ON JOSEPH SAKRAN’S dresser sits a singular artifact from his senior year of high school: a .38 caliber bullet, its brass casing patinated with age. Thirty years ago, it pierced his windpipe and carotid artery, paralyzed his phrenic nerve and one of his vocal cords, and, without the thinnest of fortuitous margins, would have killed him.
In his memory, the incident occurs as flashes of color and light, a slowing down of time, a struggle to breathe: After the Lake Braddock Secondary School Bruins’ first football game of the season, in Burke, Virginia, Sakran MC/MPA 2015 recalls, he was “hanging out with friends at a park when a fight broke out.” He saw a pop of light, and the white T-shirt and jeans he was wearing turned bright red. His friends helped him to the curb as he began choking on his own blood; a medevac chopper and an ambulance arrived on the scene; a take-charge surgeon wheeled him into an operating room.
He had been rushed to Inova Fairfax Hospital in northern Virginia—the hospital where he was born, nearly died, and, more than a decade later, returned to train as a general surgeon under the very doctors who had saved his life. It was where he would perform, for the first time, the same operation that healed him. But that patient, also shot in the throat, was paralyzed for life. It could’ve been him, Sakran reflects, “if I had been standing at a different angle.”
Inspired by the surgeons who saved him, Sakran is today the executive vice chair of surgery and director of clinical operations for surgery at Johns Hopkins Hospital, which treats hundreds of gunshot wounds a year. Of those patients who survive, roughly half will return within five years, shot again.
Often he is the one to deliver bad news to families—by far the worst part of the job, he says. No matter how good the trauma center or the surgeon, “if someone is shot in the head, there’s very little” that can be done “to bring them back to baseline.” Because “the best medical treatment is prevention,” Sakran says, he has become a leading gun-reform activist over the past decade, mobilizing tens of thousands of health care professionals to advocate for their patients and communities, and rallying diverse coalitions behind evidence-based policy change.
He has testified numerous times before Congress; published award-winning scholarship on firearm injury and its prevention; taken a year’s leave from Johns Hopkins to serve as a health policy fellow in the U.S. Senate for New Hampshire Senator Maggie Hassan; and appeared on national television and radio to build bipartisan momentum. He currently serves as board chair and inaugural chief medical officer of Brady, a bipartisan gun-violence-prevention organization named after Jim and Sarah Brady, of the eponymous Brady Bill, which mandates federal background checks for gun sales. In recognition of his innovative work and exceptional leadership in firearm-injury prevention, Sakran was recently inducted into the National Academy of Medicine, considered one of the highest honors in health and medicine.
Sakran’s story is helping to shift the narrative of gun violence, from “being pigeonholed as a criminal justice issue” to a social and public health issue. It’s a tale of a stray bullet’s impact on a single life, of improbable second chances, and of broader patterns of crime, poverty, and racial and health inequities from the 1990s to today—a story Sakran didn’t believe anyone would be interested in until he gave a talk about gun violence to polite but distracted teens from West Philadelphia during his trauma fellowship at the University of Pennsylvania.
Sakran realized he was “just a guy in a white coat” lecturing about medical trauma statistics to a predominantly Black and brown audience. “They were probably wondering, What does this guy know?” he says. “Then I told them my story,” and suddenly “all their eyeballs focused on me.” Nearly all of them had experienced a shooting in their family, or knew someone who had.
Baltimore, Maryland, where Johns Hopkins is located, has one of the highest violent-crime rates in the country. It is estimated that 80% of the hospital’s trauma patients come from within a five-mile radius. A few years ago, one of Sakran’s fellow trauma surgeons was on his way to work when he was shot in a carjacking. Gun-related crimes disproportionately burden communities of color—with homicide being the leading cause of death for Black men ages 15 to 45 for more than half a century. Framing gun violence primarily as an urban crime issue has led to policies focused on policing and incarceration while fatalities continue to escalate.
Even as low-income urban communities are overpoliced and overincarcerated, the mostly white gun industry that funnels weapons onto the streets suffers few consequences, Brady’s website notes. Remarkably, “only 5% of gun stores are responsible for 90% of the guns used in crimes across the country,” says Kris Brown, the president of Brady. But holding them accountable is an uphill battle—one Brady fights relentlessly—because of loopholes in background-check laws and protections secured by industry lobbying.
Meanwhile, firearm fatalities and injuries are on the rise. Every year, says Sakran, 45,000 to 48,000+ gun-related deaths occur, and two to three times as many injuries (a conservative estimate given uneven reporting by various hospitals in different states). The majority of fatalities are suicides. Shockingly, for the past three years in a row, guns have been the leading killer of children under 18, surpassing motor vehicle accidents and cancer—a rate that grew 87% from 2011 to 2021.
Sakran is acutely aware of his own good fortune. A first-generation Arab American, he grew up in a close-knit family whose home was always open to friends. His Lebanese mother and Palestinian father, both Catholics, immigrated from Israel. With little education themselves and hard work, they strove to provide their children with an ideal American childhood: a safe neighborhood, good schools, friends, football games, and perhaps the greatest gift of all: the freedom to be young, carefree, and unaware of your own mortality.
“No one in a million years imagined, especially at that time, that I would go from this healthy high school senior to collateral damage,” Sakran says. “Like most kids at 17, I didn’t have a focus past Friday night,” he says, referencing a Brad Paisley song. His friends and family helped him through a painful six-month recovery. His father was the one who jolted him out of a moment of despair, telling him he could feel sorry for himself or “make a difference for others.”
For years, Sakran didn’t look back as he enrolled at George Mason University, trained as a medic and a firefighter for the City of Fairfax, and pursued medical school and a surgical residency. He attended the Medical School for International Health, a collaboration between Ben-Gurion and Columbia Universities in Israel, and midway through, completed a master’s in public health at the Johns Hopkins Bloomberg School of Public Health. A random stroke of fate brought him to Harvard Kennedy School.
“They were probably wondering, What does this guy know? Then I told them my story.”
After eight years of clinical medicine, shortly after the tragic shooting at Sandy Hook Elementary School, Sakran, appalled by the rise in gun violence, began to think beyond saving individual patients to aiding vulnerable populations. He had been focused on working in low- and middle-income countries to deliver long-term interventions and build surgical care capacity, and had responded to several natural disasters, including the 2004 Indian Ocean earthquake and tsunami and the 2010 earthquake in Haiti. He wanted to make a larger impact in cities and communities in the United States. One day, his mentor handed him an ad for vlog’s Mid-Career master’s program, sensing that it would resonate with Sakran’s goals.
At vlog, he was “introduced to a whole different group of individuals,” he says—diverse leaders from all over the world who challenged him to “tap into broad perspectives, understand different vantage points, and develop a more holistic view of global issues.” The Kennedy School “was a transformative experience ... I made lifelong friends and met my wife (Francesca Ioffreda MBA/MPP 2017, a Zuckerman Fellow and George Leadership Fellow)—all because of a flyer in the mail,” he marvels.
Richard Parker, one of those lifelong friends, and a recently retired lecturer and senior fellow at the Shorenstein Center, recalls Sakran’s earnestness in engaging students and faculty members in productive dialogue. “Joe has about him a charisma of integrity ... that pulled together a wide variety of people,” Parker says. He not only “brought an informed level of thought”; he had “a willingness to say, ‘We have to be able to talk to people who don’t share our views.’”
Sakran’s ability to connect and find common ground has been crucial to navigating a politically charged issue. With Brady, Sakran is charting a way through the impasse, working with gun owners, veterans, families and communities impacted by gun violence, and health care workers to advocate for responsible gun ownership and use—not to curb gun owners’ rights, he says.
The organization was launched after Jim Brady, Ronald Reagan’s press secretary, was shot and paralyzed in an assassination attempt on the former president. It has long understood the importance of reaching across partisan lines and taking a multifaceted approach to a problem whose roots we are only beginning to comprehend.
In the early 1990s, a crime wave (including MS-13 gang activity that the teenager convicted and deported in Sakran’s case was suspected of) led the CDC’s National Center for Injury Control and Prevention to propose a new approach to guns, one similar to the campaign that made smoking, once viewed as cool and glamorous, disapproved of and widely banned.
Gun-rights lobbyists countered with legislation that forbade federal funding of research into gun-violence prevention, effectively stalling any evidence-based policy debates for the next 20 years. In 2018, the funding freeze was finally overturned, after years of advocacy. That year, with new data trickling in, the NRA took to Twitter (now X), telling “self-important doctors” to “stay in their lane.” Sakran’s visceral response—“We take care of these patients every day. Where are you when I’m having to tell all those families their loved one has died?”—went viral.
The movement he created through @ThisIsOurLane has since become an official platform for amplifying health care voices at Brady. Under Sakran’s leadership, a national advisory council was formed at Brady to drive change on multiple levels: increasing funding for firearm prevention research, reframing gun violence as a public health issue, and shifting cultural attitudes and educating people on how to use and store guns safely. There’s no single solution to stop gun violence, Sakran says. “What we’re trying to do is develop a system that makes it less likely for people to be injured.”
In the few years Sakran has been at Brady, he has helped persuade the Biden administration to establish the first White House Office of Gun Violence Prevention—in 2023—and pushed forward a landmark Surgeon General’s Advisory declaring gun violence a public health crisis.
“[Surgeon General’s] reports have historically moved the needle on a lot of issues,” he says, from improving car safety to reducing smoking-related illness. In tandem, Sakran and Brady’s advisory council are developing a guide for health care workers on how to talk to patients about firearm access and safety, and working with entertainment studios and screenwriters to show responsible gun practices onscreen.
In charting an unconventional path as a physician-activist, he has opened a door for the next generation of doctors “to have their voice be heard beyond the bedside.” Nicole Lunardi, a surgical resident at the University of Texas Southwestern Medical Center, met Sakran at Johns Hopkins. They have coauthored several research papers and advocacy articles, including a Scientific American essay on a new health-equity data tracker housed at Morehouse College’s Satcher Health Leadership Institute that will help pinpoint social and political determinants of health.
Sakran was unlike other mentors, Lunardi says. Rather than “recreating the mentor’s path to success,” he helped her “through some of a young surgeon’s biggest transitions” on her own terms, showing her that “a career as a surgeon and advocate is malleable and evolves over time,” and giving her “the courage to be unapologetic about my personal and professional goals”—an invaluable trait in a line of work that often courts controversy.
Sakran has received death threats on numerous occasions. The NRA call for doctors to “stay in their lane” reflects a long-held belief that physicians should focus on saving lives and remain impartial on political issues. And there are good reasons for doctors to be nonpartisan in how they treat patients. But Sakran and other medical professionals who see so much harm on a daily basis feel a moral calling to speak up.
“Health care practitioners are starting to see the power of their voice” and the vital role they play in “the social fabric of a community,” Sakran says. “Whether it’s gun violence or climate change or racism, all these issues are connected to health.”
Many cases haunt him. Among them is that of a mother who lost her 17-year-old son to a fatal brain injury in Baltimore. He was the first in his family to graduate from high school and to dream of going to college. As she looked up to see the faces of the disconsolate medical team, she put a hand on Sakran’s shoulder and asked if he was okay. Sakran was floored: “This mom who just lost her son, asking if we’re okay … moments like that restore my faith and keep me going.”
From time to time, Sakran examines the bullet that set his journey in motion and reflects on the work yet to be done: How can we as a nation come together to “create communities where every person can live and work and thrive without the threat of violence or harm?” Safety shouldn’t be a privilege, he says, “but a right accessible to all.”
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Photographs by Jennifer Bishop