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American Academy of Political and Social Science

Wounded: Life after the Shooting Author(s): JOOYOUNG LEE Source: The Annals of the American Academy of Political and Social Science, Vol. 642, Bringing Fieldwork Back In: Contemporary Urban Ethnographic Research (July 2012), pp. 244-257 Published by: Sage Publications, Inc. in association with the American Academy of Political and Social Science Stable URL: http://www.jstor.org/stable/23218475 Accessed: 01-10-2017 09:45 UTC

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Wounded: Life after the

Shooting

By JOOYOUNG LEE

Most gunshot victims do not die. In some estimates, 80 percent live to see another day. Yet social scientists continue to focus on gun homicide. What happens to individuals who get shot and survive? How do they experience life after the shooting? This article examines how gunshot injuries transform the lives of victims. In practical ways, gunshot injuries complicate sleeping, eating, working, and other previously taken-for-granted activities. These disruptions also have much larger exis tential significance to victims. Indeed, daily experiences with a wounded body become subjective reminders that individuals are no longer who they used to be. Ironically, in some interactions, being wounded becomes attrac tive and advantageous to victims. Together, these themes illustrate the need for more sustained ethno

graphic work on the foreground of violent crime vic timization.

Keywords: gun violence; health; identity; injury; crime

Jooyoung Lee is an assistant professor of sociologi) at the University of Toronto. He conducted this research as a Robert Wood Johnson Foundation Health 6 Society Scholar at the University of Pennsylvania. He is currently writing two books. The first is an ethno graphic study on the careers of aspiring rappers from Los Angeles. The second is an ethnographic study on the individual- and community-health effects of gun shot victimization in Philadelphia.

NOTE: This research was funded by the Robert Wood Johnson Foundation when I was a Health & Society Scholar at the University of Pennsylvania; the project received a grant from die Research & Education Fund. I am grateful to the hospital administrators, nurses, and physicians at the Hospital of die University of Pennsylvania for dieir cooperation. Robert Aronowitz, David Asch, Jason Schnittker, Philippe Bourgois, Therese Richmond, Charles Branas, Michael Bader, Alison Buttenheim, Andrew Deener, Amy Gonzales, Laura Tach, Eran Magen, Samir Soneji, and Sarah Gollust provided helpful comments and feedback at different stages of this project. John Dominski provided invaluable support as a research assistant. Most important, I thank the victims and families who allowed me to participate in and observe their lives as they faced the challenges diat surviving a shooting entails.

DOI: 10.1177/0002716212438208

ANNALS, AAPSS, 642, July, 2012

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John was drinking Petron tequila the night he got shot. On a chilly Friday night in February, he left his apartment around 11 p.m. and headed to a dance club nearby.1 After a night full of drinking and women rebuffing his advances on the dance floor, John stumbled home. While passing other patrons in the clubs parking lot, a man wearing a dark hooded sweatshirt approached him. Before John knew what was happening, the hooded man brandished what John thinks was a snubnose .38 special revolver, a favorite gun among stick-up artists for its ease of concealment.2

"Give it up!" the gunman demanded. Panicking, John quickly pulled out his cell phone, a skinny rectangular-shaped phone with a shiny metallic black finish. Before he could hand it over, the gunman fired. Five more shots rang out in quick succession. According to John, "The gun then went click, so I knew the bol [guy] was out of ammo." Gathering himself, John began chasing the gunman, who darted away. Despite his efforts, John did not get very far. A group of women within earshot stopped John dead in his tracks. One grabbed John by the arm and commanded him to sit down. Feeling his body tire, John collapsed onto the side walk. About five minutes later, police arrived on the scene and rushed John to the emergency room at the Hospital of the University of Pennsylvania (HUP), where he was treated for a single gunshot wound to the left shoulder.

By most accounts, John was lucky to emerge from a point-blank shooting with just one gunshot wound. Different people have different theories to explain how and why John survived. Members of his family think that divine intervention saved his life; his mother, Gayle, believes that a guardian angel protected him that night. John has his own hypotheses. He reasons that the shooter must have been "wet"3 or inexperienced with a gun, both of which might explain his poor aim.4 Speaking frankly, John claims that he would not have missed from such a close range: "If it were me, I would have put at least 4 or 5 'hot ones' [bullets] in a nigga."

John was one of the first gunshot victims whom I met at the outpatient trauma clinic at the Hospital of the University of Pennsylvania (HUP). Two weeks after he got shot, he returned to the hospital to have X-rays of his collarbone, which was broken by the bullet as it entered his shoulder. With his arm awkwardly tied into a cloth sling, John was in a lot of pain. In addition to giving me a detailed play-by-play of the events before, during, and after the shooting, John provided a painstaking account of all the ways that the shooting had changed his life. He explained that the bullet was still lodged somewhere beneath his right shoulder blade, which made seemingly trivial activities such as washing his face, brushing his teeth, and sneezing extremely painful and difficult to do.

During his visit, John learned that the bullet had moved from its original loca tion and was now inching closer to his spine. Although his doctor assured him that the bullet did not pose any immediate risk and that procedures to remove the bullet might actually do more harm than good, John desperately wanted the bullet out of his body. He felt uncertain about his future health and wondered whether one day he might accidentally do something that would cause the bullet to finally hit his spine: "What if I'm just chillin' one day and the bullet moves on its own? What if I'm playing football and somebody tackles me? What if I fall real hard and the bullet goes to my spine? Is that gonna get me paralyzed?"

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THE ANNALS OF THE AMERICAN ACADEMY

Later that afternoon, after John and other patients had left for the day, I sat alone in an examination room with my thoughts. As I scanned my notes from that days interviews, I started to wonder: What was it like for other gunshot victims? What kinds of injuries did they have, and how did those injuries change their lives?

During the past 20 years, social scientists from varying disciplines have exam ined different aspects of gun homicide. Although existing research depicts per sistent racial-ethnic disparities in gun homicides (Hemenway 2003), the economic costs of gun homicides (Cook et al. 1999), and the neighborhood effects of gun homicides (Sharkey 2010), few studies have analyzed the experi ences of individuals who survive a shooting. The lives of victims who do not die (from here on referred to as "gunshot victims") are neglected in existing research.

It is important to understand the lives of gunshot victims because most people who get shot do not die. About one in five one-time gunshot victims die (Rich 2009). Most live to see another day but are riddled with injuries that transform their lives in both practical and existential ways. Gunshot victims live with bodily injuries that make sleeping, eating, going to the bathroom, working, having sex, and conducting other previously taken-for-granted aspects of daily living difficult. After the shooting, gunshot victims have problems adjusting to life in a new body.

At the same time, daily experiences with failing bodies carry much larger, existential meanings to victims. Indeed, gunshot injuries can also signal that vic tims are no longer who they used to be. In this way, gunshot injuries reveal how much individuals rely on the body as a sensual scaffolding around which they create and sustain a routine sense of self. Before developing these themes, I review gun violence research and describe how I collected my ethnographic data.

Beyond Gun Homicide

Gun homicides are among the most broadly researched social problems in the United States. Researchers in sociology, criminology, medicine, economics, psy chology, public health, and related fields have advanced knowledge in multiple areas. Here I focus on three general areas that receive a great deal of research attention.

First, researchers analyze the rates at which gun homicides occur across dif ferent subgroups in the United States. In addition to depicting historical changes in the national incidence of gun deaths (Hemenway 2003), researchers show significant racial, ethnic, gender, age, and class disparities in annual gun homi cides in the United States. In 2006 African Americans were more than 9 times as

likely to die by a gun than were whites.5 According to complementary studies, homicides—of which approximately 80 percent are committed with guns (Lemaire 2005)—are the second leading cause of death among all Americans ages 15 to 24.

Second, researchers examine the costs of gun homicides. These analyses show that the most disadvantaged individuals are at the highest risk of getting shot,

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which in turn means that gunshot injuries are overwhelmingly paid for with pub lic tax dollars (Cook et al. 1999; Ordog, Wasserberger, and Ackroyd 1995). Other studies argue that gun homicides cut numerous years of productivity from the life course, which at the population level reduces the average life expectancy and increases life insurance costs for all Americans (Lemaire 2005). A team of researchers (Corso et al. 2007) estimated the total economic loss incurred by society from the years of productivity lost.

Third, researchers have analyzed the neighborhood effects of gun homicides. In broad strokes, studies show that gun homicides have negative effects on indi viduals' physical and mental health. Most recently, researchers have found that neighborhood gun homicides can have acute detrimental effects on cognitive functioning and development in youths (Sharkey 2010).

Together, researchers have amassed a large body of work on different aspects of gun homicide. Although these data are important, there are significant gaps in gun violence research because surviving gunshot victims are not included. John Rich (2009) is a notable exception. Drawing on interviews and fieldwork with young black men who are victims of violent crime, Rich challenges clinical assumptions of crime victims who "get what they deserve," whose injuries are directly linked to deviant and criminal activity. He also argues that additional work is needed to understand the long-term mental health effects of violent victimization.

I build on Rich's work and make the case for studying the phenomenological foreground of crime victimization. Drawing on Jack Katz's (1988) pioneering study on the "foreground of criminal offending," this project places the lived and embodied experiences of gunshot victims as the central phenomenon to be explained. These themes serve two complementary purposes: (1) the data advance substantive work in gun violence research by describing a population that has been overlooked, and (2) the data also provide a unique case for developing com parative analyses on how identity transformations are intertwined with bodily changes. Before exploring these themes, I summarize how I collected my data.

In the Clinic

I began this study in February 2010. Over the next six months, I interviewed forty gunshot victims at the outpatient trauma clinic at the HUP. These inter views took place on Friday afternoons between 1 p.m. and 5 p.m. Fortunately, nurses in this clinic helped me recruit gunshot victims. In addition to letting me know when gunshot victims were scheduled for appointments, nurses asked gun shot victims if they would like to participate in my study. If they agreed, nurses would come and get me out of an unused examination room, or send victims to me after their appointment was over. In return for their time and participation, gunshot victims received $20 Visa gift cards.

Several features of the trauma clinic aided my data collection. For starters, the clinic gave me a fast and efficient way to meet gunshot victims, compared to locating them in a neighborhood setting. Patients who came to the trauma clinic

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THE ANNALS OF THE AMERICAN ACADEMY

often have "dead time" when they wait to be seen by doctors or nurses or for the results of X-rays and other tests. This gave me a window of opportunity to talk with patients, who often told me that they were happy to talk with someone while waiting to be seen.

At the same time, some features of the trauma clinic complicated my data col lection. There was a great deal of seasonal variation in the number of gunshot victims visiting the clinic. On particularly slow afternoons, I could spend the entire day without seeing a patient. During the summer I faced the opposite challenge; occasionally I lost potential participants because 1 could not keep up with the high patient volume. To help meet the challenges of interviewing mul tiple victims at the same time, I hired a research assistant, John Dominski,6 who helped me collect some of these interviews.

At an interactional level, I had to overcome some anxieties and reservations. At the beginning of my research, I was overly sensitive about upsetting victims by asking them to talk about how they got shot and life after the shooting. Through a process of trial and error, I learned a much less invasive way to get victims talk ing about these matters. Instead of beginning my interviews with a focus on how they got shot, I started by asking victims to describe their reasons for visiting the clinic: "What are you being seen for today?" This approach elicited in-depth descriptions of a person's injuries, how they got injured, and most importantly, how they were making sense of these injuries.

Moreover, this article also draws from two years of ongoing ethnographic fieldwork with ten gunshot victims outside of the clinic. This fieldwork often began with spending a day shadowing gunshot victims, which allowed me to observe how injuries shape a person's lifestyle and relationships. I also accompa nied victims to work, physical therapy sessions, court appearances, underground pill markets, corner stores, parties and get-togethers, and other routine social settings.

I did not use a handheld recording device while conducting interviews or dur ing fieldwork. Although this posed some initial challenges, it also allowed me to create alternative ways of recording data. For example, examination rooms inside HUP are always equipped with a computer, which physicians use to record notes from appointments. I was able to use these computers to make occasional jottings during interviews (Emerson, Fretz, and Shaw 1995). In between interviews, I used the computer to write my field notes. Outside the clinic, I jotted notes to myself on a small pad whenever there was a break in interaction. I have done my best to capture and accurately represent the content and tone of these interactions.

Disfigurement and Shame

By all accounts, getting shot in the stomach is an intensely painful experience. Victims who have been shot in the abdomen complain about the massive blood loss and agonizing pain as they slip closer to death. Beyond the physical pain of

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the injury itself, victims are also vocal about the sense of shame that they experi ence during life after the shooting.

Gunshot wounds to the abdomen become the source of shame for victims for

a variety of reasons. For starters, gunshot wounds to the stomach, intestines, and other vital organs often radically transform how a person performs basic bodily functions. The ability to control and regulate how and where one defecates (or not) marks one of the first steps toward independence in a child's development. Victims who are shot in the abdomen often have to wear a colostomy bag for months or even years. Many victims find this experience dirty and degrading.

Gunshot wounds to the abdomen are also shameful because medical proce dures leave victims disfigured in ways that they and others find traumatic. In response to technological advancements in high-powered semiautomatic hand guns, surgeons have had to develop what is now known as "damage control" approaches to surgery (Shapiro et al. 2000), a stepwise approach to trauma sur gery in which "traditional repairs are deferred in favor of rapid measures that control hemorrhage, restore flow where needed, and control or contain contami nation" (Shapiro et al. 2000, 969).

In urban trauma centers, victims with abdominal wounds commonly undergo forms of damage control in which their abdomen is left open until a later date when the body has had time to stabilize. This "open technique" is used to help victims avoid possible infection, necrosis to the damaged area, and other postsur gical complications. "Immediate closure of abdominal incisions after exploration and treatment of gunshot wounds is not always feasible or advisable" (Cohen et al. 2001, 83). Despite the medical efficacy of these techniques, there are significant emotional and social consequences for victims that are seldom acknowledged.

These themes emerge in Winston's story. One night, while walking home from a friends house, Winston heard footsteps behind him in the darkness. Frightened, he started jogging. The footsteps quickened and grew louder. Before he got shot, Winston heard the person chasing him say, "Don't make this shit hard!" Then the gunman fired several rounds from a .45 semiautomatic pistol, a gun that enthu siasts celebrate for its "stopping power."

Winston got shot twice. The first bullet entered the arch of his left foot and exited the top of the foot. Winston, who is now 25, has permanent nerve damage and arthritis in the damaged foot. The second bullet entered Winston's body a few inches below his right armpit, exiting the other side of his torso. On its way, this bullet tore through his intestines and parts of his pancreas and kidney. Critically wounded, Winston hobbled home. His mother was awake and quickly rushed him to the emergency room, where surgeons stopped his bleeding and stabilized his body. They removed ten feet of intestines and damaged parts of his kidney and pancreas. Opting to leave his abdomen open, they covered his stom ach and intestines with a skin graft taken from both of his legs.

After waking up from a three-week coma, Winston began a long process of adjustment to his new body. Near the three-month mark, doctors cleared him to return home. To celebrate his homecoming, Winston's mother organized a big

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THE ANNALS OF THE AMERICAN ACADEMY

family dinner. Winston recalls that when he came home he almost forgot how close he had been to dying. He told me, "When I came back, it was just like I had never left." Midway through dinner, however, Winston received an abrupt reminder that he was not the same person he was before getting shot. His abdominal hernia began gurgling and growing beneath his shirt. At first, nobody seemed to notice. Then, as Winston explained in another meeting at his apart ment, some family members, particularly his cousins, noticed that his hernia was bulging out from beneath his T-shirt. Winston recalls the sting of shame in that moment: "I just looked down and my stomach started to make all these weird noises and grow." Seeing my eyes grow wide, he continued, "People lost their appetite. I felt bad, like I was a freak. I wish I would have just died that night."

Winston's abdominal hernia became the object of shame and ridicule on the rare occasions when he ventured out in public. For example, on a hot summer day Winston headed to a corner store located a few blocks from his mothers house. Although he typically wore a cloth wrap that concealed the protruding hernia from public view, he did not wear the wrap on this trip. As he approached the corner store, Winston remembers seeing a group of men staring at his bulg ing belly. As he left, he recalls, one of the men made a joke at his expense: "Ay, that boi look pregnant!" This comment was followed by a chorus of laughter. After that, he was affectionately known as "Pregnant Win" by some people in his neighborhood.

Winston had public troubles with his new colostomy bag as well. One day Winston was scheduled to meet with detectives and administrators of Crime

Victims Compensation—a public fund for individuals who are injured in Pennsylvania. As part of the process, victims have to provide statements to detec tives investigating the shooting. Winston used the subway to get to and from this meeting. Before he boarded a subway train, however, the plastic clip holding his colostomy bag closed came undone. Within seconds, fecal matter that had accu mulated in the bag spilled all over Winston's pants and hands. "1 was walking to the subway and when I was there, the clip fell off. I usually clip it on tight, but it must have come lose. I had shit all over me. People could smell it."

Troubles with the colostomy bag invaded the most private and intimate aspects of Winston's social life, transforming sexual advances made by his girl friend into subjective reminders of his disfigured body. Disgusted at his own body, Winston felt particularly ashamed whenever his girlfriend at the time, Danya, tried to have sex with him. One afternoon at his apartment, Winston told me, "She would like try to do stuff, but I just felt weird doing that when my shit was just right there [pointing to the side of his stomach]."

On another occasion, the bag came undone in the middle of the night, leaking directly onto Danya. Winston was devastated. He explained, "Right when we woke up, I knew the bag had opened. It must have filled up with gas and I might have rolled over in the night, because it popped off. When we turned on the lights, it was all over us." Winston explained later that Danya feigned indifference about the incident, but deep down he "knew she was grossed out." To this day,

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Winston still feels the sting of shame from these and other mishaps with his colostomy bag.

Damage control surgery and the open technique may have saved Winston's life. Although from a clinical perspective this is certainly the preferred outcome, gunshot victims face significant bodily changes and challenges after the shooting. Winston's colostomy bag and abdominal hernia were not only practically disrup tive but became the sources of great shame in a number of routine interactions. Family dinners, riding the subway and sexual intimacy were marred by subjec tive reminders that Winston was no longer the person that he used to be.

Retained Bullets, Changed Body

While some gunshot victims have bullets that cleanly enter and exit their bod ies, others retain the bullets. At the most basic level, bullet entry and exit depends on where a person gets shot and his or her particular body type. Individuals who get shot where they have an excess of fat tissue or muscle have natural padding that slows the bullets travel. Certain parts of the body are more conducive to "clean entry/exit" than are other areas. Bullet entry and exit is also determined by the caliber of gun and ammunition used in the shooting. The .22 semiautomatic pistol and .380 automatic colt pistol, also affectionately known as "pocket pistols" among enthusiasts, have smaller, weaker bullets that are often retained by vic tims. Finally, some bullets are specifically designed not to exit. Gun afficionados like Jesse, a white man in his mid-30s who is a proud member of the National Rifle Association (NRA) and a regular at a local gun range, is adamant about using hollow-point bullets for home defense. Although they are pricier than full metal jacketed bullets, gun owners claim that there are both practical and moral reasons to use hollow-point bullets in home defense situations: "Hollow-points are great because you don't risk the bullet going through the bad guy and hitting something or somebody else."

Retained bullets were a common source of pain and frustration for gunshot victims in my study. Just over half of the gunshot victims I met (twenty-two of forty) lived with bullets in their bodies. Their complaints ranged from chronic irritation and swelling around the wound site to serious infections and debilitat ing pain that spread across their entire body. At the same time, retained bullets were also a common source of stress and anxiety. Many victims desperately want their retained bullets removed. Despite patients' protests, however, physicians rarely remove bullets because doing so can often cause more harm than good, especially by infections and other complications of surgery (Velmahos and Demetriades 1994; Rhee and Martin 1997).

These themes come together in Kevin's story. On a hot summer night in 2007, Kevin and a small group of friends were hanging out on a street corner just out side of a Chinese take-out restaurant. While waiting for a friend who was still ordering food, Kevin remembers, a pickup truck with a "couple of bols who my

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THE ANNALS OF THE AMERICAN ACADEMY

friends had beef with" pulling up to the corner. His friends and the guys in the pickup "exchanged words," which escalated tensions between the two groups. As the truck drove away, Kevin and his friend slowly started making their way off of the corner. However, as they walked away, the truck apparently circled around the block and followed them down a side street. The passenger in the pickup truck then drew a gun and fired shots at Kevin and his friends. One friend, Deonte, was trailing behind him and returned fire at the pickup, which screeched away. Kevin explains, "My nigga Deonte always carrying, so he pulled his ham mer [gun] and started shooting at them."

As the gunpowder settled, another of Kevin's friends, Jerrod, pointed out that Kevin was "leaking" from the back of his right leg. Kevin recalls how Jerrod kept yelling at him in a half-drunken and excited state, "You leakin', man, you leakin'!" Like many gunshot victims, Kevin does not remember feeling any pain, but remembers thinking right away that his friend had accidentally shot him. He explained, "At first, I thought it might have been those guys in the truck, but I was bleeding in my leg from behind. So it had to be my nigga, Deonte."

I met Kevin four years after the shooting. When I asked why he was at the clinic that afternoon, he explained that he was playing pick-up basketball with friends when the pain became unbearable. He rested briefly and then resumed play. "Then, I came down from getting a rebound and I felt a pain like I've never felt before. It was worse then when I first got out of the hospital!" Later, while trekking through a record-setting snowfall in Philadelphia, Kevin explained that the seasons had taken on new meanings after he got shot. Although he had grown up enjoying the changing seasons, especially the snowfall, the cold and snow caused swelling and sharp pain in his leg. "Sometimes I start feeling the pain before it snows and rains," he confessed. "I get worried now when it snows because I know my leg is gonna be hummin'." Despite the years that had passed since the shooting, Kevin lived with chronic pain. At first, he could identify cer tain actions and situations that precipitated pain, but over time these attacks became more frequent and less predictable. Kevin said, "I could just be chillin', watching TV or something, and then BOOM! It feels like I got shot all over again."

Kevins injuries disrupted his working life. After he got shot, Kevin began to distance himself from friends who were still hustling on the streets. He admitted that he still sold drugs from time to time, but said that his injury, coupled with the birth of his son, changed the direction of his life. "Once you have a kid, eve rything changes."

After the shooting, Kevin began to seek out a series of low-wage jobs in the service sector. After working at a local movie theater and at a concession stand at the airport, Kevin also eventually landed a job as a member of a housekeeping staff. Following an 8- to 10-hour shift, his leg would swell and throb. On one particularly bad day, Kevin complained that his entire back felt numb and that he had a sharp pinching sensation in his neck. Despite his best efforts, he regularly fell behind other housekeeping staff, which drew the ire of his manager. "She

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always says little things to me and gets on my case because I don't always keep up with others. She tells me to stop being lazy." Although Kevin wanted to explain why he was having trouble keeping up, he worried that telling his boss about his gunshot injury would worsen his standing with her.

A few weeks later, when Kevin returned to the clinic, he was even more frus trated and dejected about his work situation. His manager was reducing his shifts and hours. Barely scraping by, Kevin returned to the clinic in hopes that he could get a doctors note explaining the severity of his injuries. He thought that having a doctors note would reduce the stigma that comes with being a gunshot victim. Still, he was uncertain with how his manager would feel about the note. Kevin explained, "I gotta show this to my manager, but don't want her to start treating me like a criminal or something."

Retained bullets can cause intense pain, even during ordinary activities, which commonly disrupts the working lives of gunshot victims. In this way, retained bullets affect virtually everything victims do. Pain and discomfort become the primary lens through which victims experience multiple aspects of their lives. At the same time, retained bullets, which constantly remind the victim and others of the shooting, carry moral baggage. Similar to victims of rape and other violent assaults who are routinely blamed for their own victimization,7 gunshot victims fear that public admission that they got shot will elicit moral suspicion from peo ple around them.8 Gunshot victims find themselves stuck between a rock and a hard place: They feel trapped between being labeled "lazy" or unaccountable at work and being publicly identified as a gunshot victim who must have been doing something illegal to get shot.

Gun Mettle

Although gunshot injuries present both practical and existential challenges for victims after the shooting, having been wounded can become attractive and advantageous in some interactions. In these situations, gunshot injuries become a symbol of a persons resiliency, toughness, and mettle. Much as stories of a criminal past can elevate an aspiring criminal's status within the underworld (Shaw 1930/1966) and young men from inner-city neighborhoods can win respect for exhibiting "nerve" and a propensity for violence in public encounters (Anderson 1999), gunshot injuries are an embodied way to signal that an indi vidual is a "badass" (Katz 1988).

Kenny, a rail-thin black man in his early 20s, used his gunshot injury to elevate his status among friends with whom he sold drugs. He was the first in his small group of street corner drug dealers to get shot, and his injury exalted him into elite status. Kenny said, "Yeah, they just look at me like I'm more hard now." Beneath the surface, however, he was careful to keep potentially discrediting information from his peers. He was careful to make sure his friends did not know that the bullet entered and exited his leg and hit one of his testicles before

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THE ANNALS OF THE AMERICAN ACADEMY

lodging in his pelvic bone. According to Kenny, the information that he had lost a testicle might jeopardize his elite status and transform him into a "freak, one nut" in the eyes of his peers.

Other gunshot victims do not have to strategically control information about their injuries. Word travels that they have been shot, and they are receive a hero's welcome on returning from the hospital. For example, David was praised by a group of young men in his neighborhood after he survived getting shot. An ath letic black man in his mid-20s, David played defensive back on his college foot ball team. After graduating he tried out for teams in the National Football League, but did not make it onto any of the teams that invited him to work out. He then tried out for professional teams in other leagues and made a practice squad.

One night while walking home from the corner store, David noticed a fight between two women in the middle of a park near a high school. He remembers standing on his tiptoes watching the fight unfold. Then, unexpectedly, some of the friends on both sides of the fight drew guns and began shooting at one another. Pandemonium ensued: "People were cheering and stuff and then bang! Bang! Bang! I ducked and started running." While leaving the scene, David got shot twice, in the back and in his calf muscle.

I met David about a week later. He was waiting for me outside of the examina tion room, sitting on a chair in the hallway. Upon first glance, I was surprised that David was a victim. He had no visible signs of the shooting and was in exceptional physical shape. As I invited him into the exam room, however, I realized the extent of his injuries. David slowly propped his body up with his hands, tenuously supporting his weight on the arms of the chair. Slowly and methodically, he limped into the exam room, dragging his injured foot across the shiny floor. Each step he took required careful deliberation and effort. "See what I gotta live with?! I got a dead leg," he exclaimed. As he plopped down in a chair, he let out a big sigh. David told me that simple walks to and from the bathroom were reminders that he was a mere shell of his former self. His eyes welling up with tears, David described the "lightning-quick agility" he used to have on the football field. "Now, my foot don't even go up or side-to-side. It's like dragging a dead person around with you!"

Despite the severity of his injury and the intense pains he experienced, young men in his neighborhood treated him with the utmost respect after he returned from the hospital. Describing a series of interactions following his shooting, David said, "These young bols think it's cool that I got shot and survived." "What do they do?" I asked. He explained, "One of them always comes up to me and shakes my hand like I'm somebody he respects now. Another one will tell his sisters and cousins that I'm hard or some shit." A friend sent him a text message praising his toughness after the shooting. One message read something like, "Heard you got shot. You a true ass nigga!"

David's private life was a different story. A significant part of his day was spent anticipating "all the little things" that he needed to do now that he had a dysfunctional

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foot. In addition to retraining his body how to drive with his left foot, he had an entirely new orientation to time and space. "Everything I do now requires me to think about nine or ten different possibilities of what might happen." In the weeks after meeting in the clinic, David shared that he was having trouble sleeping. In addi tion to recurrent nightmares in which he got shot, waking up only moments before he died, David said that he was "going crazy" replaying the events from that night. He second-guesses that night in his sleep: "What if I ran that way? What if I was a litde faster?"

Although he had been transformed into a shell of his former self and spent much of the day anticipating problems he might face with his new body, David s injuries became a badge of honor among some of his friends and youths in his neighborhood. Surviving a shooting can be perceived as a sign of resiliency and toughness, two qualities that are admired by young men in inner-city neighbor hoods. The tensions between privately experienced and publicly perceived meanings of gunshot injuries underscore the many difficulties in the lives of gunshot victims.

Conclusion

Getting shot is the beginning of a much longer process of adjustment. With wounded bodies, gunshot victims realize that many of the daily activities they had taken for granted require extra time, care, and mental energy to complete. These bodily changes and the practical difficulties they entail become existential crises as well. Taken together, bodily failings and routine disruptions signal that a per son is no longer who he used to be.

Gunshot injuries are not universally regarded as shameful and debilitating, however. In some situations, gunshot injuries can even become attractive and advantageous for victims. Through conscious manipulation or in "undeserved praise," victims learn that surviving a shooting can be seen as a sign of their toughness and mettle.

The cases presented here draw attention to the foreground of gunshot victimi zation. Currently, social scientific research is overly committed to studying gun homicide. While these data add to our knowledge of crime and can be useful for policy-makers, studies that identify background risk factors for homicide over look the lives of victims who live to see another day. It is important to conduct research on gun violence that begins with the victims' perspective. This orienta tion helps us to appreciate the multiple transformations that gunshot victims undergo after being shot.

Moreover, the data presented here also raise additional questions about the webs of social relationships that emerge after an individual is shot. In addition to ongoing interactions with physicians and other health care providers, gunshot victims become entangled with police officers and detectives, the district attor ney's office, state institutions that distribute disability and social security benefits,

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THE ANNALS OF THE AMERICAN ACADEMY

social service agencies, and religious and faith-based organizations. These multi ple institutional involvements reveal collective activity around gun violence.

In sum, gun violence research should tackle the messy and often unpredicta ble lives of victims after the shooting. This research program advances not only substantive knowledge about how gun violence affects peoples lives but also awareness about the health and safety of a population that is too often neglected in policymaking and academic writing.

Notes 1. Given the sensitive nature of my fìeldwork, I use pseudonyms and do not reveal where participants

live or where they were shot. These practices comply with my Institutional Review Board protocol #811465.

2. Unlike full-length revolvers, which are often four inches, many snubnose models have two-inch bar rels. Although the small barrel length is advantageous for concealed carrying, the snubnose revolver can also have more felt recoil and be less accurate.

3. "Wet" refers to using a street drug composed of embalming fluid placed on tea leaves. Users who "get wet" or who are "wetted" experience slowed reflexes, dissociative effects, and hallucinations.

4. Randall Collins (2008) shows that most individuals are incompetent when it comes to doing violence. Even in war, few soldiers shoot the enemy accurately

5. National Center for Injury Prevention and Control, Web-based Injury Statistics Query and Reporting System. 2006. Available from www.cdc.gov/ncipc/wisqars/. Calculations by author.

6. I was one of John's graduate student mentors during "LA@Play," a summer ethnographic training program funded by the National Science Foundation at the University of California, Los Angeles. John is now a PhD student in the Department of Sociology at Notre Dame. He continues to do ethnographic fieldwork.

7. Rape victims are commonly blamed for their purported role in instigating or inviting rape; see Wakelin and Long (2003).

8. John Rich (2009) documents how physicians, nurses, staff, and police officers routinely hold the view that gunshot victims must have been doing something illegal to get shot.

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