A Second Shot to Prevent the First

By Betsy Piland
March 21, 2026 | VOLUME 4, ISSUE 1

“The first time I did that, I was talking to these 14- and 15-year-old kids. They’re kind of paying attention to me, but not really,” he said. “Then I shared with them my own personal story, and for the first time, I saw a reaction that I had never seen before. I went from being this guy wearing a white coat to someone who could understand what they were facing in their community.”

In 2012, when he learned about the Sandy Hook Elementary School shooting, Dr. Sakran began to consider formal advocacy work. He was becoming increasingly frustrated with finding himself, day after day, treating the consequences of gun violence—chest wounds, hemorrhage, the full spectrum of critical injuries—while becoming more aware of the systemic failures bringing patients through his doors.

“We are getting incredibly good at treating the consequences, but we are doing nothing to prevent them,” he said. “It’s putting Band-Aids on a hemorrhaging system.”

Two roles, one mission

For clinicians who worry that advocacy might compromise their clinical identity, Dr. Sakran offers a different framing: The two roles don’t compete; they compound.

“When I speak to legislators about gun violence prevention, they don’t just hear another advocate’s voice,” he said. “They hear a trauma surgeon who has lived it, who has treated it, who understands the medical and human cost in ways that pure statistics can’t convey.”

That credibility—rooted in the specificity of what high-velocity projectiles do to thoracic anatomy, what hemorrhagic shock looks like in a 16-year-old, what survival actually costs a family—is something a lobbyist cannot replicate.

Over the years, that credibility has carried his work far beyond the trauma bay. Dr. Sakran has testified before Congress, published scientific papers and op-eds on firearm injury and prevention, and regularly speaks to national media outlets. He served as a health policy fellow for Senator Maggie Hassan of New Hampshire from 2019 to 2020; and now he serves as Board Chair and the inaugural Chief Medical Officer of Brady, a bipartisan gun violence prevention organization.

Dr. Sakran’s advocacy work has also changed how he practices medicine. He now sees patients as part of a larger story. He doesn’t think only of stabilizing a gunshot wound but also about long-term recovery, family trauma, community health, and recidivism prevention. His research focus has broadened from surgical technique toward prevention strategies. His teaching has evolved too, training residents and fellows to see themselves as injury prevention specialists, not just trauma responders.

“Being a physician means more than [having] technical competence,” he said. “We have a professional obligation to address the root causes of the injuries that we treat. Just as medicine evolved to address smoking or drunk driving as public health issues, we need to address gun violence as well. My advocacy work isn’t separate from my medical practice; it’s an extension of it.”

Fueling purpose

The psychological toll of trauma surgery and critical care medicine is well-documented. For Dr. Sakran, the burden is compounded by what he describes as the “second victim effect”—the secondary trauma of being immersed not just in individual patients but in policy failures, epidemiological data on preventable deaths, and the slow pace of systemic change. He estimates that his surgical and advocacy commitments run 70 to 80 hours per week, with some stretches running on “pure adrenaline and coffee.”

“Advocacy progress is glacial,” he acknowledged. “You can see another mass shooting happen, or what’s occurring in cities every night, and you can feel like you’re failing.” The hardest moments of his career—telling a parent their child isn’t coming home—never get easier. But they fuel his commitment to prevention as the ultimate form of treatment.

Still, he credits advocacy with protecting him from burnout. “Burnout sometimes comes from feeling powerless,” he said. “The advocacy work gives me agency. Instead of just treating the 15th gunshot wound victim of the month and feeling helpless, I’m actively working to prevent the 16th. That sense of purpose is incredibly restorative for me.”

The cost of silence

Dr. Sakran is candid about the hesitation he felt early in his advocacy career. Mentors warned him it would be a career killer. He worried about appearing politically motivated. He received death threats. “I realized my silence was also a choice,” he said, “and it was a choice that contributed to the status quo.”

He attributes his success to a number of factors, one being that he never leads with politics—gun violence is a public health problem, not a Second Amendment debate. He grounds everything in evidence and patient stories, the same way medicine addresses any other preventable crisis. “We don’t debate whether car crashes are bad; we study what prevents them and implement those solutions,” he said.

That public health framing has shaped much of Dr. Sakran’s work at Brady. Under his leadership, the organization convened a national advisory council of physicians, researchers, and public health experts to advance solutions on several fronts, including the reframing of gun violence as a public health issue and promoting safer firearm storage and responsible gun ownership. They also helped build momentum for the creation of the White House Office of Gun Violence Prevention in 2023. The office has since been discontinued, but its creation marked a significant moment in the federal recognition of firearm injury as a public health issue.

For colleagues wondering where to begin, his advice is simple: “Start small. You don’t have to testify before Congress on day one. Write one letter to your local representative. Have a conversation with your hospital leadership. Speak at a community event. Build your confidence and find your voice gradually. Don’t let hesitation become paralysis.”

And for those weighing whether advocacy is worth the professional and personal risk, he said, “Our patients and communities need our expertise in these conversations, and the risk of speaking out is real, but the risk of staying silent is greater.”