ABC News: Tulsa Shooter Battled Chronic Back Pain

[drusso]

Tulsa mass shooter allegedly gunned down his doctor after asking for help with pain

A patient gunned down his doctor and three other people in a mass shooting at a Tulsa, Oklahoma, medical building on Wednesday afternoon, according to police.

abcnews.go.com

"The suspect was released from the hospital on May 24, five days after his surgery, Franklin said. After his release, the suspect called several times over several days complaining of pain and wanting additional treatment, the chief said."

Tulsa gunman blamed doctor for back pain, police say

Most of the shooting occurred on the building’s second floor, and shots were still being fired when police entered the building, police said.

www.kxan.com

“We also have a letter on the suspect, which made it clear that he came in with the intent to kill Dr. Phillips and anyone who got in his way,” Franklin said. “He blamed Dr. Phillips for the ongoing pain following the surgery.”

Tulsa Hospital Shooter Targeted Doctor Over Alleged Pain From Surgery

The police said during a news conference that Michael Louis had a letter that said he intended to kill Dr. Preston Phillips and "anyone who stood in the way."

www.newsweek.com

"Police said that Louis wrote that he was suffering from pain and wasn't given relief. Louis was a patient who had recently underwent surgery and continued to complain about back pain that he was feeling afterward, Brian Dorman of CBS News tweeted."

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[lobelsteve]

New fusion guidelines will ask for weapons check? Anyone care to guess his PDMP and prior pain history?
I'm jumping to conclusions. 20/20 hindsight comes next week.

 

[myrandom2003]

Does mandatory requirement of weapons training infringe on the 2nd Amendment?
It does buy additional time before taking position of a firearm during which time any red flags can be addressed, such as comments made about harming someone. Military service exemption for evals and training.

Also...psych eval for stim trial/implant... no psych eval for weapons purchase.

 

[MitchLevi]

Does mandatory requirement of weapons training infringe on the 2nd Amendment?
It does buy additional time before taking position of a firearm during which time any red flags can be addressed, such as comments made about harming someone.

Who decides whether your trained up enough? What is the cost of that training? What are the minimum skills required?

Very tough questions to answer. I don't know personally.

 

[Ferrismonk]

Does mandatory requirement of weapons training infringe on the 2nd Amendment?
It does buy additional time before taking position of a firearm during which time any red flags can be addressed, such as comments made about harming someone. Military service exemption for evals and training.

Also...psych eval for stim trial/implant... no psych eval for weapons purchase.

and more importantly no psych eval prior to surgery for pain.

 

[Baron Samedi]

Military service exemption for evals and training.

Please no. There are so, so many people unsafe with firearms in the military -- I would be one of them without additional training.

We also have a suicide epidemic in the military, so if we are considering tightening policy to try and reduce this, I don't think military members should get an automatic pass. I have several patients with failed suicide attempts by firearm. Military members also disproportionately use firearms for suicide than the general population.

 

[MitchLevi]

and more importantly no psych eval prior to surgery for pain.

But you better get one for stim!

 

[Ferrismonk]

But you better get one for stim!

prior to stim TRIAL!

 

[ateria radicularis magna]

This doctor could have been any one of us.

 

[MitchLevi]

This doctor could have been any one of us.

I have a .45 on me.

 

[Baron Samedi]

I have a .45 Hesperia.

Against a man not afraid to die and weilding a semi automatic rifle in a crowded and hectic room filled with your own staff and patients.

 

[Gauss]

Franklin said Louis' wife confirmed with police that he blamed Phillips for his ongoing pain issues after being discharged May 24 following his surgery.

According to investigators, the 45-year-old purchased an AR-15-style rifle about one hour prior to the shooting from a local retailer, Franklin said. Louis bought the .40-caliber Smith & Wesson pistol used in the shootings on May 29 from an area pawn shop.
Louis reportedly had been seen by Phillips' office for a follow-up on his pain the day before the shooting.

Gunman bought rifle on the same day he killed 4 people, Tulsa police chief says

Two orthopedic surgeons, a medical officer staffer and a patient visitor were killed Wednesday on the campus of Saint Francis Health System in Tulsa.

tulsaworld.com

 

[Agast]

I have a .45 on me.

Dude had a rifle and the element of surprise. I don’t think you can defend against that. Maybe if someone else was the target and you’re nearby.

 

[drusso]

Against a man not afraid to die and weilding a semi automatic rifle in a crowded and hectic room filled with your own staff and patients.

Any experience with under-desk mounted holsters in the pain clinic?

forums.studentdoctor.net

 

[Baron Samedi]

Any experience with under-desk mounted holsters in the pain clinic?

forums.studentdoctor.net

Ha, I remember that thread.

Back to original topic, tragic situation and definitely could have been any of us. I have my own thoughts on what needs to be done but I'll keep them to myself. The whole topic hits a bit too close to home for me personally, so I'll just see myself out.

 

[ateria radicularis magna]

Empathize (or appear to).
Deescalate.
Have regular meetings with your staff about presenting an empathetic front.
Maybe have an “angry patient” protocol in which the patient is made to *feel* understood.
There’s really nothing else you can do. Even avoiding prescribing all opioids doesn’t totally protect you. You are a “pain doctor” or you are “my back doctor.”
Despite all precautions, I’m sure you will all remember multiple patients who made you very, very uncomfortable. This is part of the job, and yeah, it sucks. I have had multiple patients threaten to hurt me, and I like to think I’m a nice guy most of the time. Some people are crazy or so depressed or in pain that they don’t care about anything.

 

[myrandom2003]

Who decides whether your trained up enough? What is the cost of that training? What are the minimum skills required?

Very tough questions to answer. I don't know personally.

I would assume it is similar to a drivers license only without the test at the end.
make up some arbitrary rule similar to concealed carry permit training.
For example, 16 hours of weapons and safety training.


Honestly, these episodes may scare many straight prescribers of limited opioids from doing so at all.
My wife last night told me to just quit prescribing any sched2 meds. Send them elsewhere.

 

[Agast]

technically if your goal is to NOT get shot, you prescribe more pain meds not less.

Or don’t interact with anyone in pain….

 

[lobelsteve]

Does mandatory requirement of weapons training infringe on the 2nd Amendment?
It does buy additional time before taking position of a firearm during which time any red flags can be addressed, such as comments made about harming someone. Military service exemption for evals and training.

Also...psych eval for stim trial/implant... no psych eval for weapons purchase.

Few would argue against universal background checks, 21-30day waiting period, training (and/or licensure). I'd buy insurance for owning a firearm and no reason it is not mandatory.

 

[MitchLevi]

Against a man not afraid to die and weilding a semi automatic rifle in a crowded and hectic room filled with your own staff and patients.

Dude...Not gonna debate you my credentials with a weapon in a combat environment.

To get to me he has to pass through a chokepoint that would alert me to the threat.

I could die...Yes. It is unlikely I don't kill him.

What are my other options?

 

[Pain Applicant1]

Ha, I remember that thread.

Back to original topic, tragic situation and definitely could have been any of us. I have my own thoughts on what needs to be done but I'll keep them to myself. The whole topic hits a bit too close to home for me personally, so I'll just see myself out.

That's really too bad. From what you wrote, I'd be very interested in hearing about your experiences and your thoughts on this issue but no pressure, I completely understand if you choose not to further discuss things for whatever reason.

 

[GoBeers]

Empathize (or appear to).
Deescalate.
Have regular meetings with your staff about presenting an empathetic front.
Maybe have an “angry patient” protocol in which the patient is made to *feel* understood.
There’s really nothing else you can do. Even avoiding prescribing all opioids doesn’t totally protect you. You are a “pain doctor” or you are “my back doctor.”
Despite all precautions, I’m sure you will all remember multiple patients who made you very, very uncomfortable. This is part of the job, and yeah, it sucks. I have had multiple patients threaten to hurt me, and I like to think I’m a nice guy most of the time. Some people are crazy or so depressed or in pain that they don’t care about anything.

ya. remember the ortho surgeon couple years ago who got murdered in the parking lot after he didn't want to prescribe opioids to a patient on the initial consult visit? so sad

 

[myrandom2003]

California school shooting foiled

Police arrest 16-year-old after tip he was recruiting students for California mass shooting

A California 16-year-old's thwarted plan for a mass school shooting comes just a week after the deadliest U.S. grade school shooting in Uvalde, Texas.

www.yahoo.com

 

[Ducttape]

Few would argue against universal background checks, 21-30day waiting period, training (and/or licensure). I'd buy insurance for owning a firearm and no reason it is not mandatory.

but many would argue against background checks. just look at HR 8 and the US senate. here are some that are adamantly opposed.

John Barasso
Roy Blount
Ted Cruz
Lindsay Graham
Bill Hagerty
Josh Hawley
James Lankford
Cynthia Lummis
Mike Rounds
Rick Scott
Richard Shelby
Tommy Tuberville
Roger Wicker

31 other Senators "declined to respond".

 

[lobelsteve]

but many would argue against background checks. just look at HR 8 and the US senate. here are some that are adamantly opposed.

John Barasso
Roy Blount
Ted Cruz
Lindsay Graham
Bill Hagerty
Josh Hawley
James Lankford
Cynthia Lummis
Mike Rounds
Rick Scott
Richard Shelby
Tommy Tuberville
Roger Wicker

31 other Senators "declined to respond".

8 pages in total. I'd like to know what any of these folks is objecting to.

https://www.congress.gov/117/bills/hr8/BILLS-117hr8pcs.pdf

 

[Ducttape]

Dude...Not gonna debate you my credentials with a weapon in a combat environment.

To get to me he has to pass through a chokepoint that would alert me to the threat.

I could die...Yes. It is unlikely I don't kill him.

What are my other options?

he killed himself after. that gun of yours wouldnt do anything that he didnt already have in mind. your staff and those prior to the chokepoint might be construed as being expendable as they dont have the protection of your gun....

what options do we all have?

systematic change in how US society looks at guns and gun regulation, control, red flag laws, cooldown period, gun registration, get rid of assault rifles, ammo limitation

yes. cut out the anti-American anti-2nd Amendment speech....

 

[MitchLevi]

he killed himself after. that gun of yours wouldnt do anything that he didnt already have in mind. your staff and those prior to the chokepoint might be construed as being expendable as they dont have the protection of your gun....

what options do we all have?

systematic change in how US society looks at guns and gun regulation, control, red flag laws, cooldown period, gun registration, get rid of assault rifles, ammo limitation

yes. cut out the anti-American anti-2nd Amendment speech....

You're wrong. At least two lives would more than likely have been saved.

 

[Pain Applicant1]

he killed himself after. that gun of yours wouldnt do anything that he didnt already have in mind. your staff and those prior to the chokepoint might be construed as being expendable as they dont have the protection of your gun....

what options do we all have?

systematic change in how US society looks at guns and gun regulation, control, red flag laws, cooldown period, gun registration, get rid of assault rifles, ammo limitation

yes. cut out the anti-American anti-2nd Amendment speech....

Just arm everyone or increase the price of bullets. Chris Rock is right.

 

[mid|ine]

Few would argue against universal background checks, 21-30day waiting period, training (and/or licensure). I'd buy insurance for owning a firearm and no reason it is not mandatory.

I can think of at least 50 people that would argue against these common sense items...

 

[myrandom2003]

This is perfect!! Just apply a significant tax on guns and per bullet.

 

[Gauss]

Few would argue against universal background checks, 21-30day waiting period, training (and/or licensure). I'd buy insurance for owning a firearm and no reason it is not mandatory.

Florida three weeks to the day after the shooting, Scott signed into law the Marjory Stoneman Douglas High School Public Safety Act

• Minimum age to purchase a gun: The bill raises the minimum age to purchase a long gun to 21. The minimum age was 18. The federal minimum age to purchase a shotgun or rifle is 18.
• Waiting period: To purchase a gun, you must wait three days or until a background check is completed, whichever is longer. Exceptions to the three-day waiting period include licensed hunters and licensed concealed carriers, police officers and military members.
• Ban bump stocks: Bump stocks, devices that attach to rifles that can make it easier to fire a weapon faster, are banned in the state. The National Rifle Association endorses a national ban on bump stocks.
• Extreme Risk protection order: Law enforcement agencies will be able to petition a court for a temporary order that stops a person from purchasing or possessing firearms. The orders will be sought only when a person demonstrates behaviors that pose a significant danger to themselves or others.
• Baker Act measures: If a law enforcement officer takes a person into custody for an involuntary examination under the Baker Act, the officer may to seize and hold a firearm or ammunition in the person's possession and seek the voluntary surrender of other firearms or ammunition kept in the residence. Those seized firearms and that ammunition must be available for return no longer than 24 hours after the person taken into custody can document that he or she is no longer subject to involuntary examination and has been released or discharged from any inpatient or involuntary outpatient treatment provided or ordered.
• Mental competency: The law prohibits a person who has been judged "mentally defective" or who has been committed to a mental institution from owning or possessing a firearm until a court orders otherwise.
• School "guardian" program: Allow school superintendents and country sheriffs to arm school personnel under a voluntary program wherein certain employees — librarians, guidance counselors, and coaches, but not full-time classroom teachers — could be trained and allowed to carry guns on campus.
• Safe-school officer: Requires each district school board and school district superintendent to cooperate with law enforcement agencies to assign one or more safe-school officers at each school facility.

 

[Doctodd]

This is perfect!! Just apply a significant tax on guns and per bullet.

Do most criminals buy guns legally? This is a good way to deter law abiding citizens from buying a gun though.

Here’s the alternative….i didn’t see this on the news much/at all.

Police: Woman killed man who fired rifle into party crowd

Authorities say a woman in West Virginia fatally shot a man who began firing an AR-15-style rifle into a crowd of people at a party

abcnews.go.com

 

[MitchLevi]

Do most criminals buy guns legally? This is a good way to deter law abiding citizens from buying a gun though.

Here’s the alternative….i didn’t see this on the news much/at all.

Police: Woman killed man who fired rifle into party crowd

Authorities say a woman in West Virginia fatally shot a man who began firing an AR-15-style rifle into a crowd of people at a party

abcnews.go.com

These types of things happen not infrequently, and this woman is no high level gun fighter.

 

[ateria radicularis magna]

Do most criminals buy guns legally? This is a good way to deter law abiding citizens from buying a gun though.

Here’s the alternative….i didn’t see this on the news much/at all.

Police: Woman killed man who fired rifle into party crowd

Authorities say a woman in West Virginia fatally shot a man who began firing an AR-15-style rifle into a crowd of people at a party

abcnews.go.com

Do you believe your 18 year old self and all your 18 year old law abiding acquaintances had the maturity to obtain an AR at any given moment ?

 

[lobelsteve]

Do you believe your 18 year old self and all your 18 year old law abiding acquaintances had the maturity to obtain an AR at any given moment ?

I did not. But at 21 I went to a cool summer camp where I was handed an M16A2 Assault Rifle to use for 6 weeks. Training provided. Camp Quantico. Made me decide to go to medical school and not Pensacola first.

 

[Agast]

Do most criminals buy guns legally? This is a good way to deter law abiding citizens from buying a gun though.

Here’s the alternative….i didn’t see this on the news much/at all.

Police: Woman killed man who fired rifle into party crowd

Authorities say a woman in West Virginia fatally shot a man who began firing an AR-15-style rifle into a crowd of people at a party

abcnews.go.com

Also an alternative:

Man shoots himself after taking gun on Texas elementary school campus, police say

The man with the concealed weapon shot himself in the leg and was taken to the hospital for treatment.

www.wkyt.com

I’m guessing after Uvale this man fancied himself a Good Guy with a Gun and brought his concealed weapon into a gun free zone. And couldn’t stop fiddling with it daydreaming his fantasy of being bad@ss vigilante.

 

[GoBeers]

Also an alternative:

Man shoots himself after taking gun on Texas elementary school campus, police say

The man with the concealed weapon shot himself in the leg and was taken to the hospital for treatment.

www.wkyt.com

I’m guessing after Uvale this man fancied himself a Good Guy with a Gun and brought his concealed weapon into a gun free zone. And couldn’t stop fiddling with it daydreaming his fantasy of being bad@ss vigilante.

ya... and to arm teachers is going be the genius idea to save the children.

can you imagine your Teach for America classmates in college wielding guns in class? lol

 

[allantois]

he killed himself after. that gun of yours wouldnt do anything that he didnt already have in mind. your staff and those prior to the chokepoint might be construed as being expendable as they dont have the protection of your gun....

what options do we all have?

systematic change in how US society looks at guns and gun regulation, control, red flag laws, cooldown period, gun registration, get rid of assault rifles, ammo limitation

yes. cut out the anti-American anti-2nd Amendment speech....

You forgot to add how we view pain as a society; perhaps decriminalizing all drugs would help too.. if they want their opioids.. let them get them on the street

 

[allantois]

Baker Act measures: If a law enforcement officer takes a person into custody for an involuntary examination under the Baker Act, the officer may to seize and hold a firearm or ammunition in the person's possession and seek the voluntary surrender of other firearms or ammunition kept in the residence. Those seized firearms and that ammunition must be available for return no longer than 24 hours after the person taken into custody can document that he or she is no longer subject to involuntary examination and has been released or discharged from any inpatient or involuntary outpatient treatment provided or ordered.
Mental competency: The law prohibits a person who has been judged "mentally defective" or who has been committed to a mental institution from owning or possessing a firearm until a court orders otherwise.

Do you know how involuntary commitment works? Someone discharged from a psychiatric facility is by definition no longer subject to involuntary examination. Anyone can Baker Act anyone in Florida. What is the point of seizing firearms from someone for the duration of their stay in a psychiatric facility and then returning it to them? This just goes to perpetrate the myth that mental illness leads to mass shootings. What does mentally defective even mean?

 

[allantois]

ya... and to arm teachers is going be the genius idea to save the children.

can you imagine your Teach for America classmates in college wielding guns in class? lol

They can't stock classrooms with pens and paper, but they are gonna arm 4 million teachers. Also, who is to say that all 4 million teachers are mentally stable and physically fit to shoot a firearm? What kind of society do we even live in that kids have to go to school where teachers are armed??

 

[SSdoc33]

Few would argue against universal background checks, 21-30day waiting period, training (and/or licensure). I'd buy insurance for owning a firearm and no reason it is not mandatory.

few.... except EVERY republican in the senate.

if you really care about this issue, vote them out


btw, I responded to this before I saw everyone else say the same thing. still leaving it up there.

 

[bedrock]

Update on story indicates the gunman patient was in the hospital for 5 days and then released on May 24. That sounds like spinal fusion.

Also sounds like someone without good post operative pain control to be there for so long. Possibly already opioid tolerant.

Unclear how much of this was a crazy patient vs a somewhat unstable patient + spine surgeon with rigid post pain control.

One of our local spine surgeons provides 35 Norco after a lumbar fusion, no exceptions. After that 35 norco, no more opioids unless they require another surgery.

 

[SSdoc33]

im pretty sure mitch and baron both have military backgrounds. if you want to compare "ego" sizes, please PM each other

 

[Agast]

This being Oklahoma, I really doubt the spine surgeon was /that/ rigid with postop meds 1 week after discharge from a spinal fusion. And the guy wasn’t on a walker or driving restrictions so couldn’t have been that big a surgery.

 

[bedrock]

few.... except EVERY republican in the senate.

if you really care about this issue, vote them out


btw, I responded to this before I saw everyone else say the same thing. still leaving it up there.

You saw what I posted on the private forum regarding sensible gun control. I’m all for it as are most Independents.

However, I am terrified of voting democrat for any national office out of fear they will do what Biden and congress did the last 2 years, which is to pretend to be moderate during their political campaign, and but then govern hard left wing, like the hardcore socialists most modern democrats have become.

Build back better is a joke. Also the covid relief program to handout Trillions of dollars to people causes serious inflation, which I learned in high school economics, but the democratic elites think they are smarter than facts. Our allies also don't trust us after we sprinted out of Afghanistan without a plan.

I'm so grateful for Joe Manchin or our country would be even worse shape from Biden and the democrats.

I'm not happy about public shootings, but nothing is worse than handing full control of the government to democrats. The entire US would be run into the ground like California.

I would vote for Manchin, Sinema, Romney, Collins, Murkowski. They aren't unthinking robots who vote the way their political overlords order them but instead look at the big picture and the truth on both the left and right political spectrum and vote accordingly.

 

[SSdoc33]

You saw what I posted on the private forum regarding sensible gun control. I’m all for it as are most Independents.

However, I am terrified of voting democrat for any national office out of fear they will do what Biden and congress did the last 2 years, which is to pretend to be moderate during their political campaign, and but then govern hard left wing, like the hardcore socialists they are.

Build back better is a joke. Also the covid relief program to handout Trillions of dollars to people causes serious inflation, which I learned in high school economics, but the democratic elites think they are smarter than facts. Our allies also don't trust us after we sprinted out of Afghanistan without a plan.

I'm so grateful for Joe Manchin or our country would be even worse shape from Biden and the democrats.

I'm not happy about public shootings, but nothing is worse than handing full control of the government to democrats. The entire US would be run into the ground like California.

I would vote for Manchin, Sinema, Romney, Collins, Murkowski. They aren't unthinking robots who vote the way their political overlords order them but instead look at the big picture and the truth on both the left and right political spectrum.

I appreciate you comments re: gun control.

America desperately needs a third/centrist party a 'la Macron in france.

You either vote for DJT and get that dumpster fire and possibly a dictator, or vote for Biden and get what we have now. I dont think the right nor the left are happy now

 

[bedrock]

I appreciate you comments re: gun control.

America desperately needs a third/centrist party a 'la Macron in france.

You either vote for DJT and get that dumpster fire and possibly a dictator, or vote for Biden and get what we have now. I dont think the right nor the left are happy now

Agree. America desperately needs a third party.

There is a reason there are more Independents in America than any other political group.

------The majority of the country isn't happy with GOP or dems.

 

[Baron Samedi]

im pretty sure mitch and baron both have military backgrounds. if you want to compare dick sizes, please PM each other

That's going to be a thanks, but no thanks from me. I'm sure he did much cooler **** than I have, not trying to argue that. I try to only ever mention it if I'm asked or if it's relevant to the discussion.

 

[SSdoc33]

That's going to be a thanks, but no thanks from me. I'm sure he did much cooler **** than I have, not trying to argue that. I try to only ever mention it if I'm asked or if it's relevant to the discussion.

Ive noticed. Others arent as 'discrete'

 

[Doctodd]

funny how there's only one guy here thinking about dick sizes.....but i digress

The US wants to arm Ukrainians....but they want to disarm Russia. They also want to disarm the law abiding American Citizen. And today the Democrats decided to push through a gun grab when they know they will get voted out in November.

Also an alternative:

Man shoots himself after taking gun on Texas elementary school campus, police say

The man with the concealed weapon shot himself in the leg and was taken to the hospital for treatment.

www.wkyt.com

I’m guessing after Uvale this man fancied himself a Good Guy with a Gun and brought his concealed weapon into a gun free zone. And couldn’t stop fiddling with it daydreaming his fantasy of being bad@ss vigilante.

do you want to ban cars too?

Do you believe your 18 year old self and all your 18 year old law abiding acquaintances had the maturity to obtain an AR at any given moment ?

Maybe not in a blue state where parents are more concerned with gender identity, but in the rest of the country it's pretty normal to train your kids to use a gun, starting from a Daisy rifle and progressing.

Id also like to know how the 18 y/o bought about $9000 worth of guns and magazines and ammo from a Wendys job?