The only words that explain Sandy Hook: Pure evil

Since the massacre of innocent school children and those that gave their lives educating and trying to protect them this past Friday at Newtown Connecticut’s Sandy Hook Elementary School, I’ve struggled to make sense of this calamity as much as much as anyone.

As a physician who has worked to save the lives of sick and injured children, and as a father of children the same age as those massacred in cold blood, I have searched for answers to the questions, “Why?” “How do we make sure this never happens again?” and “How do I know this won’t happen to my family?” along with everyone else.

As I’ve read, seen and listened to various explanations and solutions, some better than others, most have rung very hollow. The arguments and blame fly back and forth, “We need to ban guns,” “We need more guns,” “We need more outpatient mental health treatment,” “We need to re-institutionalize the mentally ill,” and so on. The more I listen, the less I am convinced that anyone I’ve heard, from the checkout clerk at my local grocery store, to the President of the United States has any real solution to prevent this from happening again, or even make such happenings less frequent.

As I dropped my daughter off at school today, and let her get out of the car and walk away from me and out of my sight, I realized that to a certain extent, this was and always has been an act of faith of sorts. As I’ve thought more and more about this horrible incident, the questions keep coming, but without answers. I have no good answers to the above questions. In a nearly post-spiritual world where technology can do practically everything but find answers to the truly important questions in life, I realize there is a word that does perfectly describe this incident, and consolidates all of the pain, hurt, chaos, insanity, confusion, murder, blood and tears. All religion, preaching, atheism, agnosticism and separation of church-and-state arguments aside, the only word I can find that offers any sort of explanation, summary or satisfying consolidation of what we saw last Friday is … evil.

Pure evil.

If anyone doubts the existence of true evil, you’ve seen it. That is the most disturbing and frightening thing about the incident at Newtown’s Sandy Hook Elementary School. Despite all the good in this world and all the good we may try to achieve with varying levels of success as physicians trying to heal sick and injured children, or trying to protect our own children, we share this world with a certain element of pure unadulterated evil. Despite all of our necessary efforts to prevent, protect against and deter it, when someone chooses to truly commit an act of pure evil, they can. When one does so, there is very little any of us can do about it but hurt, mourn the lost, support the living and move forward with acts of good hoping time will offer at the very least, some solace and clarity.

My deepest condolences go out to the victims of this incident, their families and all of those touched in any way.

“BirdStrike” is an emergency physician who blogs at WhiteCoat’s Call Room at Emergency Physicians Monthly.

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  • civisisus

    heartfelt, I’m sure, but a complete cop-out, “doctor”. “gee, someone’s got (fill in your favorite stubbornly intractable illness) there’s very little we can do”. Are a lot of doctors actually signing up for that?

    Let’s do what little we CAN definitely do, now – like making it difficult to impossible for non-military, non-public safety professionals to continue to produce, wield or own weapons specifically designed to fire large numbers of bullets rapidly and accurately at living creatures.

    • Birdstrike

      As far as “coping out” and the gun control issue, please see my response below, to Chris Porter M.D., since your comments were very similar.

  • Marc

    Evil – please tell me where I can find this diagnosis in the medical literature.

    • Birdstrike

      You won’t find it there. One could also say, and most would agree, the acts committed here were “wrong.” You won’t find that in the “medical literature” either, so I don’t see your point. The “medical literature” doesn’t explain everything in the universe or even in Medicine, for that matter. I wasn’t using the word “evil” in the religious sense, and I specifically mentioned that.

  • http://twitter.com/PorterOnSurg Chris Porter MD

    Expressions of disbelief and condolences are fine. We all feel as you do.

    But, you wrote, “Despite all of our necessary efforts to prevent, protect against and deter it, when someone chooses to truly commit an act of pure evil, they can.”

    Are you suggesting we already do all we can? In my view, we engage in very little effort to prevent and deter gun violence.

    “When one does so, there is very little any of us can do…”

    This sounds like another shrug. Personally, I hope to see medical professionals shrug less and engage more in the substantial public health issue of gun violence.

    • Birdstrike

      My point with this post was to express my views, and reflect on what happened, with an attempt to make sense of it. I should have know that it would be futile, to make sense of such a senseless act. Also, I was not trying to “shrug” the issue of prevention and “gun control.” I knew there would be countless posts on the issue, so I chose to make a post that was less political. Since you ask for my personal opinion, I will give it to you.

      “Are you suggesting we already do all we can? In my view, we engage in very little effort to prevent and deter gun violence. 

”

      No, we are not doing all we can. It is a complex issue. I wish it weren’t. We need better mental health care, without a doubt. Access to mental health care in this country is atrocious unless you have the resources to pay cash. That needs to change.

      We need to work on reducing violence, without a doubt. I would love to take as many guns out of the hands of as many criminals as possible. On the other hand, after the events of last week, I would love to have an armed guard with a gun at the front, back and each
      side door of my child’s school. This is especially considering that even if we banned all guns tomorrow, estimates are that we have as many guns as people in this country, already. Some say, “If we had a ban on guns, this wouldn’t have happened.” Others say, “If those law abiding teachers had carried guns this wouldn’t have happened.” Which is right? I don’t know. I’d like to say the answers are easy, but they are not.

      On the other hand, in the Clinton era, there was a ban on military-style assault rifles. Did it reduce gun violence? I don’t know. Should it be up for debate again? Certainly. Should a criminal background check be required for gun purchases, specifically looking for a history of violent crimes? Absolutely. I don’t own a gun, nor do I care to, but I certainly agree with you that the issues need to be up for debate once again.

      • RJones

        Reading your article, it seemed to me that you were avoiding finding solution for something like this episode of violence by labeling it ‘pure evil’.
        We cannot, individually or as a society, allow ourselves to hide behind the crutch of saying ‘pure evil’ for that label acts far too well as a brick wall, a closed door.
        As in most things, sunshine and fresh air, which in reality is discussion and not hiding from the impacts of whatever it is we review and study is the critical path.

  • Rana pipiens

    I find it bizzare that a physician would conclude this is the result of “pure evil”. Do you believe mental illness to be the result of Satan? Is a mentally ill patient possessed by demons?

    • Birdstrike

      No. Which is why I specifically prefaced my use of the word with the words, “All religion, preaching…aside.” The use of the word “evil” does not necessarily require a belief in “Satan” or “demons” any
      more than the use of the word “good” requires a belief in “God,” or “angels.”

      • Rana pipiens

        You might want to rethink that. My dictionary says:

        “Profound immorality, wickedness, and depravity, esp. when regarded as a supernatural force”.

        I think most people would agree that the antonym of good is bad (and not evil).

        Articals like this just make a pseudomedical site look all the more ‘pseudo’.

        • Birdstrike

          “Profoundly immoral and malevolent” is the definition I was using. Thank you.

          • Rana pipiens

            Then why didn’t you just say that? ;) Evil always has a wicked/supernatural connotation – I’ve never heard it used otherwise. Also, if the killer acted out of mental illness we might conclude that his actions were amoral rather than immoral.

  • RJones

    I hate defining something like this mass shooting as pure evil. It is not. It is mental illness, perhaps even a massive chemical imbalance. It is also too easy availability to weapons.
    What constitues evil is a much larger scale. A Ted Bundy had certain evil, as well as something abnormal mentally. I won’t call his type of killing simply evil. Evil is more like the huge, and widespread violence and killings of thousands, millions of people either for “religious” control or for financial control of that particular population.
    Evil plots, and evil spreads and collects other people. Evil is near us every day, and it is up to each of us to think, and not be afraid to stop evil, as well as not be hesitant to offer help to someone who clearly is lost or falling between the so-called cracks. Remain watchful.

  • Psych NP

    I can’t believe that in this day and age a physician could interpret mental illness as evil! No wonder mental illness is still the step child of medicine.

    • Birdstrike

      I was not equating mental illness with “evil.” You must not have read the article very carefully, because I specifically prefaced my use of the term “evil” by saying, “All religion….aside,” making it sufficiently clear that I was using the term in the secular sense. I also clarified this twice in the previous comments.

      Saying that “mental illness” which is not even a specific diagnosis, is responsible for this crime as you imply, doesn’t explain anything. Frankly, such an implication is not fair to the vast majority of people with diagnosable mental illnesses who never commit violent crimes let alone shoot children. Such a generalizaton itself stigmatizes mental illness. As a “Psych NP” you should be aware that people with mental illness do not deserve to be lumped in a category with someone who murdered 20 innocent children. There’s much more to this.

      

Also, I made my views clear on the need for improved mental health care in my response to Chris Porter MD, above (“We need better mental health care, without a doubt. Access to mental health care in this country is atrocious unless you have the resources to pay cash. That needs to change.”) 



 The person who committed this crime had Asperger’s, but thousands of people have this condition and don’t commit murder, so how do you explain that? What is the evidence he had hallucinations, delusions or was not able to control his actions?



      Also, the fact that I am a physician doesn’t mean I can easily explain something this difficult to explain. As a “Psych NP,” if you can explain this calamity in a valid way other than slapping the very non-specific term “mental illness” on it, please publish. A dismayed nation awaits your wisdom. I won’t pretend to truly understand why this person did what he did.

      Is it possible this 20 year-old adult, who by all reports was very intelligent, may have been fully aware of his actions, their potential consequences, and may have purposefully and willfully committed these crimes?

      • Rana pipiens

        “You
        must not have read the article very carefully, because I specifically prefaced my use of the term ‘evil’ by saying, ‘All religion….aside,’ making it sufficiently clear that I was using the term in the secular sense”.

        Evil does not have a “secular” meaning. As you wrote in another response, ‘language is subtle’ – but you seem to have missed out on those subtleties. The way you have “prefaced the use of the term” is akin to telling someone “no offence, but I don’t think you know what you’re talking about”… when, of course, you clearly mean to offend them. You can’t make up your own meaning for words and you most definitely need to be aware of the subtleties of language if you intend your post to have legitimacy or garner any sort of respect. To be honest, I know nothing about you or this site, I simply stumbled upon it. However, if you have been commissioned to post articles, it should behoove you to take care in understanding your message.

  • http://www.facebook.com/people/John-Wickenden/729562456 John Wickenden

    You’re getting a hard time here Birdstrike……and rightly so.

    Why?

    Because in calling the actions that happened “pure evil” you’re reifying them. You’re thingifying something which is, like everything else, merely the result of a concatenation of causes. It just happens that this result is at the outer end of the spectrum we come across and clashes more with our peace of mind than most all others.

    If you’re going to work as a physician I suggest you try to rid yourself of judgementalism, otherwise there is no doubt you will judge some patients too….and that may be retrogressive to the best treatment and certainly to your own happiness in your job.

    Good luck

    John Wickenden

    Chiangmai

    • Birdstrike

      Trying to explain what happened here as “the result of a concatenation of causes” is just as much of a “reification” as mine.

      I don’t morally judge my patients. Also, as a physician, I have no experience with child mass murderers. Regardless, the person who committed this act was not my patient, so the analogy is irrelevant. I can only react to the situation as a human being and a father, not as this person’s physician. If we can’t agree to “judge” the willful mass murder of innocent children as “wrong” what can we agree is “wrong”?

      • Rana pipiens

        I think most would agree it’s “wrong”, but few here would label it as”evil”. The opinion of the killer, of course, is entirely unknown (he might even have agreed with you).

    • http://www.facebook.com/profile.php?id=1007723546 Denise Amundson

      John,
      Since when must a physician, who is also a father, not allowed to judge the actions of another human? It would seem to me that you are the pot calling the kettle black. Does this mean he is going to be less effective when seeing patients? Probably not.
      Evil does exist. I will reify it all I want to, because Adam Lanza killed 27 people! If I deny that evil exists, I may not recognize it when it would save a life. By “concatenating” or shall I say, linking events and causes, then are we not allowed to judge what we see?
      Suppose Adam Lanza’s mother could have trusted someone with her fears– perhaps a tragedy could have been avoided. By all accounts, she could see it coming, but, because she loved her son, she must have thought she could save him as the outlets available to her might have been less than useful for her per her experience.
      We’ll never know.

  • Guest

    I think this is a well written description of the things we see today. It is pure evil. I cannot imagine what people there are going through. There are no excuses. Even mental illness is not an excuse for this kind of an act. Searching for a medical reason gives people excuses to do such things. Sometimes things are done without reason and people always search for an explanation for it all to make sense. Accepting things don’t always and won’t always make sense is healthy. I think evil is the perfect word for what happened there and at every mass shooting. I have seen the mentally ill. They ask for help. They know when their thoughts are not right or people around them that care for them bring them in. It needs to be accepted that evil exists in the world and I think this was written with the perfection in the way I feel about the subject. I know many do not see what we see on a daily basis, but it is something that is difficult to separate out at times. I cannot believe you guys are saying this was not evil. What word would you use to describe it? And no, the word should not be “some type of mental illness.” Come up with a better answer for me and I’ll listen. For now, evil is the best description I have heard.

    • Rana pipiens

      Evil has a strong religious connotation. If that is what you believe, then fine. If that is what this physician believes, that is also fine. However, I don’t see that this has any place on a supposed medical website.

      • EM2BE

        I know you already went over the religious connotation and the definition with Birdstrike, so I won’t say all that here. I see your issue is that it’s on a “supposed medical website.” Religion does have its place in medicine. We have to pay attention to religion with so many patients we see. Some religions don’t allow males to perform pelvic exams. Some don’t allow blood transfusions. Some don’t allow other things. There are religious people in the hospital to help people. Priests hand out communion. There are clergy as well for many different religions to pray with people of their own faith. You can’t remove religion from medicine. Even those who are atheist have their own beliefs. We have to be aware. Even after I say all that, if you ignore the religious connotation and use the written definition, it is still accurate. What word would you use?

        • Rana pipiens

          Hi EM2BE. You’re absolutely correct that doctors should be sensitive to an individual’s beliefs. I would go so far as to say that religion can be a powerful healing tool for many people (although perhaps not due to any sort of supernatural intervention). I’m a biologist, and as a scientist I look for causes. I’m somewhat surprised that a doctor would equate mental illness with “evil” – I find
          this counter-productive. We know nothing of the person’s mental state at the time, other than they were probably quite miserable. Was the perpetrator knowingly and very purposefully projecting his pain on others; did he see nothing good in the world and think he was saving children from future pain; was he possessed by demons? Personally, I would refute the last choice, but I can form no opinion on the other two. If he knew what he was doing was immoral and had control over his actions, then this was of course a highly immoral act – but do we know this? It was a sad, tragic and highly unfortunate event, for everyone involved. Labeling it as evil is not the role of a medical doctor in my opinion.

          Having said all this, I’ve perused the site lately and realized that the author of the article is quite religiously biased in his posts. If this is a Christian medical site,
          I have no problem with that… but I think that should be made clear.

          • EM2BE

            “I’m a biologist, and as a scientist I look for causes. I’m somewhat
            surprised that a doctor would equate mental illness with “evil” – I find
            this counter-productive.”

            Okay. Sometimes there are no causes. Sometimes things happen for no reason. I’ve even read he was refused a gun a few days prior. This was premeditated. Not just a break in his mental state. I did not read anywhere that Birdstrike called mental illness evil. He called the event evil. Not a person. Not the killer. He called what happened evil. What happened was not psychiatric. What happened was evil. It’s possible the killer had something psychiatric going on. It’s very likely the killer had something psychiatric going on.

            In the emergency dept, we see many of these patients. They come in asking for help before they do anything. We place them in a psychiatric facility with a psychiatrist to help them. We hold them for hours to days in the ED until they have a place for them in a facility or until the patient is doing better and is re-evaluated completely. Yes, the psychiatric system needs help. It is not large enough to help many out there. But I can tell you one thing, if he went in the ED and said he wanted to kill multiple first graders and his mother with a gun in the house, he would have been placed in a facility for everyone’s protection. Family members will often bring them in saying they are acting differently and we get this information from them. It doesn’t even have to be that the person wants help. They just need someone in their life to notice they need help.

          • Rana pipiens

            I really don’t wish to continue this and I don’t disagree
            with what you say….but once again I fail to see how it is germane to the discussion.

            “The only words that EXPLAIN Sandy Hook: Pure
            evil”

            This is the title of the article (with my emphasis added).
            Where is the miscommunication coming from? I don’t have an answer for the cause of the event… how is ‘it was caused by evil’ an answer? If you are at a loss for a cause, say so. No need to use a word which you later pretend to not know
            the meaning of.

          • EM2BE

            Wow. I’m glad you are done. You still haven’t come up with an answer to the original question. I never said anything about not knowing the definition of evil. I figured you hashed out the definition enough already. You are on repeat now.

  • EM2BE

    I think this is a well written description of the things we see today.
    It is pure evil. I cannot imagine what people there are going through.
    There are no excuses. Even mental illness is not an excuse for this kind
    of an act. Searching for a medical reason gives people excuses to do
    such things. Sometimes things are done without reason and people always
    search for an explanation for it all to make sense. Accepting things
    don’t always and won’t always make sense is healthy. I think evil is the
    perfect word for what happened there and at every mass shooting. I have
    seen the mentally ill. They ask for help. They know when their thoughts
    are not right or people around them that care for them bring them in.
    It needs to be accepted that evil exists in the world and I think this
    was written with the perfection in the way I feel about the subject. I
    know many do not see what we see on a daily basis, but it is something
    that is difficult to separate out at times. I cannot believe you guys
    are saying this was not evil. What word would you use to describe it?
    And no, the word should not be “some type of mental illness.” Come up
    with a better answer for me and I’ll listen. For now, evil is the best
    description I have heard.

  • Rana pipiens

    Well, this will be my final comment on the matter. Obama and Romney are religious individuals and may well have been using this term in a spiritual way. I believe both also
    said to the families “our prayers are with you”. These examples, of course, do nothing to help your case and may in fact hurt your case.

    In reply to your other comments, if you felt the term “evil” was vague in its meaning, why would you use it if you sincerely meant it in a “secular’ way. More obviously, why would you use the phrase “pure evil”? I very much doubt that mental illness, or even morality, can be “pure” in the sense you are suggesting. Sorry, but I don’t see much logic in your discourse.

  • Guest

    Don’t blame the illness on the patient. And don’t blame god. All things work for gods will and if you don’t understand and you don’t know you need to study more and listen to your faith more and find the blessings that are there. And have faith that it is there, for with that, you can know you will find it. Anything less is, well, human. We can aspire to more, but in the end we are flawed sinners, all.

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