On Wednesday, 16 September, CNN produced the second “debate” by the dozen or so aspirants to become the Republican nominee for President of the United States. I listened with some interest, or should I say hope, that I would learn something new and enlightening about these individuals. A debate is a formal discussion in which affirmative and negative sides of a proposition are advocated by opposing speakers. This was no debate. Rather, it was a presentation of who could most convince the audience they best represented the conservative perspective of the Republican Party. Of particular importance to me was the very limited statements of how to bring some control to the persistent slaughter by gunfire within this country. It seems, for this gathering of “minds” the answer, smothered in the Constitution, is more guns; guns for everybody.
In 1978, I published a paper entitled “Five Years’ Experience with Penetrating Cranio-Cerebral Gunshot Wounds” (Surgical Neurology, Vol 9, Feb 1978). This was a clinical presentation of the 84 gunshot wounds to the head that presented to the University of Mississippi Medical Center during my time there. This number included only those patients who presented for care. If they were dead on arrival they were not included, and there is not telling what the number might have been if we included those who were taken directly to the morgue. And it says nothing about those victims who were shot in other areas of the body. There were no mass killings, like Columbine or Sandy Hook Elementary School. They were individual cases, including children and most were related to domestic disputes or so called accidents. The purpose of the paper was to provide some guidelines for the care and prognosis of this type of brain injury. The paper did not, of course, change the pattern of carnage. The scientific evidence presented did absolutely nothing to reduce morbidity and mortality from firearms. In fact, there is very little public or political interest in gathering scientific evidence that will change the ongoing pattern of gun violence.
In the February 26, 2015 issue of the New England Journal of Medicine there is an essay by Chana A. Sacks, MD, making a heartfelt appeal for “Reviving Research to Prevent Gun Violence.” She proposes “we shift the issue of firearm related morbidity and mortality from the political to the academic sphere…” It is clear there is very limited data available on firearm deaths and morbidity. The reason is certainly not the lack of clinical material. It is noted 30,000 people die each year of firearm injuries. Dr. Sacks maintains this is a significant health issue. But unfortunately there is no incentive, or money, to establish this as an overwhelming ongoing health problem in the United States. In fact, initiatives to gather information on the impact of gun violence have been stymied and prevented by the NRA lobby in Congress. See Kellermann and Rivara, writing in JAMA in 2013 (View JAMA 2013:309:549-50 online.) discussing Silencing the Science on gun research. Responding to pro-gun pressure:
“Congress complied and in 1996 passed a budget appropriation stating that no CDC funds ‘may be used to advocate or promote gun control.’ Precisely what was or was not permitted under the clause was unclear…but no Federal employee was willing to risk his or her career or the agencies funding to find out. By 2011 this prohibition extended to all funding from the National Institutes of Health.”
But the inertia in gathering scientific data and developing prevention strategies continues. Sacks notes that “in January 2013, President Obama signed an executive order to lift the ban on CDC-funded research but 2 years later… no reliable funding has been established.
In the “debate” broadcast on 16 September, Marco Rubio, in particular, pandered to the NRA by emphatically stating he would not violate the wishes of our founding fathers and interfere with the constitutional right to buy guns. No mention of the ongoing carnage; no appeal to establish a reasonable and responsible strategy to bring this major health problem under control. Like all politicians, particularly those on stage on 16 November, Marco Rubio is not interested in what is right, true, good, reasonable or responsible. He is most interested in what he thinks will get him elected. Guns for everybody just might get him elected.
Dr. Sacks’ appeal is simple and not vitriolic or angry, even though her impetus to write the essay was the death of her 7-year-old nephew at Sandy Hook Elementary.
“The lack of data and a research pipeline should be anathema not only to doctors in urban centers who bear witness to gun violence every day but also to physicians who own guns and understand their safe and respectful use. Acknowledging a need for research is not a commitment to enact any particular policy or to agree on an interpretation of the Second Amendment. Rather, it reflects the principle that high-quality data can inform better decisions and improve health.”
I am not a gun control fanatic trying to take guns away from lawful owners. But I do think the founding fathers are turning over in their graves with the idea they established the Second Amendment in order to sustain the carnage that politicians persist in using as a rally cry of freedom. They had no idea what the establishment of that Amendment would create. The right to keep and bear arms should not mean our children should be placed in harm’s way all across the country.
But then I forgot, Marco Rubio and his compatriots actually do believe, or say they do, that the answer is for all of us, without careful review and documentation, to go out and get a gun, any gun, a gun for every room.
Stephen King, yes that Stephen King, has published an essay titled “Guns” as a Kindle Single: it is either free or costs 99 cents. Read about the essay online. Despite his fondness for gratuitous profane language, he actually makes a very credible case for reasonable and responsible measures for gun ownership. He describes the political scene in the following way: “We’re like drunks in a barroom. No one’s listening because everyone is too busy thinking about what they’re going to say next, and absolutely prove that the current speaker is so full of shit he squeaks.”
That about sums up discussion of the political debates last Wednesday night.