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  • Multiple gunshot suicide occurs when a person commits suicide by inflicting multiple gunshots on himself or herself before becoming incapacitated. It excludes suicides where the firearms are operated by other people, such as suicide by cop. Multiple gunshot suicides are rare, but possible. In one study of 138 gunshot suicides, 5 involved two shots to the head, the first of which missed the brain. A suicide with 4 gunshots to the head has been reported. Incapacitation from a gunshot injury results from a decrease in the functioning of the central nervous system. In a suicide by firearm, immediate incapacitation can be achieved by direct disruption to brain stem tissue. Rapid incapacitation can be achieved indirectly by cerebral hypoxemia resulting from massive bleeding from the heart, the thoracic aorta, or the pulmonary artery. Damage to other major organs – the lungs, kidneys, liver, spleen – results only in delayed incapacitation. Incapacitation by a shot to the head is achieved when the bullet penetrates the cerebrum; however, numerous bullet trajectories, including a shot between the eyes, do not achieve this penetration.