Raya Elfadel Kheirbek is a professor of medicine at the University of Maryland School of Medicine and chief of the division of palliative medicine and geriatrics at the University of Maryland Medical Center.
Let me tell you about Jordan Monroe. When I first met the 24-year-old gunshot victim in the intensive care unit of the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center (UMMC) three months ago, he was heavily sedated and connected to several lifesaving devices, including a ventilator and artificial lung machine. A chest tube drained blood from his lungs and several lines carried intravenous medications to treat infections and stabilize his heart and blood pressure. His condition was grave, and we were preparing his family for the worst.
I visited Monroe frequently as the days flowed into nights, providing an extra layer of palliative support and helping to control his pain as he was weaned from life support and inched toward regaining full mental capacity. As I slowly, through his family and large network of friends, got to know the amazing person within the patient, I fought to control my anger over the senselessness of his ordeal, and my feeling of vulnerability as a mother of young adults.
A musician and budding video producer, Monroe had been driving to a friend’s house in suburban Largo, Md., with his fiancee and her 5-year-old son. As they stopped at a light, two men approached the car. One jumped into the back seat, pointing a gun at Monroe’s head and demanding everything the couple had. Monroe turned and attempted to fight. Gunshots sounded, and the gunman fled.
Monroe was unresponsive when admitted to UMMC with gunshot wounds to his neck and back. He had several vertebral body fractures with bony fragments displaced into the spinal canal, leaving him paralyzed from the neck down.
An ambitious young Black man, Monroe had been the first in his family to attend college, taking several semesters at Morgan State University. Pursuing an interest in photography, choreography and filmmaking, he had produced a Nike Spec ad featuring Miss Maryland, and his career was about to take off.
During his childhood in Baltimore, Monroe had watched his mother, Sabrina, fight hard to protect him and his brother from drugs and gun violence. Sabrina protested cuts in after-school physical education programs at the boys’ elementary school, not giving up until a social worker finally handed her a list of centers offering after-school and summer drop-in programs for Baltimore City students.
Sabrina understood the statistics working against her sons, which continue to get scarier: Gun deaths in Maryland have risen 53 percent since 2010, more than double the increase nationwide. In an average year, guns kill 724 Marylanders and wound 1,747. Black residents are 17 times more likely than White residents to die from gunshots.
Ultimately, Sabrina could not protect Monroe from random violence on a suburban street. She died last year, leaving her son heartbroken. Now, Monroe faces the devastating likelihood that he will never walk again or play catch with his fiancee’s son. Yet he and his family remain positive, sustained by prayers and trust in his treatment team.
We try to celebrate the small triumphs. Monroe has regained movement in his left arm, allowing him to operate a motorized wheelchair. He’s able to speak in a whisper and point on his iPad to communicate.
The future is uncertain, but Monroe’s experience casts a spotlight on the permanent toll that gun violence takes on the “fortunate” survivors and their families. A study published in the June issue of Annals of Internal Medicine found that those injured by gun violence spent nearly $2,500 more a month in medical bills during their first year of recovery than other patients. They also saw a 40 percent increase in pain diagnoses, a 51 percent rise in mental health conditions and an 85 percent increase in substance-use disorders compared to a control group. Family members, meanwhile, take on the burdens of caregiving, including job loss, anticipatory grief and financial hardships.
Preventing tragedies like Monroe’s remains crucial as we seek to curb the violence plaguing our cities and towns. Instituting gun safety policies with areas of genuine agreement between gun owners and non-owners will be an important first step. Just as importantly, we must work toward a comprehensive system of caring that addresses all dimensions of suffering and responds to the survivors’ complex physical, psychological, spiritual and financial needs.
For now, Monroe’s friend set up a GoFundMe page to help cover his lifelong medical expenses.
“I have to come to grips with the fact that I might never know why this happened to me, but I am going to keep on living the best I can,” Jordan wrote to me on his iPad recently. Then he raised his left hand to show me a name tattooed on his inner wrist: “Sabrina.” His face lit up, and he whispered, “She is always watching over me.”