Well over a decade ago, pediatric surgeon Dr. John Densmore and his wife bought their first home. He had just started his residency at Children’s Hospital in Milwaukee.
"You know what I remember fondly about it was that people looked out for each other," Densmore says. For instance, he’d come home after a long shift to find his walk shoveled. But, there were problems.
"I remember on a run by a park near that house one day that a Hmong kid had been shot," he says. "Sort of being dumbstruck that that could happen so close to where I was living."
Up until that point, Densmore had only encountered gunshot wound victims in the hospital.
More than a decade later, two miles from Dr. Densmore’s first home - near 73rd and Mill road, there was another shooting. A shooting between two drug dealers.
Darmequaye Cohill sold heroin. Kwesen Sanders stole Cohill’s cellphone number. He got it off Facebook and had Virgin Mobile make it his own. So, when Cohill’s clients wanted to buy they reached Sanders instead. Cohill drove to Sanders house to settle things.
13-month-old Bill Thao was nextdoor. Bill’s family was practicing choir, while he played legos with his brother and other relatives.
Darmequay Cohill got the wrong address. He fired 41 bullets, intended for Kwesen Sanders, into the house where Bill played. The prosecutor on the case likened the damaged house to swiss cheese. The bullet struck baby Bill in the abdomen and came out just below his hip. During closing arguments in Cohill’s trial, the prosecutor said, "Unlike the other children… as they laid on the ground crying and upset. Baby Bill wasn’t crying… he appeared to be in shock…"
Christmas week of 2014, Dr. Densmore was one of two head pediatric surgeons on call.
Speeding to the hospital, he had a moment to consider the big picture. "What does that say about our city?," Densmore asks. "What does that say about the place that I live, I love, I work in everyday. And I thought, this is a new low, this is a new low."
Bill Thao is widely known as Baby Bill. He’ll forever be Baby Bill - the child of Hmong parents, whose family escaped violence in Laos only to employ bullet dodging tactics learned in the jungle in a living room in Milwaukee.
Dr. Densmore says Bill was one of twelve kids he personally treated for gunshot wounds in 2014. He’s one of ten pediatric surgeons at Children’s hospital. Overall, 71 kids were treated for gunshot wounds that year.
He estimates 20 to 30 people worked together to save Bill’s life - doctors, nurses, anesthesia techs, anesthesiologists. Decades of schooling and medical training, probably hundreds of years among them.
"When you have a baby in shock, it's not as easy as putting in an IV like you or I might imagine… in a child that small that's often not an option because the veins are collapsed and there's no blood in them," Densmore explains.
It’s critical that Bill gets ample blood flow. Because once Dr. Densmore starts operating, it’s a race to outpace the bleeding. That’s where an anesthesiologist comes in. To control the fluids. Dr. Densmore refers to the anesthesiologist on call that night as his wingman.
Seconds pass -from when Dr. Densmore first sees Bill to when he’s rushed upstairs to the operating room. Nurses surround Bill’s torso and legs with blue surgical drapes to keep the area around his injury sterile. At this point, Bill still isn’t getting enough fluid. Dr. Densmore scrubs out and consults with the anesthesiologist. They try to get a line through Bill’s neck, through his arm. Still no progress.
Dr. Densmore can’t wait any longer. He scrubs back in. It’s time to operate. "And then ultimately coming to the point where I looked across at my fellow and I said are you ready because once we start this, we're going to have a very limited time," he says. "...And, the next thing I knew, as we had found a significant injury… And had tried to isolate it but it wasn’t changing… it wasn’t stopping the clock. The clock was still running the baby was getting sicker by the second. And I just remember at one point, hearing that we lost the pulse and ...realized we had to shift gears, and that I was missing something."
Two sets of arteries and veins that supply blood from the heart to the legs were severed. "And while we understood and were doing our best to control one set of arteries and veins, you know this damn bullet took out both...," he explains. "We could only see one because of the bleeding... "
After attempts to restart Bill’s heart, Dr. Densmore makes the call.
"And when you’re in that situation, the hard part is to not prolong it, to not pursue the futile out of respect for the patient," he says. "...And ultimately we lost Bill. One of the few patients I’ve lost on the table and one I'll never forget. He was loved by the people around him, even for that short period of time."
Dr. Densmore walks to the waiting room and breaks the news to Bill's family.
"I liken it sort of watching a soul become unstitched before you," he explains. "You are the deliverer of the worst news in the world."
After, Dr. Densmore went home to celebrate a belated Christmas with his family. His wife is a pediatrician so she gets it. Still, he says it was hard to stay present.
"A place like Children's is not a sterile box where the injured go and they either make it or they don't. There are people human beings in that box making it happen," he says.
Dr. Densmore has operated on too many kids with gunshot wounds to count over the course of his career. Bill was the most visceral. Dr. Densmore finds comfort through church. And he’s been writing about that night, hoping to publish a book. Still, there’s no other job he’d rather do.
"We have this saying that pediatric surgery is the potential for an 80 year cure. And, there are very few other things in medicine that give you that kind of dividend," he says.
When the cause is gun violence, a successful surgery doesn’t always achieve the 80 year cure. "One word, recidivism," Densmore says. "We've had heroic and good outcomes only to lose a child on the second admission for the same problem. That is hard."
He’s seen the same patients twice for gunshot wounds. Some don’t survive the second time. He points to a recent study based in Newark, New Jersey - a similar urban center to Milwaukee. 8.8% of gunshot survivors 18 years old and younger came back to the hospital with another gunshot wound.
"Our roles put us in a position where we see where society's fabric frays where it rips where it's failing," he explains. "You know my plea is that we all find a way to connect to each other in our lives that can start to get at the root of this, which is essentially we have people in our city who have lost all hope. They've lost all hope for a myriad reasons… geographic isolation, loss of mentorship, loss of parents… Loss of people willing to take risks to reach out of a safe zone and pull somebody along."
"We also see incredible sides of kids that are resilient and recover and are inspirational," Densmore adds. "...I see hope every time I see a victim who survives come into our hospital who has a loved one."
Doctor John Densmore says Milwaukee needs a plan. "I'd like the CDC to name Milwaukee as one of its primary youth violence prevention sites," he says. "I'd like to hear a comprehensive state and citywide plan aimed at using best methods which have been documented in the literature and then a plan for how we're going to fund that."