— We cannot stand idly by as the death toll grows
Jesse M. Ehrenfeld, MD, MPH
April 8, 2023
I will never forget that scream.
The loudest, most ear-splitting, and most agony-filled scream I have ever heard came from the mother of a young man shot with an assault rifle.
I had just told her that we could not save his life — that her son was gone forever.
My team and I had done everything we could, but the damage was too severe. A weapon of war designed and built to kill people had once again overcome the best efforts of skilled and experienced medical professionals. My patient’s mom was overcome by the pain, the anger, and the grief of losing her son — and her agonizing shriek will be seared into my memory forever.
I relived that painful experience again last month while in Nashville to deliver remarks at a healthcare technology conference. The day before I spoke, an individual armed with a pair of legally acquired assault-style rifles with extended magazines, as well as a handgun, fatally shot three 9-year-old children and three adults inside a private Christian school in Nashville. One of the children killed was the son of my colleague. This time, it was personal.
Another school shooting. More victims shot down in a building devoted to learning and development, in an environment where their lives should never be at risk from firearm violence. And even more students’ mental health and well-being adversely impacted by the experience. Since the Columbine shooting in 1999, there have been 377 school shootings, and nearly 350,000 students have experienced firearm violence at school.
All in a nation that has seemingly grown simultaneously numb to and paralyzed by the senseless slaughter. The fact that firearm-related injuries have become the leading cause of death for U.S. children and teens is as unimaginable as it is true.
I experience each horrific shooting through three unique lenses: as a parent, as a former Navy commander, and as a physician.
As a parent, I cannot begin to comprehend the overwhelming anguish these families experience. They have to live with it on the dreadful day they first learn what happened and on every day thereafter.
As a 10-year U.S. Navy commander deployed to Afghanistan, I helped provide the best possible care for combat casualties in a far-forward Multinational Medical Unit. I was trained on and became proficient in the use of an M-4 semi-automatic rifle, the military version of the AR-15. I saw firsthand the tremendous damage high-velocity rounds inflict upon the human body. Then as now, I shudder to think of the destructive effect these weapons have on the bodies of children.
As a physician who has practiced in Nashville and other cities, I know allowing more military-grade weapons in more places will make us all less safe. More firearms do not keep people safer.
No matter which lens the shootings are viewed through, my conclusion is the same: we must do more to prevent all forms of gun violence.
Addressing the Scourge of Firearm Violence
School shootings are a small subset of firearm morbidity and mortality in our nation. In fact, mass shootings — defined as an incident that sees four or more people injured or killed — account for just a fraction of U.S. firearm deaths overall. Yet, the number of mass shootings has soared to more than 600 in each of the past 3 years, as tracked by the Gun Violence Archive. The group counted 136 mass shootings through the first 93 days of 2023, and more than 10,600 firearm-related deaths from all causes over the same period — nearly 115 people per day.
As the president-elect of the American Medical Association (AMA), I know our organization has worked hard to curb firearm injuries and violence for decades. Our House of Delegates adopted more than 30 policy recommendations addressing firearm injury prevention and worked to advance commonsense measures to make firearm ownership as safe as possible. Many of us have seen the lethality of weapons of war, and we ask, as parents and as physicians, for our lawmakers to give our patients a fighting chance.
Beyond legislative efforts, we established a task force focused on firearm violence prevention, including firearm-related suicides that account for more than half of the 45,000 firearm-related deaths our nation experiences annually. Additionally, we created a continuing medical education module to help prepare physicians to counsel patients on firearm injury prevention. We will soon launch an online tool to inform physicians about laws specific to their jurisdiction on counseling, safe storage and child access protection laws, temporary transfer requirements, and extreme risk protection orders.
Despite these efforts, there’s still so much more work to do. And I’ve never been more motivated.
Solving the complex and pervasive public health problem of firearm-related injury and death can seem like an insurmountable task, but we cannot accept the status quo. Reaching consensus on commonsense measures will require consideration and cooperation on all sides and from all vantage points. I am ready to be at the forefront of these conversations and to help advance the solutions that will protect and benefit our children, our patients, our communities, and our own well-being — but I need every other healthcare professional and healthcare organization to join me.
As the father of two young boys, I drop off my children at school each day with a simple expectation that it is a safe place to learn. No parent should have to worry about their children being murdered at school or anywhere else. Continuing to stand idly by as the death toll grows, and more families and communities are traumatized, is unacceptable.
Jesse M. Ehrenfeld, MD, MPH, is president-elect of the AMA. He is a senior associate dean, tenured professor of anesthesiology, and director of the “Advancing a Healthier Wisconsin Endowment” at the Medical College of Wisconsin.
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