Those who are divorced from reality

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According to the Centers for Disease Control and Prevention (CDC), there were 39,518 suicides in the United States in 2011 (the year for which there are the most recent data). That’s just the reported/confirmed suicides. I’ll write about that a little bit more later. Of those suicides in 2011, 19,990 were by firearm. That’s half of suicides.

Those 19,990 suicides by firearm are more than the number of murders (of all types) in the US in 2011. How many more? Over 5,000 more.

When the National Rifle Association (NRA) goes after the nominee for Surgeon General because he dares say/opine/think that guns are a public health problem, you have to think about it for a second. Are guns a public health problem?

“If there were no guns, people would find other ways to kill themselves.”

Well, yeah, people hellbent on killing themselves to end their own suffering will try other things if guns are not available. But here’s the thing… Guns allow for impulsive and almost 100% fatal suicide attempts. You put the barrel to your head, pull the trigger, and that’s it. There’s no chance to back out, no chance to get saved by trauma/emergency medicine. And, if you do get saved, you’re likely to not be the same ever again.

Believe me, I’ve seen it first hand.

Furthermore, when there are more suicides total, and more suicides by gun in particular, than murders, it’s a problem. That’s reality. We’re not talking about a “what if” scenario. It’s a problem.

If I were to make a video and threaten the lives of that many Americans, there would be people coming after me… Likely law enforcement and the armed forces. Yet we do very little to prevent those 19,000+ suicides. Then, when the person tapped to be the person to set the tone of public health in this country mentions it, politicians on both sides of the aisle lose their collective minds at the snap of the fingers of one Wayne LaPierre.

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“Then let’s create a database to keep track of all people with mental health to keep them from getting a gun!”

Well, that’s really not going to work because, as the NRA is quick to point out, gun laws don’t work when there is quick and easy access to guns in grey and black markets. So how do we keep guns away from people who may commit suicide? By addressing their mental health problems so that they don’t go looking for guns — or use the guns they already own — to kill themselves. So guess what? Mental health is public health. And who but the Surgeon General to try and address this?

One of the things that people whose testicles seem to be in the firm grip of the NRA seem to ignore is reality. That reality — beside the fact that the nominee for Surgeon General is a physician — is that mental health problems are the overwhelming biggest reason for suicide attempts in this country. If we address those mental health problems through proven public health interventions, then we bring down the number of deaths from suicide. To do that — and I know this will come as a shock to some of you — HEALTHCARE PROVIDERS NEED TO ASK IF THE POTENTIALLY SUICIDAL PERSON HAS A GODDAMNED GUN IN THE HOUSE.

If you don’t realize that, then you have checked out of reality, just like I think Mr. LaPierre has. Then again, physicians may not want to do away with guns. After all, the free and open access to guns in our society pays their bills. I mean, the same statistics we have tell us that there are tens of thousands of injuries from guns. Those injuries need to be treated by physicians. That’s a lot of money for them in our fee-for-service healthcare system, right?

Sounds legit.

Speaking of stats. I mentioned up there that those numbers are just the ones that are reported and confirmed. While some of those may not be true suicides, like those that are accidents but seem like suicides, I am willing to bet good money that there are many more that are suicides but are not reported as such. Our culture is one that is ashamed and embarrassed that a person in our family or in our town may have committed suicide. So those get covered-up. Our gun culture also has people committing “suicide by cop” that is not counted as a suicide but as a homicide. And then there are the people who walk into the woods and take their lives and are never seen or heard from again. So, yeah, take that number with a grain of salt, knowing that it is based on the best estimates of the true number and that the true number might be substantially higher.

Suicide is a difficult thing to talk about because it is very taboo in the American culture and in all the subcultures within our country. Yet suicide — along with any and all forms of mental health issues — needs to be a discussion that we need to have. We need to save those 39,000+ people each year, otherwise our society is worthless. Otherwise, life is worthless. That conversation needs to be had out loud and in all segments of our society, and the current nominee for Surgeon General wanted to get that conversation going. Did we listen? No. Instead of listening to a public health expert, we listened to the NRA, to the “2nd Amendment Remedies” buffoons, and to the “Open Carry” clowns… We listened to people who are divorced from reality.

I said it the other night about our response to Ebola: My children, or my children’s children will have to apologize for the mistakes of this generation when it came to Ebola, just like I am now apologizing for the previous generation’s response to AIDS. It is embarrassing to me that we let politicians have our public health discussions instead of allowing those who really know how these things work to do just that… WORK.

Here is the Senate hearing on Dr. Murthy’s nomination, if you want to pull your hair out at the sight of well-fed, well-paid, fully-taken-care-of politicians gambling with our nation’s (and maybe even the world’s) public health. No doubt this little rant of mine, which will live in cyberspace for the foreseeable future, rules me out of any political nominations — at least at a Federal level. I can live with that. I can live with being a troublemaker.

Long live the troublemakers.

I'm a doctoral candidate in the Doctor of Public Health program at the Johns Hopkins University Bloomberg School of Public Health. All opinions posted here are my own, of course, and they do not necessarily reflect the opinions of my school, employers, friends, family, etc. Feel free to follow me on Twitter: @EpiRen

5 thoughts on “Those who are divorced from reality

  1. The New England Journal of Medicine has weighed in about the Senate’s deliberate stalling of the confirmation of Dr. Murthy’s confirmation as United States Surgeon General, due to the influence of the NRA:

    http://www.nejm.org/doi/full/10.1056/NEJMe1412890?query=featured_home

    “…..President Barack Obama nominated a highly qualified candidate, Vivek Murthy, to be the nation’s next Surgeon General, but the nomination was not advanced to a confirmation vote in the Senate because conservative lawmakers and the National Rifle Association found his very reasonable views on firearm regulation unacceptable. A highly respected physician with impressive credentials who would have been an outstanding Surgeon General was turned away solely for political reasons.

    That was in March, and nothing has happened since. Although we believe that Vivek Murthy would bring much to the job, the harsh political environment in Washington is unlikely to allow his confirmation. Given this impasse, and in these critical times, the Obama administration should select another candidate to be the nation’s public health leader. Although the Acting Surgeon General, Boris Lushniak, is well qualified, he has not been confirmed and lacks the authority to actively pursue a public health agenda for the nation. We have heard little from him during the Ebola outbreak. Now, more than ever, we need a confirmed Surgeon General who can speak to the public with authority…..”

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    • You know, I was going to include that conclusion last night when I wrote this, that the President needed to play the game and nominate someone palatable to the Republicans and even the few Democrats who serve the NRA. But I thought about it a little more. Any person worth their salt for the job could and should see guns as a public health issue, especially when it comes to suicide and accidental discharges. So, no, don’t compromise on this because it is s big public health problem, and the NRA should not be a branch of government. There are plenty of sensible solutions to the problem that do not violate the 2nd, like having doctors ask about guns and help finding a “home” for guns in possession of someone who is suicidal until their condition is improved. Or allowing a family physician to recommend gun safes or gun locks to family who owns guns and has small children.
      One of my wife’s good friends is married to a state patrolman. He has two gun safes for the rifles and guns passed down to him from his family. They also have a little girl. I’m not at all worried about her because he knows how to handle guns, he keeps them locked and unloaded, and I’m sure and reasonable healthcare provider would hear that and move on. The NRA seems more worried about unstable and irresponsible or ignorant people being put on a responsible path. Why?

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      • Open Secrets provides the list of the NRA contributions to Senate Republicans and Senate Democrats. Scroll down to see the great disparity between the NRA’s contributions targeted against Democrats-versus-the contributions against Republicans:

        https://www.opensecrets.org/orgs/summary.php?id=D000000082

        And, why shouldn’t a Surgeon General speak out about preventive healthcare/safety measures such as smoking cessation programs, child safety seats/booster seats in automobiles…and responsible gun ownership?

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        • You well know that I’m retired military.
          What is unlikely to be known here, as firearms is a rare bit for discussion is, I’m a hunter and competition shooter. As such, I have a keen interest on matters concerning firearms.
          Notable is, I am not and will not join the NRA. The NRA turned away from being a body dedicated to the sporting usage of firearms into a combination of yahoos and has over 60% interest “owned” by firearms manufacturers. As in board of directors “owned”.
          After all, having a ready-made advocacy group is great, especially when one hijacks it.
          So, I’ll stick with the much more sane and sedate CMP competitions. The Civilian Marksmanship Program was established by Congress in 1903.

          As for our mental health care system, it is a national embarrassment.
          After a handful of cases of abuse of the state mental hospital systems, we dismantled those systems in favor of a community based mental health care system.
          The problem is, we never funded that community based mental health care system.
          At least we compassionately discharged those who were in the now closed hospitals.
          Oh wait, we didn’t. In many cases, mental patients were quite literally discharged onto the street outside of the closing facility.
          That last is something I personally witnessed with Byberry mental hospital. The mentally ill homeless people became a plague upon the West Philadelphia neighborhood and eventually were pushed southward, where they created a nuisance for center city businesses. At that point, many were given a new “home”, prison.

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          • I should add, all of my firearms are locked in safes. Two are loaded and in small safes in an area of the house we frequent, as those are for the vanishingly small chance of a home invasion defense action.

            When my father, during the course of his dementia, asked for one of his firearms, I proceeded to secure his firearms in my firearms safe, as he did not have the key to it. I then addressed that issue with his physician at our next appointment.

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