Do we make gun ownership a fifth vital sign?

Please read the next few lines closely. This is not about the Constitution. Not about the “right to bear arms” or banning guns. Not about you answering this with some canned speech either way. Nor is it about having the answers. What it is about is the fact that even in small town America our neighbors have now learned what the big cities have known for a long time. It is no longer safe to send our children to school. Not inner city high schools where it has not been safe for years but any school. Not high school where teens dress funny, become alienated or bullied and hold grudges.

No, we are now up to kindergarten. It’s really not safe anymore to send your children to pre-school where they still take naps, some still wear “Pull-Ups” and everyone hugs each other. And for the record, it’s also not safe for you to go to temple, church or the movies. These are mass shootings, all by people with guns. Not bombings, not tear gas, not gang wars, all shootings. I know the story; it’s not the guns, it’s the people who have them. I could argue that when the people who have guns are “off” a bit, the guns make those people ten times more dangerous then if they had a knife. But let’s not argue that today. Bear with me as I feel we need to lead the way on this and it’s not by argument. That has not worked.

Lets talk about the problem. Mass shootings is the problem. Ok, so, it’s not the guns, it’s the people who shoot them. These shootings used to happen every few years. I vividly remember the Texas college student in the school tower picking off people with a rifle when I was young. It was traumatic then. But it happened every few years. Now we are down to a mass shooting every month or so. Newtown is just the most tragic and most recent. Here we have a young man who has been described as a loner (and much worse) being taught how to shoot guns by his Mom who decided she needed to have an arsenal at home because she was a single mother. All legal. How and why she decided her son needed to have access to those guns also is beyond my comprehension. Still legal.

As you know I have never been shy about my feelings. Us Brooklyn kids let you know how we feel. Watching a PA colleague speak on CNN about his truly beautiful daughter who was shot to death at Newtown hit home enough for me. On this problem we need a dialogue. A new way to talk about this. It’s not going away and pointing fingers is not going to take it away. If my colleagues tell me it’s not the guns, what is it? To me, even putting guns into the hands of mentally deranged, drunk, high or unbalanced people is completely nuts, so how do we make a difference? How do we NPs and PAs start to make our world healthier? Do we make gun ownership a fifth vital sign? If you own a gun, should we ask you if you have someone at home that you would worry about having access to it? Should we ask if you have a lock box? If it’s not our business, whose business is it? Should we really make it hard to purchase assault weapons? Have all the guns you need, just not ones designed for mass killing. What do we do? Argue with each other?

As advanced practice clinicians-medical practitioners we must be advocates, not just for our patients but for the health of our country. I know one thing, we either have to restrict certain people, restrict weapons or both. It’s time to talk. We need a dialogue and if we are really the advocates we say we are, we have to start it. It is time.

To play Red State, Blue State or not meet somewhere in the middle will only mean more people die. Time to be the healers we say we are.

David Mittman is a physician assistant and has practiced family medicine in Brooklyn, NY and served as President of the New York State Society of Physician Assistants.  He is also the founder of Clinician 1.

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  • http://www.facebook.com/PMRNC Linda Walker

    We now now this morning he had Asperbergers which does change things a bit. There is no link between Aspergers and violence..In fact they removed Asperbergers from the psychiatric diag manual a while ago. The “access” to the guns is also uncertain the same as the “why” he had access if he he did.. again, she had no way to know of his potential violence, it may not even be something we understand.

    • http://www.facebook.com/lidaiwei David Lee Hawks

      Aspbergers symptoms will fall under the term “autism spectrum disorder” in 2013 (not a “while ago”) in the manual. Therefore it has not been “removed” so much as its symptoms being relooked at – with the hope of greater understanding leading to more specific diagnoses to help those patients.

      It is better to focus on what we can understand, and what should be looked at and talked about, as the author argues. I’m not saying you are being defeatist, and there still will be a lot more information coming out. But we can’t just throw up our hands and say “We can’t understand, there was no way to know, there is nothing that can be done.”

  • Loretta Donovan

    Kevin, I agree that a dialogue is needed. It’s one that addresses the roles that each of us play in making our institutions safe and how we understand and are accountable for those who do not or cannot promote that safety. This is more than a local conversation (I am just a few miles from Newtown) – it must be a national one. I believe you and I can help in that regard. You have the attention of a vast healthcare audience. I have facilitation background with Appreciative Inquiry which redesigns systems for positive performance. If this makes sense, please be in touch. Loretta

  • JonSanders

    I remember Mathew Weiss. He was a disturbed, violent kid. This was well known. At thirteen he killed his grandfather, a police officer, to steal a gun. He defeated the security meant to stop kids from bringing guns to the Red Lake, Minnesota school. He killed twelve people.

    There is a fill in the blanks biography to mass shootings. Mathew Weiss of Red Lake, Eric Harris of Columbine, Adam Lanza of Newtown, and maybe forty others have the same biography with a few names and details changed.

    This isn’t – at its root – about guns. You will never plug all the paths to acquiring guns. What are you going to do about the violently mentally ill?

  • http://twitter.com/blog_CCC CCC

    Gun ownership is not the business of any healthcare worker as far as I am concerned.

    “That is none of your business” is the only canned speech that I would deliver on being asked if I owned a gun.

  • sandra miller

    I expect many people will say that their gun ownership is not a healthcare worker’s business. But whose business is it?

  • kjindal

    we need to incentivize the psychiatry and psychology professional community to see and treat patients. And perhaps as a society we need to allow them more freedom to mandate psychiatric treatment (even inpatient) on suspected dangerous individuals. Yes this does make us sacrifice some individual freedoms, but don’t we do that all the time in the name of safety (e.g. seatbelt laws, airport scanners, etc.)? And yes, this will inevitably lead to some unnecessary, even harmful treatment. But right now any psychiatrist will acknowledge that we undertreat, hospital psych beds lose money consistently, & psychiatrists don’t want to treat the difficult psychotics and unstable types because it’s just not worth it.

  • http://twitter.com/EJDBabble Emilie DiChristina

    As a clinician and gun owner, I can tell you that people will become annoyed when asked the questions proposed, much as they do when asked about seat belt use, or helmets for biking, or other similar questions. Perhaps Ms. Lanza would
    be alive if someone had asked those questions… But we all know our patients obfuscate.

    Her guns should not have been available to her child regardless of his mental status. Her guns should have had trigger locks, plus have been locked in a safe unlocked by biometrics like her fingerprint or hand print, and he ammunition should have been locked up separately. Her protection weapon should have been loaded, but still in a locked box, again only opened by her fingerprint. She made it way to easy for her son, or anyone else to turn her weapons against her and others.

    In closing, please ask!

  • larry witkowski

    We don’t need to make gun ownership a fifth vital sign because the effects are present in each of us in the glorification of the power of the gun. Our society has risen violent destruction to a deity level. That, in my opinion, is the thing that needs to be diagnosed and changed. Surely, controlled access to guns is very important, but control of the things that makes our minds leap with activity and, dare I say, pleasure or satisfaction? also needs regulation and common sense.

    Harming a defenseless someone or something with a gun should be seen as an act of supreme cowardice. Is there anything more cowardly? Perhaps doing nothing about it.

  • wiseword

    Let’s face it — a gun is a penis. If you want a bigger one, you can buy it. End of story.

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