I will never forget the day I heard about the heinous murder of Dr. Tamara O’Neal—an emergency physician in Chicago—and her colleagues by her former partner on hospital grounds.¹ Her death was a shocking reminder of the reality women face in this country, especially minoritized and transgender women.^2,3 Intimate partner violence (IPV) affects nearly one in four women in this country, and three to nine percent experience IPV during their pregnancy.^4,5

Any conversation about IPV must include a discussion about firearms. An average of 70 women every month are shot and killed by an intimate partner, and the majority of mass shootings in this country involve the perpetrator shooting a current or former intimate partner or family member.⁶ An abuser’s access to and prior use of firearms to threaten partners are strongly predictive of future homicide.⁷ Given that firearm ownership appears to be increasing, as have firearm-related homicides during the pandemic, we can expect that rates of IPV-related homicides will similarly increase.^8,9

As emergency physicians, we are no strangers to the impact of firearms and IPV. The patients whose memories have stayed with me the longest are those who were slain by guns. They are often women and children, for whom no number of thoracotomies, transfusions, or chest tubes will save.¹⁰ It can never ease the heartache of the family to whom I must say, “Despite our best efforts, your loved one has died.” Each reset of the trauma room after the death of a patient is an acknowledgement that another victim is to be expected, that another life will hang in the balance thanks to firearm-related violence. This endlessly repeating cycle of secondhand violence takes its toll on us as physicians, adding to the burnout that we face from so many different directions.

The solution to these intersecting epidemics—gun violence, intimate partner violence, and burnout—is systemic. We must advocate for legislation to decrease access to firearms. Data have already shown that restricting access to firearms decreases deaths, and, on the other hand, increasing access leads to increased mortality.^11,12 Decreasing firearm ownership among people who have been convicted of domestic violence charges or are under IPVrelated restraint orders can similarly protect those at high risk of death—including pregnant women.¹³

While we cannot bring back the lives of Dr. O’Neal or the countless others who have been murdered, common sense policies could save others just like them. Rome wasn’t built in a day and neither will comprehensive gun control reform. In the meantime, by preventing access to deadly weapons by people who are known to be at high risk of harming others, we can at least begin by protecting those in this highly vulnerable group.