In 2011, Aaron Murray bought his first gun at a sporting goods store — a .40-caliber Beretta pistol. He and his wife were fixing up a foreclosed home in a tough neighborhood in the northern suburbs of St. Louis, and he wanted to protect himself.
Two years later, following a home invasion, a bullet from his own gun would leave him paralyzed from the waist down.
About 32,000 people are shot and killed every year in the United States. But twice that number — 67,000 by some estimates — survive after being shot.
Advances in trauma medicine allow doctors to save lives that would have been cut short decades ago. But that treatment comes with a price. About $735 million is spent nationally to treat gunshot wounds each year, and low-income people are disproportionately affected by the unexpected costs.
Medical bills can quickly drain the finances of families who are uninsured; and even patients who have coverage will see the cost of their care quickly surpass their deductible. Care for victims of gun assaults also poses a growing cost to taxpayer funded health insurance programs like Medicare and Medicaid.
On top of the financial toll, gun crimes leave many young people with the pain, challenges and costs of a lifelong disability.
A home-invasion becomes catastrophic
A first-time gun owner, Murray checked videos on YouTube to learn how to clean and use his firearm. His wife, Tamieca Murray, chose a lightweight Ruger pistol. When the pair visited a local shooting range to practice their aim, they were surprised at how good it felt to shoot.
“We never realized that shooting could be so cathartic,” he said.
When Tamieca’s younger brother moved into the spare bedroom, Murray showed him where the guns were, in case of an emergency. But the teenager then shared that information with an 18-year-old acquaintance, who returned to their home to steal it a few days later.
Aaron Murray remembers the day clearly because his morning college class was canceled, giving him an extra, blissful hour of sleep. His wife had left for work, so he was alone when an intruder appeared in his bedroom.
“Around 10:30, 10:45 my bedroom door opens and I have no idea who it is,” Murray recalled. “He reaches right in the drawer before I can react.”
The intruder — later identified as Saudi Lamont Brown, who was convicted of the crime — pulled out Aaron Murray’s gun and pointed it at him. When Murray started to process what was happening, his first reaction was anger. He felt violated.
“He puts [my gun] to my head and says, ‘are we really going to do this,’” Murray remembered.
Murray jumped and tried to tackle him, reasoning that if he was going to die, he’d rather go down with a fight.
In the struggle, Brown fired three rounds. Two went through Murray’s torso, and one buried itself in his spine. Murray’s knees buckled and he dropped to the ground, as Brown fled with his gun.
Bleeding profusely, Murray dragged himself to his cell phone to call 9-\11. Police broke down the front door to get to him, and paramedics folded a sheet to carry him out to the ambulance.
That’s when the adrenaline was replaced with a searing, burning pain.
Over $700 million a year in treating gun assaults
An ambulance whisked Murray to Barnes Jewish Hospital’s emergency room in St. Louis, which treats a dozen gunshot victims every week.
Because the shooter was still at large, Murray' name was removed the hospital’s patient rolls as a precautionary measure. Even his wife, whose coworker drove her to the hospital in a panic, was barred from seeing him for six hours.
“It was horrible,” Tamieca Murray said. “We didn’t know what was going on.”
After an emergency surgery to stop the bleeding and look for bullet fragments in his intestines, Murray was confined to a hospital bed for 11 days.
When a bullet enters a human body, it pierces through skin, organs and bone. Depending on its angle and velocity, it may tumble in a circular motion, spewing fragments of lead and ripping apart a torso as if it were jelly. Treatment is rapid and highly specialized, requiring whole teams of doctors and emergency surgeries to save a person from bleeding to death.
It’s also expensive. The initial hospitalization costs about $24,700 per person on average, according to one analysis by Stanford University. If a patient has no health insurance, charges reach $86,700 for the same care.
If you include people who die in the hospital, the cost of initial hospitalizations for firearm-related injuries averaged $734.6 million per year between 2006 and 2014.
“And all of the costs surrounding long term health care, the emergency room… none of those are included,” said Sarabeth Spitzer, a medical student and the Stanford study’s lead author. “These have lasting and substantial implications for state and federal costs.”
A quarter of gunshot victims nationally are uninsured, according to Spitzer’s analysis. A third are covered by Medicaid, which is publicly-funded insurance for people who are low-income, disabled or pregnant. In states such as Missouri, which did not expand Medicaid coverage through the Affordable Care Act, a larger share of patients are uninsured. Often, the cost of their care is passed on to hospitals if the patient and their family cannot pay.
Aaron Murray had health insurance. But the deductible was $10,000, and even that proved challenging to meet.
Murray's bills at Barnes reached $62,000 for his 11-day stay. After a month of rehabilitation care, the costs to his insurance company totaled $110,000.
For expenses not covered by insurance, Aaron Murray and his family members dipped into their savings. They also applied for assistance through the Missouri Crime Victims’ Compensation Program, which covered what the insurance company did not include in the Murray’s medical coverage.
Medical bills make up the largest chunk of expenses for the state’s $7.2 million victims’ assistance fund, totaling $5.6 million in fiscal year 2013 — the most recent numbers provided by the Missouri Department of Public Safety. Victims can receive no more than $25,000 each, according to state statute..
“The biggest cost is probably the cost to the person’s individuality,” said Shawn D’Abreu, a Jefferson City-based lobbyist for people with disabilities. D'Abreu sees a direct link between the glut of handgun availability and the St. Louis murder rate.
He's greatly disappointed last year the Missouri legislature passed a bill to allow gun owners to carry concealed weapons without a permit.
“The cost, both to the individuals who are victims of gun violence, to the police officers who are endangered because guns are so readily available, to the cost to the health care system … it seems that this is something that needs to be dealt with on a systemic scale,” he said.
Recovery & Rehab
The costs of a gunshot wound don’t end at the hospital. For some, those costs continue well beyond their release.
Murray spent a month at the Rehabilitation Institute, receiving physical therapy. The costs of this type of care are not included in state totals, and are not always covered by insurance. Hospital spokeswoman Tracie Lee-Lambert said the facility charges $1,000 to $1,500 a day for patients with new spinal cord injuries.
On top of medical bills, the Murrays realized remodeling their house to accommodate his wheelchair would cost $70,000 or more. So they rented out their home and moved into a smaller one, originally built as a Habitat for Humanity project in the early 2000s.
"You have cost of self-care, you have the financial disruption that may happen if the person who is wounded is the breadwinner in the family,” said lobbyist D’Abreu, who was also paralyzed in a random attack. “They may have to go into medical debt, that may disrupt their ability to secure housing.”
Murray had to re-learn how to shower, drive, and dress himself without the use of his legs.
Five years after his shooting, Murray pauses his workout at the gym to demonstrate special maneuvers on a wheelchair. Learning do a wheelie is important, he explains, because it can help reduce the pressure that builds up in his lower back. Hopping a curb, or balancing on the back wheels to get down shallow stairs, makes getting around easier.
He teaches this to other people, at his job as an adaptive exercise therapist for Paraquad, a disability rights nonprofit in St. Louis. In the fall, he helps run a wheelchair basketball team for the Disabled Athlete Sports Association.
“It’s sad to think how much my life changed and everything. But over the past five years there’s been a lot of positivity in my life, and I wouldn’t trade it for the world,” Murray said.
In November of 2013, Brown pleaded guilty to the shooting. A St. Louis County Circuit Court judge sentenced Brown to 25 years in prison. Murray waived his right to make a victim’s impact statement — saying he was too angry to face his assailant.
Police never recovered the gun that Brown stole from Murray that day.
“Before, I didn’t really have a strong opinion about gun control. I felt safe and empowered, and I knew what I needed to do to keep myself legal and out of trouble,” Murray said.
“But … it’s just kind of insane how easy it is to get a firearm.”
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