In mid-July, Dr. Benjamin Mauck, a 43-year-old orthopaedic surgeon, was murdered in his Tennessee office. An irate patient decided to forgo an online rant and instead picked up a gun. When the media reported the killing, they also recounted a list of recent health care shootings. I’m an orthopaedic surgeon, and I’ve had my share of irate patients. In a country awash in guns, should I be worried?
The question itself is a three-level gut punch. First: How can I be an effective physician if I fear the people I serve? Second: Bullets have found their way into our schools, houses of worship, and even our beds; what right do I have to assume my office offers sanctuary? And last: As a doctor of 35 years who’s waited until now to speak out, am I partially responsible for this ever-growing list of shootings?
Soon after Dr. Mauck’s murder, the president of the American Academy of Orthopedic Surgeons sent a message to our 39,000 members. He expressed heartfelt condolences to Dr. Mauck’s family, friends, and patients. A good start. He went on to discuss the mounting threat of violence in health care settings and the need to promote workplace safety. Not just “thoughts and prayers” but a call to action. Excellent. He concluded by lauding our group’s advocacy efforts in support of the federal “SAVE” Act. “Safety from Violence for Healthcare Employees.”
Swing and a miss.
Only those in health care? Why just us and not all? Why not support a “Safety from Violence in the Produce Aisle Act"? Or a “For God’s Sake Don’t Shoot in Church Act"? How about the “We Expect Our Kids to Come Home from School Act"!?
Since the formation of the American Medical Association (AMA) in 1847, we’ve learned to advocate, but primarily for ourselves.
To be fair, my internet search turned up public statements from various medical societies. The AMA’s website states they’ve advocated for gun safety measures since the 1980s. And after the Pulse Nightclub massacre in 2016, the AMA declared gun violence a “public health crisis.” In 2018, the American College of Surgeons published its firearm safety task force (FAST) recommendations. A committee of 18 gun-owning surgeons — whose gun-owning status, somehow, imparted a level of gun violence expertise — suggested that universal background checks, “responsible” gun ownership, and innovative firearm technology might mitigate harm.
Until I penned this piece, I knew nothing about these workgroups and statements. If a doctor has to search for this information, how much of our message reaches the public? It took a barrage of sustained public service campaigns to get us to click seatbelts, don bicycle helmets, and cut down on tobacco. Shouldn’t our medical groups publicly weigh in on the wisdom of open carry in movie theaters? Where was our public outcry when politicians un-ironically suggested we place loaded weapons next to whiteboard erasers in school teachers’ desks? We need to reach people where they live. Sending position and policy statements to a visibly fractured Congress is not working.
The Biden administration managed to pass a watered-down gun bill last year, the first gun legislation since the sunset of the 1994 assault weapons ban in 2004. This new law will expand background checks for those under 21, increase mental health funding, and limit straw-buyer purchases, but it leaves out a federal red-flag law, and a ban on large capacity magazines and assault-style weapons. Like the 1994 law, it, too, will sunset in 10 years, leaving it to Congress to start from scratch in the 2030s.
Our medical groups champion mental health issues, but I see the impotent regulation of 400 million weapons as a collective lunacy. Per capita, there are 1.2 firearms for every American, the de facto members of our “well-regulated” militia. Despite our lobbying efforts and position statements, politicians, judges, and justices have allowed these weapons to permeate society, hoping that everyone will “play nice.”
Yes, a small number of doctors joined the ranks of the 48,000 firearm fatalities in 2021, and that’s shocking. But they also joined the ranks of the 300-400 physicians who, annually, complete suicide. Studies show that one in 10 doctors have contemplated or attempted suicide. The burnout rate has never been higher. Why?
In their book “If I Betray These Words,” Drs. Wendy Dean and Simon Talbot borrow the battlefield term “moral injury,” originally used to describe the trauma incurred by soldiers who passively or actively participate in morally dubious acts. The authors apply this language to the soul-crushing effects on doctors who passively comply with for-profit medicine. The stress of misaligned financial incentives — to sell medical care rather than provide health care — often contributes to burnout and, for some, signs of PTSD. Did my relative silence over 30 years add to my own moral injury?
While we’ve advocated for health care worker safety, more than 100,000 gunshot wound victims rolled through the ED doors last year. These wounded people are not news to us; we literally slip in their blood.
Years ago, Congress cut funding for gun-related injury and fatality studies. The implicit and explicit message was “stay in your lane.” Exam room conversations about guns in the home became uncomfortable, almost taboo. But the numbers of wounded and dead kept rising. And as their numbers grew, so too did the pain borne from silence.
U.S. gun violence shocks the world. Why should doctors be shocked when the “public health crisis” we confronted with jargon-laden policy statements comes knocking at our door? Our position statements have failed to stem the rising tide of firearm deaths and injuries. Maybe it’s time to pool our PAC money and speak out, not to an ineffectual Congress, but directly to those we serve.
My sincere condolences to Dr. Mauck’s family, friends, and patients. And to all the victims of senseless gun violence. From where I’ve stood — in my kids’ schools, in grocery stores, and in the blood of my patients — guns offer a false sense of safety over family-shattering risks and serve only to stoke our fears.
Ron Turker has spent the last 30 years as a pediatric orthopaedic surgeon by day and an unrelenting writer by night. Decades of caring for kids worldwide have shaped his sensibilities into a witty voice for health care equity and change. Find him on Instagram at ronturker.writer and ronturker.com.
Illustration by April Brust