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.

Letter to Gov. Walz About Guns

 

Dear Governor Walz,

 I am a psychiatrist and have practiced for most of my career in Minnesota. Much of that time was spent running an acute care unit at St. Paul-Ramsey and then Regions Hospital.  In acute care psychiatry we spend most of our time addressing psychiatric emergencies involving violence and aggression directed at self and others. The goal is to prevent injuries including suicide and homicide and we do a good job with that.  Addressing any associated firearms is part of that job.

I was driving around yesterday and heard on MPR that you may be planning to introduce legislature to toughen gun laws based on the recent tragic events.  I encourage you to do this and have written extensively about this issue and the surrounding politics.  It is quite unbelievable that nothing is ever done to address the problem solely because we have a political party that supports gun extremism.  I offer some posts off my blog to give you necessary data if you need it.

The first looks at the issue of permissive gun laws and how they affect the gun death rate of children and adolescents.  Firearm deaths are the number one cause of preventable deaths in this age group and the United States is the only high-income country where this is true.  In the study I reviewed, Minnesota is classified as a state with intermediate permissiveness in terms of gun laws.  In states in this category there were 1,424 excess firearm deaths.  States in the most permissive category had 6,029 excess firearm deaths.  I have a table in this post that compares Illinois, Minnesota, and Wisconsin as examples of strict, permissive, and most permissive gun law states:

https://real-psychiatry.blogspot.com/2025/06/pediatric-deaths-from-firearms.html

In a second post I address the issue of likely and unlikely causes of mass shootings.  There is always a lot of excuse making by gun extremists when these events occur.  Recently that has included blaming mental illnesses and even psychiatric treatments.  As an expert in treating aggression and violence I can attest to the fact that psychiatric treatment does not cause aggression.  Beyond that I would invite you to look at the data in this post clearly illustrating that the major variable in mass shootings is gun density.  Countries using the same number of antidepressants or more bracket the US in the first table and neither country has mass shootings and nowhere near the number of gun suicides or homicides. Even considering mental illness as a risk factor, people with that problem do worse in the US due to firearm availability.

 https://real-psychiatry.blogspot.com/2023/03/likely-and-unlikely-causes-of-mass.html

And finally, I have a few posts about gun extremism in the US and how it has evolved over the years.  We have gone from 19^th century local ordinances that require checking your firearms at the city limits to permitless concealed carry of much more deadly modern firearms.  And all of that is since the party pushing this agenda has no functional policies that would appeal to the electorate.  In fact, in one of my posts I point out that the same party that pushes gun extremism has pushed political violence.

Gun Extremism Not Mental Illness:  https://real-psychiatry.blogspot.com/2022/05/gun-extremism-not-mental-illness.html

Mass Shooters - The American Gun Extremist Superman:  https://real-psychiatry.blogspot.com/2024/08/mass-shooters-american-gun-extremist.html

Another Note on Gun Extremism - An Appeal to Grandparents:  https://real-psychiatry.blogspot.com/2023/01/another-note-on-gun-extremism-appeal-to.html

Current Political Violence In The USA:  https://real-psychiatry.blogspot.com/2024/10/current-political-violence-in-usa.html

You can find more posts on my blog by searching guns, firearms, or gun extremism. Good luck with your efforts to make Minnesota a safer place for all of us.

Sincerely,

George Dawson, MD, DFAPA

Additional Information:  I sent similar notes to both US Senators from Minnesota.

Photo Credit:  I took this shot of the crowd at the Minnesota State Fair on August 26, 2025. 

The Only Gun Legislation In the Past 30 years Is Nothing To Get Excited About

 

The only thing more annoying than seeing self-congratulatory legislators not solving another problem is when they discuss their rationale for their latest decision.  That was in full view on CBS This Morning Today as Tony Dokoupil interviewed four senators Chris Murphy (D), Thom Tilis (R), John Conryn (R), and Kyrsten Sinema (I).  In the interview Sen. Murphy suggests there is evidence that “the law is starting to have some impact” according to “criminologists”.

But what is the evidence?  A summary of the bill is available at this link and it is more readable that the final version on the same web site. One of the provisions was enhanced background checks for gun purchasers 18-21 years of age.  That has resulted in 230 denials. Sen. Tilis commented that 107,000 people between the ages of 18-21 applied to purchase a gun and therefore only 0.2% were denied. No comment on the negatives of putting another 100,000 guns out on the street. I tried to find data on the NICS database but it is not available for 2022.  We don't know if a 0.2% denial rate is an exception or if it is expected.  This report states the overall denial rate was 3.92%.  He goes on to say he is proud of the fact that they have passed the “biggest investment in mental health” in history and “we all agree that behavioral health had to be the foundation of everything we did.”  

Hold on Senator! Granted I am only a psychiatrist and not a behavioral health expert – but this seems like bullshit to me. The federal government and their cronies in behavioral health managed care have been rationing services while making massive profits for the past 30 years. It is as likely that your funding intervention will have as much impact as it did on the opioid epidemic.  It also happens to be a gun extremist narrative to divert attention from the primary problem of far too many guns.

Senator Sinema suggests that “every single person” who picks up a firearm and engages in mass violence is mentally disturbed.  If that were true (and it is not) – the suggested funding through the usual channels will not impact mass shooters. Mass shooters are a product of gun extremism. They see politicians every day talking about guns as the solution to many problems. Stand your ground laws that encourage both gun violence and exoneration of the gun user. They see people being shot and killed or shot at for trivial reasons.  They see indignant gun extremists claiming that “the government” wants to kick your door down and confiscate your guns – even though with the massive number of guns in this country it is physically impossible.  They see armed “militia” intimidating state legislators on their own capitol grounds. They see social media threats about the use of arms. Most importantly – they see daily mass shootings in the United States and nobody doing anything about it. Politicians seem to blame the victims, in some cases the police, or globally “wrong place-wrong time.” You do not have to be mentally ill to be confused or driven by those messages and emotion.

Most notably – there continues to be no background checks for all gun buyers and no assault weapons ban.  There was some joking about not being able to agree on a definition of an assault weapon.  That is a basic definition and it has been defined by Congress in the past but it appeared to be off the table for this crew.

Dokoupil makes a point that violence in America seems to drive legislation and maybe the tradeoff for a Second Amendment is that there will always be violence in America. He cites examples of gangsters in the 1930s and violence in the 1970s with riots and radical politics.  That is a good sound bite but it ignores the fact that there has been no gun legislation through the past 30 years of gun violence and this anemic bill was the result of a level of gun violence that should have been an embarrassment for any legislator.  He misses the obvious point that even in the Wild West (see Tombstone Ordinance of 1881), you had to check your gun when you came into town and post-World War II we had decades of common sense gun legislation that did not involve the massive carrying of firearms.  During those decades – nobody under the age of 21 could own a handgun, guns were used for hunting, and the Second Amendment was interpreted the way it was written.  During those decades the NRA was focused on gun safety and hunting rather than flooding the streets with guns. 

There was some rhetoric about how an extreme mass shooting incident led to the bipartisanship necessary to pass this mediocre bill. First off - that is an extremely high bar.  How many catastrophes does it take to move Congress?  The answer is obviously hundreds. Secondly, it is obvious that partisanship was alive and well right in the room.  None of the Senators could even touch the assault rifle issue? Assuring the rights of people refused firearm purchases was a higher priority?  Gun extremism is alive and well and as long as one party finds it necessary to fan the culture war flames - very little movement would seem possible and that is exactly what we have seen for decades.  

The gun extremism of one political party and their judges is the current problem. An atmosphere of unabated gun extremism is unlikely to have any desired effect on mass shootings, gun homicides, gun suicides, or accidental deaths. I have attached a few paragraphs on what gun extremism is below. This is my definition. I have written about potential solutions in the past – but clearly people would rather listen to the clear thinking of their elected officials instead.

 

George Dawson, MD, DFAPA

Previous Posts:

Likely and Unlikely Causes of Mass Shootings

Another Note on Gun Extremism - An Appeal to Grandparents

Gun Extremism Not Mental Illness

Elements of Gun Extremism

1:  Misinterpreting the Second Amendment:

The culture war political party and their judges ignore the text of the Amendment which is simply:

A well-regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.

Gun extremists ignore the preamble that gives the rationale for the right to bear arms and instead isolate the clause about the right to keep and bear arms and generalize it to the entire population and any firearms.  The well-regulated Militia in this case is every states National Guard.  Arms in those days were muzzle loaders that could fire 2 rounds per minute if you were an expert contrasted with 45 rounds per minute from an AR-15 semiautomatic rifle. A fully automatic AR-15 can fire 700-900 rounds per minute. Courts have taken additional steps to say that gun permits can be superfluous and that anyone requesting one should be issued one – with rare exceptions.  Local legislatures have gone ahead with permitless carry and concealed carry laws.

In debating gun extremists, a common argument is that it is protection from tyranny and that is why the Amendment is there.  When I suggested that using weapons against the US government was treason, a famous gun advocate suggested “it would depend on who won.”  Clearly there is nothing about tyranny associated with the amendment.  Gun extremists favor lawlessness and insurrection.  Their judges do as well.

2:  Putting everyone at risk:

One of the famous gun extremist arguments is that more guns results in less crime.  That is clearly not the case and the number of defensive uses of firearms does not have a significant impact on crime.  In the meantime, there are more gun suicides, homicides, accidental deaths, mass shootings, and deaths from the impulsive use of an available firearm in the US than any other high income country.

3:  Increased risk with handguns and assault rifles:

Before the gun extremism culture took over – guns in the US were used for hunting and target shooting. Some people thought they were necessary for self-defense but they were clearly in the minority.  The NRA ran Hunter Safety Courses to teach safe use of hunting firearms.  Gun extremism is a result of the culture wars approach to American politics. When one party realized they did not have much to run on they decided to make a few things up.  Gun extremism was one of those results.   Gun extremism has resulted in the proliferation of handguns and assault rifles.  Both of those weapons are designed for shooting people not wildlife. Gun extremists try to minimize the role of assault rifles by claiming that they are not fully automatic like the military version but they can still release a flurry of high velocity rounds capable of penetrating many walls – as fast as you can pull the trigger.  That is not a hunting firearm.  No need for a lot of physics - just recall that the kinetic energy of a mass is a function of the square of its velocity.  Weapons with high muzzle velocity like assault rifles will have much more energy to damage the target.

4:  Increased risk with permitless carry:

 As the gun extremists became more radical there was a progression of loosening of gun regulations.  Initially to carry guns in public you had to have a permits. In many states that required an application and background check from a county Sheriff.  For a concealed carry permit, training was required. Continued radicalization has resulted in the abolition of many of those laws so that you can purchase a handgun and carry a concealed handgun without a permit or training.  You just must meet minor age criteria. It is obvious that this is the goal of gun extremists across the USA.  Permitless carry will make every community more dangerous. Just ask your local men and women of law enforcement. 

5: The idea that gun carriers are supermen or superwomen:

In other words if you meet criteria to carry a gun - you are by definition responsible and do not make any mistakes leading to the loss of life or injury. Epidemiology teaches that just having a gun on the premises greatly increases the likelihood of death by accidental injury or suicide. Every year hundreds of police officers are injured by accidental discharge of their firearms and they have more extensive and ongoing firearms training than typical gun owners, especially in this era of vanishing qualifications. The obvious political goal of gun extremists is to eliminate any qualifications except for age and possibly (if a NICS check is run) a history of felony crime or domestic violence.   

6:  The new era of shoot first ask questions later:

There have been many incidents in the news of people being shot at and in some cases killed for ringing a doorbell or accidentally driving down the wrong road. In well televised road rage incident, a man fires several rounds from a semiautomatic handgun through his own windshield at a car he mistakenly thought had fired a gun at him.  Not a thought about how far those bullets travel and who else he might hit on a busy freeway. Is this the kind of country we want to live in?  This is the country we currently have courtesy of gun extremists. 

7:  All we have to do is enforce existing laws:

This is a favorite of gun extremists as they continue to roll back existing gun laws. They also use the slogan "If guns are outlawed only outlaws will have them."  That slogan is obviously flawed at two levels.  First, nobody has ever suggested outlawing guns and as I pointed out earlier - it is physically impossible at this point.  Secondly, nobody seems to consider where outlaws get guns. A large source is theft from legal gun owners. About 380,000 guns are stolen in 250,000 incidents in the USA each year.  In other words, one of the largest sources of illegal guns in the hands of outlaws is legal guns from legal gun owners.   Keeping the streets flooded with guns keeps that process going. 

Image Credit:  Thanks to Rick Ziegler.

 

Killer Mike's Gun Recommendations for Families

I watched TMZ Live yesterday. They interviewed the rapper Killer Mike. Harvey Levin was his usual overcomplimentary self. He asked the rapper about his recommendation that every family should have "multiple guns, all sorts of guns" and this is what he said:

"5 - 5. I have always just said 5. You should have a revolver, a semi-automatic pistol, you should have a shotgun, you should have one bolt action rifle, and you should have a semi-automatic rifle."

When questioned about the semi-automatic rifle:

"I said semi-automatic, military is fully automatic. It's not military - it just looks cool. It can look like a race car but it doesn't go 200 miles an hour. My thing is simply this - the founders of the Constitution saw a need to fight tyranny at some point and they believed that that could happen again so they wrote that provision so to get to the ultimate answer you got to dig up those old white guys and ask them. I'm simply applying - I'm going by the rules that were given to me in the Constitution - nothing more-nothing less."

When asked about the risk of an increasingly armed and divided population, Killer Mike points out that the fastest growing group of gun owners is black women and he does not want to get in the way of black people enjoying their freedom.

In terms of stopping gun violence he was in agreement with curfew and an exception for working adolescents. He believes that no new gun laws are needed and echoes the line that there are enough laws to take care of the problem already on the books and that criminals are not going to follow the laws anyway. That ignores the fact that almost all mass shooters have no criminal record and in many cases have recently purchased firearms that they use in the mass shooting crime.  Instead he recommends "Stop the Bleed" classes and joining gun associations or gun clubs. His rational is that if you have a tool that can cause harm you should be educated about what to do for that harm.  Unfortunately if you get hit anywhere in the body - the education you will need is how to be a trauma surgeon and even then you had better be at a Level 1 trauma center. 

Consistent with the previous writing on this blog Killer Mike is clearly behind gun extremism and normalizing it as a constitutionally derived right. Obvious gun extremist rhetoric includes the claim that just because an assault rifle is not fully automatic it is somehow less worrisome. Anyone who has fired an AR-15 knows that you can fire as many high velocity rounds just as fast as you can pull the trigger and if that gun is discharged in a residential community that bullet is going a long way and in some cases through multiple buildings.  In fact, all of the weapons he recommends for the family will penetrate multiple walls and are a potential risk for the entire neighborhood.  The normalization of assault rifles by the NRA and Republican party was a move away from the use of guns for hunting to the use of guns for killing people and there is no way around it.  From the testing link this was a quote about the assault rifle result.  It speaks to the mechanism of assault rifles as a combination of high velocity and bullet deformation and tumbling:

"Though the 5.56 bullets showed the most deformation, they were also terribly penetrative (19 panels, or nine walls) and, beyond the first two or three panels, created relatively large holes as they tumbled along their paths."

Just as a reminder this is the full text of the Second Amendment:

"A well-regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed"

Nothing about tyranny. Gun extremists ignore the preamble. The "well regulated militia" these days is each state's National Guard.  This country went through a period of gun regulation that was widely accepted and reasonable until one political party realized they did not have many ideas to run on and decided to make guns a part of that culture war. I don't know Killer Mike's political affiliations.  There may be a subcultural effect since this same show regularly reports gun violence and deaths within the rapper community.  

The problem with all forms of extremism is that it is an appeal to emotion and it typically ignores the facts. Killer Mike sees the problem as encroaching on the rights of black people but that doesn't address the problem that firearm homicides have increased in the black community by 39% from 2019-2020 (1). We know that the political rhetoric that more guns for defensive purposes does not put a dent in those numbers and that these are almost always impulsive homicides based on gun availability.

The answer to how to reduce gun violence is not increasing guns and I don't care what your rationale is - but that is the residue of this interview that started with that question.

George Dawson, MD, DFAPA

References:

1:  Kegler SR, Simon TR, Zwald ML, et al. Vital Signs: Changes in Firearm Homicide and Suicide Rates — United States, 2019–2020. MMWR Morb Mortal Wkly Rep 2022;71:656–663. DOI: http://dx.doi.org/10.15585/mmwr.mm7119e1

Likely and Unlikely Causes of Mass Shootings

     

The pace of mass shootings and school shootings in the United States continues unabated at this time. I am writing this like I have written many posts in the past – a few days after a mass shooting in a school.  I just heard a news reports saying that this was the 167^th school shooting since Columbine on April 20, 1999.  NPR posted a story saying that there is a shooting or a potential for shooting in schools every day (1) – based either on a gun discharge of someone brandishing a firearm in school. They reference the K-12 School Shooting Database stating that this is the 39^th incident this year that involved gunfire on school grounds.

The media descriptions of the current incident follow much of the coverage in the past about unclear motive, shocking circumstances, unpredictability, questions of an “emotional disorder” and counseling, and the devastating impact on families and the community. I saw a forensic psychiatrist interviewed speculating on the aggressive dynamics based on the detail that the shooter recently disclosed a transsexual orientation.  A clergyman was interviewed and suggested the shooter was really looking for the school minister who was providing counseling.  One of the shooter’s fiends was interviewed.  She was contacted immediately prior to the incident and promptly notified authorities – but by then it was too late. The video of the SWAT team running through the hallways and eventually running toward gunfire and killing the shooter keeps playing.  In some cases that video is compared directly to the Uvalde, Texas video  and comments are made about this is a much better example of how law enforcement should respond. I saw some of these reports where they put up the response time on the screen.  

There are the usual expressions of “enough is enough” and “we don’t send our kids to school for this to happen.”  Republican Representative Tim Burchett came right out and said what most people were thinking: “ We’re not gonna fix it….” But then to make it more palatable he added: “criminals are gonna be criminals.”  He thought we needed a “revival” to “change peoples’ hearts in this country.” Later he disclosed he was home schooling his daughter (3).

I am already on record on this blog writing about the real cause of mass shootings and gun violence in general and it is the politics of gun extremism.  The Republican party has figured out that gun extremism works for them along with several other easily demagogued social issues like abortion, voter suppression, education, anti-science, anti-climate change, and more recently “wokeism”. That has led to a series of initiatives to drastically reduce gun regulations.  There has been an undeniable increase in deaths due to gun violence.  Mass shootings, suicide, homicide, and accidental deaths are all routinely ignored as calls for regulations that were effective for decades until Republican advocates rolled them back – even though gun regulations in the past were never a problem.

The typical rhetoric used is a gun extremist interpretation of the Second Amendment.  In the case of voters, it was the usual emotional appeal that “they” were coming to take their guns.  Anyone familiar with the distribution of guns in the United states realizes this is an impossibility, but it is a rallying point for emotional rather than rational appeals.  In recent years we have seen the rhetoric extended to mental illness as a cause of mass shootings.  There is some confluence with antipsychiatry factions who falsely equate psychiatry with the pharmaceutical industry and suggest that antidepressant drugs cause the mass shooting phenomena.  This post will provide clear evidence to the contrary.

On the issue of common psychiatric disorders in comparing the countries that utilize the most antidepressant prescriptions – the prevalence of those disorders is consistent among the United States and the other countries at the top of the list.  These disorders include depression, anxiety disorders, and substance use disorders – conditions that antidepressants are all commonly prescribed for. English speaking and European countries had similar prevalence (4) with possibly lower prevalence in Asia. There are similar variations in the estimated prevalence of schizophrenia and mood disorders in different areas of the world (5, 6).  

A good summary document on the research about mental illness and mass shooting incidents is available from the Treatment Advocacy Center (10).  They summarize the results of several studies as indicating that at least one third of the perpetrators had "serious untreated mental illness."  Their review is remarkable for a wide range of methodologies and selection biases that probably overestimates the number of cases of severe mental illness in mass shootings.  Smaller sample sizes generally showed a greater number of cases of severe mental illness.  In the case of a study by Stone (11) he found that 32% of 228 mass killers had severe mental illness but during the sampling period there were 1,000 incidents.  The variation is often considered due to methodological differences in the surveys but as previously illustrated– even significant differences in incidence and prevalence of these disorders is unlikely to account for the huge differences in gun deaths between the USA and other countries.  The main difference is that people with the same mental illnesses have much easier gun access in the US.

Several studies of people involved as shooters have shown that some of them have psychiatric diagnoses and in some cases they are being treated by psychiatrists.  Some are prescribed medications but the toxicology at the time of the incident is typically not available. In a related study of murder-suicide by the New York City Medical Examiner’s office that of 127 cases over a 9-year period only 3 (2.4%) were taking antidepressants (7).  Two were taking amitriptyline and 1 was taking sertraline. The authors made the point that antidepressant use in this case series was much lower than the expected population rate.  In a series of 27 elderly men who killed their spouse and then died by suicide – more disease conditions and depression were seen as possible predisposing factors – but none tested positive for antidepressants (8).  When considering the prescribing of antidepressants in general,  epidemiological studies suggest that most of these medications are prescribed by non-psychiatrists. With the proliferation of non-physician prescribers, managed care strategies designed to accelerate antidepressant prescribing based on limited assessments, and widely advertised televisit prescribing it is likely that gap between psychiatrist and other prescribers has increased substantially and will continue to grow.

The argument has been made that people become agitated, suicidal, and homicidal on antidepressants. This is a recurrent theme that is often related to medicolegal considerations, criticism of the pharmaceutical industry, and psychiatric criticism.  There is often a suggested scenario of the antidepressants (especially selective serotonin reuptake inhibitors or SSRIs) causing agitation or activation making suicidal or aggressive behavior more likely.  After reviewing the existing evidence the FDA has placed a black box warning for suicidality in "children, adolescents, and young adults".  There are also warning and counseling bullet points on clinical worsening as evidence by: "emergence of anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia (psychomotor restlessness), hypomania, mania, other unusual changes in behavior, worsening of depression, and suicidal ideation, especially early during antidepressant treatment and when the dose is adjusted up or down".  Standard medical and psychiatric practice advises the patient of these potential risks and what the plan should be if they occur.  In 35 years of clinical practice my observations were that these symptoms were rare and most likely to occur if an antidepressant was discontinued and the patient experienced significant sleep disturbance. The patients I treated with severe aggressive behavior were generally untreated for psychiatric disorders and often had substance use disorders.  A recommendation I have not seen is that all of these incidents should be studied from a prospective comprehensive psychiatric standpoint as they occur with no selection bias.  That study should include toxicology, detailed collateral information, analysis of available medical records, and post mortem analysis if relevant.

In choosing a reference (9) for international comparison of mass shooting phenomenon it is important to consider how the database is constructed. In choosing reference 9, the author described a clear rationale and methodology.  The basic criteria include an incident where there are at least 4 shooting deaths and the shooter is acting alone and not due to criminal or terroristic motivations. Since mass shootings in the US have been motivated by neither – there would be no equivalent comparison with incidents in the US. The author also compares the US to the 35 United Nations definition economically developed countries (see Supplement 1). The time frame of 1998-2019 was chosen.  On that basis half of the countries did not have a single mass shooting incident, ten had more than one, five had more than 20 fatalities, and the US had 12 times as many incidents as the country with the second most mass shootings. Much greater detail is included in the original reference.

I prepared two reference tables based on this data (click on either table for a better view).  The graphic at the top of this page does not include suicide and homicide rates for each country.  The table below includes both of these rates.  Data sources are referenced in the tables.  

 

The countries are arranged by defined daily doses (DDD) of antidepressant medications.  DDD is a World Health Organization (WHO) defined metric for medication utilization. It looks at the total amount of a defined class of medication using the Anatomic Therapeutic Chemical (ATC) classification based on the usual prescribed dose of medication. In that system antidepressants are listed as a class.  US data are highlighted in the table because they represent the focus of this post.

What are some likely and unlikely observations from the Table.  First, it is unlikely that antidepressant prescriptions are a proximate cause of mass shootings.  The countries bracketing the US in antidepressant utilization (Iceland and Portugal) each had no mass shooting during the period of interest (1999-2018).  Second, gun availability stands out as an obvious factor in mass shootings, gun related suicides, and gun related homicides.  Third, gun availability in the US (120.5 firearms per 100 person) nearly equals gun availability in every other country in the table (128.4 firearms per 100 persons).  Fourth, no country had homicide rates similar to the US, but 3 of the countries had similar suicide rates but much lower rates of gun suicides. The reference study looks at locations, relationships, and firearms as relevant points but no comments on mental illness or toxicology at the time of the incident. The author also points out that in many countries mass shootings trigger government intervention focused on decreasing the likelihood of future shootings.  Except for a time limited assault rifle ban that does not happen in the United States.  The gun regulatory landscape is headed in the opposite direction with a movement to permitless access to handguns.

In summary, the gun violence landscape in the United States is bleak. Despite rationalizations that this is really a mental illness or mental illness treatment problem there is no real supporting evidence, since the distribution of mental illnesses in the US is the same as comparable countries with no to few mass shootings. There is low quality evidence that mental illness may be a factor in 15-30% of incidents - but the only way to explain why that is a factor is those people have much easier access to firearms.  The overwhelming evidence is that this is a problem of gun extremism, gun access, and sociocultural factors like subcultural acceptable violence, media notoriety, and politically reinforced messaging about gun use. The only way to address the problem based on international examples is to decrease gun access.  That is unlikely as long as one major party and their appointed judges need to activate their base with false messaging and flood the country with easy to access firearms.  They bear the ultimate responsibility.

George Dawson, MD, DFAPA

 

Supplementary 1:  UN Classified Developed Countries (total of 36) for reference 3 in Table and reference 9 below:  Australia, Austria, Belgium, Bulgaria, Canada, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Japan, Latvia, Lithuania, Luxembourg, Malta, Netherlands, New Zealand, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland, United Kingdom, and the United States.

 

 References:

1:   Florido A, Summers J. By one measure, the U.S. has had a shooting on school grounds almost every day.  https://www.npr.org/2023/03/28/1166630346/by-one-measure-the-u-s-has-had-a-shooting-on-school-grounds-almost-every-day

2:  K-12 School Shooting Database:  https://k12ssdb.org/all-shootings

3:  Winter J.  After the Nashville shooting a faithless remedy for gun violence. New Yorker.  Amrch 29, 2023:  https://www.newyorker.com/news/daily-comment/after-the-nashville-school-shooting-a-faithless-remedy-for-gun-violence

4:  Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013. Int J Epidemiol. 2014 Apr;43(2):476-93. doi: 10.1093/ije/dyu038. Epub 2014 Mar 19. PMID: 24648481; PMCID: PMC3997379.

5:  Goldner EM, Hsu L, Waraich P, Somers JM. Prevalence and incidence studies of schizophrenic disorders: a systematic review of the literature. Can J Psychiatry. 2002 Nov;47(9):833-43. doi: 10.1177/070674370204700904. PMID: 12500753.

6:  Waraich P, Goldner EM, Somers JM, Hsu L. Prevalence and incidence studies of mood disorders: a systematic review of the literature. Can J Psychiatry. 2004 Feb;49(2):124-38. doi: 10.1177/070674370404900208. PMID: 15065747.

7:  Tardiff K, Marzuk PM, Leon AC. Role of antidepressants in murder and suicide. Am J Psychiatry. 2002 Jul;159(7):1248-9. doi: 10.1176/appi.ajp.159.7.1248. PMID: 12091219.

8:  Malphurs JE, Eisdorfer C, Cohen D. A comparison of antecedents of homicide-suicide and suicide in older married men. Am J Geriatr Psychiatry. 2001 Winter;9(1):49-57. PMID: 11156752.

9:  Silva JR. Global mass shootings: Comparing the United States against developed and developing countries. International Journal of Comparative and Applied Criminal Justice. 2022 Mar 21:1-24.

10: Treatment Advocacy Center.  Serious Mental Illness and Mass Homicide. June 2018,  https://www.treatmentadvocacycenter.org/key-issues/violence/3626-serious-mental-illness-and-mass-homicide

11:  Stone, M. F. (2015). Mass murder, mental illness, and men. Violence and Gender. 2015; 2, 51-86.

12:  Wikipedia.  Civilian number of guns per capita by country.  https://en.wikipedia.org/wiki/Estimated_number_of_civilian_guns_per_capita_by_country

 

 

 

Racism and gun violence both exist in an overtly gun extremist society: They cannot be explained away by mental illness.

I suppose I should have not been very shocked that a Wall Street Journal editorial this morning (1) chose to double down on both gun rights and the myth that racism is not a problem and had nothing to do with the recent mass shooting – while scapegoating both mental illness and the rationed system of mental health care that we have in this country.  For good measure he added another conservative agenda item - that there was also blame for the public health officials like Dr. Fauci for mismanaging the pandemic.  This post is to straighten all of that out.

Let me preface these remarks by saying that I have no information about the most recent mass shooting other than what is reported in the media.  The author of the editorial does not seem to either. What I do have is 22 years of experience in acute care psychiatry and involuntary care. That’s right – for 22 years I was one of the guys you would have to see if you were admitted to my hospital on a legal hold for behavior that involved threatening or harming other people or yourself.  That included all kinds of violence - homicide, suicide attempts and severe self injury, and violent confrontations/shoot outs with the police.  I had to evaluate the situation with the considerable assistance from my colleagues and decide if that person could be released or needed to be held for further assessment and treatment. People (including psychiatrists) like to summarize that situation by saying: “Nobody can predict future dangerousness” and that is certainly true. But we do pretty well in the short term (hours to days).  We also do well coming up with a plan to prevent future violence.

The details about the most recent mass shooting are still being reported at this time, but so far include interviews with the families of the victims, police reports, videos, and excerpts from a manifesto written by the perpetrator.  According to reports that manifesto discussed Replacement Theory as a potential motive for the mass shooting.  Replacement Theory is a white nationalist, far right ideology that claims non-whites are a threat to the white majority in several countries including the US. A corollary is that the Democrats are trying to get aligned with more non-white voters to develop more political power. This is the rationale currently given in the media for the actions of the mass shooter who scouted neighborhoods and said very explicitly in documents that his intent was to murder as many black people as possible. He had no difficulty obtaining firearms legally – even though he was detained and sent for an emergency evaluation a little less than a year earlier for stating “murder-suicide” in response to an online question about what he planned to do upon retirement.  Those details and his response talking about how he got out of it and continued to plan to kill people are at this link.  

As a psychiatrist and member of the American Psychiatric Association, I can’t speculate on the diagnosis of anyone who I have not personally assessed and if I did do an assessment – I would need a release from the person to discuss any details.  The editorialist is under no constraints speculating that “signals were missed” and that “psychotic young males whose outlet is killing” is not the object of his column.  Instead, he makes the claim that he is really concerned about the post pandemic mental illness and addiction trends in this country. He is apparently not consulting the correct sources about what has happened in this country in terms of mental health care before the pandemic.

I will start with his anchor point in the 1970s.  At about that time Len Stein, MD and coworkers invented Assertive Community Treatment and a number of additional innovative approaches that were focused on keeping people with severe mental illnesses in their own homes.  Dr. Stein was one of my mentors and in seminars he would show what Wisconsin state hospital wards used to look like. About a hundred patients in one large room with their cots edge-to-edge and all wearing hospital pajamas. By the time I was working with him in the 1980s, those folks were living independently supported by case management teams and psychiatrists. Dr. Stein and his colleagues also ran a community mental health center that included crisis intervention services and outreach. That model of community mental health and crisis intervention is still practiced and has been covered in the New England Journal of Medicine.  Psychiatric residents are still trained in community mental health settings and many prefer to practice there.  Counties are not as enthusiastic and have shut down many if not most community mental health centers.

Community psychiatry is an obvious 50-year-old solution but it has to be funded. The same is true of affordable housing.  In some cases that housing needs to be supervised and also a sober environment. Both community psychiatry and affordable housing are casualties of business rationing that can only occur with the full cooperation of both state and federal governments. The current system costs about a trillion dollars in overhead that is directed to Wall Street profits and unnecessary meddling by middle managers. The only people who “sweep mental health under the rug” are large healthcare organizations and state bureaucrats who disproportionately ration it.  The "science of mental health" is not difficult at all.  Being forced to do it for free is difficult.

The 1980s were a critical time in establishing the managed care industry and taking all healthcare out of the purview of physicians.  While rationing psychiatric resources was being ramped up, services to treat alcoholism and addiction were essentially demolished. Suddenly you could not longer get detoxification services at most hospitals.  People were sent to social detox units run by counties where there was no medical coverage.  The thinking was that if a person developed medical complications like seizures or delirium tremens they could always be sent back to the hospital. The biggest risk was continued substance use and immediate relapse. Residential and outpatient treatment facilities never materialized.  Inadequate funding was a significant problem.  The managed care industry played a role in that case as well with absurd expectations and limits on treatment.  It is no accident that treatment for substance use disorders basically became non-existent.  None of the disproportionate rationing of mental health or substance abuse treatment is new.  It has been like this for 30 years because it is the government endorsed model of care.  

Overall, this editorial is a smokescreen over the proximate issues of guns and racism.  The author trivializes this as political rhetoric when in fact the rhetoric has all been pro-guns and pro-white supremacy.  It is the only rational explanation for turning the United States into an armed camp that has progressively increased the likelihood of gun violence. We are not talking about a pandemic precipitated phenomenon.  The gun violence has been multi-year and the pro-gun party has “doubled down” on it to make it more likely.  As far as politics go – now that we know how a partisan Supreme Court works – the Heller decision and the resulting liberalization of gun ownership should not come as a surprise.  On the issue of hate crimes, I can’t really think of anything more relevant in a case based on the public disclosures.  This was a specific crime directed at black Americans intentionally perpetrated in a neighborhood that was scouted ahead of time for that ethnicity. Brushing that aside to claim that this is a response to an embarrassing record on mental illness, when there is no evidence that is a factor is disingenuous.

American history including other recent mass shootings tells us that racism can be a causative factor.  What is never addressed is the omnipresent gun culture in the USA.  People with an apparent need for military weapons and handguns and politicians willing to give them unlimited access to carrying them in public, carrying them without permits, and stand your ground laws - encouraging violent confrontations with firearms.  All fueled by one party and their affiliated special interests.

Disingenuous discourse and misinformation is what we typically see these days. If you want the facts about what needs to be there in terms of a functional mental health system (and I know there are absolutely no business people and very few politicians that do) – ask a psychiatrist. If you want to know about what gun control needs to be in effect rather than claiming that psychiatrists are not preventing gun violence from people with no mental illness – you can also ask me.

I could put all of those details on a 4” x 6” card and it would work. 

But there is certainly nobody on the right or at the WSJ who wants to know that either.

 

George Dawson, MD, DFAPA

 

References:

1:  Daniel Henninger. The Next Pandemic: Mental Illness.  Wall Street Journal. May 18, 2022.

Graphics Credit:  Eduardo Colon, MD

The Kenosha Trial

 

I watched the Rittenhouse trial closing arguments on 11/15/2021.  Let me preface these remarks by saying that this post is not a commentary on the guilt or innocence of the defendant.  It is not a commentary on his behavior, speech, or mental status.  It has absolutely nothing to do with psychiatric evaluation or treatment. This post is all about common sense and how that has been suspended in the United States - especially over the past 10-20 years.

This post is about open carry laws in the United States. Open carry laws make it possible for people to carry firearms publicly without risk of arrest or search for merely having possession of those firearms. The original intent of these laws was to reduce the risk to hunters and target shooters when they were transporting their firearms home.  There are still regulations in many states about how those firearms need to be transported but the original open carry laws were to make sure that there was not a problem carrying the firearms to the home where they would be stored.

Over the past 10 years, we have seen a striking change in how firearms are carried in public and it is the direct result of these open carry laws. The most striking change has been the appearance of heavily armed men open carrying military style semi-automatic rifles and handguns. They were also often wearing bullet proof vests, body armor, and helmets. In some cases, they were also disguised so that their facial appearance was obscured.  Some of these groups were self-identified as militias or paramilitary groups.  Militias always have a sacred role in firearm debates in the United States because when the Second Amendment was written and approved 230 years ago – this was the wording:

“A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.”

The Second Amendment is interpreted unambiguously by gun advocates as a Constitutional right to own firearms and the most open interpretation is firearms of any kind and as many firearms as a person wants.  The sheer number of firearms possessed by Americans is a matter of public record available in many places so I do not plan to repeat it here. Record gun violence in the United States is also a matter of public record due to suicides, homicides, and accidental deaths.  The United States also has record number of mass shootings each year that can also be found in the public record and I will not repeat it here.   

For now, I want to briefly focus on the concept of militia and the idea that it is well regulated.  Militias are defined as able bodied residents between the ages of 17 and 45 years old who can be called to defend a specific state or the United States.  Private militias acting outside of the federal code definition are illegal.  That includes all groups who are not called to duty by a state governor or the federal authorities.  Even if these groups appear to be uniformed and operating under some command structure, they are illegal organizations.  All 50 states prohibit private militias from doing what state authorized militias do.  They are also prohibited from engaging in paramilitary training and in some states brandishing firearms in a way that it could be construed as threatening. Apart from these laws about militias, states also have terroristic threat statutes, and statutes that restrict firearm access to anyone with a history of domestic violence. There is a patchwork of additional law regarding background checks, safe storage of firearms, and collecting statistic data on firearm violence.  There is a currently a loophole in background checks because unlicensed private gun sellers are exempt from conducting background checks on potential purchasers.    

For at least 20 years, gun advocates and lobbyists have pushed open carry and concealed carry laws to the point that they are both unnecessary and a threat to public safety. There is no better example than when groups of private militias or heavily armed private citizens show up at public events or protests. History illustrates that these events can lead to confrontations, injuries, and even deaths when they are managed by law enforcement or the state militia – the National Guard. Is it realistic to think that untrained private citizens or illegal militias will do a better job?  Is it reasonable to have open carry laws on the books so that these individuals or groups can potentially function in a number of ways that contradict other laws about assuming police functions or threatening other citizens?

The only logical conclusion you can come to is that both heavily armed private citizens or unregulated militias with a stated purpose of assuming the function of well regulated militias or law enforcement have no standing at all and are much more likely to add more heat than light to the situation.  They knew that in Tombstone, Arizona back in 1881, when they passed the ordinance at the top of this post. This ordinance (in one way or another) precipitated the Gunfight at the OK Corral. We need to recognize that heavily armed citizens roaming around in our communities is unnecessary and a recipe for disaster.  Open carry laws need to be rolled back to 1881 or about 130 years after the Second Amendment was passed.

I anticipate plenty of blowback about that opinion. My only goals are public health/public safety and preventing both unnecessary deaths and the kinds of confrontations that led to this trial in Kenosha. I also wanted to get this opinion out there before there was a verdict by the jury, because at that point those opinions on what happened will fall along partisan lines. Few people seem to recognize the seriousness of this issue – both in terms of the high personal and financial cost of gun violence – but also the destabilizing effect it has on the country.      

I also realize that there is a sense of hopelessness in the United States that we will ever have sensible firearm rules resulting in safer communities.  For a generation there has been a massive misinformation campaign about gun rights. It is possible to have a Second Amendment the way it is written and have safer communities.  Rolling back open carry laws is the place to start. 

 George Dawson, MD, DFAPA

 

References:

Transcript Prosecuting Attorney Closing Remarks

https://www.rev.com/blog/transcripts/kyle-rittenhouse-trial-prosecution-closing-statement-transcript

 

Transcript Defense Attorney Closing remarks

https://www.rev.com/blog/transcripts/kyle-rittenhouse-trial-defense-closing-statement-transcript

 

Supplementary 1: (posted on 11/19/2021 @ 12:49 PM):

I just saw the news that the defendant in this case was found not guilty on all charges.  Staying with the theme of this post that verdict is all the more reason why open carry laws need to be rolled back. I expect the usual posturing about the need for firearms to be used for self protection, but the public health issue remains - people bringing firearms to public gatherings or even to the local supermarket is a setup for violent confrontations and their outcomes. I encountered a statistic today that armed demonstrations are six times likely to turn violent than unarmed demonstrations.  If physicians and their professional organizations don't feel they can change the law - they can advocate for common sense measures and provide the supporting data.  Primary prevention of gun violence needs to start long before there are any court proceedings. 

Supplementary 2: 

I recalled today that I took an NRA Hunter's Safety Course when I was ten years old in a remote northern part of a state.  That course was taught by a military veteran who vetted us before we could even get in to the course.  He made us promise that we would no longer play with toy guns.  The main rule of the course was "Never point a gun at another person whether you think it is loaded or not."  Somewhere along the line that rule seems to have been lost by modern gun advocates.