A charmer. A smooth talker. A ball of life.
That’s how Erica Jones remembers her godson Jermon Perry.
The 7-year-old died in March after his younger brother accidentally shot him in the head while playing with a gun. Perry is one of hundreds of children who have been shot and killed over the last decade in St. Louis, a region with one of the highest rates of child gunshot wounds in the country.
“His mom has to go through the same thing that I did,” said Jones, whose adult daughter died in a drive-by shooting in St. Louis in 2015. “It’s just a gut-wrenching feeling.”
Jermon was taken to Cardinal Glennon Children’s Hospital in St. Louis, where he later died.
There are two level-one pediatric trauma centers in the city that treat gun-related injuries in children: Cardinal Glennon and St. Louis Children’s Hospital. Since 2013, the two hospitals have treated more than 600 child gunshot wounds. Both have reported an increase in the number of patients admitted with gun-related injuries over the last three years.
In November, the Centers for Disease Control and Prevention ranked the greater St. Louis region seventh in the nation for firearm homicides among children ages 10 to 19.
Brad Warner, a trauma surgeon at St. Louis Children’s Hospital, calls the high rate of gunshot injuries in children “very sobering.” It’s now typical, said Warner, for doctors working the night shift to receive alerts for child gunshot wounds on their pagers.
“We’ll get something like, ‘Trauma Stat. Gunshot wounds. 6-year-old. ETA 20 minutes,’” he said. “That could be anything from a rifle going off to a drive-by shooting.”
Many of the gunshot wounds he treats aren’t life-threatening, particularly if a bullet passes through a child’s arm or leg.
But some children have died on his operating table. These cases, like the 12-year-old who found a shotgun in his grandma’s couch, are the ones he can’t forget.
“He and a friend were just playing around with it, and it discharged and shot him in the abdomen,” Warner said. “By the time he got to the operating room, his heart rate was already starting to drop. And we couldn’t bring him back.”
Medical professionals say children tend to be resilient when it comes to recovering from gunshot injuries.
But Nicole Wilson, a pediatric surgery fellow at Children’s Hospital, said a single gunshot wound can have a big impact.
“Bullets don’t discriminate,” Wilson said. “A bullet hits a kid, a bullet hits an adult. The injury patterns are the same. The only difference in children is that they’re smaller real estate. So a blast pattern tends to have larger repercussions in a kid.”
Wilson estimates she’s seen at least 50 children with gunshot injuries at Children’s Hospital in less than a year.
“You have an initial anger reaction of, ‘How did this kid get exposed to a gun? How is there a 3-year-old who is shot, in my ER?’” she said.
The daily toll of treating children with traumatic gun injuries can have a profound and lasting effect on doctors, even as they work to process their feelings privately with their colleagues.
For Wilson, the hundreds of children and adults she’s treated for gun injuries has led to a shift in mindset.
“I grew up in Texas with guns in the home,” she said. “I’ve gone 180 degrees since I’ve started medical school. Personally, I would not want to have a gun in the home. I know too much about what can happen.”
Pam Choi was a surgery resident at St. Louis Children’s Hospital in 2014 when she decided it was time to take a close look at their patient data.
Choi said a turning point for her was seeing a 1-year-old who had been shot while held in his mother’s arms.
“It’s a horrifying image in your mind that stays with you,” said Choi, who is now at Children’s Mercy Hospital in Kansas City. “It’s something that drives you to want to understand the problem better.”
Choi worked with a team of doctors from St. Louis Children’s Hospital and Cardinal Glennon to analyze the records of child gunshot victims treated at the two trauma centers. There were nearly 400 child gunshot victims ages 16 and under treated in St. Louis between 2008 and 2013.
Of these, the vast majority – more than 80 percent – were male.
Nearly 79 percent of child gunshot victims in St. Louis were African American, and more than half of incidents were categorized as assault.
What’s more: Almost 70 percent of patients were between 14 and 16 years old.
The study only examined gunshot victims up to age 16, but anecdotal evidence suggests a good chunk of patients treated at the two children’s hospitals are actually older teens.
Although St. Louis Children’s Hospital tries to limit their patient pool to kids ages 18 and under, they will accept patients up to age 21.
These patients “tend to not be like the typical kid in a children’s hospital,” said trauma surgeon Brad Warner. “Many of them have tattoos and facial hair. They look, for all intents and purposes, like an adult.”
These older teens — often victims of violence — are also more likely to be readmitted in the future with additional gunshot wounds.
Warner remembers one 17-year-old patient in particular who was treated four times at Children’s Hospital for gunshot injuries.
“Not four times in one episode,” he explained. “Four separate admissions with gunshots. It’s just crazy.”
The policy of accepting older teens at Children’s Hospital also means that doctors sometimes have to pivot from caring for a newborn to treating an 18-year-old gunshot victim.
“It just takes a different emotional toll on you,” said Wilson. “It’s much more like treating adult trauma.”
No one can truly comprehend what it’s like to bury a child, said Erica Jones, until you’ve lost one of your own.
“We talking about a child that we carried for nine months,” Jones said. “We watched this child crawl, walk, talk, take his first steps. So I try to get people to understand: 'You can’t know my feeling.'”
She adopted her 8-year-old grandson Jakeem after her daughter Whitney was killed by a drive-by shooter in 2015.
Whitney’s case remains unsolved, but Jones hasn’t given up hope.
Every two weeks, she calls the St. Louis Metropolitan Police Department to check for updates on her daughter’s case.
In the years since Whitney’s death, Jones has become a vocal advocate of gun control. She also founded a support group in 2015 for mothers who have lost children, called Voice of the Voiceless.
She organizes monthly meetings for grieving mothers and takes their phone calls at all hours of the day and night.
“I let mothers know: 'I have your back,'” Jones said. “If you can’t talk, I’ll talk for you.”
She tries to stay positive, even while surrounded by intense grief. But she can’t shake the fear that something might happen to her grandson Jakeem.
“I pay attention to wherever he goes,” Jones said. “I have to make sure that he’s protected at all times.”
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