“I am thankful for my life,” Tyrece Matthews said as he celebrated Thanksgiving at his girlfriend’s home. Matthews is mostly paralyzed from the waist down after he was shot two years ago; he is determined to walk again.

The silent toll of gunshot injuries

The number of deaths only tells part of the story. In the shadows, hundreds of Minnesotans hurt by gunfire struggle to repair their lives.

More than two years later, the memory of that night still haunts Tyrece Matthews.

He had just pulled up in front of his St. Paul home and grabbed his phone to check an alert when a pair of gunmen ambushed him, firing dozens of bullets into his car. One hit Matthews' spine, leaving the 42-year-old mostly paralyzed from the waist down.

The shocking surge in gun violence that has defined this decade in Minnesota and the rest of the country is usually measured in deaths, and that toll has been grim: Between 2020 and 2022, 486 Minnesotans were killed in shooting homicides, according to the state Bureau of Criminal Apprehension.

But homicides reveal only part of the story. Far from public view are the hundreds of men, women and children such as Matthews, struggling to put their lives back together after surviving gunshot injuries.

Loaded

An occasional series examining the rising levels of gun violence in Minnesota, the proliferation of legally purchased handguns used in crimes and the technological advances that make them more deadly than ever.

Just in Minneapolis, more than 400 people were wounded by gunfire in 2022. Statewide, the number of nonfatal shooting victims since 2020 is triple pre-pandemic levels. A study last year estimated the overall cost of firearm injuries in the United States at more than half a trillion dollars annually, with much of that attributed to losses in quality of life both for those struck by bullets and their loved ones.

At times, the physical injuries are minor. But just as often, they are devastating.

For Matthews and others like him, survival means both physical and psychological challenges. A single hour-long appointment can eat up a whole day through waiting on unreliable, limited transit services. Lodging is a cramped room with just enough space for a bed as he seeks more permanent housing.

Grueling physical therapy sessions push him to his limits, but they don't dim his spirit. Each time a therapist asked Matthews to exert himself one morning this fall, he was game. First, it was gauging his ability to pull himself out of his wheelchair and onto a bed. Later, she asked if he was ready — with a little help and a lot of effort — to stand and try moving his legs forward.

Matthews is determined to walk again, to stride back into the clinic on his own power. So, with the therapist steadying him, Matthews rose from his wheelchair. If even for a moment, he could be his full 6-foot self again.

"I'm willing to do whatever to get it done," he said.

Tyrece Matthews stood up from his wheelchair with the support of bars and his physical therapist during an appointment in October. He's working to get his life back after being shot.

When a person is shot, trauma surgeons like Dr. Derek Lumbard and his teammates at HCMC often have about 5 minutes' notice that a patient is coming their way.

On one night earlier this year, the group assembled in the building's stabilization room as a patient was hurried in, clinging to life: Nurses checked monitors for the patient's health history. Technicians prepared equipment to look for bleeding inside the body. A towering device stood ready to keep blood warm as it is infused into the body.

"It's all very choreographed, and it needs to be that way," Lumbard said.

They quickly took X-rays, finding holes in the patient's torso. Surgeons removed the spleen and parts of the colon and the pancreas. They had to scoop out what was left of one kidney. The team churned through 12 coolers of blood products to save a person who Lumbard calculated had an 80% chance of dying.

"I can't say I've seen it all because I'm so early in my career, but I've seen so many things that I hadn't expected to see," Lumbard said.

Trauma surgeon Dr. Derek Lumbard rushed down the stairs to HCMC's emergency department, top. Lumbard, who is studying the longer-term effects of firearm injuries, operated on a gunshot victim, bottom.
Trauma surgeon Dr. Derek Lumbard rushed down the stairs to HCMC's emergency department, left. Lumbard, who is studying the longer-term effects of firearm injuries, operated on a gunshot victim, right.

The 34-year-old surgeon's career has made him a witness to Minnesota's rising tide of gun trauma since he began practicing at HCMC in 2016.

For Lumbard, it isn't enough to keep gunshot victims brought into his trauma center alive.

"Survival from the injuries is only the beginning," he said. "If someone is still living, are you helping them thrive and actually live? Or is it good enough for them just to be alive?"

So Lumbard is also studying the longer-term effects of firearm injuries, and he participates in the Next Step program, the state's only hospital-based violence intervention program.

Launched in 2016 with workers at Hennepin Healthcare, North Memorial, Children's Minneapolis and Abbott Northwestern, the voluntary program connects gunshot survivors with counseling, case managers and support groups to reduce their chances of being hurt again. Case managers are on duty around the clock and can often be bedside within half an hour of a patient's intake.

Any of the 900 people so far served by Next Step can remain with the program indefinitely, said Kentral Galloway, the program's director. They're matched with job training, education or help finding suitable housing for a fresh start.

The program also offers weekly support groups in downtown Minneapolis, bringing together survivors such as Matthews and their relatives to unpack their trauma.

"It's like a lifelong journey because we don't really have a discharge," said Galloway, who lost a cousin in a still-unsolved shooting in 2009.

Next Step started out exclusively for survivors ages 12 to 28 but by 2020 started expanding services to anyone who needs them. Next Step's staff swelled from two to 19, and it went from helping about 114 people yearly to about 300 people per quarter.

Each survivor, Galloway says, has had their "shield broken" by gunfire and needs help regaining trust in themselves and others. That means tackling anger and tough questions: Why me? What did I do wrong? Did I deserve this?

No — "being shot is not normal," he said. But, he adds: "Now it's something that will never leave them."

Dr. Derek Lumbard, accompanied by residents Dr. Veronica Ricker and Dr. David Kahat, checked on a gunshot wound patient at HCMC.

On the night he was shot in 2021, Matthews was winding down a tumultuous relationship with a woman who did not want him to be in touch with the mother of his newborn daughter.

He said two men suddenly lit up his car with gunfire. Matthews' body shook and went numb after one of the bullets pierced his spine, but he remained conscious, slowly raising his arm to blow the horn while screaming for help.

Matthews gave police two names of those he believed might have fired at him. One suspect was shot dead two months later, and police have yet to identify the second person.

Today, Matthews has a room to himself while sharing a kitchen and bathroom with other tenants at an apartment complex as he awaits longer-term housing.

It didn't take long for guns to fill the screen as he and his girlfriend watched a dystopian German film on Netflix one afternoon this fall. At one point, amid a gun battle, Matthews leaned forward in his wheelchair to turn down the volume.

"Sometimes my mind drifts back, back to the time," Matthews started saying. "But I've kind of learned to live with it. It happens if not every day, every other day."

Tyrece Matthews watched a German movie, at one point turning down the volume during a gun battle. "Sometimes my mind drifts back," he said. "But I've kind of learned to live with it."

Matthews knows that his mental recovery is as important as his physical one. So he tries to make it to weekly evening support group meetings led by Next Step.

While picking at a plate of fried chicken, corn bread and vegetables one night, he listened as Cedric Weatherspoon — one of the group's leaders — described how people are conditioned to deal with trauma in isolation.

"We can no longer afford that," Weatherspoon said. "There has to be collective intervention around this gun violence epidemic. It's important to be vulnerable and not hide in pain."

That night, the group celebrated LeShae Jones, a Minneapolis woman who had just become the first to complete a 12-week curriculum with the group.

Jones lost her 2-year-old son, Le'Vonte King Jason Jones, in a 2016 drive-by shooting. Jones told the class that the program has helped her manage daily bouts of anger, sharpen her parenting skills and forge new friendships.

"It's helping me heal," she said.

LeShae Jones picked up her son Anthony Love after a nap at home in Minneapolis. Jones lost her 2-year-old son, Le'Vonte King Jason Jones, in a 2016 drive-by shooting.

Mildred Saulter joined the program after her own traumatic experience with gun violence.

Her daughter Makayla Saulter-Outlaw was 13 when she was shot in the head while shielding her then-year-old niece from bullets fired by a neighbor outside their Bloomington home in 2020. The man was arrested after killing his wife and is now in prison.

Makayla stunned her doctors with a rapid recovery and has since resumed school. But her mother can't escape the reminders of that evening. The sound of gunshots sparks vivid anxiety, and the sight of something as common as grass can be enough to evoke the memory of her daughter crumpled over her granddaughter in the family's yard.

The group meets for three hours each week at HCMC in Minneapolis. One night was dedicated to generational trauma, another focused on anger management.

Earlier that same night, a 15-year-old still in a gown and attached to an IV was wheeled into the meeting. The gunshot victim struggled to stay focused, frequently shifting in his seat and picking at his hair. Finally, he asked his mother to leave early because of his discomfort. An assistant wheeled him away.

The Next Step program provides survivors of gun violence with counseling, case managers and support groups to reduce their chances of being hurt again. Tyrece Matthews, above, talked about his experience as a survivor. Mildred Saulter, whose daughter survived being shot in the head, wiped away tears as she was comforted by Christy Jackson, a domestic violence advocate. Participants also celebrate successes together. LeShae Jones, center, held up her certificate after completing a Next Step curriculum, celebrating with leaders Cedric Weatherspoon and Deseria Galloway.
The Next Step program provides survivors of gun violence with counseling, case managers and support groups to reduce their chances of being hurt again. Tyrece Matthews, above, talked about his experience as a survivor. Mildred Saulter, whose daughter survived being shot in the head, wiped away tears as she was comforted by Christy Jackson, a domestic violence advocate. Participants also celebrate successes together. LeShae Jones, top right, held up her certificate after completing a Next Step curriculum, celebrating with leaders Cedric Weatherspoon and Deseria Galloway.

The suffering resulting from gun violence is piling up as more people get shot.

A Harvard Medical School study last year pegged the overall economic toll of firearm injuries in the country at $557 billion each year, or about 2.6% of the country's gross domestic product.

Zirui Song, associate professor of health care policy at Harvard Medical School and a physician at Massachusetts General Hospital, looked at the rate of firearm injuries in employees and dependents at companies with employer-sponsored health insurance, finding that such injuries more than quadrupled from 2007 to 2020.

"Firearm injuries in the United States are both a family issue and they are an economic issue," he said.

Song estimated that each nonfatal gunshot injury is responsible for $30,000 to $35,000 in direct health care spending per survivor in the first year following the shooting. Survivors also face greater risks of mental health or substance use disorders as well as physical pain.

Muscle spasms hit Matthews often; the jerking of his body can send his mind back to the night of his shooting. Work is also on hold: even before the shooting, a cervical spinal tear had stalled Matthews' job driving trucks for Holiday Station stores.

He listens to gospel music to maintain hope that he will walk again and, beyond that, get his life back.

Before meeting his girlfriend, he occasionally missed crucial physical therapy appointments because the insurance-approved rides arrived late or not at all.

Today, Matthews needs a new wheelchair. And he's wishing for a stronger shower chair after he nearly fell to the floor while trying to bathe.

"I try not to depend so much," Matthews said, sitting in his apartment. "It's not going to be forever here."

One fall afternoon, Matthews waited nearly 90 minutes outside his St. Paul clinic for a ride that was supposed to arrive within 15.

After waiting for over an hour, Tyrece Matthews got picked up by a medical transportation company after a physical therapy appointment. A single appointment can eat up a whole day due to such delays. Tears rolled down his face as Matthews talked about the challenges of his life after being shot. Kentral Galloway, director of the Next Step program, says each survivor has had their "shield broken" by gunfire and needs help regaining trust in themselves and others.

He alternated between sitting on hold while waiting for an updated cab itinerary, researching the number of the company's owner and getting exasperated as an operator complained that Matthews was growing aggressive on the call.

"I don't know how else to be right now!" he retorted.

Amid the frustration, Matthews gazed toward the St. Paul skyline.

"They meant to kill me that night," he said, unprompted.

He trailed off, then began to narrate to himself the plot of a tale whose heroic climax had yet to be realized.

"Paralyzed from the waist down, he came back," Matthews announced, with the cadence of a promoter hyping a prizefight.

"Look at him now. It sure is beautiful."

Star Tribune staff writer Jeff Hargarten contributed to this report.

Tyrece Matthews and his girlfriend, Sha, prayed before their Thanksgiving meal. Matthews knows that his mental recovery is as important as his physical one, so he attends Next Step support group meetings.

Credits

Reporting Stephen Montemayor and Jeff Hargarten

Photography Leila Navidi and Emily Johnson

Graphics Mark Boswell and C.J. Sinner

Editing Eric Wieffering and Abby Simons

Copy Editing Catherine Preus and Valerie Reichel

Design Bryan Brussee, Josh Jones and Josh Penrod