Dr. Jeffrey Kerby sat down at 9 a.m., patches of blood still clinging to his scrubs.

Kerby, director of acute care surgery and and chief trauma surgeon at UAB Medical Center, had been working since 7 a.m. the previous morning making rounds, teaching, working on research, but at 5 that afternoon, his real work began. He operated on three gunshot wound patients through the night. One, he presumed, would not make it. They’d been shot in the head. The other two were stable, but not out of the woods. He got out of his last surgery at 7:30 a.m. and at 9 a.m. he finally sat.

Earlier this week, the National Rifle Association drew public controversy when it posted a Tweet, chastising physicians for speaking out about gun violence, admonishing them to “stay in their lane.” But for Dr. Kerby, this is more than his lane. It’s his highway.

Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves. https://t.co/oCR3uiLtS7 — NRA (@NRA) November 7, 2018

Kerby graduated with a medical degree from the University of Missouri at Kansas City in 1989 and moved to Birmingham to complete his surgical residency. Since then, he’s only left Alabama when he served as an active duty United States Air Force trauma surgeon from 1999 to 2003. Today, he uses techniques he developed tending to high velocity gunshot wounds in war zones all over the world in his practice in Birmingham.

“I’m used to seeing high velocity wounds, but now we’re starting to see those wounds in civilian trauma centers because you’ve got the high velocity rifles the AK-47s the AR-15s. We’re starting to see some of those wounds more frequently,” Kerby said.

According to the Center for Disease Control, Alabama has the second highest rate of gun deaths in the country, with 21.4 deaths per 100,000 people. Kerby said the number of gunshot wounds the UAB Trauma Center has doubled in four years. He estimates 750 patients were treated this year for gunshot wounds. “It’s on a linear rise,” Kerby said. “it’s not just blips. It’s becoming a real epidemic”

Kerby shares the sentiments of the American College of Surgeons Committee on Trauma Firearm Strategy Team when it comes to gun violence: the gun violence epidemic is a public health problem that needs to be researched. “We’re not anti gun,” Kerby said. “We know that the 2nd Amendment is very important, especially to our population in Alabama, and across the country. We want to come to the table with all the parties, the NRA, trauma surgeons, public health experts, to try to come up with a solution to the gun violence problem.”

The NRA has actively lobbied against gun-violence research in the past, including advocating for the Dickey Amendment in 1996, which cut federal funding for gun violence research by 90 percent.

Alabama’s rise in gun violence is on par with the increase of gun violence in the United States as mass shootings make headlines almost daily. According to Gun Violence Archives, a not for profit organization providing public research for gun-related injuries, there have been 307 mass shootings nationwide in 2018, killing 328 and injuring 1,251.

In Alabama 367 people died of gun-related violence in 2018.

Kerby said it’s the day to day gunshot wounds that make up a big problem in Birmingham. Right now, he is focused on projects that can get trauma surgeons to patients faster and training civilians to treat gunshot wounds before medical help arrives. He leads “Stop the Bleed” courses in middle and high schools, teaching students and teachers to administer tourniquets.

“It’s a sad statement. We’re taking [kids] innocence away from them,” Kerby said. “But what I always tell people is, we don’t have to accept what’s going on, but we do have to prepare for it.”

Kerby co-wrote a study examining gun-related deaths and how to prevent them in 2017, by breaking down gun-related deaths based on gun availability, injury and death.

Kerby said there’s no individual patient story that has stuck with him more than others. He remembers them all, especially the ones that end with him sitting down with a family member to tell them their loved one didn’t make it. “We carry a lot of emotional baggage. We have to tell those families when they don’t make it. We remember those conversations. We remember every one of them. It sticks with you and it takes a toll over time,” Kerby said.

Dr. Kerby sat for two hours. And then he stood, white coat covering the blood stain on his scrubs, to do it all over again.