Trauma Surgeon an Advocate for Safer Gun Laws
Council Award Recipient: Dr. Najma Ahmed
By Mark Sampson
“The research is clear: a greater societal tolerance for civilian gun ownership results in higher rates of gun deaths, both homicide and suicide. And while I am not an expert on guns, what I am expert in is the terrible damage that is caused by bullets fired by guns and into people. These bullets serve as small metal missiles that tear apart tissues, tear apart organs and blood vessels, and in doing so, they tear apart the person and rob them of their lives, and do unimaginable harm to families and to societies.”
Dr. Najma Ahmed spoke these harrowing words during a 2019 TEDx presentation she gave about how her experiences as a trauma surgeon shaped her advocacy for stricter gun laws in Canada. She helped channel that advocacy through an organization she founded, Canadian Doctors for Protection from Guns. This issue of gun violence is something Dr. Ahmed has direct experience with: she was one of the trauma surgeons on call during the mass shooting on Toronto’s Danforth Avenue in July 2018. She has seen the impact — physical, emotional, and psychological — that easier access to guns can have on victims, their families, and the communities they live in.
Our most recent Council Award recipient is also a passionate educator at the University of Toronto Department of Surgery, instilling in the next generation of physicians not only her training, but also her wisdom and worldview of what it means to be a physician in one’s community. She is also a prolific researcher with more than 25 years of published scholarship under her belt, including a recently published article in the Canadian Medical Association Journal that looked at statistical data for gun-related violence over the past 15 years.
We have a video of her remarks 🎥 when she accepted the award at the December meeting of Council at the end of the article. Below we speak to Dr. Ahmed:
What was the catalyst for you choosing medicine as a career?
My grandfather was a physician in a small village in India, though I never knew him. He died before I was born. But my father always spoke of him with great reverence, and since I really enjoyed science, especially biological sciences, in school, it made sense for me as a career. My mother and father instilled in me a love of learning and education, which really helped as well.
How did you come to choose your specialty in trauma and acute care surgery?
When I was doing, what we called back then, my “clerkship,” I loved everything about medicine. But one thing I loved about surgery was the immediacy of it. I loved being in the OR and seeing the problem with my own eyes and implementing a plan for care. It was very inspiring and rewarding because I could see the results of our labours. You can literally pull people back from the jaws of death.
Tell us about your teaching at the University of Toronto.
It’s so rewarding to share your training, your knowledge, and your worldview with those who are learning. Med students are the best people you’ll ever meet. They’ve dedicated their lives to the service of others, and it’s such a great reward to help shape their careers as professionals.
You were on call the evening of the mass shooting in Toronto in July 2018. Take us back to that night.
It was a Sunday evening and my week was winding down. I was tidying up the kitchen and getting ready for bed when my pager went off and the hospital [St. Michael’s] called a code orange. I immediately made my way into work. Now, I’ve driven to the hospital for many years, but I had never seen anything like what I saw that night. The whole street was full of ambulances and police cars. I walked into the emergency department and every face was so serious. We train for these mass emergency situations, but we hope we never have to execute on one in real-life. I found myself in the operating room and face-to-face with the patients.
While we couldn’t help but think of the victims and the families and the loss of life, what we were also thinking in the hospital was: is the gunman neutralized? Was there more than one gunman? Were all who were injured brought to safety? Are we going to have enough blood, enough ICU beds? Then later, at around two in the morning, we finally heard that it was one gunman and he was neutralized. It came as a great relief.
When did you begin to see a confluence between your role as a trauma surgeon and as an advocate for stricter gun regulations?
Physicians have always had a role for advocating for public policy, not just for individual patients but whole communities. Whether it’s clean water, nicotine-use, seatbelts, asbestos, or whatever, physicians have always been a part of these conversations. Five years ago, we saw an uptick in patients coming to our bay with gunshot wounds. Then the Danforth shooting really woke up the public and we got some momentum as physicians.
The paper you co-authored recently in the CMAJ paints a particularly stark picture of men over age 45 who live in rural areas. Your research found the majority of deaths linked to guns in that demographic were the result of suicide.
In the press, there is a lot of emphasis, as there should, be on the interrelation of the victims and crime. But when it comes to suicide, especially in rural settings, it’s very private for families. The obituary often will not disclose that the manner of death was suicide by firearm, rather that the deceased died suddenly.
But for the families that remain, the pain is a lot to bear. So we need education around the harm of having firearms in the home and how they’re frequently used for suicide. These suicides are very impulsive, but these are lives that can be saved.
When Canadian Doctors for Protection from Guns began to advocate for Bill C-71, you became the victim of abuse on Twitter by gun advocates. What was your reaction to these attacks?
When we first started, we thought, “Oh, this is going to be easy.” We read the papers and reviewed the evidence and spoke to the experts, and it’s so easy and so obvious. We’ll talk to people, show them the evidence, and they’ll say of course you’re right.
I had no idea how active and entrenched and unmovable the Canadian gun lobby really is. They are highly motivated to keep what they see as their property, their guns, and they meet any regulation with fierce opposition. But because the science is not on their side, all they can do is smear and discredit us. They can’t make a cogent argument for why they need these gun rights. Mind you, this is a small population. Most gun owners are long-gun owners and are open to education and regulations designed to make their lives safer. The gun lobby pretends they’re speaking for them, but they have no evidence on their side.
What would you say to physicians who are contemplating advocating for or against a particular aspect of public policy?
I would say that physicians hold a very respected and unique place in society. To be a complete physician can include advocacy for a better Canada, and physicians have a long history of doing this – from the dangers of lead paint to the dangers of nicotine. At the time, their positions may have been controversial, there was likely an opposing body, but what we bring to the discussion is the ability to interpret evidence and data, and help make decisions. The general public doesn’t necessarily have access to that evidence, so we’re the conduit for the public to help them understand it. And because of this, public policy makers are hungry to hear from us.
But most of all, you may be surprised by how many people will join you if you speak up for what you believe in.
Video from Council
What can I say? I mean, I’m so honoured. Thank you, Dr. Berger, Philip, My dear friend, my colleague, my mentor. Everything I have learned about advocacy I have learned from you, and you have been my role-model with respect to how we approach these public health issues, how we speak to the public. And he — as you all know, well know, Dr. Berger has been a role-model for generations of physicians in their commitment and responsibility to do the greater good and to serve the public in our role as physicians.
I’m delighted today to be honoured and to be recognized by my colleagues and peers and mentors, many of you on the line, at the College of Physicians and Surgeons of Ontario in this virtual format, because we can’t gather together. I especially want to thank my colleagues who took the time to make this nomination. These nominations and all nominations are a lot of work, and we’re all very, very busy, particularly this year. And to the Awards Committee at the CPSO for granting me but this prestigious award. Philip, thank you for all the homework you did in putting that speech together. I’m really, really touched.
I also must thank the CPSO for their steadfast support and commitment to an evidence-based dialogue and approach to all matters related to public health, including the issue of gun violence. And I thank the CPSO for affirming that, the essential role that physicians have in advocating for health policy that improves the health and well-being of the populations that we serve. I think this is such an important stamp that you have put on this subject.
I share this award with all the doctors and the nurses and the healthcare providers who treat patients who have suffered from gun violence, and from all of us — and I show this award with the scientists and doctors who are doing research to understand this disease better and how best to prevent it. And of course, all the members of our advocacy organization ‘Canadian Doctors For Protection From Guns’, and our incredible Board of Directors, including Dr. Philip Berger, Dr. Lynn Wilson, and Dr. Julie Maggi.
Once again, I thank you from the bottom of my heart for this incredible award and recognition. Thank you again.