Words on Guns: A Pediatrician’s Perspective

As a pediatrician I have been fighting for sensible gun law for a while. I lost 3 of my small patients to gun violence. So, useful info on how to discuss guns with gun fans:

An AR 15 is an “Armalite Rifle,” after the manufacturer Armalite. Gun nuts will ask you what AR stands for. Don’t say assault rifle or they will dismiss everything else you say.

The problem is the high velocity bullets (they go through a child’s body so rapidly that they destroy tissue 6 inches around a bullet entry), rapidity of fire, and high capacity magazines (more than 10 bullets in a magazine is not necessary unless you want to kill humans). Use those terms.

If they talk about there already being background checks? Only licensed gun dealers are required to do them, and reporting is not mandatory. We need universal background checks with mandatory reporting.

They talk about how Chicago has gun restrictions but still has gun violence? It is because Indiana, across the road, has no restrictions. Easy to cross a road.

“Guns don’t kill people, people kill people”? That’s why we want background checks on the people, not the guns.

“Car accidents kill kids too”? Yes, that’s why we require driver training, a license, registration, and liability insurance. Also why we have traffic law to regulate their use.

We need:

  • to require safe storage of guns.
  • to keep bump stocks and kits that change semiautomatics into automatics illegal.
  • either magazines that cannot be exchanged (rather, need to be reloaded), take more time to replace, or take 2 hands to replace.
  • to limit the amount of ammunition people can buy, like we do pseudoephedrine.
  • to require licensing, registration, and liability insurance. Let the insurance companies pay for the mental health check and decide which guns are too dangerous to insure. The gun lobby and the insurance lobby can have a conversation.
  • red flag laws, the same in every state.

It is generally impossible to sue shielded gun manufacturers (although one case recently did succeed), and was previously against the law for the CDC to fund any research into gun violence – very unusual restrictions passed purely to protect gun manufacturers. The Dickey Amendment, passed in 1996, was recinded in 2018, but we lost decades of research.

The NRA funnels money from gun manufacturers to politicians on both sides – mostly Republican, but some Dems. There is dark money given that is untraceable, so we really don’t know who is on their payroll. The NRA actually supported Bernie Sanders when he first won office because he promised to never vote for any law that put in a waiting period for hand guns (and he never has).

The top ten traceable donations:

  • Mitt Romney $13,637,676
  • Richard Burr $6,987,380
  • Roy Blunt $4,555,752
  • Thom Tillis $4,421,333
  • Cory Gardner $3,939,199
  • Marco Rubio $3,303,355
  • Joni Ernst $3,124,773
  • Rob Portman $3,063,327
  • Todd C Young $2,897,582
  • Bill Cassidy $2,867,074

We need to educate ourselves to even begin the push for change, because what we are doing now is not working.

Gun lobbies only care about sales, while kids are dying.

Lets do this.

It’s Not Too Soon. It’s Too Late. Ask Their Parents.

Today’s blog was written by a fellow pediatrician, Dr. Chad Hayes. I could not have said it better.

Florida has some of the most lax gun laws in the country: anyone over 18 can buy  a semi-automatic weapon with no license, no firearms registration, and often without a background check. This is the state that, for a while, made it illegal for pediatricians to council parents on gun safety. If a pediatrician told a parent their guns should be in a safe, unloaded, without a bullet in the chamber–that doc could be arrested and charged with a crime.

The NRA owns our country and our politicians, and it is indeed too late for us to save the 17 children who died today. It is not too late to make rational gun laws that will save the kids who are sitting beside you doing their homework tonight.

The American Academy of Pediatrics recommendations for gun control:

  • Enact strong, effective assault weapon ban
  • Eliminate the gun show loophole, require mandatory background checks and waiting periods
  • Ban on high-capacity magazines
  • Enact strong handgun regulations
  • Require safe firearm storage under federal law

 

ChadHayes-01This afternoon, after spending a few minutes in my office, watching live coverage of our country’s most recent school shooting, I was talking about the tragedy with my nurse, who grew up in London: “You didn’t have a lot of school shootings in England, did you?”

“No, we didn’t. Nobody had guns. All people had were batons.”

I’ve not heard of many school batonings.

Among similarly-developed nations, frequent school shootings are a uniquely American problem. In fact, they are so common that many occur without drawing significant media attention. There have been several in 2018, and we’re only in week 7.

I’m writing this just a couple hours after the mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida. Reports from the scene are still fluid. From what I’ve heard so far, the shooter is in custody, and there are multiple fatalities (update: 17 so far). Those details, no doubt, will change. We will learn the true number of people injured and killed. We will see the faces of children who spent their last Valentine’s Day bleeding out on the floor of their school. We will learn the shooter’s identity (Nikolas Cruz, a 19-year-old former student), the weapons used (an AR-15 rifle), and possibly a motive.

But my intent is not to provide these details. I’m not a reporter.

What I am is a father that cannot imagine losing a child.

I am a pediatrician that cares very much about the safety and well-being of children. One that believes that no child should live in fear of being gunned down at school, that no parent should have to bury a murdered child, and that the number of times this has happened without any significant action to prevent the next tragedy is unacceptable.

I am a physician that has resuscitated children with gunshot injuries, and tried to resuscitate others. Some were suicides. Some were accidents. Their stories are powerful, but they aren’t mine to tell.

I sent out a tweet after heard about this shooting, essentially saying that maybe this time, after thisround of children is murdered, we should do more than “thoughts and prayers” and perhaps start taking actual steps towards preventing similar events in the future. It was long until I received a reply: “We don’t know anything yet and you’re [sic] attempt at politicizing this is pretty awful.”

And that seems to be the response every time this happens: “It’s too soon.” “Don’t politicize this.” “You’re using the victims to promote your agenda.” It’s the same response I heard after, just seven miles from my house, nine people were murdered in Emmanuel AME Church. It’s the same response I heard after 58 people were killed at a concert in Las Vegas. It’s the same response I heard when twenty 6- and 7-year-old children were murdered at Sandy Hook Elementary School.

So, yes. I’m using the victims to promote my agenda. And I feel like their families would probably be alright with that, because my agenda is to minimize the future victims.

Here’s the thing: There is no simple solution. There is no single solution. There is no perfect solution. There isn’t one change we can make and magically make gun violence disappear.

As with many issues, the answer—if we find one—will likely be found somewhere in the middle of two extremes. Firearms are so ingrained into American culture that to think it is at all feasible to ban them altogether is asinine. And to pretend that there are no steps we can take to work towards a safer environment for ourselves and our children is equally absurd.

The Second Amendment was written over two centuries years ago. The men who wrote it would not recognize and could not have anticipated the weapons available today. What they did anticipate was that the future would look remarkably different from their present, which is why they built into the Constitution a means to amend it in the first place. The Second Amendment, despite what the NRA would like you to believe, is not immutable.

At the time the Bill of Rights was signed, the most common weapons were muskets capable of firing a single shot before a rather complex and time-consuming reloading process.

Today’s weapons are far more accurate, far more powerful, and unbelievably fast. The term “semi-automatic” means that a round is fired with each pull of the trigger. This is to distinguish it from other types of firearms that require an additional action, such as the movement of a lever or bolt, to load and fire another round (and also from “automatic” firearms which continue to fire until the trigger is released or there is no more ammunition).

But while the term “semi-automatic” is frequently used in such a way as to demonize the weapon, the reality is that’s just how firearms work today. Just as most modern vehicles  include automatic transmissions and power windows, semi-automatic handguns and rifles are pretty much the standard. And in most states, anyone over 18 years of age (21 for handguns) and without a criminal record can walk into a store and purchase one.

A common example of a semi-automatic firearm is the AR-15 used in the Parkland massacre. These rifles are made for one purpose: to kill people quickly. Because in combat, that’s the goal. But these firearms are not restricted to the military; they are widely available to the civilian market. Certainly, most people that own them do not intend to murder their innocent neighbors; most people that own firearms are law-abiding citizens that simply enjoy shooting them at the range or keep them in case of some real or imagined catastrophe.

There are better firearms with which to hunt. There are better weapons with which to defend oneself or one’s family. But there is no better type of firearm (at least, not one available to civilians) with which to kill a lot of people very quickly. And the teenage murderer in Parkland, Florida knew that.

It is clear to me, and I think most people would agree, that there are some weapons that should not be available to the general public. At some point on the continuum from a baseball bat to a nuclear bomb, there’s a point at which one’s right to self defense is outweighed by the risks that a particular weapon presents to the rest of us. We can argue about where that point is. And we should.

We should argue about where to draw that line. We should talk about what further steps we can take to prevent people who shouldn’t have guns from obtaining them. We should talk about ways to encourage safe storage of firearms and ammunition. We should talk about preventing sales of firearms without background checks at gun shows or by individuals. We should talk about the education, training, and licensing that should be required to own a firearm. We have a lot to talk about.

I am not the expert in this field. But there are experts in this field. We should listen to them. Because while a good guy with a gun may occasionally stop a bad guy with a gun, it would be far better to have bad guys without guns.

As emotionally charged as mass shootings are–especially those involving children, they account for only a small percentage of the 30,000 or so gun deaths each year in the US. Far more people are killed by firearms in less spectacular situations like suicides, accidents, domestic disputes, or gang violence. And while we will not be able to prevent every firearm death, we can make a difference.

The thoughts and prayers aren’t working. It’s time to do something.

Because it’s not too soon. It’s too late. Ask their parents.