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.

Charleston: Let’s Not Let Roof Win

Change- just aheadDylann Roof did not murder nine people at the Emanuel African Methodist Episcopal Church in Charleston only because they were Black; he murdered them because he was a criminally insane psychopath.

Blaming their deaths on their race reeks to me of blaming the victim. We did not blame the kids at Sandy Hook; we do not blame rape victims. We did not tell the grieving relatives in Colorado that their loved ones died because they went to a movie. We told them that James Holmes was a criminal psychopath.

Yes, this particular psychopath had craziness is his head that focused on Black Americans. His brain was irreparably diseased. It is horrible that no-one noticed. It is worse that he was allowed to buy a gun. It is a nightmare that will never end for the families and friends of the people he killed.

But if we feed into his insanity we are giving him jurisdiction over our thoughts. Buying into his “I had no choice, I did it because they were Black,” adds weight to racial division that is already at an explosive level. He wanted to start a racial war: feeding into that is allowing him to win, and giving credit to his insanity.

The traditional description of psycopathology involves lack of empathy, lack of normal fear, and no impulse control. These people don’t care about anyone other than themselves: no one else is real to them. They are unable to comprehend danger to themselves. Their impulse control never develops: imagine a 2 year old who has a toy taken away, who immediately lunges to take it back, hitting the other child. Normal adults mature and learn to control their impulses, learn that other people matter. These people never do.

Psychopaths choose their targets based on the craziness circling in their brains. The victims themselves are completely innocent. If we say that they were killed purely because of White on Black racism we are treating Roof as if his thoughts are worth our consideration. They are not.

Horror, grief and anger may push us toward blowing this up, expanding it so that it includes other white men, or all white people, or even all people of any race other than Black.

That is what he wanted.

All young men are not child killers because one chose to murder at Sandy Hook; all men are not rapists because some rape; all parents are not child abusers because some beat their children. These murders could justifiably feed righteous anger and increase racial tensions, but in the end more anger can only bring more injury and death.

Healing will not happen through hatred. Hatred breeds more hatred – it knows no other path. Tolerance and consideration breed understanding; respect breeds respect; time heals.

We cannot feed evil, or it will thrive. His craziness is your endpoint if you allow yourself to hate.

If we want justice for the lives that are lost, and to find some grace in their deaths, we must use it to put an end to racial bigotry. Do the opposite of what he wanted. Say Enough.

How to Prevent Gunshot injuries

In America, gun violence is one of the top three causes of death for children between the ages of fifteen and nineteen; one in four deaths from injury in this age range is from a gunshot. In 2009 alone (the most recent year for which statistics are available), there were 114 unintentional gunshot deaths in children and adolescents, in addition to the deaths from homicide and suicide. The American Academy of Pediatrics estimates 10,000 kids were injured or killed by gunshots that year: 4559 intentional, 2149 accidental, and 270 suicide attempts (the rest were undetermined). 3000 of these kids don’t live long enough to get to a hospital; 453 died in a hospital in 2009. A firearm is forty-three times more likely to be used to kill friends or family than a burglar. In my perfect world, there would be no guns inside anyone’s homes. If you must have a gun in your home, keep it unloaded, lock it up, lock up the ammunition separately, and hide the keys. Then realize that your kids will figure out your hiding place.

Whether or not you have guns, teach your children that guns are not toys—and discuss what they should do if they see one: stop, walk away, and tell an adult. Then realize that your child’s curiosity will get the better of him or her when they do see a gun. Unfortunately, it is very likely that your children will end up at someone’s home where there will be a loaded gun. Half the homes in America have a gun, and thoughtless people do keep them loaded and unlocked. I have lost several children in my practice to gunshots—all but one incident took place in a neighbor’s house where the parents didn’t even know there was a gun present.

Kids are fascinated by guns. Your three-year-old can get to that loaded gun on the top shelf of your closet; your eight-year-old does know where the keys to the gun safe are kept; your five-year-old will grab that loaded rifle and attempt to take it into his tree house. Don’t learn this lesson the hard way, as these parents did, in my practice.