“Violence is the last refuge of the incompetent.” Isaac Asimov, Foundation

A favorite quote from my favorite author.  I mentioned on Twitter that I’m trying to reach 10k followers by 2019.  Anyone who retweets this tweet or becomes a new Twitter follower could win a copy of this (or another) book, or suggest a donation to charity

I’ve been a physician since 2006, working predominantly in pediatric emergency departments since 2009.  I’ve been fortunate to see some of the best medical care the world can provide, and some of the saddest outcomes one can picture.

Thankfully death is not a routine part of my job, but it’s not foreign.

Car accidents.

Suicide.

Child abuse.

Overwhelming infection.

Cancer.

SIDS.

Prematurity.

Drowning.

I’ve had patients die from all of these.  Every one triggers reflection among all who cared for them.  The deaths individually trigger soul-searching, but individually and collectively often serve as a call to action.

Platforms for change are made.  Foundations to support research are started.  The government provides resources, advances regulations, and creates laws.  Individuals, businesses, and groups band together to devise new methods to prevent them from happening.

Entire industries are formed around them.  Literally.  Self-driving cars that speak with one another will eventually make a significant dent in traffic fatalities, and while they may have the side benefit of becoming love dens, that’s just icing on the cake.

There is nothing controversial about this.  One doesn’t have to have been impacted by cancer to support Susan Komen.  One doesn’t have to have had a child born prematurely to support the March of Dimes.  One doesn’t have to have a loved one die in an accident to applaud Tesla’s innovation.

There is nothing controversial about trying to prevent deaths that are preventable.

Or that’s usually the case.

The Acceptable Death?

I’ve provided care for numerous children injured by guns.  Most have survived, some have not.

I’ve been told, unofficially, my emergency department sees more pediatric gunshot wounds than any other in the United States.  I don’t have official numbers, but it’s enough.

Enough because there is no acceptable amount.  One would think.

Unlike literally everything else in the world that kills children, we have not reached consensus in the United States, that we can and should do more to reduce gun deaths.  There is in fact, active opposition to this concept.

The lamest being the “learned helplessness” — it’s just a part of reality and there’s nothing we can do about it.

There are plenty of others:

I’ve never shot anyone. 

That happens to in the inner cities.  It’s gang-bangers.

I (or “my organization”) had nothing to do with it.

Laws don’t stop criminals.  They’ll just keep doing it.

Most of these are easily debunked — they are clichés that are trotted out because they make easy soundbites and avoid thought.

If the GOP truly didn’t believe laws don’t stop criminals, they wouldn’t be trying to pass travel bans and voter fraud laws to “prevent” criminals from entering this country or doing bad things, because they will do them anyway.  Certainly these laws/executive orders are unlikely to do anything, but that’s a separate discussion.

Indeed, anyone whose even half-heartedly engaged in one of these conversations has heard (or espoused) some similar comment to those above.  In fact, below is a screenshot from a brief Twitter exchange I had on the topic.

This individual uses a lot of classic deflection techniques, implied racism, and misdirection while standing up for the NRA.

The NRA has “never condoned” gun violence. Of course it has — in the aftermath of every major mass shooting of the last couple decades, it has either squashed discussion or advocated policies that would make it easier for anyone to obtain a gun.

I do believe the NRA as an organization have culpability in the perpetuating and worsening the political climate that makes ending gun violence a debate instead of a mission.

What the NRA and Muslims Have in Common

In the 17 years since 9/11, the United States has become increasingly hostile to Muslims.  It wasn’t friendly before then, but things are different now, both in terms of government policies and overall animosity.

People in elected office openly denounce all Muslims as unwelcome or as terrorists.  Some seek to bar hundreds of millions of people from ever setting foot in the United States because Islam is the predominant religion of their country.

They not only do not trust Muslims, they want to blame all Muslims, those in the United States and across the world, for terrorist acts perpetrated by a miniscule percentage of people who literally have no connection to them.

Sound familiar?

So what’s the difference between the NRA opposing gun laws being that are advanced due to firearm deaths, and Muslims pushing back against travel bans being erected due to terrorist acts?

Well here’s a non-exhaustive list:

The Thing I Worship Does Not Kill People

Sure, in the Biblical/Quranic sense, God/Allah has been known to smite someone, but generally we pray to help someone.  Islam in its proper, and common form, preaches peace.  It literally means peace.  Violence is not inherent requirement in Islam, despite claims to the contrary.

A Gun Was Designed For One Thing

A gun is either being used for violence or passively threatening violence.  Those are its main functions.  It would take a really heavy Quran to kill someone, and injuring someone is far from the primary purpose of a Quran.

The NRA Is A Lobbying Group

The main purpose of the NRA over the past few decades is to advance the interest of gun manufacturers.  It stopped being an advocate for gun owners and sensible use of guns many years ago.

Islam is not a monolith.  We have a common religious text and holy site, but we do not have a leader.  We do not have a spokesperson.  I do not have a membership card that can be revoked.  The local Imam educates me but he does not speak for me.  There is no “Pope” advancing an agenda.

Lobbying groups that advocate for Muslims, such as CAIR, primarily advocate for the right to ensure we’re not actively discriminated and can live/practice our religion with the same freedom as other religions.

This is not the same as a lobbying group advocating for sale of a weapon.  There are no flamethrower lobbying groups (as far as I know), and if there were, nearly everyone would agree we need restrictions on their manufacture and sale.  Same for grenades or rockets or other weapons whose primary purpose is injury/death.

No Such Things as Unrestricted Rights

I support efforts that reduce the spread of Islamic terrorism.  If YouTube videos from terrorists are helping to radicalize people and convince them to commit acts of terror, we should try to limit the spread of this speech on the Internet.

One could argue that is a restriction on First Amendment rights to free speech and to freedom of religion, but the only right that is unlimited is our right to “life, liberty, and the pursuit of happiness.”  Even though the First Amendment clearly states we shall not prohibit exercise of religion or abridge freedom of speech, but courts have identified many situations in which we place limits on these rights.

If you didn’t get the point — the NRA and Islam/Muslims have very little (i.e. nothing) in common.

Stay In Our Lane?

The NRA made headlines telling doctors to “Stay in their lane” regarding guns and gun violence.

There’s both a laughable lack of knowledge as well as  irony in their statement.  Physicians, and our many colleagues in healthcare, spend far more time dealing with the fallout of gun violence than the average gun owner or NRA member.

There is the irony of them trying to abridge our freedom of speech to discuss the the topic of guns.

Just the thought of talking about guns as a problem has the NRA so scared they want to intimidate doctors into silence, even working to pass legislation that prevent us from discussing the topic.  If you wanted proof that we are in our lane and the NRA is scared of a real discussion, that is it.

Unfortunately the NRA was shown as even more asinine when an emergency department doctor was murdered a couple days later outside of her hospital, as were two other people when the shooter ran inside the emergency department and was part of a gun battle with police.

Good Guys With Guns

I do believe there are such things as good guys who own guns.  That is NOT the same as the NRA motto of only a “good guy with a gun” can stop a bad guy with a gun.

My father-in-law is a good guy who owns guns – he’s as responsible of a gun owner as there could be.

He has several guns that are only used for hunting, and some older/antique ones.  All are inside locked gunsafes, which are in turn locked inside a “safe” room.  It’s essentially impossible for anyone but him and my mother-in-law to access them.

When not being used for hunting, they are out-of-sight (and out-of-mind).

If he wanted, he could use them for some nefarious purpose, I suppose.  From a personality standpoint, he’s probably less likely than me to intentionally do something stupid with a gun (and better trained to avoid accidentally doing something stupid).

However it’s that the possibility of something happening, which unfortunately is the reality in many cases, that is the problem.

When it comes to guns, it’s just too easy for a good guy to become a bad guy.  Or more accurately, an “okay-ish guy” or “normal-ish” guy to suddenly be a bad guy.

And in many cases, it’s “guy who was previously bad but unknown to law enforcement until he shot several people” that cause consternation.

THOSE bad guys aren’t walking around with scarlet letters on their forehead, but there are still ways to reduce their ability to reduce their ability to kill

Even most NRA members support background checks for all gun purchases, something the NRA as an organization has fought.  That won’t stop the bad guy without the scarlet letter on his background check from buying a gun, but it’s a start.

As in all things with science and public health, and pardon my expression, there’s no silver bullet.  It’s going to take a series of policies and solutions.  We can start with low-hanging fruit such as background checks, removing guns from the homes of people where police have concerns.

There are many things we can do to reduce the impact of gun violence.  It takes a feeble mind to think the only option is more guns.

#ThisIsMyLane