Doctors often leave bullet fragments inside because removing them can be life-threatening
According to statistics, about 75% of people who survive gunshot wounds live with bullet fragments inside their bodies, sometimes for decades. These fragments can cause pain, lead poisoning, and a constant sense of anxiety. But not all patients who have suffered a gunshot wound know exactly what remains inside them and what risks it poses.
Why Doctors Don’t Remove Bullets After a Wound
According to the authors of ZME Science, in movies a surgeon always extracts the bullet with forceps, and the patient recovers. In real life, things work differently. When a person arrives on the operating table with a gunshot wound, the surgeon’s task is to save their life. They need to stop the bleeding, repair damaged organs, and stabilize the patient’s condition. The bullet itself or its fragments often remain inside.
This is because extracting a bullet or its fragment can be more dangerous than living with it. If a fragment is lodged near the brain, spine, major blood vessels, or deep within tissues, attempting to remove it risks causing even greater damage.
Modern ammunition makes the problem worse. Hollow-point bullets are designed to expand upon entering the body, inflicting maximum tissue damage. Such bullets rarely pass through; instead, they shatter into dozens of small fragments that scatter across bones, muscles, and organs. Collecting them all is physically impossible.
Oronde McClain, who was shot in the head at age 10, spent eight weeks in a coma. Surgeons removed a third of his brain. But 36 bullet fragments remained in his skull. Doctors warned that attempting to extract them could kill him or worsen his neurological impairments.
Lead Poisoning from a Bullet Inside the Body
Most bullets contain lead or a lead-based alloy. When such a fragment remains in the body, the metal can gradually enter the bloodstream. In essence, a bullet fragment becomes a source of chronic lead poisoning — slow, nearly imperceptible, but potentially dangerous.
Fortunately, lead poisoning from retained bullets is rare. Among approximately 150,000 people with elevated blood lead levels, only about 500 had bullet fragments in their bodies. That’s less than one percent.
But in severe cases, the picture is different. Among people with lead levels of 80 micrograms per deciliter and above (while the norm is below 5), approximately 5% had retained bullet fragments. The maximum recorded level in this group exceeded 306, and such a level can be fatal.
Symptoms of lead poisoning include:
- chronic fatigue and irritability;
- abdominal pain;
- problems with memory and concentration;
- headaches;
- nerve damage;
- high blood pressure and anemia.
All of this can manifest years after the injury. Colin Goddard, who survived the shooting at Virginia Polytechnic Institute in 2007, said that symptoms appeared almost ten years later.
Some doctors note that fragments near joints can be especially dangerous: joint fluid can accelerate the breakdown of the metal and the leaching of lead.
Pain and Inflammation from Bullet Fragments
Even if lead doesn’t enter the bloodstream, the fragments themselves can cause constant physical discomfort. A fragment lodged near a nerve, joint, or in soft tissue can cause chronic pain, limit mobility, and trigger inflammation. It is a foreign body, and the body reacts to it accordingly — much the same way it reacts to rare parasites in the human body, trying to isolate the foreign object.
Surgeon Randy Smith of Emory University described the case of a young mother with a fragment in her shoulder. The woman never held her child on that side. It wasn’t just because of the pain, but also because she didn’t want to “pass on negative energy” to her baby. This may sound irrational, but for a person whose body literally contains a reminder of the violence they experienced, such a reaction is entirely understandable.
Oronde McClain, 25 years after being shot, still suffers from seizures. The right side of his body is partially paralyzed. Thirty-six fragments in the skull are no joke.
How Living with a Bullet Inside Affects Mental Health
Physical pain is only part of the problem. For many survivors, fragments become a source of constant anxiety.
For many survivors, bullet fragments are a constant reminder of what they experienced
Randy Smith conducted research on the mental health of people with retained bullet fragments. The results showed that such patients have significantly higher rates of depression.
For some people, the bullet is a constant reminder of the trauma they experienced, — explained Randy Smith.
However, not everyone experiences it the same way. Some view the fragments as proof of their own resilience — a symbol that they went through the worst and survived.
When a Retained Bullet Needs to Be Removed
There is no universal protocol here. The decision to remove depends on the fragment’s location, symptoms, and surgical risks. But there are situations in which bullet extraction becomes necessary:
- the fragment causes chronic pain or limits mobility;
- the fragment is located near a joint and may deteriorate faster;
- blood tests show elevated lead levels;
- the fragment shifts and threatens to damage blood vessels, nerves, or organs;
- an infection develops or an inflammatory reaction occurs around the bullet fragment.
The problem is that regular lead testing for people with bullet fragments is far from standard practice. Some researchers and clinicians insist that such tests should be performed, especially when symptoms appear or if the fragment is in a high-risk area.
An even more serious problem is that many patients don’t even know they have fragments left inside them.
Some people aren’t even told they have a retained bullet fragment. How can they seek information about it if they don’t know? — says Randy Smith.
Is It Dangerous to Live with a Bullet in Your Body
Stories of gunshot wound survivors rarely make headlines after hospital discharge. But that’s precisely when the long struggle begins for many — with pain, anxiety, and sometimes slow poisoning that no one told them about.
The main takeaway from the available data is that patients with retained bullets deserve full knowledge of the risks, regular blood lead level monitoring, and access to psychological support. For now, all of this remains the exception rather than the rule.
