In 2019, Mia Tretta, then a high school freshman at Saugus High School in Santa Clarita, California, was shot in the stomach with a bullet from a .45-caliber semi-automatic pistol fired by a schoolmate. Two students were killed during the attack, including her best friend, and two others were injured.
When he graduated from high school, he enrolled at Brown University, the scene of another shooting in December 2025, while studying for finals in his dorm room.
When messages came in about an active shooter on campus, he felt pain where he had been shot in the stomach. The college student experienced a phenomenon she called “phantom bullet syndrome,” similar to phantom limb syndrome, in which someone feels like there is something that is not there. It happens whenever she feels extremely stressed, she said.
“It's crazy to say that the first time I was the lucky one because even though I was shot, I wasn't killed,” said Tretta, now an anti-gun violence advocate who studies public affairs and education. “And the second time I was the lucky one because it was a few blocks away.”
Tretta represents a small but growing group of young people who have experienced more than one shooting. It also embodies the findings of a recent study linking exposure to gun violence with chronic pain.
The study, published in BMC Public Health in January, found that both direct and indirect exposure to gun violence is linked to higher rates of chronic pain among American adults.
Researchers at Rutgers University studied six types of gun violence exposure: being shot, being threatened with a gun, hearing gunshots, witnessing a shooting, knowing a friend or family member who was shot, and knowing someone who died by gun suicide. Using a nationally representative survey of 8,009 people, they found that 23.9% had pain most days or every day, while 18.8% said they had a lot of pain.
Daniel Semenza, lead author of the study, told The Trace that whether someone has lost a person to gun violence or has been shot, their physical and mental health are inextricably linked.
“Your body, through the experience of post-traumatic stress, will feel like it's happening over and over again,” said Semenza, research director at the New Jersey Gun Violence Research Center and an associate professor at Rutgers University.
Tretta underwent surgeries to remove the bullet, he said, and then received a nerve block to relieve the ongoing pain from his wounds. But bullet fragments remain in his body years later, he said.
He was also diagnosed with psoriatic arthritis, a chronic disease that causes swelling, pain and stiffness in the joints.
“I have dealt with chronic pain, immunodeficiencies and body differences since the shooting occurred,” Tretta said. “Every time I have a fever, it's something completely different than anyone else I know, or even before shooting for me. I shake uncontrollably and it hurts to even touch my arm.”
The Rutgers study is one of the first to focus on outcomes such as chronic pain as part of an emerging body of work on the toll of exposure to gun violence on physical health.
“It highlights the fact that among the thousands of people who die each year, there are many people who knew them,” Semenza said. “The cost of gun violence is much greater than we originally anticipated.”
Efrat Eichenbaum, an inpatient psychologist who has treated gun violence survivors and their families at a Level 1 trauma center in north Minneapolis, said the study accurately reflects what she has seen in her clinical work.
“You can clearly see the trauma that follows an event like that,” he said. “Not just for the survivors, but for their families. It's not even limited to family members. It's an issue that affects entire communities.”
David Patterson, a professor emeritus at the University of Washington whose work focuses on pain, says the study shows, in particular, how far the impact of gun violence extends and how costly the problem is to society.
“Chronic pain is itself a major health problem and costs our society billions of dollars because it is so difficult to manage,” he said. “You can't cure it; you have to control it.”
Back in her dorm at Brown, Tretta explained that medical care doesn't end when someone leaves the hospital after a trauma like hers. This goes on for years.
“Your body will never be the same as before,” he said. “There is no time when you can't feel the 7 or 8 inches of scar tissue running through the center of your stomach. It's just a constant physical reminder, because you can't leave your body.”
This article was published by The Trace, a nonprofit newsroom that covers gun violence in the United States. Subscribe to their newsletters here.
