Gunfire In the Streets

 

True crime television is very big in the United States right now.  It is well produced and, in most cases, more engaging than typical fictional crime dramas.  Much of it shows real time police work with body cam and camera crew footage.  It gives a generally good presentation of police officers and detectives including demands of the job and their disclosure of the emotional toll and empathy for crime victims.  A cross section of police departments are sampled and they represent themselves very well.  I have been consistently impressed with their degree of professionalism and approaches to solving crimes. 

The striking part of these videos is the level of violence on the streets of the US and what the police have to contend with.  There seems to be a pattern of reactivity that many people have that leads them to try to evade the police or physically resist their efforts to detain them at all costs.  These aggressive confrontations often occur for trivial reasons.  A common example is a routine traffic stop that turns into a high-speed chase and multiple collisions or a single high impact crash.  The person apprehended has suddenly gone from a misdemeanor crime or traffic ticket to multiple felonies and jail time. 

Nowhere is the escalation more evident than firearm related crimes. I have seen many of these situations where the first action taken by the offender is to open fire on the police.  Open the car door and start shooting.  Pull off the covers in bed and come out shooting.  Wrestle with two officers in close proximity to your girlfriend, get loose, grab a gun, and start shooting. Hole up in your house or apartment and when the police show up start shooting through the windows and walls.  I saw one episode where 96 rounds from an assault rifle were fired though the apartment walls at police officers on a stairway (they did not fire a single shot).  And all of that gunfire took less than a couple of minutes.

Any reader of this blog knows that I support reasonable gun laws, abhor the current trend to maximize the number of guns on the street, and see easy access to guns as a major public health problem.  I also dispel the conventional political wisdom on guns as only being problems in the hands of the mentally ill or people taking antidepressants.  Gun violence in this country is directly proportional to high gun density and lax gun laws.  True crime TV quickly reveals that the primary equation for gunfire on the streets is an angry young man with access to firearms.  I have seen about a hundred of them interviewed on these shows. Most have no clear explanation for what happened.  They uniformly regret that it did happen – mostly because the consequences they are facing. And nothing would have happened if there was no easy access to handguns.  What would have been a fistfight became a gunfight with somebody dead and somebody in prison for the rest of their lives.

Although, the sampling for the shows is undoubtedly biased toward the sensational – I decided to take a look at what has been researched and written about in terms of gunfire on American streets.  For context I have posted the tree stump from outside the Spotsylvania Court house.  At least it was in that spot when it was sawed off by gunfire during a battle in the Civil War in 1864.  It was subsequently sent to the Smithsonian where it is displayed today.  For scale, historians estimate that during the three-day Battle of Gettysburg – 6 - 7 million rounds were fired from small arms and 50,000 artillery shells were fired from 630 cannons.  The combined weight of the bullets, shells, and gunpowder was about 569 tons.  That is a lot of gunfire considering the standard military rifle of the day was a single shot musket that fired a Minié ball. 

One of the main questions I thought about was how much gunfire exists on American streets today with much more liberal gun laws and firearms with high-capacity magazines.  How would a typical day on American streets compare with the Civil War figure?  Globally we know that Americans purchase about 15.5 -22.7M firearms (rifles, shotguns, handguns) per year over the past 5 years. According to a 2017 estimate from Small Arms Survey, US citizens held 393.3M legal and illicit firearms or about 120.5 firearms for every 100 citizens.  The next closest country was Yemen with 52.8 per 100 citizens.  No other high-income countries had more than 40 firearms per 100 citizens.  

Incredibly the government is prohibited by law from collecting data and statistics on ammunition purchases so it is typically estimated from financial reports.  According to those estimates, Americans purchase about 10-12B bullets per year. That is 1600 times the number of rounds fired in the bloodiest battle of the Civil War.  For a weight comparison, the metal projectiles from 10B 9mm rounds would weigh 82 Tons, the full cartridges 132 Tons.  Of course, within that number there are people who may fire thousands of rounds at a gun range and some people who may not fire a single round every year.  Some rounds will be fired from illegal firearms. Some rounds will be fired during hunting.  Is there any way to estimate how many gunshots may be a direct danger to the public?

There are several sources of information.  Public health statistics offer indirect data on the end results.   There are about 132 firearm related deaths per day.  40% are homicides and 57% suicides.  The remaining gun deaths are from accidental deaths, police shootings, and undetermined gun deaths.  Beyond that another 200 people are struck by gunfire each day. A total of 320 people per day are struck by gunfire in the US and killed or wounded.  For comparison during Vietnam War (1965–1973), an average of approximately 20 American soldiers were killed and 53 were wounded every day.

It is difficult to impossible to find valid estimate of all gunfire in the US on any given day.  Several sources extrapolate from 30M recreational shooters and 10M hunters hunting and shooting at target ranges every day.  That us typically in the range of millions of rounds fired each day.  Using the most conservative figure for ammunition purchased, that figure might be as high as 27M rounds per day across all settings (gun ranges, hunting, fatal and non-fatal shooting).  Acoustic detectors of gunfire are deployed in only 100 cities in the US. Some files of gunfire detection are publicly available but as difficult to read CSV files.  There is some controversy about whether these systems lead to more traffic stops in minority areas and I cannot locate any national estimates from these devices.  Two studies have documented that about 88% of acoustic detected gunshots were unreported to the 911 systems.   Some authors have also included celebratory gunfire as another source of gunfire on the streets.

As a physician interested in public health and reducing gun deaths – the only way any of this makes sense is political interference.  Gun extremism is a problem in this country.  It has been a progressive political force for the past 40 years.  It is the most likely reason for a lack of tangible data on total rounds of ammunition sold per year in this country or even more basic information about total gunfire occurring at all crime scenes in the US every year.  At every crime scene, all of the expended shell casings are marked, numbered and photographed by location.  Collecting and reporting that data to a central location would be an easy job in this era of information, even if it would be an underestimate (not all firearms eject expended cartridges). 

There is only access to the end result – gun deaths and injuries.  The politics is such that we have become desensitized to it – even though the rate of gun violence in the US is higher than the casualty rate in the Vietnam War.  That was a war that was protested as unnecessary, but nobody is protesting the unnecessary gun violence in this country.  It is being sold at the highest levels as the price we all must pay for the hallowed Second Amendment.  

If you watch true crime TV like I do – pay attention to the senseless gun violence. Pay attention to how much gunfire occurs and the setting.  Pay attention to what the veteran police officers say about it.  Most of those shows do a good job of showing the impact it has on families and the police officers. 

And ask yourself why we can’t do better.   

 

George Dawson, MD, DFAPA

 Image Credit:

This is an image of a tree stump that resulted when the tree was sawed off by small arms fire during a Civil War battle.  The details of that battle are from where it resides in the Smithsonian Institute.  

"Until May 12, 1864, this shattered stump was a large oak tree in a rolling meadow just outside Spotsylvania Court House, Virginia. That morning, 1,200 entrenched Confederates, the front line of General Robert E. Lee's Army of Northern Virginia, awaited the assault of 5,000 Union troops from the Second Corps of the Army of the Potomac. Twenty hours later, the once-peaceful meadow had acquired a new name, the Bloody Angle. The same fury of rifle bullets that cut down 2,000 combatants tore away all but twenty-two inches of the tree's trunk. Several of the conical minie balls (bullets) are still deeply embedded in the wood. Unusual objects of war, such as this tree stump, come to symbolize the horror and heroism of a great battle. Originally presented to the U.S. Army's Ordnance Museum by Brevet Major General Nelson A. Miles, the stump was transferred to the Smithsonian in 1888."

 

References:

1:  Carr J, Doleac JL. The geography, incidence, and underreporting of gun violence: new evidence using ShotSpotter data. Incidence, and Underreporting of Gun Violence: New Evidence Using Shotspotter Data (April 26, 2016). 2016 Apr 26.

2:  Hansen JH, Boril H. Gunshot detection systems: Methods, challenges, and can they be trusted?. InAudio Engineering Society Convention 151 2021 Oct 13. Audio Engineering Society.

3:  Kaufman EJ, Wiebe DJ, Xiong RA, Morrison CN, Seamon MJ, Delgado MK. Epidemiologic Trends in Fatal and Nonfatal Firearm Injuries in the US, 2009-2017. JAMA Intern Med. 2021;181(2):237–244. doi:10.1001/jamainternmed.2020.6696

2009–2017: ~120,232 firearm injuries/year, or 329 every day — comprising 34,538 deaths (~95/day) and 85,694 ED visits for nonfatal injury (~235/day)

4:  Kaufman EJ, Song J, Xiong R, Seamon MJ, Delgado MK. Fatal and Nonfatal Firearm Injury Rates by Race and Ethnicity in the United States, 2019 to 2020. Ann Intern Med. 2024 Sep;177(9):1157-1169. doi: 10.7326/M23-2251. Epub 2024 Jul 30. PMID: 39074371.

2019–2020: the burden rose to an average of 1 firearm injury every 4 minutes and 1 firearm death every 12 minutes — ~252,376 total injuries with 84,908 deaths over the two years (~346 injuries and ~116 deaths per day).

A key public-health caveat is that these figures capture people who are shot and wounded or killed, not all rounds fired — there is no comprehensive national surveillance system that counts total gunfire or nonfatal, uninjured shooting incidents; nonfatal shootings and firearm uses "far outweigh" homicides and suicide deaths

5:  Koper CS, Baas G, Taylor BG, Liu W, Sheridan-Johnson J. Validating open-source data on fatal police shootings against self-reports from a national sample of police agencies. Inj Epidemiol. 2025 Oct 21;12(1):68. doi: 10.1186/s40621-025-00625-6. PMID: 41121442; PMCID: PMC12538985.

Another Note on Gun Extremism - An Appeal to Grandparents

 

I cannot let this latest incident slide by. A colleague posted this article yesterday about a 6-year-old boy who shot a teacher during an altercation inside of a Virginia school. At the time I am typing this the teacher was listed in critical condition. The way this incident is reported is bizarre for a guy whose K-12 years were 1956 to 1969. It has nothing to do with banning guns – but it has everything to do with gun extremism to the point that people get casual about guns. They either forget that children and young adults do not have the necessary judgment to responsibly handle guns or the adults themselves do not exercise adequate judgment and either allow their children to have access to guns or do not secure them at home. Using firearms to settle trivial or inappropriate disputes is a clear example of a lapse in judgement.

Let me paint the picture about what it was like in the 1950s and 1960s before we were deluged with gun demagogues. Many families in the remote area where I was raised hunted for food or sport. The hunting included deer, rabbits, ducks, geese, pheasants, and partridge.  I don’t have any statistics but if I had to speculate – the hunting families were in the minority.  Most families that did not hunt and had no firearms on the premises. The only exception might be World War II veterans with souvenir weapons – mostly not maintained and unloaded.  If you had friends from hunting families and there was a chance that you might go hunting or target shooting with them – you had to take an NRA (National Rifle Association) Hunter’s Safety course. Most people took that course when they were in middle school.  It was taught by a middle-aged guy I knew from church.  He presented the course in a very calm matter-of-fact manner and clearly outlined all of the dangers of firearms.  I recall anecdotes about people being accidentally shot at home and injuries from the wrong ammunition being used in the wrong gun.  Rule number 1 was "never point a gun at anybody - even if you think it is not loaded."  We all fired air rifles and .22 caliber rifles at indoor ranges in his basement and at a larger range in the basement of a retail store downtown.  All guns had to be pointed downrange at all times away from the shooters.  Nobody fired a handgun, because you had to be 21 years of age to do that and we were all 12 or 13.

There were no political or marketing movements focused on firearms at the time.  We had to be NRA members to take the course. As long as you were an NRA member you got a monthly copy of their publication the American Rifleman.  The centerfold for that magazine was a long list of “sporterized” military rifles that could be purchased at a low price. I recall many days pouring over that list and thinking about what kind of rifle I would buy when I was old enough.  I never did buy that rifle.

The other incentives to stay engaged with the gun community was getting ratings based on your marksmanship. If you could demonstrate certain scores on targets you would qualify for small military style medals saying that you were an Expert or Distinguished Marksman. Like most skills, it took a little practice (but not that much) to become proficient in shooting. Contrary to some stories that you read today about hunters and school – nobody ever brought a gun to school. There were no Second Amendment discussions and no suggestion that the training had to do with militias. The result was that there was a small group of middle school kids who had taken a safety course focused on handling firearms while hunting.

That did not mean there were no firearm related deaths in my small community. During those early school years there were 2 suicides and a hunting accident, all involving kids who I knew.  Firearms are never completely safe even with limited access and training.

Back to the article – let me examine two direct quotes starting with:

“Experts said a school shooting involving a 6-year-old is extremely rare, although not unheard of, while Virginia law limits the ways in which a child that age can be punished for such a crime.”

Extremely rare but not unheard of is quite an introduction.  Within the space of 2 generations, we have gone from unheard of to rare but not unheard of. Without being an expert on Virginia law my speculation is that any legal decision about culpability and punishment is based on the capacity of a child to formulate a plan and rationally decide to shoot someone.  The irony here is that you can watch true crime television and see the same problem in all of the 20+ year old men who impulsively commit gun homicide. There are no reasons for these homicides.  They all seem to occur during trivial arguments where somebody gets angry and starts shooting.  The problem, is depending on the judgement of children and immature adults and the solution is not providing them access to firearms.

“Today our students got a lesson in gun violence,” said George Parker III, Newport News schools superintendent, “and what guns can do to disrupt, not only an educational environment, but also a family, a community.”

Unfortunately – the students did not need this “lesson”. From the description they were all traumatized and school shootings are so common in the US, that they are continuously exposed to it. I would not be shocked to learn that many of the students and parents involved had been worrying about an event like this for a long time. The people who ignore this “lesson in gun violence” are all adults.  Many of them are in positions where they could make a difference but consistently fail to do so – or even make decisions that increase the likelihood of future incidents. In the case of politicians, you share responsibility by voting for gun extremists.

As a country are we so oblivious to gun extremism and gun violence that we continue to allow a political party and a politicized gun organization to compromise the safety of school children and teachers? My appeal today is to the grandparents out there – people of my generation. If you remember what the gun atmosphere was like when you were a kid – compare it to what is going on right now.  Were there kids in your first grade class getting into altercations with teachers?  Was there gunfire in primary school?  Do you recall routinely hearing about primary and high school students being shot and killed?  Were there military style high capacity firearms widely available?  Were there armed militias wearing body armor standing outside of your state capitol?  Did the musicians you listen to endorse a lifestyle that involved gun violence to settle minor disputes? Were there people suggesting that you needed to carry a gun around with you at all times for protection? Could you pick up a gun and carry it around with no training and/or no permit?  If you are a person of my generation - the answer to these questions is no.

That is the country we have become. And it is all due to one political party, their politicized allies in the community, and their judges in the Supreme Court drastically changing gun access and attitudes about firearms in the community.  Nobody is safe with these people in power. 

Be a single issue voter and vote the gun extremists out.

 

George Dawson, MD, DFAPA

Supplementary 1:  Update on the incident that initiated this post.  Reports in the press today (1/9/2023) say the teacher was intentionally shot with a 9 mm handgun that the 6 year old took from his mother. There are conflicting reports that the teacher was trying to disarm the student when the shooting occurred.  She was shot though the hand and into the chest. She assured the safety of the rest of the students before seeking help for herself. The status of the handgun while all of that happened is unclear. She was reported as being in stable condition in a hospital.  The school is closed to give "students and families time to heal."

Supplementary 2:

Based on an initial response to this post let me be clear about the way to reign in gun fanaticism in the US.  To my knowledge no responsible person has ever suggested "grabbing guns" or "coming for your guns".  There are too many firearms in the United States for that or for gun "buy backs" to ever be practical. The gun grab argument was basically invented to create gun extremism.  Nobody was worried about it in the 1970s.

We are stuck with widespread gun availability and we need to keep them out of the hands of people who are likely to do the most damage.  Unfortunately that means a majority of people who would not fail either background checks or red flag laws. They are also probably more susceptible to the impulsive use of firearms not just for gun homicides but also gun suicides.  A good starting point would be:

1.  Universal background check - no state to state loopholes or private sale loopholes.

2.  Red flag laws - already incorporated broadly in the FBI NICS (National Instant Criminal Background Check System) database.  That would include people adjudicated by a court as being at high risk of harming themselves or others if they had firearms.  Red flag laws should depend only on a direct or indirect threat to harm with a firearm. Since there is a very serious bomb hoax statute - an actual threat to an individual or a facility should be taken at least as seriously.  The standard should ne a threat to use a firearm and not having to provide the likelihood or using the firearm or potential dangerousness of the person making the threat.

3.  People with substance abuse disorders or mental illnesses at high risk for violence to self or others.  That should include a permanent ban on firearm acquisition where determined by a court.

4.  People with a history of actual violence to self or others. 

5.  Additional factors per the NICS system.

6.  Serious discussion is needed about the permit less system that is now in place in many states. A practical law would be to prohibit assault weapon sales, high capacity magazine sales, and increase the age for handgun purchases to 25+.  But now that there has been a lifting of the moratorium on gun violence research the research on gun violence in this age group and what kind of firearm is being used will make these conclusions obvious.  

7.  Stop encouraging legal gun violence. Stand your ground laws, permit less carry, and widespread access make guns available for dispute resolutions that do not require lethal violence. 

8:  Waiting periods for gun purchases. I have had too many people tell me that a waiting period saved them when they had transient thoughts of self harm.

Supplementary 3:  The easy access to firearms by everybody who want them is based on many false premises.  Here are a few:

1.  Do you really want everybody on the street to carry a firearm? Or do you only want a few special people to be carrying these firearms?   The assumptions here are obvious.  Only the good guys or maybe the masculine guys should be carrying guns. How do we determine who those people are?  Is it sex or gender based?  Or maybe it should depend on race?  Is there a box you can tick to just get a gun. Maybe this is why the gun extremists eliminated all of the boxes.  Thinking through that problem is just too hard.

2.  Maybe the gun extremists really mean that everyone should carry a gun. In that scenario it is fairly predictable that more and more minor disputes and arguments will be settled by gun violence. We have seen that happen in many national cases already and it obviously happens on true crime TV.  Even the Sheriffs in western towns in the 19th century saw this as a problem and had people coming into towns check their guns. (see Tombstone statute from 1851)

3.  There is an assumption that gun owners, especially concealed carry owners are supermen (or superwomen) who never make a fatal mistake with a gun, never get in an argument where they might threaten somebody with a gun, know where their gun is at all times, and never accidentally shoot themselves. We know from the data that none of that is true and we can see recordings of real time incidents on television that illustrate this fact including the news report that lead to this post.

References:

1:  Finley B, Barakat M. Police: 6-year-old shoots teacher in Virginia classroom.  Associated Press.  Fri, January 6, 2023 at 2:20 PM CST  Link

2:  American Progress.  Fact Sheet: Weakening Requirements to Carry a Concealed Firearm Increases Violent Crime.  October 4, 2022. Link

Graphics Credit:

Photo of the Polychrome Mountains that I shot in Alaska.