1 00:00:15,356 --> 00:00:24,916 Speaker 1: Pushkin Midnight, June fifth, nineteen sixty eight. Robert F. Kennedy 2 00:00:25,196 --> 00:00:28,676 Speaker 1: is running for the Democratic presidential nomination. He's just been 3 00:00:28,676 --> 00:00:31,836 Speaker 1: declared the winner of the California primary. He's now the 4 00:00:31,836 --> 00:00:35,116 Speaker 1: front runner. The White House is in his sights. 5 00:00:35,796 --> 00:00:41,996 Speaker 2: I want to express my gratitude to my dog, Freckles, 6 00:00:41,996 --> 00:00:45,676 Speaker 2: who has been the line. I don't care what they 7 00:00:45,676 --> 00:00:47,756 Speaker 2: say about me, but when they start to attack my dog. 8 00:00:50,236 --> 00:00:52,756 Speaker 2: And I'm not doing this in the order of importance, 9 00:00:52,756 --> 00:00:54,836 Speaker 2: but I also want to thank my wife, Beth full. 10 00:01:11,316 --> 00:01:15,116 Speaker 3: And her patience during this whole effort is. 11 00:01:16,796 --> 00:01:21,836 Speaker 2: Fantastic. Thank you very much. The Freckles has. 12 00:01:21,796 --> 00:01:22,556 Speaker 3: Gone home to bed. 13 00:01:23,596 --> 00:01:25,676 Speaker 2: He thought very early that we were going to win, 14 00:01:25,796 --> 00:01:26,596 Speaker 2: so he retired. 15 00:01:27,916 --> 00:01:30,676 Speaker 1: You can hear the supporters packing the room despite the 16 00:01:30,796 --> 00:01:32,476 Speaker 1: hour and the sweltering heat. 17 00:01:34,036 --> 00:01:37,156 Speaker 2: Hey, hey, hey, I want. 18 00:01:36,996 --> 00:01:37,916 Speaker 4: To hear really loud. 19 00:01:38,116 --> 00:01:40,556 Speaker 2: Boom's gonna be the next president of United States. 20 00:01:48,676 --> 00:01:49,796 Speaker 3: Hey, here's a bad lessen. 21 00:01:54,116 --> 00:01:57,236 Speaker 1: He leaves the stage out to the kitchen, pauses to 22 00:01:57,236 --> 00:02:00,236 Speaker 1: shake the hand of a bus boy, and out of nowhere, 23 00:02:00,396 --> 00:02:03,636 Speaker 1: a young man emerges holding a twenty two caliber revolver 24 00:02:04,116 --> 00:02:09,596 Speaker 1: eight shots. Boom boom, boom, boom, boom boom, boom boom. 25 00:02:09,596 --> 00:02:12,796 Speaker 1: It's chaos. You can hear it, can't you. There's a 26 00:02:12,836 --> 00:02:16,236 Speaker 1: photograph of this moment. Kennedy sprawled on the ground, the 27 00:02:16,316 --> 00:02:19,396 Speaker 1: bus boy crouched by his side, his face turned to 28 00:02:19,436 --> 00:02:23,476 Speaker 1: the camera, picture of anguish. 29 00:02:23,916 --> 00:02:26,276 Speaker 2: I don't know, I can't what happened to you know, 30 00:02:26,596 --> 00:02:27,236 Speaker 2: nobody might. 31 00:02:27,196 --> 00:02:29,916 Speaker 1: Have been shown. 32 00:02:30,596 --> 00:02:41,916 Speaker 2: I'm not Jimmy plugged in. Jimmy plugged in. Please day back, 33 00:02:42,036 --> 00:02:44,716 Speaker 2: everybody else, just please day back. Just a doctor come 34 00:02:44,796 --> 00:02:45,236 Speaker 2: right here. 35 00:02:45,676 --> 00:02:48,196 Speaker 5: Let's roll some videotape on this sat here for him. 36 00:02:48,236 --> 00:02:56,196 Speaker 2: Some reason, would a doctor come right here? A doctor here, 37 00:02:56,356 --> 00:02:57,156 Speaker 2: doctor right here. 38 00:02:57,316 --> 00:03:02,196 Speaker 1: I'm not calling pay the video. My name is Malcolm Gobwell. 39 00:03:02,316 --> 00:03:06,156 Speaker 1: You're listening to Revisionist History, my podcast about things overlooked 40 00:03:06,316 --> 00:03:11,196 Speaker 1: and misunderstood. This episode is part four of our investigation 41 00:03:11,476 --> 00:03:14,836 Speaker 1: of the messed up way Americans talk about guns. The 42 00:03:14,876 --> 00:03:17,836 Speaker 1: Supreme Court just issued one of the most important gun 43 00:03:17,916 --> 00:03:21,316 Speaker 1: rights cases in its history, and devoted pages to the 44 00:03:21,316 --> 00:03:26,396 Speaker 1: fourteenth century, the seventeenth century, the eighteenth century, the nineteenth century, 45 00:03:26,596 --> 00:03:30,916 Speaker 1: the Civil War, reconstruction, the Constitutional Convention, and an obscure 46 00:03:31,156 --> 00:03:36,236 Speaker 1: disputatious merchant from Bristol, But nothing about the present day, 47 00:03:36,836 --> 00:03:39,476 Speaker 1: as if the crisis of gun violence on our streets 48 00:03:39,556 --> 00:03:43,236 Speaker 1: is beside the point. We get our ideas about guns 49 00:03:43,316 --> 00:03:47,116 Speaker 1: from a television western written by screenwriters from Hollywood whose 50 00:03:47,236 --> 00:03:50,916 Speaker 1: understanding of the American frontier is one hundred percent backwards. 51 00:03:51,636 --> 00:03:55,956 Speaker 1: It's all a little weird, and in this episode, I 52 00:03:56,036 --> 00:03:59,916 Speaker 1: want to offer an explanation for how things got so weird. 53 00:04:00,556 --> 00:04:03,716 Speaker 1: One I think gets missed, that is, except by the 54 00:04:03,716 --> 00:04:11,356 Speaker 1: people who treat gunshots for a living. Oh I see, okay, okay, 55 00:04:11,636 --> 00:04:15,596 Speaker 1: So let's walk through what happens. Sir He Sir hen 56 00:04:16,556 --> 00:04:21,956 Speaker 1: Is comes up to Kennedy backstage at the Ambassador Hotel 57 00:04:22,676 --> 00:04:26,596 Speaker 1: and fires eight shots from a twenty two caliber revolver, 58 00:04:27,156 --> 00:04:33,476 Speaker 1: three of which hit Senator Kennedy, right, that's our understanding, Yes, 59 00:04:33,756 --> 00:04:38,876 Speaker 1: Jordan commisero trauma surgeon at Duke University. Where so where 60 00:04:38,916 --> 00:04:39,916 Speaker 1: do those bullets go? 61 00:04:40,836 --> 00:04:45,636 Speaker 6: So the bullet that that struck him in the head 62 00:04:46,036 --> 00:04:51,436 Speaker 6: hit right behind his right ear sort of if you 63 00:04:51,516 --> 00:04:54,316 Speaker 6: feel everyone has like a little bit of a bony prominence, 64 00:04:54,796 --> 00:04:59,836 Speaker 6: so roughly around there, and the other two struck him 65 00:05:00,076 --> 00:05:04,276 Speaker 6: in the axilla, and they think the chest. Although it 66 00:05:05,316 --> 00:05:08,636 Speaker 6: would seem that from the accounts of the thoracic surgeons 67 00:05:08,636 --> 00:05:14,996 Speaker 6: as they really laid them, those were of minimal consequence. 68 00:05:15,356 --> 00:05:19,556 Speaker 1: Yeah, it's really the headshot that we're concerned with. Yes, 69 00:05:20,036 --> 00:05:25,596 Speaker 1: and have you in your experience? Have you ever We'll 70 00:05:25,596 --> 00:05:27,556 Speaker 1: come back to this, but I'm just curious whether you 71 00:05:27,636 --> 00:05:30,436 Speaker 1: ever treated an analogous gunshot wound. 72 00:05:30,276 --> 00:05:30,676 Speaker 2: To the head. 73 00:05:30,996 --> 00:05:34,676 Speaker 1: Yes, you have. Yes, When a bullet strikes you behind 74 00:05:34,716 --> 00:05:36,356 Speaker 1: the ear, what happens. 75 00:05:38,956 --> 00:05:41,756 Speaker 6: Largely these are mostly fatal injuries. 76 00:05:42,876 --> 00:05:46,836 Speaker 1: By the next morning, Kennedy was dead. I want you 77 00:05:46,916 --> 00:05:50,876 Speaker 1: to imagine what would happen if Kennedy were shot today. 78 00:05:52,756 --> 00:05:55,116 Speaker 1: One of the iron laws of medicine is that the 79 00:05:55,156 --> 00:05:57,436 Speaker 1: more you treat a condition, the better you get it 80 00:05:57,556 --> 00:06:01,996 Speaker 1: curing it. Practice makes perfect, You develop your skills, you 81 00:06:02,076 --> 00:06:05,956 Speaker 1: start to anticipate anomalies and variations. You're more motivated to 82 00:06:05,956 --> 00:06:10,836 Speaker 1: try new ideas, introduce new techniques, develop new technologies. And 83 00:06:10,876 --> 00:06:13,676 Speaker 1: nowhere is that iron law more in evidence in the 84 00:06:13,756 --> 00:06:16,636 Speaker 1: United States than when it comes to the treatment of 85 00:06:16,716 --> 00:06:20,516 Speaker 1: gunshot wounds. If you're an American trauma surgeon, you get 86 00:06:20,556 --> 00:06:26,436 Speaker 1: a lot of practice. World War One, World War Two, Korea, Vietnam, Iraq, 87 00:06:26,476 --> 00:06:31,036 Speaker 1: on Iraq to Afghanistan. Every generation of trauma surgeon got 88 00:06:31,036 --> 00:06:33,916 Speaker 1: a war of their own, the best kind of crash course. 89 00:06:34,676 --> 00:06:37,116 Speaker 1: Then they come home to the other war, the one 90 00:06:37,156 --> 00:06:42,356 Speaker 1: in the streets. This is an area of genuine American expertise. 91 00:06:44,356 --> 00:06:46,996 Speaker 1: I was curious about this, so I went to see 92 00:06:47,036 --> 00:06:49,476 Speaker 1: a man named Edward Cornwell. Third. 93 00:06:50,316 --> 00:06:55,996 Speaker 7: I got to Hopkins in nineteen ninety eight as the 94 00:06:56,076 --> 00:07:01,476 Speaker 7: chief of Trauma, and my experience had been nine years 95 00:07:01,476 --> 00:07:04,716 Speaker 7: at La County Hospital, which was among the busiest trauma 96 00:07:04,756 --> 00:07:07,676 Speaker 7: centers in the country, five as a surgical. 97 00:07:07,316 --> 00:07:11,156 Speaker 1: Resident around and everyone told me that if you ever 98 00:07:11,196 --> 00:07:13,956 Speaker 1: got shot, Eddie Cornwall was your best hope for coming 99 00:07:13,956 --> 00:07:17,436 Speaker 1: out in one piece. Mid sixties fit a little hint 100 00:07:17,436 --> 00:07:20,396 Speaker 1: of Patrician about him. He grew up in Washington, d c. 101 00:07:21,036 --> 00:07:23,516 Speaker 1: Trained at USC Medical School, and worked there in the 102 00:07:23,596 --> 00:07:27,036 Speaker 1: nineties South Central in the middle of the crack epidemic. 103 00:07:27,396 --> 00:07:30,276 Speaker 1: He opened the trauma center at Johns Hopkins University in 104 00:07:30,356 --> 00:07:34,436 Speaker 1: nineteen ninety eight. Other American cities had seen a decline 105 00:07:34,476 --> 00:07:37,356 Speaker 1: in a murder rate by that point, but not Baltimore. 106 00:07:37,556 --> 00:07:40,116 Speaker 7: We have a protected conference that takes place every Department 107 00:07:40,116 --> 00:07:43,956 Speaker 7: of surgery does so called morbidity immortality conference. We talked 108 00:07:43,956 --> 00:07:46,116 Speaker 7: about every patient that died or had a complication in 109 00:07:46,156 --> 00:07:50,876 Speaker 7: the prior week, and I showed that a table where 110 00:07:50,876 --> 00:07:54,116 Speaker 7: we have five consecutive days on our trauma service, where 111 00:07:54,196 --> 00:07:57,356 Speaker 7: every single day a twenty year old died gunshot to 112 00:07:57,396 --> 00:08:00,316 Speaker 7: the chess dead on arrival, gunshot to the chess, dead 113 00:08:00,356 --> 00:08:03,716 Speaker 7: on arrival, stab wounto the chess erthor ecademy. You need 114 00:08:03,756 --> 00:08:05,796 Speaker 7: to have time to go to the operating rooms, literally 115 00:08:05,836 --> 00:08:09,316 Speaker 7: opened their chests in the emergency department, declared dead. Five 116 00:08:09,316 --> 00:08:12,916 Speaker 7: different surgeons, including myself. One day, a whole basketball team 117 00:08:12,916 --> 00:08:16,276 Speaker 7: of twenty year olds essentially dead in the emergency department, 118 00:08:16,836 --> 00:08:21,116 Speaker 7: prompting us to identify that we had this dramatic increase 119 00:08:21,236 --> 00:08:24,436 Speaker 7: in the brazen nature of gunshot wounds more to the 120 00:08:24,476 --> 00:08:26,116 Speaker 7: head or the chest or both. 121 00:08:27,076 --> 00:08:30,156 Speaker 1: Then Cornwall came home to DC, once known as the 122 00:08:30,276 --> 00:08:33,236 Speaker 1: murder capital of the United States, to head the trauma 123 00:08:33,276 --> 00:08:34,436 Speaker 1: center at Howard. 124 00:08:35,556 --> 00:08:39,516 Speaker 7: It's interesting I did my residency at La County Hospital, 125 00:08:39,676 --> 00:08:43,076 Speaker 7: this huge eighteen story structure. I had a fifteen floor 126 00:08:43,116 --> 00:08:47,156 Speaker 7: elevator ride from the er to the operating room in 127 00:08:47,276 --> 00:08:50,916 Speaker 7: La County, and I was glad for it sometimes because 128 00:08:50,916 --> 00:08:53,236 Speaker 7: I'm think should I go on the right chest, should 129 00:08:53,276 --> 00:08:54,356 Speaker 7: I go on the left chest? Should I go on 130 00:08:54,396 --> 00:08:56,716 Speaker 7: his abdomen? Then I get the Hopkins I had a 131 00:08:56,756 --> 00:09:00,196 Speaker 7: seven floor elevator ride, shorter timeframe. I'm here, I have 132 00:09:00,236 --> 00:09:02,476 Speaker 7: two floor elevator rights. So the more expert I was, 133 00:09:02,716 --> 00:09:04,996 Speaker 7: the shorter the elevator ride. I was glad I had 134 00:09:04,996 --> 00:09:06,556 Speaker 7: a fifteen floor elevator R. But by the time I 135 00:09:06,596 --> 00:09:09,116 Speaker 7: get to Hopkins, I'd seen it all, so I didn't 136 00:09:09,116 --> 00:09:11,516 Speaker 7: he need a fifteen seven floors is fine. I had 137 00:09:11,556 --> 00:09:12,436 Speaker 7: two floors. 138 00:09:12,076 --> 00:09:18,676 Speaker 1: Here South Central East Baltimore, Central Washington. I mean I 139 00:09:18,716 --> 00:09:20,836 Speaker 1: spent a morning with him at the hospital with a 140 00:09:20,876 --> 00:09:24,036 Speaker 1: colleague of his, a next Army surgeon named Mallory Williams. 141 00:09:24,636 --> 00:09:27,756 Speaker 1: It was a Tuesday. He'd worked the weekend and operated 142 00:09:27,796 --> 00:09:30,396 Speaker 1: on two kids, nineteen and twenty who'd been in a 143 00:09:30,436 --> 00:09:31,036 Speaker 1: gun battle. 144 00:09:31,756 --> 00:09:33,516 Speaker 7: I take the nineteen year old to the operating room. 145 00:09:33,516 --> 00:09:36,956 Speaker 7: He's clearly tender, he clearly has evidence of contamination. To 146 00:09:37,036 --> 00:09:38,716 Speaker 7: go to the operating room, spend three and a half 147 00:09:38,796 --> 00:09:40,956 Speaker 7: hours doing the things that I mentioned, the liver, the stomach, 148 00:09:41,036 --> 00:09:43,956 Speaker 7: small and testain coal in the record, but let's still 149 00:09:43,996 --> 00:09:46,076 Speaker 7: lease that out well, let me just say one last 150 00:09:46,076 --> 00:09:49,676 Speaker 7: thing about him, because it's like wild wild West. In retrospect, 151 00:09:49,676 --> 00:09:53,556 Speaker 7: it becomes obvious to me that one bullet enters here 152 00:09:53,836 --> 00:09:56,836 Speaker 7: and goes through his stomach his liver is large intestine, 153 00:09:56,876 --> 00:10:00,436 Speaker 7: and goes out here. Another bullet enters in his upper 154 00:10:01,356 --> 00:10:04,876 Speaker 7: gluteus buttocks and goes across the ouven and hits some 155 00:10:04,956 --> 00:10:08,276 Speaker 7: small intestinal injuries, bounce off the pelvic That bullet is 156 00:10:08,356 --> 00:10:10,716 Speaker 7: deformed and lodge's abdominal wall. 157 00:10:11,316 --> 00:10:14,156 Speaker 1: But while he's treating the nineteen year old, he's worrying 158 00:10:14,196 --> 00:10:16,596 Speaker 1: about the twenty year old because there must be something 159 00:10:16,636 --> 00:10:19,156 Speaker 1: going on between the two of them, right, And now 160 00:10:19,156 --> 00:10:21,196 Speaker 1: the two of them are in the same hospital. 161 00:10:22,076 --> 00:10:24,156 Speaker 7: I made sure that the other kid doesn't go to 162 00:10:24,156 --> 00:10:26,556 Speaker 7: the IC where which typically put these patients, because I 163 00:10:26,556 --> 00:10:28,276 Speaker 7: don't want the two families down there. 164 00:10:28,436 --> 00:10:30,996 Speaker 6: You know, I see you. 165 00:10:30,076 --> 00:10:30,236 Speaker 3: You know. 166 00:10:30,316 --> 00:10:33,076 Speaker 7: So we have them remote locations in the hospital from 167 00:10:33,116 --> 00:10:33,516 Speaker 7: each other. 168 00:10:34,276 --> 00:10:36,916 Speaker 1: Do that for forty years and learn from all the 169 00:10:36,956 --> 00:10:39,356 Speaker 1: other trauma surgeons around the country who are doing the 170 00:10:39,396 --> 00:10:44,156 Speaker 1: same thing, and you get good. Yeah, what's what flaw 171 00:10:44,156 --> 00:10:49,036 Speaker 1: a medical standpoint? What would you looking forward? What is 172 00:10:49,076 --> 00:10:53,116 Speaker 1: the hypothetically if I gave you if I was a 173 00:10:53,436 --> 00:10:56,756 Speaker 1: if I gave you a wish, I said you could, 174 00:10:57,196 --> 00:11:00,476 Speaker 1: you could, you could solve one problem in your field 175 00:11:00,636 --> 00:11:01,356 Speaker 1: that would. 176 00:11:01,916 --> 00:11:03,716 Speaker 7: Well reduce gun gun deaths. 177 00:11:03,796 --> 00:11:07,036 Speaker 1: No, no, I mean what's in your Yeah, they would 178 00:11:07,036 --> 00:11:11,476 Speaker 1: reduce gundest So what medically speaking, what is one one 179 00:11:11,796 --> 00:11:15,516 Speaker 1: medical trick that you could I could give you that 180 00:11:15,556 --> 00:11:17,516 Speaker 1: would have the biggest impact on how many people die 181 00:11:17,556 --> 00:11:18,276 Speaker 1: from a gun shoggler? 182 00:11:18,636 --> 00:11:22,596 Speaker 7: My trick wouldn't be medical. Yeah, it's not medical for me. 183 00:11:22,876 --> 00:11:25,716 Speaker 7: It would be two parents in every home. That almost 184 00:11:25,756 --> 00:11:28,716 Speaker 7: sounds today to say that today it sounds you might. 185 00:11:30,996 --> 00:11:36,556 Speaker 1: Say that you think we have progressed as far as 186 00:11:38,116 --> 00:11:40,796 Speaker 1: you think we're We've done most. We've got most of 187 00:11:40,796 --> 00:11:43,156 Speaker 1: the low hanging flute in terms of how to save 188 00:11:43,236 --> 00:11:44,196 Speaker 1: somebody once they arrive. 189 00:11:44,516 --> 00:11:46,876 Speaker 7: Yeah, I got some slize of share there, but I 190 00:11:48,196 --> 00:11:51,156 Speaker 7: don't think we have another peak in my lifetime. So 191 00:11:51,276 --> 00:11:53,636 Speaker 7: once you get to ninety five percent, there aren't any 192 00:11:54,316 --> 00:11:56,956 Speaker 7: The fruit is high up on the tree, right. 193 00:11:59,316 --> 00:12:02,276 Speaker 1: That's how good trauma surgeons are now. They're looking for 194 00:12:02,356 --> 00:12:07,436 Speaker 1: solutions outside the hospital. Now, think about the implications of 195 00:12:07,476 --> 00:12:10,636 Speaker 1: that in a place like Washington, DC. In the last 196 00:12:10,636 --> 00:12:13,716 Speaker 1: thirty years, the number of homicides in Washington in a 197 00:12:13,756 --> 00:12:17,196 Speaker 1: typical year has been cut in half. People look at 198 00:12:17,196 --> 00:12:20,356 Speaker 1: that statistic and say, oh, the city's gotten a lot safer, 199 00:12:20,996 --> 00:12:24,396 Speaker 1: But isn't some part of that decline simply that Eddie 200 00:12:24,436 --> 00:12:27,676 Speaker 1: Cornwall and Malory Williams and all the other trauma surgeons 201 00:12:27,676 --> 00:12:31,236 Speaker 1: of Washington, DC are now saving lives that were once lost. 202 00:12:32,396 --> 00:12:35,196 Speaker 1: A city's murder rate is not a measure of the 203 00:12:35,276 --> 00:12:39,876 Speaker 1: number of people victimized by potentially lethal violence. No, it's 204 00:12:39,916 --> 00:12:43,316 Speaker 1: a measure of the number of people victimized by potentially 205 00:12:43,476 --> 00:12:47,676 Speaker 1: lethal violence minus how good a job doctors do at 206 00:12:47,756 --> 00:12:50,636 Speaker 1: saving that person's life once they get to the hospital. 207 00:12:51,596 --> 00:12:54,076 Speaker 1: So how important is the second half of that equation? 208 00:12:54,756 --> 00:12:58,396 Speaker 1: Do people like Eddie Cornwall move the needle on homicide 209 00:12:58,436 --> 00:13:02,836 Speaker 1: rates a lot or just a little? Which is why 210 00:13:02,876 --> 00:13:06,316 Speaker 1: when I got back from DC, I called up Jordan Commissera, 211 00:13:06,676 --> 00:13:10,316 Speaker 1: trauma surgeon at Duke University, to talk about the assassination 212 00:13:10,356 --> 00:13:14,236 Speaker 1: of Robert Kennedy, because it seemed like looking at Kennedy's 213 00:13:14,276 --> 00:13:17,116 Speaker 1: injuries through the lens of the present day would be 214 00:13:17,156 --> 00:13:29,996 Speaker 1: a good way to try and answer this question. There 215 00:13:30,076 --> 00:13:34,396 Speaker 1: is a long tradition among trauma surgeons of speculating about 216 00:13:34,436 --> 00:13:37,396 Speaker 1: which famous shooting of a political figure would have turned 217 00:13:37,396 --> 00:13:41,716 Speaker 1: out differently given today's medical nohow. If you flip through 218 00:13:41,756 --> 00:13:45,316 Speaker 1: trauma surgery journals, you can find all kinds of examples. 219 00:13:45,836 --> 00:13:48,116 Speaker 1: By the way, you can't play this game if you're 220 00:13:48,156 --> 00:13:51,476 Speaker 1: a trauma surgeon in Canada because they've never had any 221 00:13:51,516 --> 00:13:55,756 Speaker 1: of their leaders assassinated, or England because they've had just one. 222 00:13:55,916 --> 00:13:59,036 Speaker 1: France had one president's stab to death in eighteen ninety four, 223 00:13:59,516 --> 00:14:02,716 Speaker 1: and in nineteen thirty two, President Paul Dumaer was gonned 224 00:14:02,716 --> 00:14:06,756 Speaker 1: down by a Russian anarchist. Germany not really no one 225 00:14:06,836 --> 00:14:08,876 Speaker 1: major unless you want to count the killing of the 226 00:14:08,916 --> 00:14:11,716 Speaker 1: Form Minister in nineteen twenty two. But in the United 227 00:14:11,756 --> 00:14:16,236 Speaker 1: States you can play this game for days. You've got 228 00:14:16,276 --> 00:14:19,596 Speaker 1: Abraham Lincoln in eighteen sixty five, shot to the head 229 00:14:19,796 --> 00:14:22,716 Speaker 1: from a forty four derringer pistol. Does he live today? 230 00:14:23,396 --> 00:14:25,836 Speaker 1: A couple of years ago, a group of neurosurgeons at 231 00:14:25,836 --> 00:14:29,436 Speaker 1: Brigham and Women's Hospital in Boston re examined his autopsy 232 00:14:29,476 --> 00:14:33,276 Speaker 1: records and concluded, probably not. It was the worst kind 233 00:14:33,316 --> 00:14:36,756 Speaker 1: of head injury. What about James Garfield twentieth President of 234 00:14:36,796 --> 00:14:40,196 Speaker 1: the United States, shot twice. The second bullet hit him 235 00:14:40,196 --> 00:14:43,156 Speaker 1: in the back, missing the spinal cord and embedding itself 236 00:14:43,196 --> 00:14:46,356 Speaker 1: behind his pancreas. He's rushed to the hospital. It's a 237 00:14:46,356 --> 00:14:49,396 Speaker 1: minor injury, but they get obsessed with taking out the 238 00:14:49,436 --> 00:14:53,076 Speaker 1: bullet and that contaminates the wound. He's shot in June. 239 00:14:53,356 --> 00:14:56,876 Speaker 1: He dies in September because of a sepsis infection. He 240 00:14:56,956 --> 00:15:02,116 Speaker 1: survives today easy. William mc kinley is next September sixth, 241 00:15:02,236 --> 00:15:06,436 Speaker 1: nineteen oh one, shot twice in the abdomen. He lives today. 242 00:15:07,236 --> 00:15:14,636 Speaker 1: JFK no. He's dead on arrival at the hospital, but go. 243 00:15:14,676 --> 00:15:17,796 Speaker 7: To nineteen eighty. Ronald Reagan a sixty nine year old 244 00:15:17,836 --> 00:15:21,636 Speaker 7: man with a gunshot wound to the left chest. He 245 00:15:21,676 --> 00:15:24,916 Speaker 7: doesn't survive. In nineteen hundred, he doesn't survive in nineteen twenty. 246 00:15:25,876 --> 00:15:29,556 Speaker 7: He might have survived in nineteen forty whose blood transfusion 247 00:15:29,556 --> 00:15:33,476 Speaker 7: he needed blood. I am nineteen sixty, but certainly a 248 00:15:33,516 --> 00:15:36,076 Speaker 7: sixty nine year old gunshot womb. The chess were the 249 00:15:36,076 --> 00:15:39,236 Speaker 7: first one hundred plus years of our history would largely 250 00:15:39,316 --> 00:15:40,596 Speaker 7: be largely be fatal. 251 00:15:42,316 --> 00:15:45,516 Speaker 1: If Ronald Reagan had died of his wounds. The way Lincoln, 252 00:15:45,716 --> 00:15:49,396 Speaker 1: McKinley and Garfield did, the world would have been very different. 253 00:15:50,076 --> 00:15:53,316 Speaker 1: He shot in March nineteen eighty one. He's just two 254 00:15:53,316 --> 00:15:57,156 Speaker 1: months into one of the most consequential presidencies in American history. 255 00:15:57,796 --> 00:16:00,876 Speaker 1: Does the Berlin Wall fall in nineteen eighty nine without 256 00:16:00,916 --> 00:16:05,876 Speaker 1: Reagan in office? Maybe, but maybe not. History is shaped 257 00:16:06,036 --> 00:16:09,556 Speaker 1: not just by assassin's bullets, but also by the ability 258 00:16:09,556 --> 00:16:13,156 Speaker 1: of doctors to treat the damage done by assassin's bullets. 259 00:16:13,876 --> 00:16:16,996 Speaker 1: It's the Robert Kennedy case though, that caught my eye. 260 00:16:18,276 --> 00:16:21,196 Speaker 1: I wanted just to start, how did you come to 261 00:16:21,236 --> 00:16:25,596 Speaker 1: be interested in revisiting the assassination of Robert Kennedy? 262 00:16:25,796 --> 00:16:27,796 Speaker 6: So I was walking through the hallway one day came 263 00:16:27,836 --> 00:16:30,876 Speaker 6: across Ted Pappis, who's one of our general surgeons, and 264 00:16:30,956 --> 00:16:38,156 Speaker 6: he had done a series of historical works, and he said, 265 00:16:38,596 --> 00:16:41,116 Speaker 6: you know, have you ever heard about Robert Kennedy? And 266 00:16:41,196 --> 00:16:43,716 Speaker 6: which seems like kind of an odd question because everyone's 267 00:16:43,836 --> 00:16:46,556 Speaker 6: I would think I heard about Robert Kennedy. And he said, well, 268 00:16:46,556 --> 00:16:48,156 Speaker 6: I think I may have gotten a hold of some 269 00:16:48,196 --> 00:16:52,036 Speaker 6: of the original documents related to his assassination. Would you 270 00:16:52,116 --> 00:16:53,916 Speaker 6: be interested in combing through them with me? 271 00:16:55,236 --> 00:16:58,356 Speaker 1: So Commsero sits down with his colleagues. It goes through 272 00:16:58,356 --> 00:17:02,756 Speaker 1: what papus has found, autopsy reports, testimony from the surgeons 273 00:17:02,796 --> 00:17:07,676 Speaker 1: who treated Kennedy, and they reconstruct the case. So walk 274 00:17:07,716 --> 00:17:09,716 Speaker 1: me through what happens to him at he shot. 275 00:17:11,356 --> 00:17:14,796 Speaker 6: Yeah, so you know, I've always sort of envisioned this 276 00:17:14,876 --> 00:17:18,236 Speaker 6: chaotic scene where you know, his limited security and his 277 00:17:18,356 --> 00:17:22,916 Speaker 6: chief of staff went and saw sought the available the 278 00:17:22,956 --> 00:17:25,116 Speaker 6: assistance of the available physicians. 279 00:17:26,036 --> 00:17:27,836 Speaker 1: He's lying on the ground in the kitchen of the 280 00:17:27,876 --> 00:17:33,196 Speaker 1: Ambassador Hotel. Today they would be Secret Service protection, contingency plans, 281 00:17:33,476 --> 00:17:36,116 Speaker 1: an ambulance on call. There was nothing like that in 282 00:17:36,196 --> 00:17:40,236 Speaker 1: nineteen sixty eight. For bodyguards. Kennedy has two celebrity athletes, 283 00:17:40,596 --> 00:17:43,716 Speaker 1: the football player Rosie Grier and the Olympic gold medal 284 00:17:43,796 --> 00:17:47,196 Speaker 1: decathlete Ray for Johnson. No one is prepared for this 285 00:17:47,316 --> 00:17:48,196 Speaker 1: kind of emergency. 286 00:17:48,916 --> 00:17:55,476 Speaker 6: And then this is sort of where the Senator then 287 00:17:55,476 --> 00:17:58,196 Speaker 6: gets on lucky and where a lot of victims get 288 00:17:58,196 --> 00:18:01,636 Speaker 6: on lucky. Is he is taken to sort of the 289 00:18:01,676 --> 00:18:06,916 Speaker 6: closest hospital, but not necessarily the facility that's best equipped 290 00:18:06,956 --> 00:18:08,756 Speaker 6: to care for someone who had been shot in the head. 291 00:18:09,396 --> 00:18:13,116 Speaker 1: Kennedy gets taken to Central Receiving Hospital on sixth Street, 292 00:18:13,476 --> 00:18:16,636 Speaker 1: just west of downtown. They stabilize him there, but they 293 00:18:16,636 --> 00:18:20,116 Speaker 1: don't have a neurosurgeon, so he has to be retransported 294 00:18:20,356 --> 00:18:24,276 Speaker 1: to Good Samaritan Hospital just stuff Wilshire. And what did 295 00:18:24,356 --> 00:18:27,356 Speaker 1: that that mistake cost him? How much time. 296 00:18:28,716 --> 00:18:31,596 Speaker 8: I calculated in the paper and let me double check. 297 00:18:37,756 --> 00:18:40,476 Speaker 8: So he got to the operating room a Good Samaritan 298 00:18:40,756 --> 00:18:42,956 Speaker 8: two and a half hours after the shooting. 299 00:18:43,276 --> 00:18:45,676 Speaker 1: Two and a half hours. In your world, two and 300 00:18:45,716 --> 00:18:47,916 Speaker 1: a half hours is a long time, is. 301 00:18:47,876 --> 00:18:48,716 Speaker 6: A very long time. 302 00:18:49,996 --> 00:18:53,476 Speaker 1: Yeah, So he gets he gets to Good Samaritan to 303 00:18:53,556 --> 00:18:54,076 Speaker 1: what happens. 304 00:18:54,556 --> 00:18:59,756 Speaker 6: So they finish stabilizing him, they inspect for his other runds, 305 00:18:59,796 --> 00:19:02,676 Speaker 6: and then they decide pretty quickly to take him to surgery. 306 00:19:03,356 --> 00:19:08,876 Speaker 6: And they they wound up removing you know, roughly about 307 00:19:08,876 --> 00:19:11,796 Speaker 6: a five centimeter two and a half inch piece of 308 00:19:11,876 --> 00:19:14,676 Speaker 6: bone surrounding where he was shot in the back of 309 00:19:14,716 --> 00:19:20,316 Speaker 6: the head, right behind the ear, and to breed which 310 00:19:20,396 --> 00:19:22,716 Speaker 6: was the standard of the day, sort of everything that 311 00:19:22,756 --> 00:19:28,596 Speaker 6: looked abnormal along the bullet track, tried to remove fragments 312 00:19:28,596 --> 00:19:32,756 Speaker 6: of his skull and then brought him back to the 313 00:19:32,796 --> 00:19:35,956 Speaker 6: intensive care unit where they tried to cool him, which 314 00:19:36,036 --> 00:19:39,196 Speaker 6: was a sort of common practice at the time, to 315 00:19:39,236 --> 00:19:43,316 Speaker 6: reduce swelling in the brain. They gave him medications, specifically 316 00:19:43,356 --> 00:19:47,476 Speaker 6: steroids in something called manitol, which is a diuretic. Both 317 00:19:47,516 --> 00:19:49,876 Speaker 6: of those are aimed at reducing swelling of the brain, 318 00:19:50,516 --> 00:19:54,116 Speaker 6: one of which manatol, is still very commonly used today. 319 00:19:55,116 --> 00:19:57,876 Speaker 6: Dexamethasone is no longer used for this type of injury, 320 00:19:57,996 --> 00:20:03,196 Speaker 6: based upon data from large clinical trials that occurred long 321 00:20:03,236 --> 00:20:03,636 Speaker 6: after this. 322 00:20:03,716 --> 00:20:07,796 Speaker 1: Of course, he was in a coma. He never came 323 00:20:07,836 --> 00:20:11,156 Speaker 1: out of it. He was pronounced dead at one forty 324 00:20:11,156 --> 00:20:16,116 Speaker 1: four am the next morning. So now let's redo this. 325 00:20:16,596 --> 00:20:19,796 Speaker 1: But it's twenty twenty three. There's no delay today. Right today, 326 00:20:19,836 --> 00:20:22,436 Speaker 1: he's if you're shot in the Ambassador Hotel in La today, 327 00:20:22,436 --> 00:20:24,356 Speaker 1: where do you go? Where's the nearest trauma center? 328 00:20:26,876 --> 00:20:30,876 Speaker 6: I believe the closest Level ones trauma center is probably 329 00:20:31,036 --> 00:20:33,516 Speaker 6: USC But yes, you would go straight to a Level 330 00:20:33,556 --> 00:20:34,396 Speaker 6: one trauma center. 331 00:20:35,036 --> 00:20:38,516 Speaker 1: A Level one trauma center is a recent invention, a 332 00:20:38,596 --> 00:20:42,316 Speaker 1: high tech, on demand medical unit attached to a traditional 333 00:20:42,356 --> 00:20:46,436 Speaker 1: hospital with every kind of specialist on call twenty four 334 00:20:46,476 --> 00:20:49,476 Speaker 1: hours a day, and you would get there, I. 335 00:20:49,436 --> 00:20:50,796 Speaker 6: Mean today, rather rapidly. 336 00:20:50,876 --> 00:20:52,956 Speaker 1: Today he gets So he arrives at at a level 337 00:20:52,996 --> 00:20:55,476 Speaker 1: one trauma center. Let's just say for the sake of argument, 338 00:20:55,516 --> 00:21:00,636 Speaker 1: it's fifteen minutes. Yeah, the and in your so the 339 00:21:00,676 --> 00:21:02,956 Speaker 1: difference between two and a half hours and fifteen minutes 340 00:21:03,036 --> 00:21:03,556 Speaker 1: in your. 341 00:21:03,396 --> 00:21:07,476 Speaker 6: World is might as well be a year. 342 00:21:07,956 --> 00:21:13,596 Speaker 1: Yeah, yeah, And when he gets there, he's treated very differently. 343 00:21:14,956 --> 00:21:20,516 Speaker 6: So at Duke, the neurosurgery team that's in the hospital, 344 00:21:20,956 --> 00:21:24,916 Speaker 6: which is for us always a resident and potentially always 345 00:21:24,916 --> 00:21:27,436 Speaker 6: a faculty member. The rest of the trauma team would 346 00:21:27,436 --> 00:21:30,756 Speaker 6: be paged ahead of time and waiting for the patient 347 00:21:31,636 --> 00:21:32,476 Speaker 6: when they arrived. 348 00:21:32,556 --> 00:21:36,196 Speaker 1: In the resuscitation day, Kennedy got an X ray once 349 00:21:36,236 --> 00:21:39,396 Speaker 1: he arrived, a one dimensional image that made it hard 350 00:21:39,396 --> 00:21:43,076 Speaker 1: for the surgeons to know exactly where his bullet was. Today, 351 00:21:43,436 --> 00:21:47,476 Speaker 1: he'd get an immediate CT scan in three D, an 352 00:21:47,516 --> 00:21:49,596 Speaker 1: extraordinarily detailed image. 353 00:21:50,396 --> 00:21:53,676 Speaker 6: In most trauma centers, including Duke, there is a CT 354 00:21:53,796 --> 00:21:56,396 Speaker 6: scanner that is about ten feet from where the patients 355 00:21:56,436 --> 00:22:00,196 Speaker 6: first arrive, so there's very little care, very little delay. 356 00:22:00,956 --> 00:22:04,676 Speaker 1: You finish the CT scan, you're how many how many 357 00:22:04,756 --> 00:22:06,796 Speaker 1: minutes in are you from the moment the patient has 358 00:22:06,876 --> 00:22:08,316 Speaker 1: arrived at the hospital. 359 00:22:09,196 --> 00:22:13,236 Speaker 6: Unless the patient was so unstable in terms of their 360 00:22:13,236 --> 00:22:16,156 Speaker 6: blood pressure or heart rate that that required additional stabilization 361 00:22:16,236 --> 00:22:18,476 Speaker 6: that should be occurring within ten or fifteen minutes. 362 00:22:19,556 --> 00:22:22,716 Speaker 1: Commasaro began to talk through the difference between how a 363 00:22:22,756 --> 00:22:26,236 Speaker 1: brain injury like Kennedy's was treated in nineteen sixty eight 364 00:22:26,876 --> 00:22:29,756 Speaker 1: versus today. He gave me close to an hour of 365 00:22:29,836 --> 00:22:36,476 Speaker 1: technical description, step by step. So in sixty eight, given 366 00:22:36,556 --> 00:22:39,636 Speaker 1: standard of care and the extent of his injuries, he 367 00:22:39,756 --> 00:22:42,316 Speaker 1: has zero chance of survival. 368 00:22:43,156 --> 00:22:45,076 Speaker 6: About as close to zero as you can get. 369 00:22:45,236 --> 00:22:48,876 Speaker 1: Yeah, what's what's his percent survival chance today? He's not 370 00:22:48,996 --> 00:22:51,916 Speaker 1: dying at two forty five the next morning under this protocol? 371 00:22:52,676 --> 00:22:54,596 Speaker 6: I think it is far less likely he is dying 372 00:22:54,636 --> 00:22:56,276 Speaker 6: at two forty five the next forty Yeah. 373 00:22:56,356 --> 00:22:56,796 Speaker 2: Yeah. 374 00:22:57,076 --> 00:23:01,276 Speaker 1: Listening to you describe the differences between sixty eight and 375 00:23:01,356 --> 00:23:05,156 Speaker 1: the present day, it sounds like night and day. You 376 00:23:05,236 --> 00:23:08,116 Speaker 1: have the same intention today as they did in sixty eight, 377 00:23:09,276 --> 00:23:12,876 Speaker 1: reduced to swelling in the brain, repair, stop the bleeding, 378 00:23:13,396 --> 00:23:15,916 Speaker 1: but the ways in which you're going out about doing 379 00:23:15,956 --> 00:23:20,956 Speaker 1: that are markedly different, totally, markedly different. How do I 380 00:23:21,036 --> 00:23:23,716 Speaker 1: describe the leap that's been made between then and now? 381 00:23:24,236 --> 00:23:26,956 Speaker 1: What's it like. Is it like I've driven in a 382 00:23:27,036 --> 00:23:29,756 Speaker 1: car from nineteen sixty eight. It doesn't seem like it 383 00:23:29,796 --> 00:23:34,396 Speaker 1: belongs to a different paradigm than a car today. 384 00:23:35,116 --> 00:23:39,956 Speaker 6: It's the difference between a bicycle and an electric car. 385 00:23:40,516 --> 00:23:46,876 Speaker 1: Oh okay, yeah, that makes a lot of sense. Oh 386 00:23:46,916 --> 00:23:51,916 Speaker 1: that's huge. So what does commasarows? What if on the 387 00:23:51,956 --> 00:23:57,916 Speaker 1: Kennedy assassination tell us that medicines contribution to falling homicide 388 00:23:57,996 --> 00:24:02,956 Speaker 1: rates is a very big deal bicycles to electric cars. 389 00:24:03,796 --> 00:24:06,836 Speaker 1: Here's a back of the envelope calculation on how big 390 00:24:06,876 --> 00:24:11,476 Speaker 1: this effect is from the University of Massachusetts in two 391 00:24:11,556 --> 00:24:15,916 Speaker 1: thousand and two. Estimated improvements in traumacare probably lower the 392 00:24:15,916 --> 00:24:18,836 Speaker 1: death rate from serious injury about two point five to 393 00:24:18,876 --> 00:24:23,676 Speaker 1: four percent a year. So if nothing else changes, if 394 00:24:23,716 --> 00:24:26,876 Speaker 1: there's still just as many would be murderers walking around, 395 00:24:27,396 --> 00:24:29,396 Speaker 1: that's how much your murder rate is going to fall 396 00:24:29,436 --> 00:24:32,556 Speaker 1: every year on its own. Let me quote to you 397 00:24:32,596 --> 00:24:36,996 Speaker 1: from their conclusion. Compared to nineteen sixty, the year our 398 00:24:37,036 --> 00:24:42,076 Speaker 1: analysis begins, we estimate that without these developments in medical technology, 399 00:24:42,556 --> 00:24:46,356 Speaker 1: there would have been between forty five thousand and seventy 400 00:24:46,556 --> 00:24:50,996 Speaker 1: thousand homicides annually. The past five years instead of an 401 00:24:51,116 --> 00:24:56,956 Speaker 1: actual fifteen thousand to twenty thousand. Those estimates are insane. 402 00:24:57,356 --> 00:25:00,836 Speaker 1: If doctors hadn't up their game, the number of Americans 403 00:25:00,876 --> 00:25:03,916 Speaker 1: being murdered every year in the United States might be 404 00:25:03,956 --> 00:25:07,356 Speaker 1: as much as three or four times higher than it 405 00:25:07,396 --> 00:25:11,756 Speaker 1: is now. Here's another example. It's from the trauma center 406 00:25:11,916 --> 00:25:15,356 Speaker 1: at the University of Tennessee Medical Center in Memphis, a 407 00:25:15,396 --> 00:25:19,396 Speaker 1: city with a pretty serious homicide problem. The Memphis trauma 408 00:25:19,436 --> 00:25:22,916 Speaker 1: staff looked at every gunshot wound their hospital had treated 409 00:25:23,156 --> 00:25:26,876 Speaker 1: from the mid nineteen nineties to twenty fifteen, and what 410 00:25:26,956 --> 00:25:29,716 Speaker 1: they found is that every way you look at it, 411 00:25:30,116 --> 00:25:33,516 Speaker 1: gun violence in Memphis got worse in that period. The 412 00:25:33,596 --> 00:25:36,876 Speaker 1: number of gunshot wounds they saw increased. In fact, the 413 00:25:36,956 --> 00:25:40,476 Speaker 1: number went up fifty nine percent just between twenty ten 414 00:25:40,956 --> 00:25:44,356 Speaker 1: and twenty fifteen. The severity of the wounds they saw 415 00:25:44,476 --> 00:25:47,356 Speaker 1: got worse. The number of people being wheeled in with 416 00:25:47,556 --> 00:25:52,516 Speaker 1: multiple gunshot wounds more than tripled. In absolutely every sense, 417 00:25:52,756 --> 00:25:56,276 Speaker 1: the patients coming into that hospital in those years showed 418 00:25:56,316 --> 00:26:01,596 Speaker 1: that Memphis was becoming a dramatically more dangerous place. But 419 00:26:01,716 --> 00:26:05,436 Speaker 1: what happened to the mortality rate of gunshot victims coming 420 00:26:05,516 --> 00:26:09,516 Speaker 1: into that hospital during that period, it went down. It 421 00:26:09,596 --> 00:26:13,676 Speaker 1: dropped by a third. The trauma doctors at the University 422 00:26:13,676 --> 00:26:17,476 Speaker 1: of Tennessee Medical Center are so good that they made 423 00:26:17,516 --> 00:26:21,356 Speaker 1: the increase in bloodshed on the streets of Memphis all 424 00:26:21,396 --> 00:26:25,516 Speaker 1: but invisible. So what does the homicide rate in Memphis 425 00:26:25,796 --> 00:26:29,396 Speaker 1: tell us about the level of violence in Memphis. Nothing. 426 00:26:30,156 --> 00:26:34,276 Speaker 1: That's implication number one. We probably should stop using homicide 427 00:26:34,356 --> 00:26:37,076 Speaker 1: rates as a measure of how safe and healthy a 428 00:26:37,116 --> 00:26:37,836 Speaker 1: community is. 429 00:26:41,636 --> 00:26:44,116 Speaker 5: Homicides or get all the attention, right, They get all 430 00:26:44,116 --> 00:26:46,556 Speaker 5: the attention from the media. They get all the attention, 431 00:26:47,556 --> 00:26:51,236 Speaker 5: you know, from the response, you know, like the mayor 432 00:26:51,316 --> 00:26:53,876 Speaker 5: might show up on the scene, or the whole prosecutor 433 00:26:53,956 --> 00:26:54,916 Speaker 5: might show up on the scene. 434 00:26:55,036 --> 00:26:59,116 Speaker 1: That's Natalie Hippel, a criminologist at Indiana University. 435 00:26:59,756 --> 00:27:01,916 Speaker 5: They tape off the whole scene, and not every non 436 00:27:01,956 --> 00:27:04,756 Speaker 5: fatal shooting gets that kind of response. So those are 437 00:27:04,796 --> 00:27:08,636 Speaker 5: the numbers that people are sensitive to, But I don't 438 00:27:08,676 --> 00:27:09,596 Speaker 5: know that it means much. 439 00:27:10,196 --> 00:27:12,356 Speaker 1: A few years ago, Hippo and a group of other 440 00:27:12,396 --> 00:27:16,276 Speaker 1: criminologists argued that we should shelve the homicide statistic in 441 00:27:16,316 --> 00:27:18,636 Speaker 1: favor of a measure of what they call bullet to 442 00:27:18,676 --> 00:27:22,236 Speaker 1: skin contact. That is just a measure of how many 443 00:27:22,356 --> 00:27:25,556 Speaker 1: bullets have hit people in a given community over the 444 00:27:25,556 --> 00:27:29,476 Speaker 1: previous year. Which makes more sense, right because now we've 445 00:27:29,476 --> 00:27:32,436 Speaker 1: corrected for the bias caused by doctors saving so many 446 00:27:32,476 --> 00:27:36,676 Speaker 1: more lives. The problem is that that bullet to skin 447 00:27:36,796 --> 00:27:40,796 Speaker 1: number doesn't exist. No one pulls that statistic out. The 448 00:27:40,876 --> 00:27:43,996 Speaker 1: police lump all those cases in the general category of 449 00:27:44,036 --> 00:27:46,836 Speaker 1: aggravated assault, mixed in with punches and shoves. 450 00:27:47,556 --> 00:27:49,636 Speaker 4: They don't have a definition for a non fatal shooting. 451 00:27:49,636 --> 00:27:53,116 Speaker 5: There's no way to pull those data out of those sets. 452 00:27:53,836 --> 00:27:58,396 Speaker 1: Wait, there's stop there. You're telling me that we are 453 00:27:59,716 --> 00:28:03,356 Speaker 1: the most wealthiest and most sophisticated country in the world 454 00:28:03,356 --> 00:28:06,876 Speaker 1: that is simultaneously in the grip of a prolonged chronic 455 00:28:09,316 --> 00:28:14,436 Speaker 1: of gun violence. We have no we have no hard, 456 00:28:14,876 --> 00:28:19,516 Speaker 1: useful numbers on the total number of of shootings. 457 00:28:19,996 --> 00:28:24,236 Speaker 4: Nope. So not that the federal government maintains. 458 00:28:25,036 --> 00:28:28,196 Speaker 5: As soon as you drop down to aggravated assaults, they're 459 00:28:28,236 --> 00:28:30,316 Speaker 5: really really messy, and so no, we don't. 460 00:28:31,196 --> 00:28:33,636 Speaker 1: What hippol had to do was go through all the 461 00:28:33,676 --> 00:28:37,756 Speaker 1: old aggravated assault records compiled by the Indianapolis Police Department 462 00:28:37,996 --> 00:28:40,676 Speaker 1: and pull out the gunshot wounds by hand. 463 00:28:41,676 --> 00:28:43,836 Speaker 5: The first thing we did was pull all the aggravated 464 00:28:43,876 --> 00:28:47,156 Speaker 5: assaults that you know, and they report to they report 465 00:28:47,196 --> 00:28:48,916 Speaker 5: to the FBI, and so they pulled all those case 466 00:28:48,996 --> 00:28:51,756 Speaker 5: numbers and we started reading. I mean literally, this is 467 00:28:51,836 --> 00:28:53,716 Speaker 5: just you know, in the bucket, out of the bucket, 468 00:28:53,716 --> 00:28:54,796 Speaker 5: in the bucket, out of the bucket. 469 00:28:55,196 --> 00:28:57,156 Speaker 1: This is thousands and thousands, thousands. 470 00:28:57,236 --> 00:28:58,356 Speaker 4: Yeah. 471 00:28:58,396 --> 00:29:00,316 Speaker 1: How many people were engaged in this project? 472 00:29:02,196 --> 00:29:03,836 Speaker 4: Gosh, well, I mean we had a full time. 473 00:29:03,676 --> 00:29:06,596 Speaker 1: How many graduate students lives did you ruin in the Yeah. 474 00:29:08,636 --> 00:29:11,516 Speaker 4: We have, well, each of us had our own. I mean, 475 00:29:11,596 --> 00:29:12,956 Speaker 4: there wasn't a lot of funding. 476 00:29:13,316 --> 00:29:16,036 Speaker 1: For newer cases. She got the police to help her out. 477 00:29:16,476 --> 00:29:18,476 Speaker 1: Indiana has a reporting requirement. 478 00:29:18,916 --> 00:29:21,636 Speaker 5: If you show up the emergency department and you're stabbed, 479 00:29:21,756 --> 00:29:25,116 Speaker 5: or you're shot, or you're really badly bludgeoned or something, 480 00:29:25,516 --> 00:29:29,116 Speaker 5: they are the medical facility is required to report that 481 00:29:29,156 --> 00:29:30,396 Speaker 5: to the police. 482 00:29:30,796 --> 00:29:32,756 Speaker 1: So every day the police would send her the list 483 00:29:32,796 --> 00:29:35,756 Speaker 1: of reports they'd gotten from the trauma center the night before. 484 00:29:36,956 --> 00:29:40,556 Speaker 5: The procedure was detective goes to the scene, figures out 485 00:29:40,596 --> 00:29:42,556 Speaker 5: what's going on, and then writes up what they know 486 00:29:42,636 --> 00:29:44,996 Speaker 5: about the incident. That happened that right then and there, 487 00:29:45,076 --> 00:29:48,076 Speaker 5: and then that goes out, So that's usually within twenty 488 00:29:48,076 --> 00:29:50,836 Speaker 5: four hours. But I got on that email list, so 489 00:29:50,956 --> 00:29:53,276 Speaker 5: then I'm forwarding them to my research assistant. 490 00:29:53,316 --> 00:29:55,596 Speaker 4: The two of us are reading every single one. 491 00:29:55,916 --> 00:29:57,116 Speaker 1: How many are you getting a day? 492 00:29:57,956 --> 00:30:00,196 Speaker 4: Oh, my email right now? Hundreds? 493 00:30:00,956 --> 00:30:02,436 Speaker 1: Well, you're getting hundreds of. 494 00:30:02,356 --> 00:30:04,116 Speaker 4: My email my police department emails off the hook. 495 00:30:04,476 --> 00:30:08,236 Speaker 1: So this is all the bullet to skin reports from 496 00:30:08,236 --> 00:30:10,036 Speaker 1: the city of the al Yeah. 497 00:30:09,836 --> 00:30:13,076 Speaker 5: And Indianapolis is the seventeenth largest city in the country. 498 00:30:12,916 --> 00:30:15,156 Speaker 5: They have they run about eight hundred thousand people, give 499 00:30:15,236 --> 00:30:18,716 Speaker 5: or take, So you can only imagine what this must 500 00:30:18,716 --> 00:30:20,796 Speaker 5: look like in Chicago or New York. 501 00:30:21,756 --> 00:30:25,236 Speaker 1: What she's finding is what you'd expect she'd find. Indianapolis 502 00:30:25,596 --> 00:30:28,556 Speaker 1: is just like Memphis. The curve for bullet the skin 503 00:30:28,636 --> 00:30:31,876 Speaker 1: contact is going one way and the curve for homicides 504 00:30:32,076 --> 00:30:35,996 Speaker 1: is going another. But the whole thing is absurd. Right 505 00:30:36,636 --> 00:30:40,036 Speaker 1: in the hospitals of Indianapolis, the trauma surgeons have marshaled 506 00:30:40,196 --> 00:30:43,676 Speaker 1: the very finest of twenty first century technology and spend 507 00:30:43,876 --> 00:30:47,676 Speaker 1: millions upon millions of dollars to save every last life 508 00:30:47,756 --> 00:30:51,156 Speaker 1: they can. But does the city know whether gun violence 509 00:30:51,276 --> 00:30:54,596 Speaker 1: is going up or down, sure, but only because Natalie 510 00:30:54,636 --> 00:30:57,596 Speaker 1: Hipple and her graduate students are going through their emails 511 00:30:57,636 --> 00:31:02,676 Speaker 1: every morning. One last question. I don't mean this in 512 00:31:02,716 --> 00:31:05,236 Speaker 1: a disparaging way. The way you describe your work sounds 513 00:31:05,756 --> 00:31:06,956 Speaker 1: insanely depressing. 514 00:31:08,516 --> 00:31:12,516 Speaker 5: Thank you for acknowledging that is depressing. I've started checking 515 00:31:12,516 --> 00:31:14,156 Speaker 5: in on grad students. You know, I'm like, you're going 516 00:31:14,196 --> 00:31:15,836 Speaker 5: to read alect but when I hire them, I'm like, 517 00:31:15,876 --> 00:31:19,036 Speaker 5: this is this is not you know something that you 518 00:31:19,116 --> 00:31:21,756 Speaker 5: have you know over coffee and donuts and do your 519 00:31:21,796 --> 00:31:22,236 Speaker 5: work right. 520 00:31:22,356 --> 00:31:24,036 Speaker 4: You're going to it's going to change your mood. 521 00:31:24,756 --> 00:31:28,796 Speaker 1: Which brings us to the second implication of the homicide equation, 522 00:31:29,156 --> 00:31:31,876 Speaker 1: which is that maybe these two things, how good the 523 00:31:31,916 --> 00:31:35,716 Speaker 1: doctors are and how lackadaisical. The rest of society's response 524 00:31:35,756 --> 00:31:40,276 Speaker 1: to the problem has been are connected. Economists love to 525 00:31:40,316 --> 00:31:43,396 Speaker 1: talk about moral hazard. I'm sure you've heard that phrase. 526 00:31:43,876 --> 00:31:47,796 Speaker 1: Its formal definition is the lack of incentive to guard 527 00:31:47,796 --> 00:31:52,076 Speaker 1: against risk where one is protected from its consequences. Someone 528 00:31:52,116 --> 00:31:55,356 Speaker 1: lives in a flood zone. You subsidize their flood insurance. 529 00:31:55,636 --> 00:31:58,116 Speaker 1: So what happens when their home is washed away? They 530 00:31:58,156 --> 00:32:01,196 Speaker 1: rebuild it in exactly the same place. Why should they 531 00:32:01,236 --> 00:32:03,876 Speaker 1: give up their beautiful views of the ocean If someone 532 00:32:03,876 --> 00:32:08,476 Speaker 1: else is picking up the tab, that's moral hazard. Or 533 00:32:08,716 --> 00:32:11,636 Speaker 1: here's another example. The rate of people dying in car 534 00:32:11,716 --> 00:32:15,876 Speaker 1: accidents fell dramatically for years, which makes sense. Cars got 535 00:32:15,916 --> 00:32:19,876 Speaker 1: a lot safer, more people wore their seatbelts. But recently 536 00:32:20,196 --> 00:32:24,036 Speaker 1: the death toll has started to climb again. And why. 537 00:32:24,716 --> 00:32:26,916 Speaker 1: Maybe it's because your car is filled with all kinds 538 00:32:26,956 --> 00:32:29,276 Speaker 1: of warnings and bells, and you're strapped in like a 539 00:32:29,276 --> 00:32:31,996 Speaker 1: baby and protected by a dozen airbags, and you feel 540 00:32:32,036 --> 00:32:35,436 Speaker 1: so safe that you have that extra drink and drive 541 00:32:35,476 --> 00:32:37,916 Speaker 1: a little faster and answer all your texts while you're 542 00:32:37,996 --> 00:32:40,636 Speaker 1: driving down the freeway. So you end up being worse 543 00:32:40,636 --> 00:32:45,276 Speaker 1: off than before. That's moral hazard. If someone else is 544 00:32:45,316 --> 00:32:47,636 Speaker 1: doing the work of taking care of us and lowering 545 00:32:47,636 --> 00:32:51,756 Speaker 1: our risk, we have the freedom to behave like idiots. 546 00:32:53,076 --> 00:32:55,556 Speaker 1: I said at the beginning of this series that I 547 00:32:55,596 --> 00:32:58,396 Speaker 1: wanted to explain why the way we talk about guns 548 00:32:58,756 --> 00:33:02,156 Speaker 1: is so messed up, Why the Supreme Court makes such 549 00:33:02,356 --> 00:33:07,356 Speaker 1: ridiculous rulings, Why gun control advocates push ideas that are 550 00:33:07,396 --> 00:33:12,116 Speaker 1: so beside the point. And I think a big part 551 00:33:12,156 --> 00:33:16,796 Speaker 1: of the answer is moral hazard. Moral hazard is indifference. 552 00:33:17,196 --> 00:33:20,516 Speaker 1: It is the freedom purchased by other people's hard work. 553 00:33:21,116 --> 00:33:24,436 Speaker 1: Doctors have become so skilled, have taken the problem of 554 00:33:24,476 --> 00:33:28,316 Speaker 1: treating the wounded so seriously, have deployed every inch of 555 00:33:28,356 --> 00:33:31,716 Speaker 1: their ingenuity in trying to keep the wounded alive. But 556 00:33:31,796 --> 00:33:35,236 Speaker 1: the rest of us are free to fiddle while Rome burns. 557 00:33:54,156 --> 00:33:56,156 Speaker 1: So you've got the CT scan. So now you know, 558 00:33:57,316 --> 00:33:59,276 Speaker 1: you know, you know where the bullet is, and you 559 00:33:59,356 --> 00:34:02,636 Speaker 1: know the extent of the damage, and presumably in your 560 00:34:02,716 --> 00:34:06,556 Speaker 1: mind is just imagine you're the physician here. You're formulating 561 00:34:07,316 --> 00:34:09,236 Speaker 1: as you look at these things a strategy for what 562 00:34:09,276 --> 00:34:10,076 Speaker 1: you want to do next. 563 00:34:10,316 --> 00:34:14,596 Speaker 6: Yeah, So for an injury in this location, I would 564 00:34:14,676 --> 00:34:19,276 Speaker 6: want a what's called a ct angiogram, which is a 565 00:34:19,316 --> 00:34:23,676 Speaker 6: picture of the blood vessels that supply and then drain 566 00:34:23,756 --> 00:34:27,116 Speaker 6: the brain, which can be done, you know, within about 567 00:34:27,476 --> 00:34:30,676 Speaker 6: takes an extra sort of five minutes or less. Again, 568 00:34:30,716 --> 00:34:32,756 Speaker 6: this was not available at the time that the senator 569 00:34:32,836 --> 00:34:33,276 Speaker 6: was injured. 570 00:34:33,876 --> 00:34:38,836 Speaker 1: Kennedy's brain is flooded in blood. But today COMMISERA would 571 00:34:38,836 --> 00:34:41,236 Speaker 1: have a sense of where the damage is and he 572 00:34:41,236 --> 00:34:42,116 Speaker 1: would call for help. 573 00:34:43,356 --> 00:34:46,436 Speaker 6: So if I'm the surgeon, that's taking care of the senator, 574 00:34:46,756 --> 00:34:49,436 Speaker 6: and there is evidence that blood is coming out of 575 00:34:49,476 --> 00:34:52,436 Speaker 6: a very large blood vessel, then I am calling one 576 00:34:52,476 --> 00:34:56,236 Speaker 6: of my colleagues who specializes in in vascular neurosurgery to 577 00:34:56,236 --> 00:34:59,316 Speaker 6: tell me to meet in the operating room and potentially 578 00:34:59,356 --> 00:35:01,996 Speaker 6: taking the senator to an operating room that has the 579 00:35:02,036 --> 00:35:05,796 Speaker 6: capability for us to opulate operate simultaneously. So while I'm 580 00:35:06,276 --> 00:35:10,636 Speaker 6: working directly on his head, removing the skull, taking out 581 00:35:10,676 --> 00:35:13,996 Speaker 6: any blood clot that I can, making space for swelling, 582 00:35:14,076 --> 00:35:17,636 Speaker 6: which is largely the purpose of the surgery. Stop the bleeding, 583 00:35:17,876 --> 00:35:21,316 Speaker 6: make room for the brain to swell, get control of 584 00:35:21,356 --> 00:35:25,996 Speaker 6: any infection that's going to occur by removing dead tissue. 585 00:35:26,236 --> 00:35:30,276 Speaker 6: Then at the same time, my partner could be accessing 586 00:35:30,316 --> 00:35:33,756 Speaker 6: the blood vessels through either the wrist or the groin, 587 00:35:33,916 --> 00:35:36,596 Speaker 6: kind of like how a heart catheterization takes place, except 588 00:35:36,636 --> 00:35:38,036 Speaker 6: you don't stop with the heart. You go up to 589 00:35:38,076 --> 00:35:42,356 Speaker 6: the brain to try and either block off extensive bleeding 590 00:35:42,676 --> 00:35:45,156 Speaker 6: if you can't salvage the blood vessels, or salvage the 591 00:35:45,196 --> 00:35:47,596 Speaker 6: blood vessels from the inside out. 592 00:35:48,076 --> 00:35:51,996 Speaker 1: So keep going. So you've got You've brought in this 593 00:35:51,996 --> 00:35:54,916 Speaker 1: this specialist to deal with the blood vessel while you 594 00:35:54,956 --> 00:35:58,796 Speaker 1: are removing parts of the skull and dead tissue. Yep, 595 00:35:58,876 --> 00:36:00,076 Speaker 1: what happens next. 596 00:36:00,196 --> 00:36:04,836 Speaker 6: Now, since they make mention to operating at the upper 597 00:36:04,876 --> 00:36:06,996 Speaker 6: part of the brain, a bit the occipital lobe that 598 00:36:07,076 --> 00:36:11,636 Speaker 6: they reference, which makes us conclude that the bullet trajectory 599 00:36:11,716 --> 00:36:16,556 Speaker 6: somewhat passed upward from the cerebellum upward into the occipital lobe. 600 00:36:17,116 --> 00:36:20,996 Speaker 6: There it raises the possibility of removing a large part 601 00:36:20,996 --> 00:36:24,916 Speaker 6: of the skull up top, which they did not do. 602 00:36:26,196 --> 00:36:27,876 Speaker 6: And likely part of the reason that they did not 603 00:36:27,996 --> 00:36:31,356 Speaker 6: do that is it really hadn't become more of a 604 00:36:31,436 --> 00:36:34,516 Speaker 6: standard at the time because the data just didn't exist 605 00:36:34,516 --> 00:36:35,396 Speaker 6: that it was helpful. 606 00:36:36,316 --> 00:36:39,636 Speaker 1: They didn't use a microscope in nineteen sixty eight, Commis 607 00:36:39,756 --> 00:36:43,636 Speaker 1: arrow would which would give not only magnification but illumination. 608 00:36:43,956 --> 00:36:47,556 Speaker 1: They're operating in a very confined space. Back then, the 609 00:36:47,556 --> 00:36:50,756 Speaker 1: standard of care was to locate and remove every single 610 00:36:50,796 --> 00:36:53,796 Speaker 1: bit of debris you could find. We don't do that anymore. 611 00:36:54,156 --> 00:36:56,636 Speaker 1: It does more harm than good. And then maybe the 612 00:36:56,636 --> 00:36:59,556 Speaker 1: biggest issue of all, After a brain is injured, it 613 00:36:59,596 --> 00:37:03,116 Speaker 1: begins to swell, and it's the swelling that poses the 614 00:37:03,116 --> 00:37:06,196 Speaker 1: greatest risk to the patient. Today we know far more 615 00:37:06,236 --> 00:37:07,556 Speaker 1: about how to reduce that swelling. 616 00:37:08,236 --> 00:37:10,956 Speaker 6: I've wondered if your hands her hands hand jerks up 617 00:37:10,996 --> 00:37:14,916 Speaker 6: and instead of getting shot back here, the bullet comes 618 00:37:14,916 --> 00:37:19,956 Speaker 6: across his occipital lobe. The senator probably has a visual 619 00:37:19,996 --> 00:37:26,036 Speaker 6: field deficit, a blind spot, but quite possibly survives same thing. 620 00:37:26,156 --> 00:37:28,996 Speaker 1: If the headshot was a little lower, that might not 621 00:37:29,076 --> 00:37:31,996 Speaker 1: have made a difference back then, but today possibly. 622 00:37:33,236 --> 00:37:37,196 Speaker 6: Yeah. So I had another patient that came to mind 623 00:37:37,676 --> 00:37:41,316 Speaker 6: that actually made me think of the senator. He was 624 00:37:41,796 --> 00:37:45,916 Speaker 6: a young person who had been shot not in the 625 00:37:45,996 --> 00:37:50,036 Speaker 6: back lobe, but the front low so damaged part of 626 00:37:50,076 --> 00:37:54,916 Speaker 6: the jaw, but more importantly, afterwards injured the crotted artery, 627 00:37:55,076 --> 00:37:58,076 Speaker 6: one of the main blood supplies to the brain. You know, 628 00:37:58,116 --> 00:38:00,796 Speaker 6: the two crowded arteries supply about eighty percent of your blood, 629 00:38:01,596 --> 00:38:06,156 Speaker 6: and was hammrhaging extensively from that prior to when it 630 00:38:06,756 --> 00:38:11,116 Speaker 6: then damaged the brain itself. And we did you know 631 00:38:11,276 --> 00:38:14,716 Speaker 6: very nearly exactly what I laid out to you. One 632 00:38:14,716 --> 00:38:18,356 Speaker 6: of my partners, who's a vascular neurosurgeon, working from inside 633 00:38:18,356 --> 00:38:21,276 Speaker 6: the blood vessels, fed a wire to help repair this. 634 00:38:21,796 --> 00:38:24,156 Speaker 6: I took off a large chunk of the patient's skull. 635 00:38:24,996 --> 00:38:28,236 Speaker 6: The patient was in a coma for several weeks, was 636 00:38:28,276 --> 00:38:32,836 Speaker 6: in the ICU for about for several months, but then 637 00:38:32,916 --> 00:38:39,836 Speaker 6: went home and cares for himself works. I don't think 638 00:38:39,956 --> 00:38:42,556 Speaker 6: I would ever sort of categorize him as perfect. But 639 00:38:43,596 --> 00:38:47,156 Speaker 6: you could meet him and other than part of his 640 00:38:47,476 --> 00:38:50,356 Speaker 6: scar extends in front of his hairline, the rest is 641 00:38:50,396 --> 00:38:54,796 Speaker 6: hidden behind. You would not be able to sort of say, oh, yeah, 642 00:38:54,796 --> 00:38:56,356 Speaker 6: you were shot in the head or you had a 643 00:38:56,356 --> 00:38:56,956 Speaker 6: brain injury. 644 00:38:57,156 --> 00:39:03,556 Speaker 1: Yeah. So that's another another scenario for Robert Kennedy. If 645 00:39:03,556 --> 00:39:07,556 Speaker 1: the bullet had gone today, had hit him there, he 646 00:39:07,916 --> 00:39:08,716 Speaker 1: could have survived. 647 00:39:09,956 --> 00:39:15,116 Speaker 6: There are many scenarios where he survives. 648 00:39:15,836 --> 00:39:19,276 Speaker 1: And what happens when someone survives a violent act that 649 00:39:19,316 --> 00:39:22,076 Speaker 1: once upon a time would have killed them. The world 650 00:39:22,156 --> 00:39:26,796 Speaker 1: changes in a million, small and large ways. Two months 651 00:39:26,836 --> 00:39:30,676 Speaker 1: before Robert Kennedy was assassinated in Los Angeles, Martin Luther 652 00:39:30,796 --> 00:39:34,596 Speaker 1: King was assassinated in Memphis. Single shot to the face 653 00:39:34,876 --> 00:39:38,476 Speaker 1: from a Remington rifle, broke his jaw, traveled down his spine, 654 00:39:38,756 --> 00:39:42,156 Speaker 1: severed his juggular vein, and lodged in his shoulder. Kennedy 655 00:39:42,276 --> 00:39:45,396 Speaker 1: was in Indianapolis at the time. Addressing a crowd, and 656 00:39:45,436 --> 00:39:48,956 Speaker 1: he gives his most famous speech where he tells everyone 657 00:39:48,996 --> 00:39:52,596 Speaker 1: the terrible news. Remember as you listen that he was 658 00:39:52,636 --> 00:39:55,516 Speaker 1: speaking off the cuff. He had no time to prepare. 659 00:39:56,236 --> 00:39:57,836 Speaker 1: This was from his heart. 660 00:39:58,916 --> 00:40:03,876 Speaker 3: For those of you who are black and are attempted 661 00:40:03,876 --> 00:40:10,356 Speaker 3: to be filled with hatred and mistrust of the injustice 662 00:40:10,356 --> 00:40:16,636 Speaker 3: of such an act against all white people, I would 663 00:40:16,636 --> 00:40:19,516 Speaker 3: only say that I can also feel in my own 664 00:40:19,556 --> 00:40:24,116 Speaker 3: heart the same kind of feeling. I had a member 665 00:40:24,116 --> 00:40:27,916 Speaker 3: of my family killed, but he was killed by a 666 00:40:27,956 --> 00:40:31,596 Speaker 3: white man. But we have to make an effort in 667 00:40:31,596 --> 00:40:35,676 Speaker 3: the United States. We have to make an effort to understand, 668 00:40:37,516 --> 00:40:40,476 Speaker 3: to get beyond, or go beyond, these rather difficult times. 669 00:40:42,076 --> 00:40:47,556 Speaker 3: My favorite poem, my favorite poet, was Eschylus, and he 670 00:40:47,596 --> 00:40:56,836 Speaker 3: once wrote, even in our sleep, pain, which cannot forget, 671 00:40:58,116 --> 00:41:02,276 Speaker 3: falls drop by drop upon the heart, until in our 672 00:41:02,316 --> 00:41:08,756 Speaker 3: own date despair against our will comes wisdom through the 673 00:41:08,796 --> 00:41:10,356 Speaker 3: awful grace of God. 674 00:41:12,796 --> 00:41:15,556 Speaker 1: We had someone who might have been president who could 675 00:41:15,636 --> 00:41:21,076 Speaker 1: quote Eschylus from memory, and then Kennedy issued a challenge 676 00:41:21,076 --> 00:41:24,476 Speaker 1: for the country to do something about the violence tearing 677 00:41:24,516 --> 00:41:28,316 Speaker 1: us apart. But I think only the doctors were listening. 678 00:41:29,436 --> 00:41:32,196 Speaker 3: What we need in the United States is not division. 679 00:41:33,756 --> 00:41:36,356 Speaker 3: What we need in the United States is not hatred. 680 00:41:37,076 --> 00:41:39,436 Speaker 3: What we need in the United States is not violence 681 00:41:39,836 --> 00:41:45,876 Speaker 3: and lawlessness, but is love and wisdom and compassion toward 682 00:41:45,956 --> 00:41:51,116 Speaker 3: one another, and a feeling of justice toward those who 683 00:41:51,196 --> 00:41:55,956 Speaker 3: still suffer within our country, whether they be white or 684 00:41:55,996 --> 00:41:56,956 Speaker 3: whether they be black. 685 00:42:23,836 --> 00:42:28,396 Speaker 1: Our revisionist History Gun series was produced by Jacob Smith, Bend, 686 00:42:28,516 --> 00:42:33,476 Speaker 1: daph Haffrey, Piara Powell, Tally Emlin, and Leemn Gistoo. We 687 00:42:33,596 --> 00:42:37,196 Speaker 1: were edited by Peter Clowney and Julia Barton. Fact checking 688 00:42:37,276 --> 00:42:42,116 Speaker 1: by Arthur Gomberts and Kashelle Williams. Original scoring by Luisquira, 689 00:42:42,596 --> 00:42:49,276 Speaker 1: mastering by Flonn Williams. Engineering by Nina Lawrence. I'm Malcolm Gladwell.