Photo by Richard Foertsch/Photoprose Philip J. Andrew, executive director of the Illinois Council Against Handgun Violence

Like most 26-year-olds, Philip J. Andrew still has much to learn about the world. But he has received an education in real life during the last five years that most people never get — or want. The education of Phil Andrew began early on May 20, 1988, the first day of a summer break that looked especially promising for him. A 20-year-old student, he had arrived home the previous evening in the tony Chicago suburb of Winnetka from his junior year at the University of Illinois in Urbana-Champaign. Andrew had been training all year with the college swim team and felt, he recalls, "in the best shape of my life" — more than ready for the competitive swim meets scheduled for the summer. Even more exciting for him were the two internships he had lined up: one in U.S. Rep. John Porter's office, the other working for the Lake County state's attorney. By all appearances, he was laying the groundwork for a future involved in public service. Andrew was sitting in the kitchen of his family's comfortable home talking to his mother, Ruth Ann, when an unwelcome visitor arrived at the back door. Her name was Laurie Dann, and she would turn his plans for the summer upside down and alter the course of his life. Dann, a name many Illinoisans never will forget, had just left Hubbard Woods Elementary School, where she had shot several children. Eight-year-old Nicholas Corwin, who was shot in a second-grade classroom, died; five others survived their wounds. Police already were searching the neighborhood for Dann when she entered the Andrews' large home, clad in a T-shirt, shower curtain and plastic garbage bag, and carrying two handguns. At first, Andrew and his mother were sympathetic toward Dann, who told them she had been sexually assaulted and was afraid she would be in trouble with police because she shot her attacker. But it soon became apparent Dann's story made little sense. Dann allowed Ruth Ann to leave the house to wait outside for her two daughters' return from high school. Andrew's father, Raymond, also was allowed to leave when his son promised Dann he would stay.

At a moment when she seemed to let her guard down, Andrew grabbed one of her guns, a .22-caliber semiautomatic Beretta, and removed the magazine. But when Dann heard police outside the house, she told Andrew she wanted him to stay with her. Then, without warning, she shot him point-blank in the right side of his chest.

The bullet punctured both of his lungs, severed his esophagus and ripped through his stomach and pancreas before lodging in the left side of his back. His lungs began to deflate. Andrew dived into a pantry to reload the Beretta, then held it aloft to cover himself as he ran from the house.

Outside, Andrew collapsed in his family's driveway. Inside, Dann went to a bedroom, put the barrel of her .32-caliber Smith & Wesson revolver in her mouth and committed suicide.

Thus began Philip Andrew's education — about the violent nature of modern America, about the way his government really works, about shootings so epidemic that some people no longer regard them as a crime issue but rather as a public health menace.

As horrifying as it was, the Dann story is far from the deadliest account of gun violence ever told. Earlier this year in Palatine, seven people were killed with a .38-caliber weapon at a Brown's Chicken & Pasta restaurant. In July, a San Francisco gunman killed eight people in an office with two semiautomatic Tec-9 pistols and a .45-caliber handgun. And just weeks ago, at Fort Knox in Kentucky, a man shot

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three people to death with a .38-caliber revolver before killing himself.

Statistics on gun violence in Illinois are startling. In 1992 there were 1,559 firearm deaths in the state — an increase of 394 over five years earlier, according to the Illinois Department of Public Health. The number of homicides by firearms rose especially sharply during the same period — to 979 from 582. Even children aren't spared: In the metropolitan Chicago area, 28 children under the age of 15 were killed by gunfire as of early last month.

So Philip Andrew feels particularly lucky not to be just one more statistic. He suffered few lasting effects from his shooting and was even able to rejoin his college swim team.

But his story alerted people that such a nightmare could happen in their own neighborhoods, no matter where they lived. Violence could march into a five-bedroom, three-bath home just as it could into an inner-city housing project. And it could occur, unprovoked, to just about anyone — including innocent children whose parents had the means to give them a privileged start in life.

"I wound up giving a statement from the hospital about gun control," says Andrew. "To me, this showed they were just too available." He started spreading that message right away — to the media, community groups, and in testimony the following year before legislative committees considering gun control measures.

For all that he'd been through, Andrew received the U.S. House of Representatives Award for Outstanding Courage and Heroism and was nominated for the NCAA Valor Award.

He became active in local and statewide gun control organizations, splitting time between school work, lobbying and speaking to citizens groups. He now attends DePaul University School of Law in Chicago and works as executive director of the Illinois Council Against Handgun Violence.

The first lesson Andrew learned during his journey from victim to advocate came in 1989, gleaned from hours of working side by side with the likes of then-Lt. Gov. George H. Ryan, who is now secretary of state. Despite the unlikely alliance between Ryan, a Republican, and liberal Democrats such as former state Sen. William Marovitz and state Rep. Barbara Flynn Currie, the House killed legislation that would have banned the manufacture, sale and import of more than 60 types of semiautomatic weapons.

The National Rifle Association and its state affiliate launched an intense campaign against the legislation, putting especially heavy pressure on downstate and Republican lawmakers to oppose it. Legislators spent nearly as much time on the floor debating the National Rifle Association's aggressive tactics as they did debating the bill at hand. By the time the final vote was called, extra security had to be added at the Capitol because some lawmakers had received anonymous warnings that they'd be harmed if they supported the measure.

"These weapons aren't regulated at all," Andrew says. "They aren't used for sport. They aren't used for hunting. They're used for killing people. But the House killed it anyway. It's the type of thing that makes you realize what special interest groups are and what they can do."

As he learned about lobbying groups and the influence they wield, he also learned that widespread support for a measure doesn't equate to passage if legislative leaders are not supportive. Gun control hasn't been a high priority for Gov. Jim Edgar nor any of the three top veteran leaders, House Speaker Michael J. Madigan, Senate President James "Pate" Philip and House Minority Leader Lee A. Daniels. Sen. Minority Leader Emil Jones Jr. has been in leadership just one year.

"People in Springfield know that nothing is going to happen until leadership wants it," he says. "But outside [of Springfield] they don't know that."

Andrew also learned that emotional stories of handgun violence — no matter how steeped they may be in facts and figures — don't sway many votes in the legislature. For one thing, he says, such stories are countered with emotional arguments about the constitutional right to bear arms and the familiar "guns don't kill people; people kill people" rhetoric. For another, they don't hold much weight against generous special interest treasuries such as that owned by the National Rifle Association.

So even armed with his grisly experience and persuasive arguments — which began with his contention that just about anybody could obtain a handgun in Illinois — he failed to see any of the measures he promoted that year signed into law.

"I became more and more involved anyway," Andrew says. "Having lived through what I did and seeing what happened to the children that were victims in the Laurie Dann case, I knew these guns were too available. If the legislators weren't going to realize it, I thought, we had to get at them by educating the voters."

Despite the defeats that came during his first year of lobbying, he saw a state law enacted in 1991, pushed by Edgar, that requires gun dealers to wait 72 hours to complete handgun sales and 24 hours for shotgun or rifle sales. Gun dealers in Illinois also are required to do a phone check of potential buyers' criminal and mental health histories.

Yet despite such success, Andrew wonders whether his message is getting through. To this day, his group must routinely fight to retain the state's requirement for a simple gun permit, known as the firearm owners' identification, or FOID, card. "You would think that wouldn't even be an issue anymore," he says. "But there are still people fighting it."

So Andrew, like many advocates, learned that the debate over gun control had to move into new territory —just as gun violence has. The fact that Laurie Dann invaded the peaceful suburb of Winnetka demonstrated that gun-related violence has spread to places many thought immune to such savagery. This year, the medium-sized city of Rockford already had seen a record number of homicides by early November; 14 of the 20 victims there were killed by firearms.

And once-safe Chicago suburbs are seeing increases, too. The number of suburbanites treated for gunshot wounds at Christ Hospital in Oak Lawn has climbed significantly in the last few years. Dr. Gary Merlotti, a trauma surgeon at the hospital, says just four people from the suburbs were treated there for "penetrating injuries" — 80 percent of which are gunshots — in 1990. The number jumped to 100 in 1991 and 140 in

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1992 at Christ.

"For more handgun control to happen in Illinois, we must move suburban voters," says Andrew. "That's where the bulk of votes are now. Until their legislators understand how much of an issue it is to their own constituents, nothing will move. But it's becoming a suburban issue. Look at Dick Phelan and his newfound love for gun control. Do you think he was always into it? No — his polls showed voters care about it. This is one issue the inner city and suburbs are agreeing on."

Phelan, president of the Cook County Board and a candidate for the Democratic gubernatorial nomination, pushed through an ordinance in mid-October banning possession and sale of assault weapons in Cook County. He would like to see a similar ban for the entire state.

But others don't think the spread of violence necessarily will spur united suburban support for state measures. "There's always hope but I don't see any signs of it happening," says Rep. Louis I. Lang (D-16, Skokie), a frequent sponsor of gun control legislation. "Some lawmakers are hardened against it ... they're tired of debating it. Many have as much as said, 'I'm tired of this issue, you're never going to get my vote, go away.'"

Just as gun control advocates seek to broaden the constituency involved in gun control debate, so are they trying to shift the terms of the debate. Increasingly, they speak of firearm violence as an issue of public health, not of criminal law.

Andrew sees this shift as logical and necessary. Since suffering extensive injuries from a single bullet, he sees a clear connection between health and gun violence. "When it affects so many people's health to the extent that it has, then it becomes a public health issue," he says.

Josh Sugarmann, executive director of the Violence Policy Center in Washington, D.C., says this line of thinking has been espoused for some time but only recently has garnered much attention. "Now is when the press finally has focused on it as a health issue," Sugarmann says. "It's a new take on an old issue. But is the gun control movement ready to take advantage of it? That's a good question."

Dr. Merlotti of Christ Hospital says the health care field has been viewing handgun violence as a public health epidemic for some time. Just as past epidemics have caused widespread death and disability, he says, gun violence does the same. "What's new is that it's going out to the general public from this perspective," he says. "Our strategy has to be directed like it would for an epidemic like AIDS. We have to teach improved gun safety and stop the proliferation of handguns the same as we teach people to wear a condom."

Dr. Robert R. Tanz, a physician of academic and emergency pediatrics at Children's Memorial Hospital in Chicago, is part of a national coalition called the HELP Network (the acronym stands for Handgun Epidemic Lowering Program). This group of 122 organizations promotes regulation of handguns and ammunition as a way to fight what they see as the public health emergency caused by the weapons. "The prevalent approach to handguns as a crime problem is not effective and probably irrelevant," Tanz says. "There's much more to it than crime. When 5,000 kids are dying every year from handguns, it's an epidemic. There's nothing else you can call it.

'... But when you come to the end, the mechanism of death is the gun...'

"In a lot of ways it's analogous to the polio epidemic," he says, in that it strikes randomly and without notice. "We need to treat it in a way that's analogous to an immunization campaign ... finding ways to prevent people from getting handguns. Now, is it as simple as finding a vaccine? No. Its roots are in deeper problems in our society — racism, poverty, our failure to fund schools properly. But when you come to the end, the mechanism of death is the gun. There always will be racism and poverty. But one thing we can have control over as an immunization against violence is the removal of handguns."

Sugarmann says the shift in debate to the public health arena expands the audience listening to arguments in favor of gun control. "Doctors have a great deal of credibility with people," he says. "They offer us a way to connect with the general public."

But not everyone buys the public health argument.

"Our perception is that it's bogus," says Tom Burckhalter, secretary of the Illinois State Rifle Association. "We see it as a failure of the criminal justice system, but they're trading off the respect doctors have earned."

"It's a packaging issue, isn't it?" asks Northwestern University law Professor Daniel Polsby, who pointed out that he is not a member of the National Rifle Association and does not own a gun. "Call it a criminal justice issue, a public health issue ... the way one thinks about handgun control shouldn't be changed by how it's packaged. You have doctors' groups organizing around this, and their obvious peg is the public health peg. But it's still politics. These people have an agenda. It's just talk ... it's white people from Winnetka. It doesn't advance the substantive discussion of the issue ... which involves why people have guns in the first place."

Aside from hunters and sportsmen, people have guns for protection or to promote a criminal lifestyle, he says. Gun control laws will not convince the criminal element to turn in their handguns, he says, pointing to Chicago as an example. Ordinances there effectively ban assault weapons and handguns, yet there were more than 15,000 shootings in the city in 1992 resulting in 700 deaths.

Polsby says he sees what amounts to political hypocrisy on the issue all the time. "It annoys me to hear people like [Illinois] Atty. Gen. Roland Burris and President Clinton advocate gun control while they're surrounded by Secret Service people with guns!" he says. "There's a reason they're carrying guns, and there are thousands of people who don't have armed guards at their sides but feel they need to be protected. There are thousands of gun control laws on the books, and they don't seem to alter people's behavior. Why pursue more? I mean,

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isn't that a little bit neurotic?"

A realistic solution to the violence wrought by handguns would tackle the reasons people turn to crime or the reasons they feel a need for protection, Polsby says. In his view, the solution will not stem from debate over whether guns are a public health or a criminal justice issue.

Hand in hand with the public health angle is the economics of gun violence. Andrew found this out when he added up his medical bills following his shooting. Including his two-week stay at Highland Park Hospital, his treatment came to about $70,000 in 1988. "That was from a single bullet from a low-caliber gun," he says. "With multiple bullets from high-velocity guns, the bullets can cause even more injuries."

The most recent studies done by the federal Centers for Disease Control were back in 1985. Even then, treatment costs were high: Medical personnel and hospital costs averaged $373,500 for each victim who died, $33,000 for each victim hospitalized and $460 for each victim treated outside the hospital. And with about 85 percent of gunshot victims lacking private health insurance, the public foots these bills through government insurance programs or other rising costs.

"It's been estimated we spend $20.4 billion treating firearm injuries every year when you factor in direct costs and lost productivity due to injury or disability," says Andrew. "When you think about health care reform, this is one area we can do cost containment in. Trauma care is one of the fastest growing areas in terms of cost. We're doing a lot more now to cut down on car accident injuries. What about gun injuries?"

Merlotti pulled the charts of two recent gunshot victims at Christ Hospital to offer examples of how costs mount the moment someone is brought to a trauma center for treatment — in part because of the surgeons, nurses and X-ray and laboratory technicians who must be on hand to treat trauma cases. "These are very labor-intensive injuries," he says.

In one case, involving a relatively "simple" wound in which a bullet entered near the victim's navel and exited near his spine, the victim spent about 25 minutes in the emergency department, was sent to an operating room for treatment of multiple small bowel injuries, then sent to the recovery room and on to a standard room for four days. Although Merlotti called this a "comparably innocuous" wound — one in which the victim was not in shock and was not placed in intensive care — the bill came to $ 11,000.

A more complex case, in which a man was shot in the head behind his left ear, required a CAT scan to diagnose the extent of his injuries. He then was placed in intensive care for six days before being moved to a regular room; his care continued with ongoing rehabilitation. "His bill will be $40,000, but he's going to have a good outcome. He's going to be able to get back to society in a functional state." To Merlotti, the highest costs occur due to lost productivity when a person dies or is permanently maimed. "When someone becomes a paraplegic or is killed at age 20 from a handgun, that's a lifetime of productivity gone. The medical bills seem relatively cheap compared to that."

The big question now is whether the broadened debate over gun violence will amount to anything. Andrew is somewhat optimistic that it will if gun control advocates are vocal about their feelings and channel their energy into particular measures. He acknowledges critics' arguments that restrictive laws haven't stopped gun violence in many places, and so has helped push his group to target gun manufacturers and suppliers.

The Council Against Handgun Violence is promoting four major legislative initiatives in Illinois and at the national level: holding manufacturers of Saturday Night Specials and assault weapons responsible for deaths and injuries caused by these products; taxing firearms and ammunition to pay for trauma care; banning the manufacture, sale and possession of assault weapons; and limiting the number of federally licensed dealers to those who actually operate out of a storefront.

There are more than 286,000 federally licensed firearms dealers in the United States, Andrew says. But only about 2,000 licensees, or 7 percent, operate storefront gun shops or sections in sporting good stores. "The rest are dealing guns out of their offices, homes, basements, the trunks of their cars," he says. "There's no restriction on where they sell them." In Illinois there are about 10,300 federally licensed dealers, with 2,400 in the Chicagoland area.

"Ideally, all we need is just people coming out and going to the polls to vote for people who support their own feelings about gun control," he says. "All it would take is people becoming active. And if the [legislative] leadership would realize these are politically expedient positions to take, we could push these things through."

But his experience leaves him wary. "The NRA [National Rifle Association] still has a lot of money and a lot of clout. It's not easy to change lawmakers' minds unless voters start writing them letters and making a lot of phone calls."

Mixing health care and economics into the debate is no guarantee that support will galvanize for measures like those Andrew promotes.

"Do we take this unique moment, when interest in the issue by nongun control people is really high?" wonders Sugarmann. "Do we channel that enthusiasm?" A host of side issues make him skeptical that this will occur, including a rift within the handgun control movement itself between "the controllers" — those who merely want to limit handgun accessibility — and "the banners."

Whether fear of mounting violence turns into support for further gun control measures will depend on what voters and decision-makers learn from the experiences of people like Phil Andrew.

"I don't think of any of these things as absolute cure-alls," Andrew says of the measures he supports. "But I think it's time we take some steps toward getting some of these guns off of the street, even if it's just going to save one life."

Adds Sugarmann: "The debate may have shifted, which has given us a big opportunity to gain support, but it's not going to be our only opportunity — and that's the problem. If support doesn't shift now, we will have another chance. This violence is going to keep on going; in fact, things will only get worse." *

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