Several years back, I took this radiograph on a patient of mine, and I shared it with a few friends in the training community. As luck would have it, the picture and my short narrative, somehow came across Clint Smith’s desk. He shared it through his channels, and before long, this image was all over the interwebs.
Maybe you saw it back then? If you didn’t, let me refresh your memory! This patient came to me, at my dental office, for two reasons (it bears mention at this point that I’m not your regular dentist that does whitening and teaches you how to brush…I mostly address abscesses, rotten teeth, and dental trauma in the Hispanic population of Middle Tennessee) FIRST: he couldn’t open his mouth, and SECOND: he was concerned that whenever he drank water, it came out his nose. Hmm…well, neither of these things is normal, so as is the custom in my office, the patient’s blood pressure and pulse are taken, their medical history is reviewed, and any necessary radiographs are made.
Imagine my surprise when I inquired about the patient’s black eye and small abrasion/laceration beneath his right eye. (In Spanish). “Oh, I got shot.”
“You WHAT?” I exclaimed.
“I got shot in the face. I was minding my own business when a narco hit me with his pistol then shot me. I passed out. I woke up, and decided I needed to get out of there before the narcos realized I was alive. So I got on a few buses and came here, to Nashville.”
After the X-ray, and my clinical exam, it was easy to see what happened. The bullet (a Federal 230 grain Hydrashok) entered the patient’s midface, at a downward angle, and traveled through his maxillary sinus, exiting through the maxillary tuberosity, shattering the first and second molars, and entering his mouth (depositing pieces of jacket along the way), then spiraled through his mouth, into the right mandible, and then fragmented, leaving a large hunk of the jacket entangled just above the substance of his right parotid gland, THEN the remaining core of the projectile went left, further tumbling through his mouth and buccal mucosa, coming to rest in front of the tissue of his left auditory meatus.
So his chief complaints of not being able to open his mouth made sense, since the bullet had effectively, “door chocked,” his jaw from fully opening, mostly due to soft tissue swelling as well as the mechanical presence of the bullet’s core. Also, he had what we call an, “oral antral communication,” meaning the wall between his sinuses in his nose and the space inside of his mouth, were one. Hence, the water when he drinks, coming out his nose.
When this information got out, people said silly things like, “.45…so puny it’ll send the badguys to the dentist!” And other dumb nonsense. But think about this from a defensive gun use perspective (even though THE facts of this case may have been otherwise) where the bullet actually did it’s job! It was delivered to a vital area, did a considerable amount of internal damage, fully deposited all of its energy in the target, and made the recipient lose consciousness, instantly, at least for a indeterminate amount of time (he estimated five minutes or longer). From a civilian self defense perspective, if I was forced to use THAT round delivered to that location, I’d consider that effect, a success! That would give me enough time to run away, call 911, or get to a secure (or more secure area).
Bottom line, handgun projectiles suck at stopping people. But this one, DID, in this instance. It stopped them quite effectively, so much so, that they left the damn country! .45’s aren’t a death ray, but they CAN stop people from doing whatever it was they were doing!