Guns are killing more U.S. children. Shooting survivors can face lifelong challenges

Aaron Hunter was 13 when he woke up in the hospital after being shot in the head while playing with friends. The shooting happened June 22, 2023 in Sarasota, Florida. The bullet entered just above his right ear and lodged halfway into his brain.

He doesn't recall the shooting, or even remember being around a gun, he said. "All I remember is I was picking mangoes with a friend, and then I went to another friend's house, and then I remember waking up in the hospital."

Taken by helicopter to Johns Hopkins All Children's Hospital in St. Petersburg, neurosurgeon Dr. George Jallo rushed Aaron into the operating room.

It took hours to control Aaron's bleeding and brain swelling, and to clear the debris from the bullet's path — the fragments of bullet, bone and hair, Jallo said.

Aaron survived the surgery, but Jallo was still worried: "I know he's alive, but I don't know if he's going to be able to talk, I don't know if he might not be able to move an arm or leg. Or I don't know if he's going to be able to see out of one eye."

The medical staff who treated Aaron at All Children's said it's a miracle that his recovery has gone so well. He wasn't paralyzed, and learned to walk again — and in time to walk into the building on his own for the first day of school last August.

Aaron could still see, but his peripheral vision was damaged. And while he could walk, his balance was still off, and he struggled with weakness on one side of his body.

Aaron's rehabilitation involved months of physical and occupational therapy, up to four days a week. Sometimes, he had to cut short his school day, leaving early for appointments at All Children's outpatient facility in Sarasota.

"It burns," he moaned during a therapy session in October, while lying on a sliding platform, feet up against a vertical plate. He was supposed to use his leg muscles to thrust his body backwards on the sliding platform, again and again.

The physical therapy assistant, Whitney Walker, urged him to stick with it and complete 20 reps. He was sweating and shaky, but he powered through.

Aaron had made tremendous progress, Walker observed. She started working with him just six weeks after his surgery. Back then, "he would fatigue pretty quickly right after, I would say, about five minutes," she recalled.

Gun injuries and mortality among young people are increasing in the U.S. Firearms are now the leading cause of death for children and teenagers, whether that's from gun-related assault, suicide, or "unintentional" deaths (accidents). Research also indicates that nonfatal firearm injuries among minors are increasing as well.

As devastating as the deaths are, it's estimated that 2-4 times as many U.S. children survive a gunshot injury. But they can face life-long challenges such as disability, pain, mental trauma and financial burdens.

How was Aaron shot? It remains unclear

The Sarasota Police Department is still investigating what happened in the June 22 shooting.

But Aaron's mother, Erica Dorsey, strongly suspects the group of kids found a gun, and were playing around with it when it went off.

The nightmare began when a neighborhood boy knocked on her door in a panic. Aaron had been shot, he told her.

"I just didn't believe it at first," recalled Dorsey. "But then the kid said, 'Do you hear those sirens?' You could hear sirens in the distance."

"And he said, 'You hear that? Those are for him, they're coming to pick him up!' I was like, oh Lord."

The head trauma that Aaron sustained was immense, Dr. George Jallo recalled.

"When someone sustains a gunshot wound to the head, either: They're going to die en route. Two, there's probably really nothing for us to do. Or three, the call is wrong and [the bullet] might have just grazed him."

Estimates show a rise in gun-related injuries among youth

In 2023, Aaron was one of 15 pediatric patients treated for gunshot wounds at All Children's. That represents a tripling from 2019, when the hospital treated five patients.

Three months into 2024, the hospital has already treated five young patients for gunshot wounds.

"Certainly we don't like that," said Dr. Chris Snyder, medical director for the pediatric trauma program at All Children's.

"Trauma is one of those specialties where we kind of want to work ourselves out of a job, if you will, of trying to prevent these kinds of injuries," Snyder said.

Florida is seeing a spike in such injuries, and so is the U.S. as a whole.

The U.S. Centers for Disease Control and Prevention estimates that nonfatal firearm injuries among all U.S. children and teens surged more than 40% in 2020, and remain high.

While most of the shootings involved assaults or self-harm, some were accidents, like Aaron's seemed to be.

But even unintentional gunshots can wind up being deadly, Snyder warned.

"You can imagine if you get a toddler that, you know, finds grandpa's handgun and if they shoot themselves," he said. "We had a case where a toddler was shot through the heart. No amount of special equipment or training is going to save the patient at that point."

The road to recovery affects physical and mental health

More children survive shootings than die from them.

And simply witnessing gun violence has been linked to post-traumatic stress disorder, anxiety and other psychiatric issues among children, according to Nirmita Panchal, a senior policy manager at KFF and author of a recent brief on the subject. Being exposed to gun violence can also disrupt education.

Survivors of gun injuries are often left with ongoing disabilities, trauma and financial burdens, Panchal added.

A recent study in Health Affairs found kids with gun injuries are much more likely to develop pain disorders, mental health problems, and substance abuse. Medical costs for those children increased 17-fold in the year after their injury.

The trauma can affect the entire family. The study, which focused on families with commercial health insurance, found that parents of shooting survivors experienced a 30% increase in psychiatric disorders, and the mothers had 75% percent more mental health visits. Parents and siblings also received less routine medical care.

Erica Dorsey agreed that her son's shooting was disruptive in multiple ways, and despite his progress, the ripples continue to be felt. Aaron was in intensive care for about three weeks after his surgery. He was discharged from the hospital in July, but months later the injury still dominated their lives.

"It's exhausting because it's like therapy, doctors appointments – it's the follow up," she said.

Moving around was really tough at first, Aaron said.

"I would say the hardest part was getting back to walking, that was the hardest," he said.

Months of therapy and ongoing medical monitoring

Because traumatic brain injuries can affect the entire body, Aaron had to re-train many muscle groups, according to Whitney Walker, the physical therapy assistant.

Over time, Aaron's balance improved. During one physical therapy session, he had to stand on a wobbly platform while bouncing a ball off a trampoline. In another exercise, he balanced in a push-up position while trying to steady rubber balls in the center of a disc.

There were moments of physical discomfort that forced him to pause, but he pushed himself to keep going — and sometimes chose the harder option during certain exercises. And he kept Walker and his mom laughing with a sense of humor throughout.

"I think the biggest thing is having such a strong family dynamic, and with Aaron having such a following behind him, I think that has motivated him to continue to work harder," Walker said.

In February, about eight months after the shooting, Walker discharged Aaron from physical therapy, though he still has regular follow-ups with the medical team at All Children's.

Aaron still has a bullet fragment inside his brain. It was too dangerous to remove because it's near a critical blood vessel, Jallo said. Leaving the fragment in place puts Aaron at risk for seizures, so he takes medication to prevent them.

At his 14th birthday party last month, family and friends wore t-shirts that said "#AaronStrong." They invited a few Sarasota police officers to join the celebration, according to a post on the department's Facebook page.

Erica Dorsey said she thanks God every day that Aaron is alive. But she constantly remembers that many other families affected by gun violence fared worse.

"I just feel like any chance that I can, I'm going to stand up for the moms whose kids didn't make it," she said, "who had to bury their children over something so senseless, and something that's so avoidable."

Dorsey now spends time as a local activist, telling parents who own guns to store them safely and educating children about the harms they can cause.

Aaron says he's staying away from guns, and other kids should too.