want to acknowledge that you are not alone.”

Williams said he also needed to acknowledge his own failings in the past.

“I thought by being a doctor I was doing enough. But the reality I recognize now is that there was much more that could be done in the community upstream — things that could be done outside of the hospital to put myself out of a job.”

A tragedy in Dallas on July 7, 2016, made Williams realize there was more he could be doing.

During what was supposed to be a peaceful protest against Black men being killed by police officers, a Black U.S. Army veteran with an assault rifle shot 14 police officers, killing five. Seven of the injured officers were transported to Parkland Memorial Hospital, where Williams was in charge of the trauma team.

“It is still the most memorable night in my career, and I don’t mean memorable in a good way. It is something I think about every day, even to this day. It has permanently changed who I am and how I view the world,” Williams said.

Shortly afterward, a press conference was scheduled to discuss the mass casualty event. Williams was invited to attend, but initially declined, saying he wanted “zero triggers to remind me of that night.”

“But my wife told me ‘get over yourself, this is not about you, this is something bigger than you. The narrative right now is how Black men are evil or Black men are violent. There was a Black doctor there in charge, trying to save these police officers. They need to know that.’”

Williams decided to be present at the press conference so he could be seen, but did not intend to speak.

That changed when he became unhappy with the tenor of the press conference.

“I was debating in my head what to do. If I don’t say something, this moment will be lost, but if I do, I will probably most certainly be fired because that was not my role that day.”

“In the end, I decided to say something, and I tell you if you have these opportunities to do the right thing, it is liberating,” he said.

During an anguished interview with national media, Williams said: “I understand the anger and the frustration and the distrust of law enforcement, but they are not the problem. The problem is the lack of open discussions about the impact of race relations in this country. It weighs on my mind constantly. This killing has to stop. Black men dying and being forgotten. People retaliating against the people who are sworn to defend us. We have to come together and end all this.”

The impact of that day led Williams away from surgery for two years as he worked on police-community relations in Dallas and became a national leader on public health and racism.

He worked full time as medical director of a community health institute to address health care disparities within Dallas County, and the Dallas mayor appointed him chair of the Dallas Community Police Oversight Board.

“I started doing things outside the hospital that could have an impact,” Williams said. “It was necessary to communicate, converse and collaborate with those outside the hospital — those that are closest to the problem — to develop solutions.”

Williams noted that those situations were the epitome of “beyond the knife.” 

“My scalpel was totally useless in those situations,” he said.

Williams said the solution is to talk about the external, systemic issues rooted in structural racism — the social determinants of health, such as criminal justice, economic opportunity, health care access and affordability — that have existed for generations.

“Solve that and you will solve a lot of issues, not just gun violence,” he said.