In May, multiple people were struck or even killed by stray bullets in cities across the country, including Sacramento, Calif., and Des Moines, Iowa. In Washington, D.C., a 6-year-old is recovering from getting shot on a playground.

Thursday, Betty Howard, a 58-year-old special education teacher, was talking with friends inside a real-estate office in Chicago's South Side when she was killed by a stray bullet.

While stray bullets affect lives nationwide, there's little research about their prevalence and whom they affect. Nevertheless, some communities have made protection from stray bullets a childhood lesson.

A Public Health Issue

Mother Jennifer Groebe has lived the nightmare. Seven years ago, her 10-year-old son, Chris Rodriguez, was struck by a stray bullet from a robbery across the street from where he was having a piano lesson.

Groebe was waiting in her car when the shooting happened and was nearly hit herself.

"I thought rocks went through the rear passenger seat window on the left and then out through the right," Groebe tells NPR's Arun Rath. After the bullets ripped through her car, she ran to check on her son.

"Chris was sitting there, and the teacher was frozen. The kids were a little disturbed, and Chris said, 'I can't feel my legs! I don't want to be paralyzed,' " Groebe says.

Chris was in the hospital for two months and is now paralyzed. He uses a wheelchair and suffers from chronic pain because of nerve damage.

Groebe says her son is still trying to have a normal life. He's a junior in high school, plays wheelchair basketball and is getting ready to go to college. But he lives with the physical pain of the shooting every day.

Chris' story caught the attention of Dr. Garen Wintemute, an emergency room doctor at the University of California, Davis. Wintemute wanted to know more about the extent of this problem as a health risk. He was surprised to find there were not any studies. He started his own, which he published in 2012, but there is still little research on the issue.

There are still not enough data to say how frequently these shootings occur, but Wintemute was able to analyze more than 300 cases that covered a one-year time frame.

Violence is often thought of as disproportionately affecting young men, and accurately so, Wintemute says. The victims of stray bullets, however, are incidental to that violence and tend to be proportionate with the general population. He found that more than 30 percent of the victims of stray bullet shootings are children, like Chris, younger than 14. Males and females were affected about equally.

"[It's] not the age group that we're used to thinking about, not the gender that we're used to thinking about when we think about violence," he says.

Wintemute says about 41 percent of stray-bullet victims were in their homes, often indoors and sometimes even asleep in bed. He says 60 percent of the incidents occurred as a byproduct of intentional gunfire. Other causes included hunting and celebratory gunfire (bullets returning to the ground after being shot into the air).

'Innocent Bystanders'

In some communities, gunfire is a part of daily and nightly life. Some schools even conduct "duck and cover" drills like the ones conducted when the threat was missiles from the Soviet Union.

"Now the concern is missiles from down the block," Wintemute says. "Fear of random violence impacts daily life in entire communities."

Marsha Lee of Chicago lost her son to gun violence in 2008; he was killed when he tried to stop a robbery. Today, she worries about three young girls she helps care for. The little girls are 6, 7 and 9 years old, and these days she finds she has to talk to them about what can happen when bullets fly, the way kids have been taught to "stop, drop and roll" if on fire or to not talk to strangers. Lee says things have changed.

"Now, I have the added burden of trying to teach them how to protect themselves, hopefully, in case of stray bullets," Lee says. She says she teaches the girls to get down low to the ground and to stay there until it's over. She tells them to check on themselves and those around them once the bullets stop flying.

Lee now works for an organization that seeks to prevent gun violence, Purpose Over Pain. She worries constantly about the girls.

"When you have children at the age that I'm talking about," she says, "they're nothing but innocent bystanders."

Copyright 2015 NPR. To see more, visit http://www.npr.org/.

Transcript

ARUN RATH, HOST:

From the studios of NPR West in Culver City, California, it's ALL THINGS CONSIDERED. I'm Arun Rath. Here are some news events that may not have caught your eye last month. A 23-year-old man shot and killed by a stray bullet near Sacramento. A University of Tennessee football star grazed by a stray bullet. In Des Moines, a 19-year-old girl shot and killed, also by a stray bullet. Then this past Thursday 58-year-old special-ed teacher, Betty Howard, was talking with friends inside a real estate office in Chicago Southside, when it happened again. Officer Orlando Long, a beat cop in Chicago, spoke to WGN outside Northwestern Memorial Hospital where his sister had just been pronounced dead.

(SOUNDBITE OF NEWS STORY)

ORLANDO LONG: And I am aware of what's going on in Chicago and the area, but it just has to stop because like you said, this hits home - it has hit home now.

RATH: Across the country, these shootings are hitting home and lives are being torn apart. That's our cover story today. Jennifer Groby is one parent who has lived the nightmare, seven years ago during a typical afternoon with her 10-year-old son Chris.

JENNIFER GROBY: We had a piano lesson. It was at a different time than usual. We got there early. We got ice cream, waited out front and then when he went in for the lesson, I waited in the car.

RATH: That was the last time Jennifer would see her son walk. Chris Rodriguez later found out the details about what happened that day.

CHRIS RODRIGUEZ: I was having a piano lesson and someone at the same time was robbing a gas station that was across the street. And from what I understand, he tried to shoot the person behind the register because he was calling the police. And he shot everywhere.

RATH: Two bullets nearly killed his mom sitting in her car outside as Chris took his lesson.

GROBY: I thought rocks went through the rear passenger seat window on the left and then out through the right.

RODRIGUEZ: Then another one went through a wall and hit me. I just flew back kind of. And I couldn't sit up. And my stomach felt like it was vibrating and like shaking. And at first I thought I was, like, being possessed or something, and then I heard other people saying they heard gunshots. And then someone said, oh, I think he's shot.

RATH: After the bullets ripped through her car, Jennifer ran to check on her son.

GROBY: Chris was sitting there and he - the teacher was frozen. The kids were a little disturbed. And Chris said, I can't feel my legs. I don't want to be paralyzed. And then some other person came in and by then everything happened. I called his dad. His dad came. The first responders came. And it was just kind of a daze after that.

RODRIGUEZ: I was in the hospital for two months. I knew I had gotten shot. Am I going to be okay? Am I going to be able walk? And then that's when they told me I won't be leaving there walking, and that I was paralyzed.

RATH: Today Chris is in a wheelchair and suffers from chronic pain from nerve damage. Chris's story caught the attention of Dr. Garen Wintemute, an ER doctor the University of California Davis. Chris's story made Dr. Wintemute want to know more about the extent of this problem as a health risk. He was surprised to find out there no studies and that there are still very, very few.

So he published his own in 2012. There's still not enough data to say how frequently these shootings occur, but Wintemute was able to analyze over 300 cases that covered a one-year timeframe. He found that over 30 percent of the victims of stray bullet shootings are children, like Chris, under the age of 14. And nearly half the victims are female. I asked Dr. Wintemute why women and children seem to be disproportionately caught in the middle of this violence?

GAREN WINTEMUTE: Well, it's actually that they are caught proportionately in the middle of this. Here's the key distinction - we tend to think of violence, accurately, as a problem that disproportionately affects young men. These cases, by and large, are incidental to violence, but these people obviously were not targets. These are stray bullets. So in a sense, the victims of stray bullet violence represent the population at large - a third children, half girls and women, not the age group that we're used to thinking about - not the gender that we're used to thinking about when we think about violence.

RATH: How many of these victims ended up being shot in their own homes?

WINTEMUTE: A plurality of the victims, about 41%, were at their own residence. And of those, we know at least two thirds were indoors. Not uncommonly, given that these occur at night, they were in bed, asleep.

RATH: And we've been talking about, in the context of violent confrontations - is that the cause - the main cause of stray bullet incidents, or?

WINTEMUTE: It's absolutely the main cause. 60 percent of the stray bullet shootings that we've found occurred as a by-product of intentional gunfire.

RATH: And what were the rest?

WINTEMUTE: One was hunting, which only accounted for about 7% or so of the injuries that we identified. But the other one is what's called celebratory gunfire. Everybody's familiar with the act, if not the term. It's the firing of guns into the air at New Year's Eve, Fourth of July and so on. I thought that would be fairly common, and it actually accounted for less than 5 percent of the cases.

RATH: Some of these scenarios you describe the victims living in, they sound like war zones - you know, kids who are taught to avoid crowds, hide in bathtubs for cover. Cases where the CDC even advises people to remain indoors in some communities. What about the psychological impact of all of this?

WINTEMUTE: Consider living in a neighborhood where gunfire is part of daily and nightly life. One has to always be vigilant. Schools and people in their homes to duck-and-cover drills. I remember duck-and-cover drills when the concern was missiles from the Soviet Union. Now, the concern is missiles from down the block. Children are taught if you're at home and there's gunfire, head for the bathtub, because that's the closest thing to bullet-proof we have here at home. Fear of random violence impacts daily life in entire communities.

RATH: It sounds like a prescription for PTSD.

WINTEMUTE: It does indeed.

(SOUNDBITE OF PHONE CALL)

MARSHA LEE: It's as if we, we're at war here.

RATH: Marsha Lee lives in Chicago. She lost her own son to gun violence in 2008. He was killed when he tried to stop a robbery. Today she worries about three young girls she helps care for. The little girls are 6, 7 and 9 years old. And these days, Marsha finds she has to talk to them about what can happen when bullets fly.

LEE: Things have evolved. With the three little girls that I am close to I have a different talk with them.

RATH: Remember the talks you got as a little kid? Safety lessons like stop, drop and roll if you catch fire, warnings about household hazards, admonishments not to talk to strangers.

LEE: Now I have the added burden of trying to teach them how to protect themselves, hopefully, in case of stray bullets. They have to get down low, get down on the ground and stay on the ground until it's over. And when it's over, you have to check yourself and check one another and see if anyone has been hit.

RATH: She's now with an organization that works to prevent gun violence. It's called Purpose Over Pain. Marsha worries constantly about the girls.

LEE: When you have children at the age that I'm talking about, they're nothing but innocent bystanders.

RATH: The children who survive a shooting often lose their sense of innocence. Chris Rodriguez initially forgave his shooter.

RODRIGUEZ: When the trial had happened, I guess, I was still kind of under the assumption that the pain would be temporary. And as, I guess years later, looking back, thinking, look at all this pain that I have to go through, it just gets harder.

RATH: Now at 17 he says his feelings have hardened.

RODRIGUEZ: I know I said I forgave him, but I think - but I don't know. As I got older, it just feels harder too.

RATH: Chris's mom says he's still trying to have a normal life. He's a junior in high school now. He plays wheelchair basketball and he's getting ready to go to college. But he lives with the physical pain of the shooting every day. Transcript provided by NPR, Copyright NPR.

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