Sunday, December 15, 2013

A Gun In The Snow





A colleague of mine was out for a walk today.  It is a brisk winter day in Minnesota.  There is about 6 - 8 inches of snow cover.  He was walking across the street and found this handgun laying there.






He took a picture of the gun and called the police to pick it up.  They were there in 20 minutes.

My views on violence and gun violence are fairly well known. My recent position has been that arguing with gun advocates and the pro-gun lobby in Congress is futile.  But when I saw this posted on Facebook with the accompanying story I couldn't help but think: "Guns are so common they are falling on the ground like wallets."  Only a fool believes that this level of gun availability does not result in death and injury of all kinds including accidents, suicides, and homicides.  Only a fool believes that with this level of gun availability it is possible to prevent guns from ending up in the hands of people who are not competent to use them.  I live in a state that passed a concealed carry law that  is basically the right to carry a concealed firearm.  It passed a few years ago by tacking it on to unrelated legislation.  The gun and holster look like a common one that is sold to those who complete a brief concealed carry course.  The main argument of the concealed carry contingent was that they were supermen of sorts.  There was literally nothing that would compromise their judgment if they were carrying a handgun.  Since then there have been a number of incidents involving concealed carry owners showing that in fact problems happen.  In the most notable incident a concealed carry owner opened fire on an undercover police officer.  I think it is safe to assume that there are probably at least as many lapses of judgment involving concealed weapons as there are driving automobiles.  The main difference is that people spend more time driving.  The reporting of these incidents is not transparent and that is typical of much gun legislation.

On a worldwide basis, small arms fire is a leading cause of death and disability.  I had the opportunity to see how some of that was transacted when I lived in Africa for two years.  In travelling as little as 100 miles there were frequent roadblocks at times.  The intent of the roadblocks was not clear but each roadblock was manned by police or paramilitary personnel and everybody was heavily armed.  The American friend that I most frequently traveled with told me about a time he got out of his car to ask if there was a problem.  One of the police officers pushed the barrel of a machine gun into his chest and prodded him back to his car.  He previously served in a country where a fellow volunteer accidentally drove through a police checkpoint because there was nobody around.  It appeared to be abandoned.  He made it a short distance before he was shot through the head by soldiers out of sight up on a hill.

In the US, besides the obvious problems with the legal availability of firearms there is also the issue of the black market and stolen firearms.  Since 1994 an average of 232,000 firearms are stolen every year and 80% of those are not recovered.  Stolen guns account for 10-15% of the guns used in crimes.  The majority of guns used in crimes are purchased by proxy or so-called straw purchase sales including other tactics like diversion of guns to criminals by licensed gun dealers.  There are several common sense changes that can occur in firearm policy that might make a difference in the sheer number of firearms in the general population and their availability to criminals.

This week marked another school shooting.  It marked the anniversary of the Sandy Hook Elementary School shootings.  In practically every school shooting easy access to firearms is a major part of the problem.  There are clear models for what happens to firearm deaths when some restrictions are placed on their access.  Fareed Zakaria has a new feature Global Lessons on Guns on his Sunday news program GPS.  Last Sunday he reviewed gun policies in Japan.  Getting a license to have a firearm in Japan is very difficult.  The authorities need advance information on where it will be stored and they need a detailed floor plan of the residence where it will be stored.  In a country of 130 million people there were a total of 4 firearm homicides last year.  By contrast, in the United States with a current census of 317 million people, there were 31,672 firearm related deaths (see Table 1-1 and 1-2).  The example from Japan is also interesting because it looks at the issue of violent video games.  They are played at a higher rate in Japan than the U.S. and it obviously had no impact in the context of extremely limited gun availability.

Even though I think there are better approaches for psychiatry to focus on than strictly gun policy and confrontations with a pro-gun lobby we need a basic level of awareness that current gun laws in the US are probably not what the Framers of the Constitution intended.  I think they would be as shocked as anyone if they found a gun in the street.  They would be equally shocked to find out that 7 times as many Americans die every year as a result of firearms than died in the Revolutionary War.  (see Table 1)

George Dawson, MD, DFAPA

6 comments:

  1. The discrepancy between Japan and the US is terrifying.

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  2. It's a gun, not a live grenade. It's not going to discharge itself. I know it is practically a condition of psychiatric licensure to believe the mere sight of a gun is icky, but a little perspective is needed. I do not think George Washington, who was a general, would be shocked by the sight of a lost gun. He had seen far worse in 2 wars. There were morons and drunks in the 18th century too and I'm sure they lost muskets.

    If someone left it in the street, it probably wasn't lost but purchased illegally and used in the commission of a crime then dumped. And none of those "common-sense measures" would have any effect on its existence in society.

    "There are clear models for what happens to firearm deaths when some restrictions are placed on their access." How is that working out in Chicago?

    You compared US to Japan. Now compare it to Switzerland and see if the identified independent variable holds up. Then compare Chicago to Houston and look at the same alleged independent variable.

    BTW, since you brought up this week's school shooting, that was quickly ended by the presence of an armed guard at the school. So consider the idea that just maybe that the right person armed in open carry was life saving in a big way.

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    1. If a gun if it picked up by a middle aged physician intent on turning it in to the police - it's just a gun. It's potentially something else if it is picked up by a kid on the way to school.

      I disagree with you about Gen. Washington and cite the total deaths in the Revolutionary War and current firearm deaths on an annual basis in the US. The annual carnage from gun violence in the US easily exceeds that figure. A better modern comparison would be the Vietnam War. The death and disability from that war touched everybody and every two years total firearm deaths exceed the number of deaths in that war.

      I would encourage anyone with ideas about firearm access in Switzerland to watch Zakaria's special to see how that actually plays out there. Firearm access is much more tightly controlled in Switzerland than in the US, contrary to the rhetoric here about how the Swiss have unlimited access to any weapons that they want and that Switzerland is an idyllic setting for gun enthusiasts.

      As far as city to city comparisons go a lot depends on the ease of gun diversions close by. One of the gun dealers with the highest diversion rate to criminals (see the link) is less than 2 hours away from Chicago.

      I don't know the full details about the recent shooting but 12/14 report and floorplan in the Denver Post said that the shooter killed himself. A previous report said he came in looking for a specific person who left the building when he heard about it. Initial reports credited that action and "active shooter" protocols for the students with saving lives. But in all of these situations we are left with the question of where the gun comes from and why there is easy access. The Zakaria special also talked about suicides in the military and the potent effect of separating firearms from suicidal soldiers and even ammunition from soldiers on weekend passes.

      The issue of easy access to a highly lethal weapon cannot be explained away. That is probably why every firearm comes with the warning that inappropriate use can result in serious injury or death.

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  3. You said that the founding fathers would be shocked by the sight of a gun. These were hardened men who were very familiar with weapons who discharged them frequently. They are not going to get the vapors at the sight of a weapon. Washington was a general, Jefferson was a marksman who won shooting contests. I think they would have picked it up and add it to their collection, probably marveling at its superiority to muskets. Read any of the Federalist Papers on the 2nd amendment..these guys were not only pro-gun rights, they loved their guns.

    Inadvertently, in trying to refute me by using Switzerland as an example you are confirming that the independent variable is culture not gun proliferation. Swiss citizens are part of a militia and own heavy duty semi and automatic weapons. This is a point made years ago in the book, "The Sumurai, the Mountie and the Cowboy" on culture and attitude toward weapons.

    You can find out about the circumstances on the recent shooting. You are incorrect on all counts about what happened, he just didn't kill himself out of the blue and he intended to kills dozens. Here is what really happened that vast right wing media outlet, CNN:

    http://www.cnn.com/2013/12/14/us/colorado-school-shooting

    He also purchased a shotgun legally, and as far as we know had no mental health history, so I don't know how you realistically screen him.

    So let's get rid of the culture variable and look at two American cities:

    http://i.imgur.com/en3HZ5T.jpg

    It is pointless to try to offer Japanese solutions to an American issue. Japan never had 300 million guns in circulation.

    Good guy with a gun is the best answer to bad guy with a gun as the recent Colo incident and the carnage in Chicago affirms.

    I don't consider Fareed Zakaria an objective journalist so that appeal to authority won't work with me.

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    1. I don't think the issue is whether Washington or Jefferson would get the vapors. It is common these days to use the founding fathers to justify easy access to firearms and you can find as much contrary evidence. The question is whether they would want firearms lying around in the street where anyone including children could access them. Of course this is not a Revolutionary War weapon - this is a semi-automatic pistol.

      The link you posted to CNN comes to the same conclusion my source did - the perpetrator shot himself. I have a previous post on the "good guy with a gun" rhetoric and of the the inherent problems with that approach.

      As far as Zakaria not being an objective journalist try this reference:

      Rosenbaum JE. Gun utopias? Firearm access and ownership in Israel and
      Switzerland. J Public Health Policy. 2012 Feb;33(1):46-58.

      From the abstract: "Gun advocates claim mass-casualty events are mitigated and deterred with three policies: (a) permissive gun laws, (b) widespread gun ownership, (c) and encouragement of armed civilians who can intercept shooters. They cite Switzerland and Israel as exemplars. We evaluate these claims with analysis of International Crime Victimization Survey (ICVS) data and translation of laws and original source material. Swiss and Israeli laws limit firearm ownership and require permit renewal one to four times annually. ICVS analysis finds the United States has more firearms per capita and per household than either country. Switzerland and Israel curtail off-duty soldiers' firearm access to prevent firearm deaths. Suicide among soldiers decreased by 40 per cent after the Israeli army's 2006 reforms. Compared with the United States, Switzerland and Israel have lower gun ownership and stricter gun laws, and their policies discourage personal gun ownership."

      I think that the Israeli reform in this case was not allowing their soldiers to take their ammunition home on the weekends. It turn out that separating soldiers from their weapons and ammunition saves lives and is a source of a current initiative to prevent suicide in veterans. The military even acknowledges that access is a safety problem.

      I think you also miss the main point of my post. The gun access issue to me is really a side issue compared with figuring out a way to do primary and secondary prevention. I don't fool myself into thinking that advocates for easy access of firearms will respond to any argument no matter how feasible.

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  4. What is that awful-looking gun, anyhow? It looks like a home-built.

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