Tuesday, June 14, 2016
Worst Mass Shooting in US History
I got up Sunday morning and the CNN headlines stated: "50 dead, 53 injured.....". What appears to have been a single shooter entered an Orlando nightclub last night at about 2AM and shot 92 people with an assault rifle. I saw Dr. Michael Cheatham of Orlando Regional Medical Center say that a mass casualty incident was declared and an additional 6 trauma surgeons and a pediatric trauma surgeon were brought in. The FBI is investigating it as an act of terror or a hate crime. The shooter was a 29 year old man who had been investigated by the FBI for possible ties to Islamic extremism. He had been working as a security guard for a company who provides services to the federal government. He was licensed to purchase firearms. He purchased two firearms shortly before the shooting - a Sig Sauer MCX Carbine 0.223 cal on June 4 and a Glock 19 9mm pistol on June 9 from the same gun shop. Some reports suggest he was also carrying a Walther P22 .22LR pistol, purchase date unknown. Prior to this incident the worst mass shooting incident was the Virginia Tech incident in 2007 that killed 32 people.
At the time of the attack the shooter called 911 and pledged allegiance to ISIS and mentioned the Boston bombers. President Obama came on the networks at 2PM and referred to the incident: "This was an act of terror or hate." He pointed out that this was an attack on all Americans and he encouraged solidarity. In an earlier commentary (posted above) he discussed solutions. He used the example of highway traffic fatalities and how they were approached from a scientific and public health standpoint. Vehicle safety improved. Driver behaviors especially driving while intoxicated was confronted. Although he did not mention it, the drinking age in the United States was increased to age 21 largely by political leverage using federal highway money granted to individual states. He pointed out that these same public health measures cannot be used in the case of firearm violence because Congress has blocked research on firearm deaths and violence. He discussed a situation that he had just encountered, where people being tracked by the FBI for frequenting ISIL web sites could be put on the no-fly list but they could not be prohibited from purchasing firearms. That legislation is blocked by a gun lobby with a primary thesis that some members of the government want to take away Second Amendment rights and firearms from law-abiding citizens. The President points out that nothing could be further from the truth and cited the fact that more firearms have been sold during his administration that practically any other time of the Republic. I think the manufacturing statistics might back up that claim at least based on a chart I created during the first half of his administration. Further information corroborating this statement is available at the document Firearms Commerce in the United States 2015 on the ATF website. There is plenty of data there to corroborate both the President's remarks and the potential financial conflict of interest of the firearms lobby. I am sure that the gun advocates will be the first to say they deserve credit for gun commerce rather than the President. My speculation is that they would deflect the conflict of issue by either wrapping themselves in the Second Amendment or as advocates for all of the law-abiding gun owners.
I think that most physicians agree with a public health approach to gun violence and would like to see more data and strategies. The existing data shows that gun availability is the single largest determinant when it comes to firearm deaths either due to suicide or homicide. It accounts for the greatest correlation with adverse outcomes from gun violence. By comparison psychiatric diagnosis does not.
The President's comments on the further political aspects of gun control legislation in the US especially people being investigated by the FBI, like the perpetrator was on two occasions cannot be prohibited from obtaining firearms. That speaks directly to the pro-gun argument that all we have to do is focus on existing laws and get the guns out of the hands of the bad guys. This law potentially puts guns directly into the hands of the bad guys and nothing is being done about it. The Obama video was posted 10 days prior to the Orlando attack.
I won't belabor the points I have already made in a series of posts on this blog. We are still seeing the same microanalysis and political opportunism that has become a routine part of mass shootings. We are still seeing the lack of solutions like we have seen in the past. The way it looks I can continue to post on the issue on out into the future it will probably be a problem long after I am gone. I heard a gun advocate on public radio this morning and what he said after this incident was not only depressing and disingenuous, but it typifies a rigid illogical stance that no place in science, medicine, or the 21st century. It illustrates why the gun lobby has Congress enact laws to stifle funding for epidemiological work on gun mortality and morbidity. I suppose at this point it is just a question of when we hit the tipping point. When will the majority of Americans start to reject this illogical philosophy?
If the gun advocates hit the street with this hard line attitude after the scope of a mass shooting like we witnessed in Orlando - I shudder to think of what the eventual human cost is going to be.
George Dawson, MD, DFAPA
Embedded video per PBS and the instruction on their site. Original video was from June 2, 2016