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Dr. Leana Wen, physician and Health Commissioner of Baltimore City, recently wrote an article for the New York Times. What Bullets Do to Bodies explained her experience with the unimaginable horrors of bullet wounds from super scary assault rifles. First things first . . .

Whatever hospital Dr. Wen is referring to is in Baltimore. Note that location and make sure that you never end up there. The emergency room in question took a full two minutes to discover a “grapefruit” sized exit wound on a patient with a known gunshot wound. Right there in the opening of this article I’d already lost any respect for the author’s judgment.

The first bit of true Ph.D. level wisdom we get from Dr. Wen is this little gem: “Early in my medical training, I learned that it is not the bullet that kills you, but the path the bullet takes.”

Thank Jesus. And here the rest of us were assuming that bullets sitting on store shelves around the world were silently murdering us. Apparently Dr. Wen needed six years of medical school to teach her that a bullet needs to actually travel into the body to cause damage. Folks, our education system failed this one.

We then learn from Dr. Wen that expanding rounds fired from scary “assault rifles” explode inside of the body. That’s why they “liquefy organs” or shatter bones in a hundred pieces. Because the bullets literally explode. Here’s the picture that supposedly illustrates the point:

News flash: bullets don’t explode inside a body. By the same token, I’ve seen hundreds of gunshot wounds on humans and other animals. I’ve never seen a single liquefied organ.

I’ve seen organs absolutely shredded, partially from bullet fragments, but mostly from shards of bone. Bones splinter (and even turn to powder). But that’s not the effect of an exploding bullet; that’s the result of one solid object interacting with another solid object at high speed.

I don’t know if Dr. Wen is intentionally misleading an ill-informed public, or is simply ignorant of the kinematics of injury. In any case, I wasn’t surprised to find that the article posted on the New York Times site is now a hastily corrected version of Dr. Wen’s first mistaken attempt. As originally published, it said:

A handgun bullet enters the body in a straight line. Like a knife, it damages the organs and tissues directly in its path, and then it either exits the body or is stopped by bone, tissue or skin.

This is in contrast to bullets from an assault rifle. They are three times the speed of handgun bullets. Once they enter the body, they fragment and explode, pulverizing bones, tearing blood vessels and liquefying organs.

This shows that Dr. Wen — who presents herself as an expert — doesn’t understand that rifles and handguns can fire either solid or expanding rounds. Apparently, in Dr. Wen’s world, handgun bullets don’t fragment and can’t tear blood vessels.

The reality: whether the bullet is expanding or solid, whether it’s fired from a rifle or pistol, bullets can do incredible damage to a human body. But sometimes they don’t.

I’ve seen plenty of tiny icepick wounds from M855 rounds fired from an M4 (see: photo at the top of the post). And I’ve seen an FMJ from an AK-74 turn a femur into what looked like Jell-o.

I’ve seen a patient shoot himself point blank in the hip with a .45ACP fired from a pistol, creating an injury so minor that he was able to hide it from his wife. For weeks. And I’ve seen a bullet from a .357 Magnum revolver make a heart look like half a heart.

Dr. Wen’s hyperbolic diatribe is accurate is some respects. Bullets fired from rifles typically move faster than bullets fired from handguns. They generally do more damage than pistol rounds. That’s why we use them.

The point of any cartridge, however, is to deliver as much energy as possible to the target given the physical limitations of the cartridge and the firearm. The idea is to do as much damage as possible with each round. And that’s what, in any self defense situation, everyone wants.

Put another way, shooting someone to little effect is the last thing you ever want in a military or defensive gun use.

While in combat in Afghanistan, using a rifle, I shot someone center mass. He leaned over and continued to shoot at my friends with renewed vigor. That was far more terrifying than the shots that missed. Right then, I desperately wished my round had done more damage, not less.

I imagine it’s the same for just about anyone in a self defense gun use situation. After all, if your life is threatened, would you like to stop the people trying to kill you and your family, or just injure/anger them?

As an aside, I’ve treated hundreds of penetrating traumas from gunshot wounds (primarily from rifles) and explosive devices. They can be absolutely devastating. But I’ve never had a gunshot wound do the kind of damage that I’ve seen created in some motor vehicle accidents.

After I arrived at a high speed head-on collision with a tree, I found one adult male patient under the driver’s seat of his Blazer. Yes, he was crushed to the extent that his entire body was shoved underneath his seat. I’ve never seen a bullet do that. And I can’t imagine the article Dr. Wen might write if she’d ever seen something like that, too.

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74 COMMENTS

      • dunno about liquified, but you can convert them to mush with a hi-v varmint softpoint. Anyone who’s shot say, a coyote in the lungs, liver, kidney, etc, with say, a 55 gr Vmax from a 22-250, at less than 200m of range and then done an autopsy will tell you that it’s quite obvious the organ has ceased to exist. The Mach II effect of the temporary gas cavity CAN displace spinal disks, sever the spine, and pulp vital organs.

        • Too bad we can’t post pics. I shot a jackal with RF’s .500 S&W lever gun.
          There was nothing left in the chest cavity. There was a cone shaped red spray on the brush for about 8-10′. Truly devastating.

        • When Montana did not have a speed limit proper (reasonable and prudent), we used to describe deer hit by cars going 120+ as aerosolized.

          Nothing but a red dusting for 20 yards.

        • Speaking of high velocity, I guess she’s not familiar with Hydrostatic shock from extremely high velocity rounds, typically from a rifle, i.e. 5.56 / .223, 6.5 Creedmoor, etc. All with rounds capable of exceeding ~3K FPS generally speaking. The weight of the round isn’t what creates the Hydro-static shock wound conditions. The exceedingly high velocity of the round is what causes H.S.. With a 5.56 round, specially loaded for “predators”, and rated at 3,600 FPS by Hornady, I went coyote hunting. I have some of their 4,000 FPS stuff, but not used it yet. BTW, repeated use of the 4K FPS stuff may cause premature wear to the barrel. Although Hornady clearly states on the box it’s not the case with their product, huh. Upon my shot impacting the animal in the main part of the body, directly behind the shoulder, he dropped like a rock. I was surprised at the amount of devastating internal damage and exit wound. He was ~140 yards out.

          The heart and lungs were literally exploded and “liquefied.” The animal also had one eye that was protruding out of its socket. This was due to Hydrostatic shock induced by the hyper-velocity round. The brain, surely was heavily damaged too, from H.S. tendency to create peripheral damage to organs not impacted directly by the bullet. Interestingly enough, months later, I watched an episode of Pigman and saw something very similar. Pigman hit the hog in the frontal area of the shoulder, almost head-on shot. The extreme pressure change in a fraction of a second, popped the eye completely out of the socket, left hanging on its cheek and the other bulging out. He made a quick comment about high velocity rounds creating extreme pressure, which caused the eyes to pop out.

          A quote from my research: “In such selected cases, brain tissue was examined histologically; samples were taken from brain hemispheres, basal ganglia, the pons, the oblongate and from the cerebellum. Cuff-like pattern hemorrhages around small brain vessels were found in all specimens. **These hemorrhages are caused by sudden changes of the intra-vascular blood pressure** as a result of a compression of intra-thoracic great vessels by a **shock wave caused by a penetrating bullet.** ” Army medics have reported cases of this in field. Ex: shot in the shoulder, but lethal wounding to the brain and / or heart as the cause of death. Not the bullet wound channel itself. Apparently, the vast majority are not wounds that can be repaired either.

        • I replied in more detail about what you’re describing wound wise in a lower post. It’s referred to as Hydro static shock. Briefly, due to extremely high pressure changes that occur in a fraction of a second, a huge pressure wave is sent to susceptible organs, i.e. the brain, heart lungs, kidneys, eyes, etc., depending on where it’s impacted This causes immediate incapacitation of the animal and can kill the animal quicker than the bullet wounding channel. It’s been found by Army medics in the field too. High velocity handguns, i.e. the five-seven, .357 Sig, 40 S&W and 9 MM with +P and P+P loads, are all capable of H.S. wounding. At the other end of the spectrum, .the 45 ACP, cannot create this type of lethal wound. It relies on size of the round to due to work. This is one of the reasons the Special Forces renewed their use of the 9 MM, along with large capacity clips in the smaller, but just as lethal high FPS rounds. http://www.Luckygunner.com has a great comparison of larger, slow firing FPS rounds vs. the much faster, but smaller rounds, I listed some above. The smaller sized rounds, which have seen huge gains through the use of highly improved powders and projectile designs, etc.

    • You seriously need to go back to school then and pay attention in science if you really believe what your dumbass just said….. I’ve blown more shit up with a .17 super mag than a 12 gauge with slugs… Major difference here is a tiny object moving at extreme speeds causing displacement of material vs. a large object impacting the same material at a lower speed creating more of a “smack” than material displacement. So you are saying that the laws of physics do not apply to firearms on this planet? When an f-16 flies right over your house at low altitude and mach speed your Windows blow out but when the Boeing747 flies directly over your home at the same altitude does it leave a new fault line in your neighborhood? No! Because the f-16 tho smaller by all means is moving so much faster it displaces air creating an extreme pressure difference around its flight path in which your home was just in causing your windows to blow out of your home…. And possibly even blowing out your ear drums and giving you shell shock if you where in it or in the immediate area of the air displacement. This is why we need populous control. I’m a damn dropout and obviously have more common sense. Also please read the safety manual that came with your circular saw to realize that can remove body parts…. We would hate for you to lose anything more than the braincells you are obviously lacking. 😀

  1. Considering this was in the New York Slimes, what do you expect? They hate the right to keep and bear arms, and want the general citizenry to be disarmed. If it were ever discovered that they took payouts from criminal organizations, it wouldn’t surprise me in the least.

  2. “I don’t know if Dr. Wen is intentionally misleading an ill-informed public, or is simply ignorant of the kinematics of injury”

    Yes. Willfully on both counts.

  3. She’d collapse from the vapors if she ever encountered a wound from a proper hunting round.

    Bullets do damage to their target. That is their purpose. They’d be useless if they didn’t.
    Knives cut things. That is their purpose. They’d be useless if they didn’t.
    Hammers deliver forceful blows. That is their purpose. They’d be useless if they didn’t.

  4. Why focus on “assault rifles”? They fire intermediate cartridges. Take the Fudd-est moose-hunting rifle you can find and tell me what a soft point from that will do to a human being. What, did you think a round meant to drop a 1,500 lb animal at 600 yards would be like a love tap?

    • Oh you should have seen the original before they corrected it. It was clear that Dr. Wen thought that “assault rifles” actually fired different, more deadlierer ammunition than other firearms.

    • Extrapolate that a bit further; the fuddiest fudd gun of them all settles all controversy on wounding by conventional small arms…the 12 gauge shotgun. If FMJ bullets from intermediate cartridges are bad, powerpoints from high powered hunting rifles even worse, then high velocity, hollow point sabot slugs must entirely vaporize human targets.

      Any comparison that suggests FMJ from intermediate cartridges does more damage than any comperable hunting round must be fatally flawed: there is a reason the bullets intended and used to harvest game are designed the way they are, and are not FMJ, and it’s all about how much damage they inflict on mammalian bodies.

      This is yet another example of someone who can’t be this stupid and have the education and position they have. The only plausible explaination is that she is lying, and given that her lie is material to her position, ought to be removed from any position of public trust. The second most plausible explanation is that she is exceptionally and completely incompetent to hold a license to practice medicine. It beggars the imagination and stretches credulity to suggest this explanation, but if it is the case, the result might be a bit different, that is, competence not being a criteria for public office (a noisome oversight on the part of the framers I think) she may keep her position, but ought not to be allowed to practice medicine any longer.

      Alas, the days of needing to be either competent or honest are behind us, and any sort of duplicitous, incompetent behavior acceptable. I wonder what, at this point, one must do to be called out for one’s behavior.

      It seems to me there was a time when publicly revealing oneself to be either a liar or a fool was carrier ending. I suppose that changed when the liars and fools took over.

      Meritocracy being the natural way of things, sans the artificial and often arbitrary limits we impose as a society, there will eventually be a reckoning, and a reset. The only questions are when, how, and what the reckoning will set us back in infrastructure, knowledge, resources and manpower.

      Progressives gave us the participation trophy, and the problems that accompany attempting to tolerate anything and everything without cost analysis, and it is they who must be blamed when the whole mess runs off the rails and must be set right, or the Republic perish.

      Let us neither forget nor forgive when the time comes. At core, these people are nhilists, and if we don’t do something, or get very, very lucky, they are going to get us all killed.

  5. Correction: June 16, 2017
    An earlier version of this article imprecisely described ammunition used in handguns and assault rifles. Rifles and handguns can both shoot either expanding or non-expanding bullets; rifles do not shoot only expanding or handguns only non-expanding bullets.

    lol. the NYT should stop publishing on the subject of firearms to avoid embarrassing themselves.

    • ” . . . the NYT should stop publishing on the subject of firearms to avoid embarrassing themselves.”

      Embarrassing themselves on the subject of firearms is not within their capabilities. They will continue to espouse nonsense when it comes to firearms. It’s in their DNA. Embarrassment? Not so much as a nano-strand (is that a thing? just askin).

    • 1) I knew you’d say that.
      2) there was that jackass who shot himself in the leg with his 357 and uploaded it to YouTube, including walking to his car.
      3) the ballistics of 357 are so clearly better than those of 45acp that I didn’t realize anyone would debate them. The low end of full load 357 magnums are almost twice as powerful as the low end of standard pressure 45acp. 45 vs 9mm I can understand, 45 vs 357 is no contest.
      4) I’m actually in complete agreement, so I’m not sure why I am arguing.

      • Drew, I believe the jackass you’re referring to shot himself in the thigh with a .45 ACP FMJ, not a .357 Mag.

        • Yeah, by golly, that be said jackass. Mea Culpa. Good thing I was already in agreement with the Gov, or I’d be really embarrassed right now.

        • Got to give him some props for swallowing his pride and sharing. The mustache on the other hand – there’s no excuse for that.

          I wouldn’t imagine an FMJ loping along at 750-800fps would do that much damage no matter how heavy it was unless it hit bone. Or a vital organ. Or a femoral artery. Actually, he’s lucky he can still walk, that would have done a number on his patella.

      • ‘4) I’m actually in complete agreement, so I’m not sure why I am arguing.’

        Personally I’m a little disappointed nobody argued the point. Usually you’ll find someone that will take the lightest carry load they can find in .357 out of a 2″ snubby and compare it to the hottest 185gr +p+ load from a full size 19 11 and claim that the .45 is more powerful. Caliber wars are so much fun.

  6. “I’ve never seen a single liquefied organ.”

    I’ve seen something pretty close:
    I shot a deer that was 130 yards away with a 130 grain expanding bullet from a rifle chambered in .270 Winchester. Muzzle velocity was something like 3,100 fps and impact velocity was in the neighborhood of 2,800 fps. The deer was walking fast and quartering away so I had to hit farther back than I normally like. The bullet struck the deer’s liver on its way to his heart. That bullet turned his liver into the likes of corn flakes.

    That isn’t exactly liquefied. It is getting pretty close.

  7. Could you change the image that shows on the article list? That image is fine for the article itself, but not something people will want to see while scrolling the article list.

    • Heck no, I’m proud of that photo. I did my first ever tendon repair on that dude. I had no idea what I was doing. I was literally doing it while staring at books and getting advice from a doc back home on Skype, while in a Connex in the middle of southern Afghanistan. Got mad props on it when I finally medivaced him out (4 days after the injury) and the surgeons there in Qualat looked at him.
      The wound was perfect though, THE example of what M855 does to soft tissue. The guy limped into my hooch. After some pain killer and irrigation, I could (and did) pass my pinky right through the wound. Neat and clean.
      According to Dr. Wen, it must have been a defective round, as, you know, it did not explode, detonating and shattering his leg into hundreds of pieces.

  8. I only met Dr. Wen once but I can assure you she is lying. I am much bigger than she is indicating 🙂

  9. That lady is an embarrassment to the medical profession. And I thought Asians were supposed to be smart…

    Maybe she’s good at math. Or something.

    • Years ago Asians were smart. They were the best students in most of American universities. Then came “no child left behind,” and everybody became equally dumb.

  10. “I’ve never had a gunshot wound do the kind of damage that I’ve seen created in some motor vehicle accidents… I can’t imagine the article Dr. Wen might write if she’d ever seen something like that, too.” Her driving… LOLOLOLOL Did she cause the accident you referred to?

  11. I don’t know if Dr. Wen is intentionally misleading an ill-informed public, or is simply ignorant of the kinematics of injury.

    That or english is not her first language and she lacks the ability to precisely articulate her ideas.

    A handgun bullet enters the body in a straight line. Like a knife, it damages the organs and tissues directly in its path, and then it either exits the body or is stopped by bone, tissue or skin.

    This is in contrast to bullets from an assault rifle. They are three times the speed of handgun bullets. Once they enter the body, they fragment and explode, pulverizing bones, tearing blood vessels and liquefying organs.

    Sounds like a lot of sensationalism. Bullets don’t explode and don’t liquefy organs. Further there is no magic line where all guns are either handguns or assault rifles. There is a gigantic gradient from weak cartridges to powerful cartridges that depend on powder charge, barrel length, distance from the target, and with greater magnitude, the type of cartridge used. A 300 Win Mag out of a bolt action rifle with a 3rd magazine will do amazing more damage in one shot than a 9mm fired from a handgun, rifle, or “assault weapon” (whatever that is).

    In my opinion, this is a mix of:
    1) Her lack of english skills to precisely articulate her ideas resulting in inaccuracies.
    2) Her sensationalizing these events beyond reality.
    3) Her ignorance of firearms, their function, their varieties, and the cartridges they accept.
    4) Her communist/and or leftest (same thing) bias in demonizing the ownership of guns.

    • Bullets do not necessarily go in straight lines in the body; many things can cause them to move in myriad directions. My father had a case where a man was shot with a fmj military rifle round. The bullet entered his shoulder, ricocheted off the scapula, crossed over to the opposite scapula, and then deflected downward. there was no exit wound, but chest x-rays didn’t show a bullet. Turns out it had made it all the way down his leg and lodged by his knee. another of his favorites was the man who walked into Cook county with an entry wound in his forehead and an exit wound at the back of his skull. The nurse at the desk was more than a little shocked at the sight. Turns out, the bullet had hit from the side, deflecting off the skull and traveling under the skin all the way around until it exited at the back of his head. No serious injury was suffered.

      • “ricocheted off the scapula, crossed over to the opposite scapula”
        I’m assuming this was a cadaver, what with his spinal column severed and all.

  12. Dr Leana Wen Jan 2013.jpg

    Born January 27, 1983 (age 34) Shanghai, China

    So native Chicom. Arrived in the US in 1991 (during the reign of billybob Clinton). WTH is she IN the US?

  13. I’ve shot deer, with .223 Federal Fusion, in the boiler room. Upon field dressing the deer I’ve found the heart and lungs to, in effect, be a liquefied soup, with no discernible tissue indicating what organ it originated from. Just a lack of heart and lungs in a bloody, soupy chest cavity.

    Also, bullets do fragment. This could be seen as akin to exploding from a lay perspective.

    Not to take away from critiquing the ignorance of the article or the furthering of gun control.

    But it would be disingenuous to sink to their level of hyperbole. Anyone who has hunted medium to large game has seen this. That she stated that it appeared as though the organs were in a liquefied state is not lost on me. Many a hunter has described things in such terms, myself included.

    Carry on.

    • I’ve killed hundreds of medium to large game animals, I’ve never seen a heart and lungs missing as you have. I’ve certainly never witnessed a .223 round account for the liquefaction of several pounds of tissue.
      But I do get your point. Someone that didn’t know what they were talking about could claim that bullets explode, or that they liquefy organs. And that’s my point. Dr. Wen has no idea what she is talking about, or she is just lying to you. After all, she is not a “layperson”. Dr. Wen is claiming to be an expert, working in an ER treating gunshot wounds, as a physician. She claims to be the exact opposite of a lay person.

      • Bill Russel and Tom in Oregon above both note similar findings. Tom’s is little extreme however. 😀

        I’ve harvested 8 deer that I shot myself. 2 had what could best be described as soup left of the heart and lung tissue, i.e. liquefied, and the bullet had shattered the front leg and fragmented in both instances.

        What is she an expert in? Medicine? Ballistics?

        I’m not looking for an argument. I do believe one can be a layperson in one instance while being an expert in another. Just because she is an ER doc experienced in treating gun shots does not (obviously) make her an expert in any other arena.

        I do appreciate your points. I did read your article. This is obviously propaganda in furtherance of a gun control position.

  14. I’d rather be hit by most pistol rounds over most rifle rounds any day of the week.

    …but pistol rounds do not magically go in a straight line. They act unpredictably as well, even if they don’t tumble the same way. I suspect the good doctor is exasperated at trying to stop gangbangers from leaking vital fluids all over (and some innocents injured as well) and is just basically venting.

    Being a trauma doc doesn’t make you an expert on terminal ballistics just like being an airplane mechanic doesn’t mean you can fly.

  15. The good news, although not pointed out by the author, about those with medical degrees (I went to medical school before transferring to research at a nearby medical school to get Ph.D.) is that most folks at that intellectual level are open to new information and value it.

    Actually, they’re used to being wrong. It’s actually part of the process of discovery and the scientific method.

    And, most welcome being wrong as it invites them to learn something new and gain deeper insights into the topic in which they have an interest. It’s drilling down to the correct answer or interpretation.

    I’d be surprised if Dr. Wen didn’t appreciate you guys’ input. In fact, I’d bet she would. Write her directly without pejoratives and condemnation and share you knowledge and opinions and I’ll bet she writes back in thanks.

    As always, it pays to be nice if you want someone to listen. Rail uncontrollably and hysterically and you’ll just fit a stereotype someone else may have.

    If you have information and knowledge to share every scientist and physician I’ve ever known would listen. If you have bile to dump none of them will. Civility still pays.

    David

  16. Another case of someone who is an expert (I use the term lightly with her, I also would reject her as a doctor for failing so hard at this article) in one field, thinking they are an expert in all fields.

  17. The vacuum behind a bullet also causes a lot of damage as it passes through tissue. A lot of physics in play. But beyond the obvious science what exactly is her point?

  18. Unfortunately, the shooter in Virginia reportedly used a semiautomatic assault rifle. I once treated a patient shot in the pelvis with a similar weapon.

    See? Another reason to restrict “+250% Damage” weapons!

    (apparently, good doctor had never seen point-blank wound inflicted by 12G with Brenneke slug)

  19. I worked in an inner city emergency room for about five years,there were a lot of injuries from assault,with various weapons. A surgeon told me he would much rather treat a gunshot wound than someone attacked with a baseball bat. In my five years I saw many more wounds and deaths from baseball bat,kitchen knife,beer bottle,etc.. Gunshot wounds were relatively rare.
    I think a lot of these doctors are schooled by anti-gun organization literature and their comment are agenda driven.

  20. I only read the first couple of paragraphs of this and bailed. Dr. Wen and the rest of the Idiots that run Baltimore would never be capable of writing anything accurate or informative. Ask a combat medic if you want to learn about bullet wounds.

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