gun violence


Rare Common Ground: Gun Dealers And Public Health Workers Unite To Cut Suicides

(Image taken, with permission, from a New Hampshire Firearm Safety Coalition poster)

(Image taken, with permission, from a New Hampshire Firearm Safety Coalition poster)

By Richard Knox

The elegantly dressed woman looked out of place at Riley’s Sport Shop, the largest gun dealer in New Hampshire. Owner Ralph Demicco was behind the counter. He noticed she didn’t make eye contact.

“I’d like to buy a gun,” she said. “Could I see that one?”

Demicco sensed something was amiss. “Should you really be buying a gun?” he asked.

She immediately broke into tears. “I took her into the backroom,” Demicco recalls. “She confided that she’d been released from the state mental hospital in Concord that morning. She said she told her doctor she wasn’t ready to go and if he discharged her she was going to take her life. Apparently he didn’t put any stock in that.”

Demicco asked the name of her psychiatrist, then told her to go home and wait for the doctor to call. Then he called the doctor, who intervened. It was a suicide that didn’t happen.

The incident stuck with Demicco. But it wasn’t until later that he realized that gun dealers could take more concerted action to prevent gun suicides — by far the nation’s leading cause of firearm fatalities. That came after a Dartmouth Medical School injury prevention researcher alerted him that three different customers had killed themselves in a single week within hours or days of buying their guns at Riley’s.

The partnership is a rare instance of common cause between gun enthusiasts and public health proponents, amid increasingly polarized public views.

“That was stunning,” Demicco says. He started meeting with the Dartmouth researcher and other gun retailers and health workers. They decided to create a group called the New Hampshire Firearms Safety Coalition. Their idea is catching on — in Massachusetts, Vermont, Maryland, New York, Virginia, Tennessee, Texas, Colorado, Utah, Nevada and California, according to Elaine Frank, chair of the New Hampshire coalition.

Frank is the Dartmouth injury-prevention specialist who alerted Demicco to the problem. Early on in the coalition’s work, a public health worker came to a meeting after talking to gun shop owners around the state. She expressed surprise they were so positive.

One of the gun dealers in the group said, “I could be insulted by that,” Frank recalls. “He said, ‘Why would you think we’d be less interested in suicide prevention than you are?’ It was absolutely an ‘aha!’ moment.”

The partnership is a rare instance of common cause between gun enthusiasts and public health proponents, amid increasingly polarized public views on how to reduce the nation’s death toll from firearms. It’s not embraced by all gun proponents; some fear it’s a stalking horse for more gun controls.

But it’s a real-life example of what President Obama and others are calling for: a public health approach to the nation’s gun violence crisis.

“The concept of collaboration, which is often lost, is very much alive in this area of suicide prevention,” says Bill Brassard, spokesman for the National Sport Shooting Foundation, which represents gun dealers.

A prominent gun control advocate at the Harvard H.T. Chan School of Public Health agrees. “What you want to do are the things that are easiest to do — the low-hanging fruit — and show we can work together,” says David Hemenway, author of “Private Guns, Public Health.” “It takes a long time to build trust. But this is happening.”

The payoff could be large — potentially bigger than gun control measures proposed to stem homicides.  Continue reading


Should The Pediatrician Talk To You About Gun Safety?

In 10 years of taking my kids to the pediatrician, I’ve never been asked if I have a gun in the house.

Maybe it’s because I live in Cambridge, where I’m pegged as a left-leaning, kale-consuming, hybrid-driving, yoga junkie (guilty!) whose world view does not include gun ownership. Still, as part of routine children and family health, I like the idea of pediatricians getting more involved in the debate about gun violence since they may be positioned to intervene before disaster strikes.



In a thoughtful piece in The New England Journal of Medicine, two local pediatricians, Judith Palfrey (Children’s Hospital Boston, Harvard Medical School) and Sean Palfrey (Boston Medical Center, Boston University School of Medicine) make an excellent case for why more doctors should actively consider the prevention of gun deaths in children. In their piece, they cite this 2012 American Academy of Pediatrics statement:

The American Academy of Pediatrics (AAP), recognizing all these vulnerabilities, declared in a policy statement on firearms in October 2012 that “the absence of guns from homes and communities is the most effective measure to prevent suicide, homicide, and unintentional injuries to children and adolescents.”

Causes of Death among Persons 1 to 24 years of age in the United States, 2010. Data are from the Centers for Disease Control and Prevention. (New England Journal of Medicine)

Causes of Death among Persons 1 to 24 years of age in the United States, 2010. Data are from the Centers for Disease Control and Prevention. (New England Journal of Medicine)

The Palfrey’s write:

In the early 1990s, there was a surge of violence and firearm-related deaths. The death rate was so high (nearly 28 of every 100,000 people 15 to 19 years of age)2 that pediatricians joined with other professionals (police officers, clergy, and educators) to find ways to combat the epidemic. Pediatricians began to address the protection of children from gun-related causes alongside the prevention of other types of injuries, poisonings, child abuse, lead toxicity, and infectious diseases.

Screening tools and basic interventions became routine practice through nationally accepted programs such as Connected Kids and Bright Futures. AAP guidelines recommend that when families report the presence of firearms in the house, pediatricians should counsel about gun removal and safety measures (gun locks and safe storage). One mother responded to routine screening questions asked by one of our colleagues, “Why, yes, I have a loaded gun in the drawer of my bedside table.” Until that moment, she had apparently never considered the risk to her child. Continue reading

Boston Medical Center Trauma Docs Speak Out On Gun Control

Boston Medical Center (Wikimedia Commons)

Boston Medical Center (Wikimedia Commons)

No one has a closer view of the tragedies wrought by gun violence than doctors at a place like Boston Medical Center, which has the busiest emergency and trauma service in New England. Today, as gun control is front and center on the national stage, a group of BMC emergency doctors posted an open letter on the new Boston Trauma blog. It reads in part:

As witnesses to the consequences of gun violence on a daily basis and in response to the recent horrific events of December 14th, we feel strongly that a frank discussion of the role of firearms in our society is overdue.

Trauma providers see injuries and deaths due to firearms first-hand. The 16-year-old who will never again move his lower extremities after being shot multiple times will never become a statistic worthy of the media’s attention; his future is limited and punctuated by further suffering due to his condition. Or the 20-year-old shot multiple times in the head whose mother does not recognize him due to the damage to his face as the trauma team fights to save his life. This young man dies despite the heroic efforts of every component of the medical community. Such people come to us on a daily basis and for each one that dies there are hundreds more who are forever altered by sublethal firearm injuries and who go unnoticed by society at-large.

Read the full post here. It concludes:

We do not want silence on our part to be interpreted as acceptance of the status quo. We insist on a meaningful discussion of the role of firearms in our society. We believe that military grade/assault type weapons and high-capacity ammunition clips that have the sole purpose of taking human life should have no role in a society at peace. The easy access to them by an individual represents an unnecessary and unacceptable threat to our society and to the individuals within it.

Approaching Gun Violence As A Public Health Problem

"Non-Violence sculpture by  Carl Fredrik Reuterswärd )Wikimedia Commons)

“Non-Violence sculpture by Carl Fredrik Reuterswärd (Wikimedia Commons)

I would certainly describe something that kills 30,000 Americans before their time every year as a public health problem, wouldn’t you?

So would three Harvard experts who argue in the Journal of the American Medical Association today that the best way to curb gun violence is to treat it as a public health challenge not unlike smoking or car accidents.

From the press release:

They offer more than a dozen recommendations, based on successful strategies used in other public health crises. For example, they suggest a new, substantial national tax on all firearms and ammunition, to more accurately reflect the true societal costs of gun ownership and to provide a stable revenue source to target gun violence prevention. Such a tax would function like the tobacco tax, which provides crucial funding for smoking prevention efforts.

Other “off-the-shelf” approaches to preventing gun violence can be borrowed from efforts used in the 1970s to prevent accidental poisonings, the authors say. In the case of potentially harmful drugs, child safety packaging was introduced. In the case of guns, a similar strategy would be the manufacture of “smart guns” with security codes or locking devices. Also, routine education and counseling by physicians and national networks for education and prevention helped significantly reduce childhood poisoning deaths; similar efforts could help curb gun-related deaths. Continue reading

Personal History: One Woman’s Lifetime Of Losses From Gun Violence

By Ilyse Levine-Kanji
Guest Contributor

“Nothing endures, not a tree, not love, not even a death by violence.” — John Knowles, A Separate Peace

When I first read that sentence in 8th grade English, my grandfather had been dead for about two years. I wondered about the validity of the sentence when I read it then. Thirty-five years later I know it’s not true. Violent deaths, and the survivors they leave in their wake, endure – painfully so.

Hans Wachtel, husband, father, grandfather, doctor, murder victim.  Dr. Wachtel is pictured here, in the 1970s, after delivering a colleague's baby. (Courtesy)

Hans Wachtel, husband, father, grandfather, doctor, murder victim. Dr. Wachtel is pictured here, in the 1970s, after delivering a colleague’s baby. (Courtesy)

My grandfather, Hans Wachtel, escaped from Nazi Germany and became an obstetrician-gynecologist in Chicago. He received a Bronze Star for his bravery as a medic in the United States Army during World War II and, according to my family, he was one of the first white doctors in the Chicago area to treat African-American patients after the War. My grandfather made a successful life for himself, his American-born wife, and their five children (2 of whom he adopted after their birth parents died).

In 1977 my grandfather suspected that one of the doctors in his OB-GYN practice was performing unnecessary Cesarean sections on low-income women in order to get more money from Medicaid. When my grandfather confronted the other doctor, the doctor hired two people who shot my grandfather as he got into his car one cold February morning on his way to work.

For $2,000 two men killed my wonderful grandfather — a heroic, generous man who truly loved his family, his patients and life. One of the killers gave my grandmother “the finger” when he was being led out of the courtroom during their trial. Since there was no death penalty in Illinois in 1977, the killers sit in prison to this day. Every couple of years the Illinois Prisoner Review Board holds a parole hearing – and we have to relive the grisly facts of the murder. Violent deaths certainly endure.

For $2,000 two men killed my wonderful grandfather — a heroic, generous man who truly loved his family, his patients and life. Violent deaths certainly endure.

As a child, I remember thinking that if only the two men “just” had knives, my 68-year-old grandfather, who seemed so big and strong, could have had a chance. Even though I’m much older now, I can still hold the same fantasy. In any event, I know he had absolutely no chance when he rolled down the car window to answer the strangers’ question and was shot with several bullets through his temple.

Time passed after my grandfather was murdered. Continue reading

After Shooting, Conversation Turns To Health Insurance


The heated debate over gun control following the July 20 movie-theatre massacre in Aurora, Colo. has quickly evolved into a discussion about health insurance. Kaiser Health News reports that some of the victims most seriously injured in the shooting rampage have no insurance coverage, so in addition to struggling for their physical lives, they are also fighting to pay their medical bills. Carol Eisenberg reports:

The most seriously wounded continue to fight for their lives and may face medical bills in the hundreds of thousands and even millions of dollars. Among them is 23-year-old Caleb Medley, who is in an induced coma after being shot in the head, and whose wife, Katie, gave birth to their first child last week. The couple has no health insurance, and their friends and family are raising money online to pay their medical bills.

Like Medley, many of the victims are between the ages of 19 and 34 – a group with a 28 percent uninsurance rate in Colorado, the highest among any age group, according to a 2011 survey by Calonge’s group.

Calonge notes that many young people are employed and have the opportunity to buy insurance through their jobs but decline coverage because they are making comparatively low salaries and see themselves as young and healthy.

“One of the things the tragedy points out is that assessment of risk isn’t always right,” he said.

…Some believe the discussion about the victims’ medical bills may change attitudes about the 2010 health care law. “It will make the issue of people without insurance suddenly needing care more vivid,” said Norman Ornstein, resident fellow at the conservative American Enterprise Institute.

Last week, in a column in The Boston Globe, John McDonough offered his own health insurance perspective to the Aurora story:

Here’s another thing you can do: remember, next time Mitt Romney talks about how he will “repeal and replace” the Affordable Care Act/ObamaCare (with no replacement in sight), that if fully implemented in 2014, the ACA guarantees that no American citizen will have to go through the second assault Caleb is now facing because of our nation’s despicable health insurance system. Continue reading