Doctors who care for trauma patients maintain a steely grip on calm and competence in the face of tragedy. But caring for those whose lives have been interrupted or ended by sudden, severe injury takes a personal toll.
As Twin Cities physician Dr. Carolyn McClain explained at a Minnesota Medical Association (MMA) gathering Thursday, every doctor has a case that haunts them. The case that broke McClain's heart: a child brought to the emergency room early in her career who died after a family member backed over the youngster. As she shared this with other doctors at a previous medical conference, a trauma surgeon who had cared for Florida mass shooting victims listened intently and then made this point:
Many cars now have backup cameras, which might have saved the child, the surgeon said. But when it comes to firearms, where are the technological advances and societal improvements — such as the widespread recognition of drunken-driving risks — that could prevent gun deaths?
The provocative question relayed by McClain provided just the right kickoff to the pioneering Minnesota workshop on gun-violence prevention put on by the state's medical association. The MMA, which represents over 10,000 state physicians, merits praise not only for organizing it but for channeling members' passion toward finding realistic solutions to a public health scourge. Beginning the discussion by considering the changes that have reduced motor vehicle deaths both inspired members and focused them on the workshop's goal — proposing practical reforms.
The MMA has already taken a courageous stance on gun-violence prevention, one that not all members approved of. It issued a statement last March calling gun violence a "public health crisis" and then backed much-needed state reforms — such as criminal background checks on all purchases and transfers or exchanges of firearms. "Failure to intervene in the face of this significant epidemic is not an option," the MMA said.
About 100 people attended Thursday's workshop, with many driving to the St. Paul location on a cold night from across the state. Their firsthand experience caring for victims and their instinctive demand for evidence-backed reforms brings welcome perspective to a debate too often fueled by anger. Hopefully, doctors in other states will organize similar workshops.
According to the U.S. Centers for Disease Control and Prevention (CDC), yearly firearm deaths rose from 28,874 in 1999 to 39,773 in 2017, the last year for which the data are available. These numbers encompass a wide range of causes: homicides, suicides, unintentional deaths and deaths from "legal intervention." The CDC also crunched the data for the gun death rate. It has climbed steadily, from 10.3 per 100,000 people to 12 in 2017. Minnesota fared somewhat better, with an 8.2 rate and 465 firearm deaths in 2017.
These numbers and recent mass shootings, such as last year's at a school in Parkland, Fla., had alarmed and engaged Minnesota doctors. But a dunderheaded tweet from the National Rifle Association took that energy to the next level. The NRA tweet, dated Nov. 7, complained that medical journals published articles about gun control. "Someone should tell self-important anti-gun doctors to stay in their lane," the tweet said.
The nation's doctors countered with a massive social media response summed up by this phrase: "This is our lane." The slogan has had staying power. But no matter how often it's retweeted, it's not enough. The MMA's workshop admirably recognized that. At the end of the evening, recommendations included physicians reaching out to their legislators more often and "normalizing" talking to patients about responsible gun storage.
Other recommendations included extending Medical Assistance for new mothers to help them with depression and other challenges to their well-being that can occur months after giving birth. According to one physician at the workshop, firearms (used in domestic violence and suicide) and drugs are a surprising source of maternal mortality in Minnesota.
It's the power of stories such as McClain's that has the potential to be a real game-changer, however. Those who championed car safety improvements got their message out without opponents thinking that their cars might be taken away. A reframing of the gun-violence prevention campaign — one that involves relaying this comparison — would be helpful. Doctors are well-positioned to lead this shift and, perhaps, change some minds.