On September 17, 2013, I joined the growing ranks of physicians who have gotten a message they hoped never to receive: “There has been a mass shooting in the area. Prepare to receive casualties.”
That morning, a gunman was indiscriminately mowing down people at the US Navy Yard. Within an hour my hospital had geared up to provide both medical and supportive care, answer calls from those seeking to know the identity of victims, and coordinate other services with the rest of the hospitals in the city. In the end, we provided care to only one bereaved family and treated a few minor injuries. Still, the experience drove home the point that medical services are essential to the sense of justice and safety of an entire community. Knowing that physicians and hospitals are there for emergencies contributes immeasurably to the well-being of a community as a whole.
Although on September 17, I was proud that no survivor who came to my hospital would have been turned away, on September 18, it was back to business as usual. In the ordinary course of events, medical care in the US is distributed too much based upon what people can afford rather than upon what they or the community actually need. In an emergency, people are treated without regard to their resources, but as soon as the dust settles, only those who have been accepted into the tent of the insured have their needs recognized. Others are left literally out in the cold, or driven into bankruptcy and abject poverty, merely from the misfortune of being ill or injured. The process of healing social rifts, from the effects of atrocity to the more subtle corrosion of poverty and chronic disease, requires the availability of medical care to all.
The days following the shooting drove home other lessons. As more information about the gunman emerged, we learned that he had a history not just of mental illness, and violence, but of prior gun violence. He had apparently recently rented an assault weapon and may have tried to buy a handgun. In the end, he passed a federal background check and lawfully purchased a shotgun. Perhaps because he did not have an assault rifle, the death toll was much less than it might have been. But my religious tradition teaches us that whoever saves single life, it is as if he had saved a whole world. The twelve victims and the gunman himself were each a world lost, lost in a sea of inadequate gun regulations, NRA obstructionism, and a society that puts the right to have a weapon before almost any other right of citizenship.
As a physician, and particularly as a psychiatrist, I am also acutely aware that the tragedy of mass shootings is overshadowed by the daily tragedies of gun murders, accidental and suicidal gunshot wounds and deaths. As a political activist I am continually amazed that the issue of controlling health care costs has been ruthlessly divorced from the issue of controlling the violence, especially gun violence, that drives patients to our hospitals, operating rooms, rehabilitation facilities and morgues at rates unheard of in any other civilized society.
Whatever meaning we choose to derive from this terrible event, it is my belief that all physicians have an obligation to use our medical standing to highlight the tragedy posed by unregulated gun access, and by implication, the drain on medical resources that these completely unnecessary injuries represent.
Julia Frank is a psychiatrist who blogs at Progress Notes.
