What’s One Bullet?

Ernie Purnell

In 2011 and 2012, while more than 900 people were being murdered on the streets of Chicago, creative-writing students from DePaul University fanned out all over the city to interview people whose lives have been changed by the bloodshed. The result is How Long Will I Cry?: Voices of Youth Violence, an extraordinary and eye-opening work of oral history.

Told by real people in their own words, the book contains the extraordinary stories of 34 Chicagoans. This is one of them.


Ernie Purnell is a nurse in the Cook County Trauma Unit at the John H. Stroger Jr. Hospital, located at Ogden and Harrison on Chicago’s West Side. Formerly known as Cook County Hospital, Stroger is a central hub for violence-related treatment in the city, and much of its patient population is economically challenged and without medical insurance.

Purnell is a tall, stocky 47-year-old who grew up in an impoverished African-American neighborhood on the West Side. His beard has a little gray and he wears glasses. Despite the difficult nature of his work, he is jovial and often laughs in amazement at what he has to deal with every day.


One of the favorite questions that my younger patients ask is, “What type of gun did I get shot with?”

And I answer, “I don’t know. I just know you have a hole in you. We’re going to assume a big gun because the hole in you sure is big!”

They’re like, “Oh, did you get the bullet out?”

“Well, I don’t know, we’ll have to see.” And one of the things I like is showing them the X-ray. It’s like, “Okay, guess what that is! That’s the bullet that’s still inside of you!”

And they gasp and are like, “Are you going to get it out?” “Mmmm, depends…”

When a young person comes in, we have to physically take care of them. So we need to figure out what’s wrong and treat them. Because the goal is to save lives. So number one: Save their life, regardless of what happened before. You’re here, you’re a patient at Stroger Hospital, we just need to deal with this. We start an IV, draw blood for labs, get that X-ray, maybe a CAT scan, give them medications for pain, a contrast to light up their insides so that we can see what’s going on. And then, we prep ‘em depending on where they’re going.

After we break through saving lives, the second step is getting past those trust barriers. A lot of our patients don’t want to tell us what happened, who they are, what’s going on, or their medical history—and those are really, really important things that we need to know about while treating them. They may not want any treatment. They may think like, “Okay, you’re just holding me here until the police get here.” And it’s like, “No, not really.” Or, “You’re going to finish me off.” Which is not true, but sometimes you have to deal with those types of attitudes. Or, “You’re holding me until the other person can get here to finish me off.”

Sometimes there’s the one who walks out, or the one who gets really angry at the staff—but you can tell that anger is not really with us. It’s the situation, and you’re trying to get them to understand that. It can be kind of a rough transition until they realize that we just want to save their life. And we talk to them always within the confines of the trust—because once you lose trust, that’s it.

For young adults, the reason they wind up in the emergency room is usually gang-slash-crime-related. I won’t say everybody’s in a gang, but a gang-related crime is usually the background of what’s going on. You kinda want them to understand how serious it is, because a lot of our young people, they see these things on TV—people get shot and get up all the time, and then, in the next scene, they’re okay. They have this idea that, “I can get shot four or five times and then live, so what’s one bullet?” And then, when you tell them that one bullet didn’t just go through you—it bounced, it rico- cheted around inside of you, so it hit a lot of things—they’re like, “What? Bullets can do that?” Uh, yeah. It’s not like TV or a video game—at all. You don’t get up again.

They don’t realize that one bullet can cause massive damage to the human body. I like to bring them to the reality of it: “Okay, we took out part of your bowel. The bowel is responsible for digestion, which means that you may have to change your diet, particularly if we gave you a colostomy bag. You’re going to have to learn what to do in social situations, because you can’t eat everything that you want to eat.” Or they had to take out a kidney, and then I explain what a kidney does. Or they had to take out a part of your liver, and I explain what a liver does. Or they had to take out a part of your lung, and I explain what the lung does. And it’s like, “You’re only 16. These are not parts that you should be missing at this time.” And, unfortunately, sometimes you have to explain to them, “If your spinal cord’s been transected, that’s game over for your legs. I’m sorry.” Or they’ll ask, “Will I be able to have sex or have children?” That all depends because sometimes you lose your testicles, so that’s no. They don’t like that part. But those are the consequences of your decisions, you know. You went out there, you got shot. Unfortunately, this time it took out your scrotum, so it’s a done deal.

And a lot of patients, when they find out that they’ve lost certain body parts, or when you have a patient who becomes quadriplegic or paraplegic, the support system that he thought he had—including his friends or his girlfriend—they tend to drift away before his hospital stay is actually over. And so he’s forced to re-evaluate those relationships. And, usually, he’ll draw closer to the ones who truly love him, which are the ones who are really actually visiting him—usually a grandparent or parent, aunt, uncle. It makes him think. Sitting in the hospital bed, the only thing you can do is think. Because you can’t run the streets, you can’t go with your friends, you can’t do too much of anything, so you need to re-evaluate what brought you here to the hospital.

Our whole trauma team deals with the families. The doc may have to go out and explain what’s going on with the patient. And I may have to play liaison between them and the patient, because the families want to see their loved one—and, depending on what’s going on, they can’t come in just yet. My job is to try and get them in, you know, and at least see the patient— maybe just see them on their way to surgery. At least you saw them—‘cause there is the chance that this may be the last time you have to say whatever you’re gonna say, do whatever you’re gonna do with that person. And that’s both ways. It’s both ways.

We have met the parents who, you know, they’re tired. They’re like, “I have talked to him or her over and over and over and over again, and she just keeps doing X, Y and Z. I don’t understand. Why am I not reaching my child?” They want us to talk to their children—sometimes the child just needs to hear it from someone else. And then, you know, it’s like, “Well, you need to listen to your parents, because they kinda know what they’re talking about.” We try to encourage the parents: “Don’t give up on them—‘cause the teen years, they’re just the crazy years. This is when you have to hold on a little bit tighter.”

And then you have some people where it’s like, “Yikes, your parents are nightmares!” You can see it in some of the things they say, some of the things they do, and some of the ways they appear when they come in to check on their child. It’s like, really? Drunk? High? These are not good things. These are not good role models. One parent was like, “Don’t worry about him.

He’s just gonna die anyway.” And I’m like, “You do realize he’s only 15?” So you want to tell the child, “Until you get away from your parents, I can’t see you changing, because they’re the major influence in your life and they’re leading you way down the wrong path.” You will sometimes get the victim and the assailant at the same time, and the best thing to do is to try and keep them as separate and as far away from each other as possible. Because it’s not them. They’re injured, so they’re not going to do anything to harm each other anymore. It’s the families—and when the families get here, that’s when things blow up.

Of course, everyone’s innocent because, regardless of who the victim is, the family is always going to provide support. If they’re the assailant, then the family will usually buy into the idea that the other victim must have done something to trigger the assailant to attack. If they’re the victim, then the assailant must have attacked the victim for no reason. They never get down to the reasons of what really happened. So yeah, things have blown up here to full-fledged fights where we actually do have to call in the police and people do have to get arrested.

I’m hoping that more youth will be involved with education. I’m hoping that they’ll understand that you gotta be educated to get out. I tell my gentlemen: Try nursing. I let them know there’s something else you can do with your life. You don’t have to sell drugs. You don’t have to run with a gang. It’s like, “Aren’t you tired of your mother crying? Aren’t you tired of that? You can do something that actually makes a difference, helping people instead of hurting people.”

I just try to be a role model for them. When they say, “Well, you don’t know my story, you don’t know my life,” I’m like, “Yeah, I kinda do. I didn’t live your life, but I do know what’s going on in your life.”

I grew up over here on the West Side. I actually grew up in this neighborhood here at Congress and Central Park. Now I think it’s called East Garfield Park, but back then it was all just called the West Side. I saw a lot of gang activity growing up, a lot of hopelessness, helplessness, a lot of drug activity.

There was this one girl I knew—I will always remember this one forever—she played Russian roulette and she lost. I was like 13 when that happened. And it’s like, “A: Why are you playing Russian roulette? B: Why are you drinking? C: How did you get access to a gun?” There were just so many questions. And to see so many of my peers—because we were all friends—going in a different direction than I did, it was kind of depressing.

I went on to high school. Back when I went—I graduated in 1982— they opened up a program where you could basically go to any high school in the city. Before, you were stuck to districts. So I went to Taft, which is up on the Northwest Side. Oh! Going to Taft as part of the first big group of African-American kids was like going back into the 1950s to civil rights times. We were met with protests. We were met with rioting. We were met with name-calling. People pulled their kids out of school. It was insane. I stuck it out—I made it through my four years and graduated—but I got to literally see what racism is all about.

I went to college, and then, once I graduated, I came back to the West Side to contribute back to the population that produced me. I knew I always wanted to help people. It was just a matter of how was I going to help people. My mother was a big influence ‘cause her heart’s, like, huge. One of the earliest things I can remember is, she allowed some of our family members to come up from Mississippi, and they lived with us for however long they wanted to before they moved on to other houses here in the city. And after that, I saw how she would always take care of homeless people or people in the neighborhood who just needed help.

So I started my journey in nursing when doors opened through the military. I became a nurse in the Army National Guard, and I transitioned from the military to my civilian life. That was back in 1988 or 1989. The military helps you to focus: You work as a team player and you learn not to complain at all. It’s like, “Look, this is a job, this is what you signed up for, this is what you’re gonna do. Go do it.” And it gives you that mentality: “I’m here to work and I’m going to work to the best of my abilities. And, when it’s over, it’s over till tomorrow.” I’ve been working at Cook County Hospital for almost 20 years and in trauma since 2002.

I always tell patients, “I’m not here to judge you; I’m just here to fix you. If you choose not to change, you know that’s on you. If you know the things that can happen to you—jail, death, permanent disability—then you have the opportunities. If this is the life you’re choosing, then I’m just here to try and put you back together again.”

We take care of some of the worst injuries, some of the worst of the worst. But there are patients who you would think would never survive who actually survive—and it’s just amazing. It’s amazing. I just told a patient the other day, “I work in a land of miracles.”

We do have patients die, of course. When it’s happening, if the patient can talk, they’ll let you know something’s not right. Or they stop talking, which is a bad sign, but a lot of people are like, “Oh great, they’re calm.” And it’s like, “Mmm—they’re dying.” The next thing you’ll notice is the monitor: The patient’s vital signs will start changing—and changing drastically for the worse. Then you contact the doctor, you make sure the patient’s airway is okay, make sure he’s breathing. And then sometimes you have to explain to him, “We have to put you to sleep. We have to put a tube in to help you breathe.” But sometimes you don’t have time to explain—you just have to do it. And it can be very scary for everyone involved, because we have to figure out what’s wrong in a short period of time and then fix it. And sometimes we can’t figure it out in time.

But I’m sorry, a lot of people think you can get used to watching a young person die. You don’t get used to it. Young people have so much potential and, when you talk to them, you realize, “You’ve got so many other gifts that you could use, that you could contribute to the world.” And then to kinda see that just ebb away, and you think about the people in their lives that it’s going to affect because that person is gone. But for every 10 that we lose, maybe there’s two that’ll turn around and actually succeed and change their lives. And who knows? From that, maybe they could change the world.

—Interviewed by Michael Van Kerckhove