Do GSWs change you?

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kwooder

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This is something I have been wondering.

Does working with GSW change your attitudes and beliefs about guns. Anyone's love for hunting, shooting, etc change because of your experience with trauma?

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Originally posted by kwooder
This is something I have been wondering.

Does working with GSW change your attitudes and beliefs about guns. Anyone's love for hunting, shooting, etc change because of your experience with trauma?

Nope, I still believe gun control should be limited to hitting what you aim at. That said, I suppose after seeing lots of GSWs, I know I don't ever want to be shot, so maybe I'm more careful with my own weapons and secureing weapons on scene. Of course, given that I've worn a bullet-proof vest for a living so my views are a bit skewed.

- H
 
I'll be installing trigger locks on my firearms as soon as my kids are old enough to pull a trigger. And my kids won't know where the keys are. But no, I'm no less hesitant to shoot an intruder/moose/duck/ etc. Firearms are an efficient way to kill something, much better than running their head through the windshield and tossing them 100 feet in the air only to slam into a tree. Its messy I tell you....all those CT scans....all those people. Better to just have a nice clean gunshot. (Besides, you all know from working trauma that it takes twice as long to dictate an MVA as a GSW.)
 
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I never met as many hunters as I have rotating through ED's. Well, besides working in a redneck mom-n-pop appliance store in the bible belt. I do think working trauma helps you respect guns more, but anyone smart enough to be a doctor should respect guns already.
 
On a side note, what do you think about the assault rifle ban?

I find it quite ridiculous. All I want is a friggin bayonetted AR-15. Just kidding, but when I get one, I would like to have a collapsable stock.
 
What a fascinating discussion. "I have seen much by the way of trauma and I find that guns are the most efficent"

I cannot believe how backwards some of you sound, I almost wish it was tounge in cheek. Alas I an quite sure that it is not and some of you actually believe what you wrote.

Sad sad sad comming from a group of future/current physicians.
 
Originally posted by orthoguy


I cannot believe how backwards some of you sound

I don't think it sounds like backwardedness, it's more like the jadedness that is so common. The cruel reality of medicine is only coped with by a sort of aloofness among those who understand. I not one of those yet.
 
There is a large difference between a jaded physician who is hardened by all he/she sees and one who advocates for a dated backwards philosohphy that grows into a public health burden (which the individuals above seem to do).

Emergency medicine physicians who advocate for gun ownership are akin to endocrinologists who tell their diabetic patients to eat more Twix bars.
 
That is a good point. I'm just really big on education and respect for firearms, just like automobiles. Privilege, not Right.
 
Originally posted by orthoguy
There is a large difference between a jaded physician who is hardened by all he/she sees and one who advocates for a dated backwards philosohphy that grows into a public health burden (which the individuals above seem to do).

Emergency medicine physicians who advocate for gun ownership are akin to endocrinologists who tell their diabetic patients to eat more Twix bars.

I disagree. One, it seemed to me that the individuals saying they had guns, used them for hunting. They didn't seem to be advocating indiduals run outside and buy up guns and shoot up other people.

Two, there was an element of tongue in cheek, which may seem callous but is also a mature coping mechanism to a lot of the bad crap that one sees in the ER. But this is a select forum and I don't find them that offensive. but this is me

Third, your assumption that because someone supports the individual right to own a weapon means they are callous and insensitive seems reactionary and shows an illogical leap.

I, personally, don't own a gun and can't imagine every having one. However, my father (an ortho is he callous and uncaring because he owns guns?) and brothers all own guns to hunt with and occasionally target shoot.

The problem with GSW in the ER is not a problem simply of guns being available. (unfortunately, I don't think the problem is that simple) It is a complex problem of financial, societal and cultural issues.

I agree that individuals have no need for automatic weapons, but I am also not going to say that individuals should not own guns to hunt with either.
 
Orthoguy,

I am not usually one to voice my opinion so loudly, but I believe that you may be somewhat off base by your rebuttal and position on EM, gun ownership, and the "sad" future of medicine you allude to.

1) Hand guns are without a doubt the most easily accessible and "potent" form of morbidity and mortality that can be purchased by the public. I am sure you will agree with this, however, in a sense, they are very similar to the second most potent and accessible form of mortality and morbidity the public can purchase - the automobile, which as an orthopedist I am sure you are well familiar with. Just as the wheel of a car is dependent upon the person who sits behind it, the trigger of a pistol, rifle, or high powered assault rifle will find prey only when guided by the person pulling it. From that standpoint, I believe that society should be held accountable for their own actions, and as physicians we should do our jobs of providing medical care (which undoubtedly everyone on this post does and will do), and reserve our opinions of right versus wrong for our own actions in and out of the ED, floor, or OR.

2) As for a public health burden, I believe you are right in your position to allude to diabetes and endocrinologists advocating higher sugar intake - just as most major hospitals across the country have permitted the construction of McDonald's, Taco Bell, Burger King, etc within their hospital grounds. I suppose the Ray Kroc chest pain center or the Dave Thomas Cardiac Cath Wing would be appropriate construction possibilites, akin to the Smith and Wesson General Surgery Suite or the Ruger Rehabilitation Center. - Before you generalize a subset of physicians and future physicians, please try to relate the larger current picture (and think about being "jaded" each time you stop at a large hospital cafeteria between your cases)

3)As for your specialty - I have witnessed and worked with many "tongue and cheek" viewpoints within the orthopedic community, especially while standing through a 10 hour tib/fib reconstruction piecing together over 20 individual fragments of bone. Not to speak specifics, but there were many comments akin to the "efficiency" of gunshot wounds while the 32 year-old MVC patient was receiving his ORIF. To this day I don't generalize or carry ill-will toward the Orthopedic community for those comments, albeit they may have been made by hardened surgeons.

It is easy to confuse the "Jaded viewpoint" from the advocation of a dated, backward philosophy - especially when the climate of current academic medicine may to some extent foster these beliefs. However, I think it would be better viewed as a reasonable position by those who are exposed to the "Front lines" of these types of injuries as legislation after legislation to permit gun ownership are renewed, increases in the national speed limit are passed, the battle over obesity and diabetes becomes more ineffective, and the desire to become a physician begins to be more in line with our country's need for physicians (which to date it is far from doing).

I do not intend to open can of moral and legal worms, just to clarify a position and defend my position since I may fall into the category of a "sad" future physician. I own a handgun and a rifle, and I am TRAINED to do so - does that make me an advocate for firearms? I would argue that if that is such the case, then I am also an advocate for foreign automobiles because I drive one, for high fat foods and poor diabetic control because I occasionally eat a piece of pizza, and that as the future of medicine, I am a bad role model for the future of our career. Gee - I guess I'll be a bad doctor too.
 
First off......guns don't kill people......people kill people. When was the last time that a gun "spontaneously fired?"

Banning guns because people using them may kill someone is like banning driving because a someone driving may kill someone.

Just my 2 cents
 
Good and basic point that lawmakers ignore. I love guns. They are part of our history and a fun activity. I would even be for smart gun control. I can live with the laws that make sense. I think 10 rounds in a handgun magazine will let me defend my household (I may have to perform a tactical reload during) and it just means a little more effort on the range. I don't need a grenade launcher or a sound supressor either, these things should be regulated.

Other things, like the length of a barrel, capacity for a bayonet and pistol grip (all things strictly regulated by the assault rifle ban) don't make the gun more lethal. The operator makes it lethal.

I just want smart laws that aren't just scare tactics to the general public who don't know the facts. (murder by bayonet on assault rifle = non existent).

My three cents.
 
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The above 2 individuals who compare guns to cars because both can be used to kill people have missed a very large point and that is in the intent of the manufacturing and the ease at which it can be used to violently take a life. I will not address the *****ic "guns do not kill people" nonsense.

That being said I had no idea what a vocal NRA membership the SDN had.
 
Originally posted by orthoguy
What a fascinating discussion. "I have seen much by the way of trauma and I find that guns are the most efficent"

I cannot believe how backwards some of you sound, I almost wish it was tounge in cheek. Alas I an quite sure that it is not and some of you actually believe what you wrote.

Sad sad sad comming from a group of future/current physicians.


Yawn...


I've seen GSWs change lots of people. Some rather dramatically.;)
 
Having been a firefighter, EMT, ER Tech, volunteer and med student on my way to becoming an ER doc I've worked in communities and EDs in many states and regions for about 15 years including north Philly. I've seen lots of GSW. I personally have never seen an innocent bystander victim of gun violence. I'm sure they're out there but I've never seen it. I've seen people shot by other dealers, shot by someone they were robbing, shot by someone whose spouse/girl or boyfriend they were doing, shot themselves, shot by cops and shot just for hanging out on the street with all thier gang buddies while dressed in gang colors from head to toe ("Don't cut my jacket!"). But they always had a part in the situation. I'm not saying that the innocent don't exist. I just haven't seen them and it's not for a lack of looking.
 
No point missed Orthoguy - just a comparison being made by two potentially lethal objects available for purchase, irrespective of their intent for manufacture. Lethality is in the hands of the person holding its potential - other than accidents (both car and gun alike), please enligten us how else guns kill if not in the hands of a person intent to do so. NRA membership? While it is evident that you are against gun ownership, you seem to miss the point that the majority of those who have posted in this thread have not commented on their stance on gun ownership or the NRA. I don't belong to the NRA - please don't lump me in with your opposition to our freedoms.

I do not mean to offend or encourage arguement, but I believe the focus of this thread has shifted drastically from its initial topic.
 
Originally posted by NinerNiner999


I do not mean to offend or encourage arguement, but I believe the focus of this thread has shifted drastically from its initial topic.

Maybe we should broaden the original question to include Motorcycles, horses, anything that might land a someone in the ED because of accident, misuse etc.

Because you've seen one too many motorcycle accidents, will you never own a motorcycle?
 
Originally posted by Apollyon
"Orthoguy" has been beaten up in other forums, and apparently has hijacked the account of someone else. Don't let these tools muck up our forum with people trolling.
I fully agree. I don't understand why this person isn't banned for using someone else's ID. This hijacking happens to every single thread s/he posts in.
 
Originally posted by Sessamoid
I fully agree. I don't understand why this person isn't banned for using someone else's ID. This hijacking happens to every single thread s/he posts in.

Get over it.

Besides I did not hijack the thread, my posts spoke to the original post and its replies. You however have hijacked the thread by attempting to turn this into a discussion about me.
 
If we really want to decrease the "public health burden" we should do something about the greatest scourge facing our nation today, an enemy we have all heard of but rarely seen, the cause of more morbitity and mortality than Twix, guns and '78 Gremlins combined...

Yes Ladies and Gentlemen...

We must ban "THESE TWO DUDES"
 
Originally posted by EMRaiden
If we really want to decrease the "public health burden" we should do something about the greatest scourge facing our nation today, an enemy we have all heard of but rarely seen, the cause of more morbitity and mortality than Twix, guns and '78 Gremlins combined...

Yes Ladies and Gentlemen...

We must ban "THESE TWO DUDES"

There was a study published the other day in the journal Trauma that basically stated that, unless we get control over this major public health issue, we are likely to see "these three dudes" by early 2006 with projections of "these four" and possibly "these five dudes" by early 2010 or 2011. We need to set a goal of reducing "these two dudes" to "this one dude" by late 2005 if we are to have any chance.

Bush needs to come out with a "Two Dudes" left behind initiative.
 
Originally posted by kwooder
This is something I have been wondering.

Does working with GSW change your attitudes and beliefs about guns. Anyone's love for hunting, shooting, etc change because of your experience with trauma?

Nope! Criminals will always find a gun and use it in a way that is against the law. I'll be damned if I'll let the governemt not allow me to carry a gun. Then only the victims will not be armed. We have the right to protect ourselves (believe it or not it is your responsibility, the government is just nice enough to provide an agency to help)

Plus, Knives kill more people every year than guns!
 
Originally posted by EMRaiden
We must ban "THESE TWO DUDES"
My city and county are facing serious budget shortfalls, and unless we can get some funding from somewhere, the after-school activities programs will be cut. Just think of the potential for disaster: all those teenagers, out there on the streets...

MINDING THEIR OWN BUSINESS!

Especially if these two dudes are out there, it's just not going to be pretty.
 
Originally posted by edinOH


Bush needs to come out with a "Two Dudes" left behind initiative.

Pardon my ignorance, but please explain what Two Dudes means.
 
I love guns, I was raised in the south, and hunting and sport-shooting (aka target practice) are a part of my heritage and culture. So, naturally, I will definately defend our right to have firearms.

However, I think automatic weapons are unecessary for the general public, and they should remain illegal for those outside of law enforcement and the military. That being said, what difference does it make if my hunting rifle is an AR-15, which shoots a single round at a time, or a .22 bolt-action, which also shoots a single round at a time?

Either gun, in the hands of someone determined to do harm with it, will still do harm.

But the point I don't see spoken of very often is the fact that the right to bear arms is part of the Bill of Rights. I personally hold the belief that any ammendment in the Bill of Rights is immune from repeal, since the Bill of Rights was necessary for our Constitution to be ratified in the first place. If you had removed even one of those points, then the Constitution would never have been ratified, and the US would not exist in the form we know it today, or for the last 200+ years. You can limit certain aspects of gun ownership and use (as with automatic weapons, etc.), but I believe that is as far as you can go without threatening the very foundation of the United States.

This may seem sensationalistic, but please believe that I am not being argumentative, I am merely poiting out that our country was founded in part dependant upon the very belief that we as citizens must have the right and ability to protect ourselves, from those individuals who would wish to do us harm, and from the very government of our country.

I have worked for a number of years in an emergency setting, and I have seen people destroy each other with fists, knives, guns, cars, golf clubs, baseball bats, tree limbs, bottles, and numberous other objects.

I think the proper way to deal with gun violence is not to take guns away from everybody, but to take them away from the criminals. I have no problem registering my guns. I have no problem passing a background check to get one. My only problem is that taking them away from the law-abiding citizens will leave them exclusively in the hands of criminals. This is counter-productive, if you ask me.

It is a tragedy that inoccent victims every year are injured by guns, both by accident and purposeful disregard of proper use. My children will be taught early and thoroughly the use and respect of firearms. They will know that to touch a firearm without me present will result in a fate worse than death.... my anger! I will go to every length to prevent my children from being in that situation. This includes early and frequent education and use of firearms. This removes the 'mystique' about something one is not supposed to touch (which we all know only makes children want to do it more!). I had no curiosity about guns while growing up, because they weren't taboo, merely respected. My personal belief is that education combined with proper and thorough enforcement of existing law will work wonders. Too bad only a very few seem inclined to do either one.....:(
 
In answer to the original post. My family has been ranching in the southwest for generations. I grew up with guns around the house. I'm comfortable with them and know how to use them. After the last several years in the ED I've come to a few conclusions.

1. I will never have a gun in my house. I don't need one and its pretty clear that no matter how you secure them bad things sometimes happen with them. The key point here is need. I need my car and many of the other dangerous things in my house but I don't need a gun in my house. Everybody thinks its someone else's kid who will get into the locked gun cabinet, their kid knows better. I've taken care of more than one shot kid whose parents swore they always kept the gun locked/hidden where the kid couldn't get to it. This includes one kid who found the key for the trigger lock. Some of those same parents swore they had taught their kids to respect and stay away from guns.

2. Our country has way way to many loose guns floating around. Way more than many other countries. I don't want to take away your right to have a handgun, shotgun, or rifle in your house if you want to but I sure wish we had some limits.

3. EM for whatever reason does seem to attract more then its share of fairly extreme gun advocates and all the shot kids/bystanders/domestic violence/suicides in the world won't change their minds

Just my opinion which I'm sure many of you will vehemently disagree with.

Kwooder-- Everybody who comes into the ED shot, stabbed, or beaten swears they were minding their own business (walking their grandma to church) when TWO DUDES shot, stabbed or beat them for no reason.
 
ER mud fud, you and I (whether you like it or not) agree again.
 
Awww heck...I'll bite.

As has been stated previously, it is not the weapon that kills people. It is people killing people. Trying to remove weapons from the hands of the public simply means that only the criminals will have weapons. Banning weapons has never been successful in preventing homicides. In a certain Asian country, weapons were banned several centuries ago. So, the farmers there took there tools and converted them to weapons (e.g. nunchaku, etc.). These converted farm implements were successfully used as weapons and still exist today in that form.

How many people are maimed or killed each year with screwdrivers? About 10 years ago, I went through training in police officer survival and we were advised that we would be more likely to run across screwdrivers than guns. Additionally, we were trained that more people are injured/killed with screwdrivers than any other implement.

If we want to make a difference, than we need to learn to get along better and learn how express our displeasure without poking holes (or whacking) in one another.

Wook
 
More likely to run accross a screwdriver than a gun?

1. Aren't there a lot more screw drivers out there than guns?

2. Given the choice, wouldn't you rather confront a criminal with a lesser wepon, ie a screwdriver as opposed to a gun?
 
Although I grew up in a Southern family, we never had guns around. I didn't own a gun until I'd been in medical school for 2 years. Now I have 2, a deer rifle and a shotgun (I was actually in the middle of cleaning the 30.06 when I read this thread for the first time). The reason I preface my statements with this personal history is to point out that I didn't grow up "brain-washed" in the gun culture. To the best of my knowledge I don't know anyone in the NRA. No one ever suggested to me that guns are an intrinsic part of my heritage or that I wasn't a real man if I didn't have one.

Having said that, I think gun control is simply another method society has come up with for abdicating personal responsibility. When a gang member or the D.C. sniper or the "trenchcoat mafia" kills someone, it's not because a gun manufacturer forced the gun in their hand. It's because they are 1. crazy (sanity challenged?), or 2. they chose to commit an evil act. Without a gun they would have simpley found another way to do it. The only person responsible, and the only person who should receive the blame is the one who pulled the trigger.

Acts of violence did not begin with the introduction of the gun. Plenty of people killed and maimed each other before bullets came around, and plenty would do so if they all suddenly vanished. Even in recent history, when guns were too expensive to be easily attainable, gang violence occurred with bats, knives, "zip guns," bottles, bricks, whatever. I have heard reports that machine guns were once so difficult to attain that only two or three were available amongst all the families and organizations of the real mafia until after the Vietnam War. It didn't stop them from commiting violent crimes.

I also want to emphasize something mentioned by a previous poster. The second ammendment is an integral part of what our country was founded on. Its intention was not, as some have said elsewhere, so that Bubba can put squirrel meat on the table every night--a necessity which many would consider outdated and obsolete given the pervasive presence of the local supermarket. It was intended to protect a citzen's right and ability to defend his home and family from any and all agressors. "Bad" people will always do whatever they think they can get away with. We should not lightly consider taking away anything from good people that might be considered a deterrent.
 
Originally posted by wook
Awww heck...I'll bite.

As has been stated previously, it is not the weapon that kills people. It is people killing people. Trying to remove weapons from the hands of the public simply means that only the criminals will have weapons. Banning weapons has never been successful in preventing homicides. In a certain Asian country, weapons were banned several centuries ago. So, the farmers there took there tools and converted them to weapons (e.g. nunchaku, etc.). These converted farm implements were successfully used as weapons and still exist today in that form.

How many people are maimed or killed each year with screwdrivers? About 10 years ago, I went through training in police officer survival and we were advised that we would be more likely to run across screwdrivers than guns. Additionally, we were trained that more people are injured/killed with screwdrivers than any other implement.

If we want to make a difference, than we need to learn to get along better and learn how express our displeasure without poking holes (or whacking) in one another.

Wook

I won't spend too much more time on this since I believe the decision to own guns is a mostly a personal one and each individual has to decide on their own if the benefits of having a gun in their house outweighs the risks. I also realize that the gun lobby/culture in this country is to strong and pervasive to ever allow for significant gun control. Living with a ridiculous amount of gun violence is just going to be part of the price we pay for living in certain parts of this country.

As for this argument. It is difficult to take out an entire schoolyard full of kids or kill someone more than 100 yards away with nunchaku. I also don't know of any five years olds who killed themselves with nunchaku that they found hidden in their dads closet. Having been mugged I can state clearly that I much prefer being threatened with a knife or screwdriver than a gun. As I said last time I was threatened by a kid with a knife, " Cool, I can outrun a knife" I then promptly outran him. There is a reason that hunters, people who shoot up schools, and the military generally(but not exclusively) prefer firearms to screwdrivers. They work a lot better for killing things
 
Originally posted by ERMudPhud
As for this argument. It is difficult to take out an entire schoolyard full of kids or kill someone more than 100 yards away with nunchaku. I also don't know of any five years olds who killed themselves with nunchaku that they found hidden in their dads closet. Having been mugged I can state clearly that I much prefer being threatened with a knife or screwdriver than a gun. As I said last time I was threatened by a kid with a knife, " Cool, I can outrun a knife" I then promptly outran him. There is a reason that hunters, people who shoot up schools, and the military generally(but not exclusively) prefer firearms to screwdrivers. They work a lot better for killing things

Multiple studies show that a gun in your household is much more likely to kill a household member than an intruder.
 
Originally posted by kwooder
Pardon my ignorance, but please explain what Two Dudes means.

Drunk guy: "I was just standing there, and these two dudes kicked the **** out of me."

And, the corollary: "I was just standing there, minding my own business, and this guy stabbed me in the chest!"

Sometimes, when minding your own business, the two dudes come and visit. Minding your own business is the most dangerous job in the US.
 
In my experience, SOME GUY is a force to be reckoned with regardless of implement - screwdriver, gun, knife, or just pushing you off the front porch with his bare hands. He'll fix your wagon, even if you are just minding your own business at the convenience store. I suspect he is half of the two dudes mercenary squad.
 
What I learned from EM is that I never want to be shot with a .45. I've seen lots of gunshot wounds of all types, but nothing short of explosion injuries matches the damage I saw from one of those puppies. Wherever the bullet went, the flesh was turned into hamburger (bone included). Damned impressive projectile, that.
 
Originally posted by Sessamoid
Damned impressive projectile, that.

From what I understand, that's the precise reason the caliber was developed and implemented. Seems almost inhumane, notice the military has switched to the cleaner 9mm since the early 90s. Humanity or larger magazine capacity?
 
Originally posted by tRmedic21
I think the proper way to deal with gun violence is not to take guns away from everybody, but to take them away from the criminals.

Brilliant! Exactly! Yes!

You all read this?! If not, re-read it again and again until you "get" this very simple concept.

Most gun laws only keep guns out of the hands of law-abiding citizens. You want to live in a society where only the thugs have guns?
 
Originally posted by kwooder
Good and basic point that lawmakers ignore. I love guns. They are part of our history and a fun activity. I would even be for smart gun control. I can live with the laws that make sense. I think 10 rounds in a handgun magazine will let me defend my household (I may have to perform a tactical reload during) and it just means a little more effort on the range. I don't need a grenade launcher or a sound supressor either, these things should be regulated.

Other things, like the length of a barrel, capacity for a bayonet and pistol grip (all things strictly regulated by the assault rifle ban) don't make the gun more lethal. The operator makes it lethal.

I just want smart laws that aren't just scare tactics to the general public who don't know the facts. (murder by bayonet on assault rifle = non existent).

My three cents.

Ten rounds is not enough. In every situation you want to have firepower superiority or at least parity. A fifteen round magazine is much better.

When you get right down to it, a shotgun is a better home defense weapon then a handgun. First because if you load it with bird shot it has very little penetrating power once it hits a wall.

Second because you can get something like my Mossberg 590 and attach a bayonet to it giving you greater "reach" if things get down to hand-to-hand.

Third because the sound of the slide being worked is the universal signal on most planets for "freeze."

I live in a pretty safe neighborhood so my shotgun is locked up and is not exactly "readily available."

And I have a small arsenal of assault rifles which I like to shoot.

Come on, folks. Not too many convenience stores are robbed at the point of a $4500 M-16. Anybody who needs or can afford military weapons in the commision of his crimes probably can circumvent any law you care to place on the books.

And I have yet to hear a perp yell "fix bayonets!" to his homies as they stride up to the counter of the gas-station they intend to rob.

The so-called "assault rifles" which were banned are really no different then a typical semi-automatic hunting rifle except for cosmetic features and the ability to hold more rounds. They are not, repeat not, automatic weapons which are legal in most states but require a moderate amount of paperwork to own.

The real purpose of the ban was to advance another incremental step towards banning all guns, ensuring that only criminals and the government have access to firearms.
 
Just an FYI to one of the previous posters:

Automatic weapons are not illegal, at least in most states. In my state it is realtively easy to own one provided you are a law-abiding citizen and can afford one.

Assault rifles were not banned, either. Just the importation or manufacture of new "assualt rifles."

By the way, the definition of "Assualt Rifle" is a lightweight select-fire (AUTOMATIC or semi-automatic) weapon firing an intermediate powered cartridge from a closed bolt and capable of engaging targets from zero to several hundred yards. this is to distinguish it from a "machine pistol" or "submachine gun" which generally are not capable of select fire (automatic only), fire from an open bolt, and are only suitable for short ranges.

The liberal definition of "assualt rifle" is one that "looks dangerous."

Idiots.
 
As a future toxicologist, I thought I would make a plea to lower the lead content of bullets -- this should be a public service initiative. We see patients who have retained bullets in their body who subsequently develop lead toxicity. People can die from this! If we all push for this, maybe we can push the lawmakers to mandate lead-free bullets.
 
Originally posted by jawurheemd
As a future toxicologist, I thought I would make a plea to lower the lead content of bullets -- this should be a public service initiative. We see patients who have retained bullets in their body who subsequently develop lead toxicity. People can die from this! If we all push for this, maybe we can push the lawmakers to mandate lead-free bullets.

"I was being compassionate when I shot dat foo, I used steel shot!"
 
the united states has the highest rate of homicide of any of the 36 most developed economies in the world. we beat israel hands down. and we're neck-and-neck with northern ireland. of every 6 homicides in the us, 4 of them are due to firearms.

for suicides, we're about average compared to other nations, but over half of people who kill themselves in america do it with guns. the people who use guns tends to be guys, and they tend to be more successful the first time around.

i understand that we want to keep guns away from criminals, not people who aren't criminals--this is not a profound concept. but people who don't seem like criminals, in rage or depression, can do things that are very bad. beyond this, it would be impractical to limit the access of 'obvious' criminals to guns to do this when firearms are generally legal and background checks can be deceiving. so we need to be more aggressive. guns are a luxury, and this is simple utilitarianism: the luxuries of the few must give way to the necessities of the many.

also, as a previous post mentioned, guns are statistically less likely to protect your family than harm them--every lock is pickable and every child is curious. while i understand people must have some vices, this one may be too costly to keep around.

admittedly, sometimes when dealing with patients i want to ban alcohol and cigarettes and fatty foods. i know these aren't reasonable ideas, as these vices are even more entrenched than guns are in our society, and sometimes i enjoy them in moderation. it's alright to have an occasional crappy meal or a drink with your friends, it might even be a good idea.

but there are other things that are not good in moderation--you shouldn't occasionally smoke crack, or beat your wife. these things really don't have much use in moderation; they are negative even in the smallest quantity. crack, duh. beating your wife because rage and violence and power can be addictive.

so psychologically, what's going on here? why do we like guns? is the power--the potential for violence--that someone feels owning or holding a gun addictive? is it insecurity or low self-esteem or chemicals released in our brains when we see explosions and destruction? some silly psychology being masked as an amendment? it would be hard to prove this. and even if it was true, it would be even harder to get people to accept this. but something tells me there's more going on here then our simple desire for protection--statistically it doesn't add up.

i am not saying that people would stop being violent if guns were outlawed. culturally and biologically people often just don't get along. but the impact of our short-sighted violence might be mitigated.

would there be a significant blackmarket, and would common folk be left defenseless against criminals with guns? yes, but it looks like keeping a gun in your house doesn't do much good anyways, so you might be better off. beyond this, criminal deterrance (from worrying about you having a gun in your household) doesn't seem very effective--former gov bush proved that when he relaxed restrictions on the death penalty there was an actually increase in the frequency of crimes punishable by death in texas.

there are gun advocates who reference studies where stricter gun control has had variable effects on the rate of homicide in certain cities. these studies have problems. gun control is not the same as banning guns all together. and driving to another city is very easy. there are no metal detectors or bouncers on highways. it seems that the variability of homicide (either positive or negative) in the studies is not impacted by the laws. perhaps more importantly, the stricter laws are likely to be enacted in cities that have higher rates of gun related homicide.

and last thing--not to generalize, but the NRA as a whole is crazy. in a recent newsweek article, they talked about how some communities have passed laws prohibiting minors from carrying guns WITHOUT PARENTAL PERMISSION. that's nuts. what's even more nuts is that the NRA filed suit to overturn this law. i guess if everyone in school has guns, then the unpopular kids won't plan another columbine because the jocks and cheerleaders will shoot 'em up

why is the NRA so furious in their fervor? maybe they're just weird. but we also have to remember--to be in the NRA these days is to be in a very awkward minority. for many, hearing someone say 'guns don't kill people' is like hearing the tobacco industry say 'cigarettes don't cause cancer'. it hits a nerve--no one buys it anymore, and it makes those who advocate guns more and more fundamentalist in their beliefs. this creates an environment where the dialogue stops and progress becomes stagnant.

and that brings us to where we are now: the NRA is lobbying ungodly sums of money onto congress, and EDs around the country are being bombarded with stupid gang members and too curious children and innocent bystanders and psychopathic criminals--all with holes in places they shouldn't be and pieces rearranged where god never meant them to be, and we get more business and we can all pretend we're Noah Wyle.
 
Originally posted by tum
the united states has the highest rate of homicide of any of the 36 most developed economies in the world. we beat israel hands down. and we're neck-and-neck with northern ireland. of every 6 homicides in the us, 4 of them are due to firearms.
Comparisons to other countries are unfair and pointless. The US is by its very nature more violent than other countries for a number of reasons not having to do with guns. We're one of very few developed nations that recently grew to power in a "frontier" mentality, which generally involves killing what you eat, and killing those who would try to steal what you eat. More importantly, we have by far the most diverse population, ethnically, culturally, and economically, of any of the developed nations. Diversity means differences, differences means conflict, and conflict means violence. That's just the way this country is, and coming from a non-dominant ethnic group I can say that sometimes it sucks. But that's the way it is, and you can't blame that part on guns.
beyond this, it would be impractical to limit the access of 'obvious' criminals to guns to do this when firearms are generally legal and background checks can be deceiving.
It is not impractical. It is imperfect, but I think it's going too far to imply that such measures are useless.
so we need to be more aggressive. guns are a luxury, and this is simple utilitarianism: the luxuries of the few must give way to the necessities of the many.
So you are proposing banning guns altogether. That's quite utilitarian (if it is practicable in this country). However, we do not live in a strictly utilitarian country. We have values that supercede simple utilitarianism.
while i understand people must have some vices, this one may be too costly to keep around.

admittedly, sometimes when dealing with patients i want to ban alcohol and cigarettes and fatty foods. i know these aren't reasonable ideas, as these vices are even more entrenched than guns are in our society, and sometimes i enjoy them in moderation. it's alright to have an occasional crappy meal or a drink with your friends, it might even be a good idea.
More people die from the consequences of smoking, poor diet, and lack of exercise than from gun ownership by a long shot. Why is banning guns acceptable but banning fatty foods, cigarette smoking, and being lazy fatass unacceptable. Given your utilitarian bent, I'd think cigarettes would be the first thing to go on your list. After that, you should ban sitting around on the couch doing nothing. Then ban fast cars and limit all cars to <=30 mph, ban motorcycles and bicycles (those are dangerous too), definitely ban dangerous sports such as skydiving, downhill skiing, and motocross.
so psychologically, what's going on here? why do we like guns?
I don't think it's any one thing for all people. As a country we like guns for lots of different reasons. For some people it's just fun. Things that make loud noises and blow up other things are just cool, as our preference for action movies clearly demonstrates. Some like the security aspect. Others like the sporting aspect, and not necessarily hunting other living creatures. What difference does it make?
former gov bush proved that when relaxing restrictions on the death penalty actually increased the frequency of crimes punishable by death in texas.
I am no fan of either Bush, but that statement is unfair. You're drawing a cause and effect when none is proven. All you have is a temporal association, but so many other factors change over time that you can't state "A caused B". The most consistent predictor of violent crime in this country is the overall health of the economy and the unemployment rate. The utilitarian thing to do would be to have the government employ all the people that can't or won't find jobs. All studies about changing gun laws (either more or less lenient) are similarly flawed. To draw conclusions from them is shaky business.
in a recent newsweek article, they talked about how some communities have passed laws prohibiting minors from carrying guns WITHOUT PARENTAL PERMISSION.
Uhh, why is that nuts?
this creates an environment where the dialogue stops and progress becomes stagnant.
Yeah, because we all know that the NRA is the only unreasoning, extremist viewpoint being expressed on this topic.
and that brings us to where we are now: the NRA is lobbying ungodly sums of money onto congress, and EDs around the country are being bombarded with stupid gang members and too curious children and innocent bystanders and psychopathic criminals--all with holes in places they shouldn't be and pieces rearranged where god never meant them to be, and we get more business and yay, we can all pretend we're Noah Wyle.
Umm, yeah. None of us likes the gun traumas. The trauma surgeons especially hate them. They don't pay. I wouldn't mind being in Noah Wyle's shoes though. He's dated some amazing beautiful women.
I don't think the changes you are suggesting (an outright ban on firearms) are consistent with the values of our country. There are countries that hold those values, but they don't have the Stars and the Stripes flying above them.

Disclaimer: I am not, nor have I ever been, a member of the NRA. I have never owned a gun (not even a BB gun), and I've fired a gun only once when target shooting with friends. I am not a rabid pro-gun advocate, but I think people who want guns banned outright want to live in a different country than the one we share now.
 
<edit> In re-reading this post, I think some could construe it as argumentative and angry. Please be assured that it was not intended that way; I am merely trying to show some people that there are other viewpoints that are rational and not simple bullheadedness. Please read it in a tone of normal conversation, not anger. Thanks!

I think people who want guns banned outright want to live in a different country than the one we share now.

That was exactly my point earlier. If you ban guns in the hands of law-abiding citizens, you might as well have taken away the right to vote, the freedom of speech, or any of the other basic freedoms guaranteed by the United States Constitution, because that document would never have been ratified without these inclusions.

If you want to live in France, or in England, where even the cops don't have guns, then by all means, go for it. Do you think a simple law is going to prevent gang-bangers on street corners and drug dealers and petty hoods from getting their hands on guns? Do you really? NO! Of course not! And once they realize they are the only ones who have them, what's going to stop them from coming into YOUR home at night? Just because some people choose not to excercise their right to own and use firearms responsibly, should the vast majority of us who do so have ours taken away? NO.

I know a cop whose 3 y/o son killed himself with his father's duty weapon, but did the cop give up his career and give away all his guns? No, it was a tragic accident, and we (should) do all we can as parents to protect our children (which he didn't). Far more teenagers die in car accidents than by gun violence, accidental or intentional. Same goes for drugs (at least where I'm from, I can't speak for the whole country). But not only can we not take away cars, we can't even mandate that anyone under 21 years of age must drive a 1976 Thunderbird, simply for their own protection.

I've seen Amish children run down by truckers while in their wagons on the way to school. I've seen men who woke up at night and tried to smoke their oxygen tubing thinking it was a cigarette. I've seen patients lying in beds at nursing homes with no legs, blind, deaf, and demented, but the family refuses to make them a DNR, hanging on for 3+ years, telling themselves, "Grandma's going to get better."

The point is, there are lots of injustices in this world, and there are lots of tragedies that can be averted. Removal of any and all dangerous objects may make one safer in the short-term, but I believe it can also make one weaker. The human immune system is one example. I believe life is similar.... have you ever dated a girl who was so sheltered by her family that she had no clue to to interact socially, or how to enjoy life outside of the family dwelling? I still hold the belief that most people who are deathly afraid of guns don't understand guns. I respect guns, but I am not afraid of them.

Education and regular application takes away the mystery surrounding nearly everything. I remember when I was first learning to start IVs. I though it would be cool and I would feel better about myself having done it. After doing 1000 of them, it wasn't so cool anymore, it was just part of routine work. I thought medical school would be the same way, and guess what? I have learned a ton of stuff, and most of it has cleared up misconceptions. How many of you couldn't wait to get your first intubation? Or chest tube? Or crike? Or appy? Or suture? See what I'm saying? Proper use and education will remove the mystique and the curiosity that goes along with it. That's what my kids will have, I don't know about yours.....
 
Originally posted by tum
the united states has the highest rate of homicide of any of the 36 most developed economies in the world. we beat israel hands down. long winded inaccurate anti-gun rant snipped
but joking aside, it just sucks.

Sources please. Most of the rhetoric you posted is simply that.

From the CDC (http://www.cdc.gov/nchs/fastats/firearms.htm):
Annual Firearm Deaths:_ 28,663 (2000)
Age-Adjusted Death Rate: 10.4 deaths per 100,000 population (2000)
Death Rate for Males Ages 15-19: 22.7 deaths per 100,000 population (2000)
Death Rate for Black Males Ages 15-19: 62.2 deaths per 100,000 population (2000)
Firearm Suicide Deaths:_6.0 per 100,000 population (2000)
Firearm Homicide Deaths: 3.9 per 100,000 population (2000)

More? According to the CDC (http://www.cdc.gov/nchs/fastats/pdf/nvsr50_15TB18.pdf) in the year 2000 there were 776 death nationwide attributed to the accidental discharge of a firearm. Of these 86 were under age 15 years. So much for the anyone can pick a gun lock arguement. There were far more deaths in this age group related to unrestrained passengers in MVCs than by guns.

More? According to a CDC taskforce report looking specifically at gun control laws (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5214a2.htm) "Although firearms-related injuries in the United States have declined since 1993, they remained the second leading cause of injury mortality in 2000, the most recent year for which complete data are available (1). Of 28,663 firearms-related deaths in 2000 --- an average of 79 per day---16,586 (57.9%) were suicides, 10,801 (37.7%) were homicides, 776 (2.7%) were unintentional, and an additional 500 (1.7%) were legal interventions or of undetermined intent. " and "On the basis of national law assessments (the Gun Control Act of 1968 in the United States and the Criminal Law Amendment Act of 1977 in Canada), international comparisons (between the United States and Canada), and index studies (all conducted within the United States), available evidence was insufficient to determine whether the degree of firearms regulation was associated with decreased (or increased) violence. The findings were inconsistent and most studies were methodologically inadequate to allow conclusions about causal effects. Moreover, as conducted, index studies, even if consistent, would not allow specification of which laws to implement." Further findings were (parphrased) that it was impossible to actually study the effectiveness of gun control laws for a variety of reasons. The taskforce dismissed studies on both sides of the issue as scientifically invalid.

Obviously I am "anti gun control". But, I am even more rabid about public health science. We are, or are going to be physicians. That carries with it a great deal of public credibility. Please do not forget that. We can have a debate, we can disagree, heck, we don't even have to like each other :), but please, please, at least look at the hard, credible data available on the issues you speak for. Raise the level of public discussion to that of science instead of the meda based sensationalism you drew on for your post.

- H
 
When controversial topics get so polarized, we stop listening to each other, things get personal. As FoughtFyr said, we have a special responsibility, especially as EPs to understand the issue --the burden of disease from guns is huge in the US. I like this SDN forum--people are amazingly helpful to each other. We can continue to respect each other in this thread. It hasn't gotten ugly here, but it's feeling a bit heated and tenuous.

I agree that banning guns is not the answer to the violence in the US. As Sessamoid notes, our problems run a lot deeper than that. However, I don't agree that "law abiding" people having them at home helps the situation. You're all docs or future docs, and make clinical decisions based on evidence. There's NO evidence that having a gun at home will protect you or your family. The evidence from multiple studies show that it's much more likely that someone in your very household will be killed by that gun. The research is good quality-- they control for reverse causation (these people didn't buy their guns to kill themselves or their family). Here's a policy brief--keep in mind that by definition, a case control study cannot prove causation only increased risk (Of course you can't do an RCT):

http://www.upenn.edu/ldi/issuebrief8_8.pdf

The "law abiding" people fighting gun legislation also keep them accessible to "criminals." This is not only because they keep guns in the above-ground marketplace. Gun tracing programs show that a huge supply of guns come into the inner city by way of suburban homes of these "law abiding" gun owners that get robbed.

Foughtfyr, thanks for the links. I've read that MMWR report on gun laws. It says specifically says that insufficient evidence should not be taken as a conslusion of ineffectiveness. There are definite methodologic problems studying the effects of policy on a population when so many factors interact to affect outcome (suicide, homicide). Also, gun restrictions affect the immediate area, when the gun trade actually crosses borders as tum noted. Also, they didn't say it was impossible to study gun laws. They encouraged more research.

Here's a link to an older story on Dr. Garen Wintemute, an EP at UC Davis. He's NOT for banning guns. He's for tighter gun control and points out the loopholes and shortcomings of our gun policies. The gun lobby has harassed him for years and he's had multiple threats to his life, but he keeps putting out his research. Not surprisingly, that there isn;t enough evidence for the MMWR report, huh?

http://www.time.com/time/reports/heroes/dropguns.html

P.S. The Constitutional "right to bear arms" is to guarantee the right to a militia, not individual rights to a gun. Exact words:
"A well regulated militia being neccessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed" The origin of this right was the war of independence and the frontier, when there was no organized police force and the US was a small and vulnerable new nation.

Thanks for reading! :)
 
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