The Bullet's Yaw: Reflections on violence, healing and an unforgettable stranger

Jeffrey Mains was in shock. During a vengeful rampage, a deranged former security guard had fired a hollow point bullet into Mains' truck. The bullet's path through steel slowed its velocity, causing it to tumble sideways when it collided with Mains, a phenomenon that ballistics experts call the "bullet's yaw." The bullet's impact and ensuing yaw were over in a blink, but the effects were profound. Mains' bowel was pierced and leaking, his liver lacerated and one diaphragm ruptured. When the ambulance arrived, Jeffrey Mains was nearly unconscious; he was bleeding internally and desperately needed surgery. He was rushed, lights blazing and sirens calling, to the UC Davis Medical Center. This is where, several weeks and many complications later, he became my patient. During my three-year residency in emergency medicine I treated thousands of patients-strangers such as Jeffrey Mains. Most passed through my life swiftly and their illnesses left but a wisp in my memory. A handful of patients, however, marked me forever. The Bullet's Yaw is the story of one of these unforgettable strangers and what he taught me about life, violence and healing.