A psychiatrist who survived two gunshot wounds shares how it felt and what to do if you're shot
- Rising gun violence in the US increases the risk you or someone you know may receive a gunshot wound.
- After being shot twice, Joseph Jackmovich used his medical knowledge to perform basic first aid.
Dr. Joseph Jackmovich — a psychiatry resident at Indiana University School of Medicine — was working on his Honda Civic with a few friends one day in 2020 when they heard four loud bangs from a passing car.
Jackmovich remembers feeling the sensation of long, hot bee stings, one in each leg.
But it wasn't until he placed his hand over the wound on his left leg, pulled it away, and saw blood, that he realized he'd been shot — twice. Two bullets had passed through his upper legs, just narrowly missing his arteries.
At the time of the shooting, Jackmovich was a family medicine resident, and he used his knowledge and training to deal with his wounds before paramedics arrived.
With gun violence on the rise in America, it's more important than ever to prepare yourself with basic first aid knowledge.
There are now 120 firearms for every 100 people in the US, and over the past decade, more than 1 million Americans have been shot.
This doesn't necessarily mean you or someone you love will ever get shot, but gun violence has become more common: In fact, between 2019 and 2020, 70% of police agencies reported an increase in nonfatal shootings.
Below, Jackmovich offers three first-aid tips and shares what you can expect from treatment and recovery for a gunshot wound.
First aid tips: How to treat a bullet wound
After experiencing a gunshot wound, follow these key steps.
1. Make sure you're safe
Jackmovich's first instinct was to call 911, but he didn't know if the drive-by shooters would come back. So, he focused on getting himself and his friends off the street and into the house as quickly as possible.
If you could still be in danger, you may want to wait to call 911 until you know you can safely make the call.
- After an intentional shooting: You may need to evacuate the scene before calling 911.
- During an active shooting: You may need to hide somewhere out of the shooter's view before making a call.
- After an accidental shooting: You'll want to secure the gun and turn the safety on, after you call 911 or while on the line with the dispatcher.
Important: In some areas, you can also now text 911 — so you can still contact emergency services even while hiding or if you need to stay quiet for any other reason.
2. Call 911
Regardless of where the bullet hit you or how much you're bleeding, all gunshot wounds require medical attention — and the sooner you receive treatment, the lower your risk of deadly complications.
Always call 911, or have someone else call, as soon as it's safe to do so. In cases of medical emergencies — like Jackmovich's — the dispatcher will send an ambulance with paramedics and emergency medical technicians (EMTs) to provide care.
3. Manage the bleeding
Uncontrolled bleeding is the leading preventable cause of death in people with gunshot wounds.
First, you may need to remove some clothing to identify the location of the bullet wound. Next, you want to try to control the bleeding and get the blood to clot.
Note: If you'd like to learn more about how to stop bleeding for severe injuries, check out Stop the Bleed, a course from the American College of Surgeons.
In the case of arm and leg injuries, it also helps to tightly wrap a medical-grade tourniquet 2-3 inches above the wound.
One of Jackmovich's friends, a former infantry sergeant in the Indiana National Guard, happened to have a tourniquet in his trunk. That friend applied the tourniquet to Jackmovich's left leg to limit blood loss.
If you don't have access to a tourniquet, you can use a belt or tie an article of clothing around your limb. If the wound is elsewhere on your body, you can apply a clean cloth to the wound — a T-shirt, gauze, or towel will work — and use both hands to apply direct pressure.
While waiting for the paramedics to arrive, Jackmovich tried wiggling his toes and lifting each foot off the ground to check if he'd lost any feeling in his limbs.
"I was trying to assess what physical things I could still do. I knew I could still move but the growing numbness in my right leg was making me pretty nervous," Jackmovich says.
What to expect from medical treatment
Medical treatment for a gunshot wound is based on the level of damage — which usually depends on the type and speed of the bullet, as well as the location of the wound.
Bullet wounds that hit major organs, blood vessels, or bones tend to cause more immediate damage. In these cases, you may need to stay in the hospital for around several days while your care team performs any necessary surgeries and monitors your recovery.
Since the bullets that hit Jackmovich didn't damage any of his major organs or bones, he spent less than an hour in the ER before being discharged.
"I was incredibly lucky, to say the least," he says.
Jackmovich received an abdominal and pelvic CT scan to assess for bleeding and other damage and fentanyl for pain. Following discharge, he took a course of prophylactic antibiotics to prevent infection. He also had two follow-up appointments with his primary care doctor in the weeks following the injury.
The FMJ 9mm bullets that hit Jackmovich were small and fast-traveling, which made his injuries less complex — and fortunately, neither of them got stuck.
However, if a bullet doesn't exit your body, you may need surgery to remove any remaining pieces. If removing bullet pieces could cause additional damage to your organs, medical staff may opt to leave them — eventually, scar tissue will form around them.
For severe wounds, you may also have surgery to:
- Find and remove pieces of broken or shattered bone
- Clean the wound
- Insert drains or tubes for body fluids
- Remove portions of damaged organs
If you lose a lot of blood, you may also need a blood transfusion.
What's the cost: The average out-of-pocket cost to treat a gunshot wound is about $5,254 if you're discharged from the ER the same day, and $95,887 if you're admitted to the hospital. Keep in mind, though, that health insurance companies usually help cover these costs.
Potential complications
The potential complications for a gunshot wound depend largely on the location of the injury.
When a bullet hits your spinal cord, it may lead to partial or full paralysis or death. People with gunshot injuries to the chest or abdomen are most likely to return to the hospital due to complications.
Complications from abdominal gunshot wounds may include:
- Peritonitis: Without treatment, this inflammation of the membrane lining your inner abdominal wall and covering your abdominal organs can lead to sepsis, a life-threatening whole-body infection.
- Hematoma: This pool of clotted blood within your tissues usually goes away on its own, but it can cause sharp abdominal pain. If the hematoma becomes too large, it may also cause further damage by compressing your organs.
- Collapsed lung: This happens when a bullet wound in your chest causes a tear in your lung, allowing air into the space between your lungs and chest wall. Trapped air prevents your lung from filling and causes it to collapse. A collapsed lung can cause shortness of breath and can be fatal without prompt treatment.
Head wounds that aren't fatal may cause complications like:
- Post-traumatic epilepsy: You may experience recurring seizures that happen as a result of a traumatic brain injury (TBI).
- Cerebral edema: This buildup of fluid increases pressure around the brain.
- Cerebrospinal fluid (CSF) leak: The fluid surrounding your brain and spinal cord may leak out. Without treatment, this leak can cause headaches and potentially lead to meningitis.
Note: Gunshot injuries to the head and torso are most fatal. But limb injuries can also cause serious damage to bones, tendons, ligaments, muscles, nerves, and major blood vessels. Long-term side effects may include fractures, nerve pain or numbness, loss of function, or in some cases, loss of the limb.
In general, Jackmovich says infections remain one of the most common complications of gunshot wounds, since the bullet can pull material and debris into the wound.
This is why it's crucial to take the full course of antibiotics prescribed by your doctor, and follow all aftercare instructions. Pay attention to any signs of infection and call your doctor immediately if you notice the following symptoms:
- A fever above 100.4°F for more than four hours
- Tan, green, or yellow, or thick, foul-smelling pus from the wound
- Increased drainage from the wound
- Red streaks around the wound
What to expect from recovery
Jackmovich used a cane for several weeks before he could walk again with no support and return to work.
"The pain from the wounds felt like I was hit with a large blunt instrument on each leg, so walking or sitting was pretty excruciating for a while. I tried to walk around the home to keep myself moving, but kept it minimal enough to not cause any additional injury," he says.
Like treatment, recovery time can range vastly depending on the location and severity of the injury. A minor gunshot wound may heal within weeks, but a more severe injury could cause lasting complications, such as long-term mental health symptoms or chronic pain.
With that in mind, recovery may include:
- Taking antibiotics, pain relievers, or other medications to deal with complications
- Participating in physical therapy
- Changing your dressing and caring for your wound
- Using ice packs to relieve swelling, if your provider approves
A gunshot injury can be traumatizing, so it can help to prioritize your mental health along with your physical health. In addition to post-traumatic stress disorder, you could experience the following symptoms:
Following the incident, Jackmovich says he felt especially wary in open spaces when cars drove by. He advises reaching out to a therapist, who can help you process what happened and manage any mental or emotional symptoms.
"Keep your support network close," he says.
"It's not a flaw or weakness to seek therapy, and the coping skills you learn can be invaluable for moving past the experience and ultimately healing," Jackmovich says
Insider's takeaway
No matter how much you're bleeding or where you've been shot, a gunshot wound always requires immediate medical attention. Always call 911 once you can safely do so, and then make an effort to control the bleeding by applying as much pressure to the wound as possible.
Treatment and recovery for gunshot wounds can vary widely. When no major organs, bones, or blood vessels have been damaged, you may leave the hospital the same day. In other cases, though, you may need extensive surgery, physical therapy, and medication.
"It's a scary process but nowadays these injuries can very often be successfully treated — even in severe cases. If you go to the ER for treatment, you are going to receive excellent care," Jackmovich says.