Posted on June 10, 2024

Spoiler Alert: Problems are not Solved in the Face of Actionable Solutions and Frank Evidence

If you were born in the United States, I bet you two Indian nickels that you are slathered in that special sauce of American exceptionalism. A hearty thanks to social media for instilling the belief that you are so exceptional that the entire world needs to know about your mankini wax gone awry. “It was horrible. HORRIBLE!” you cry. The world needs to KNOW. And, they will all pay.

This is a stupid example, don’t listen to me.

But you’ve had it rough. I know. Life isn’t fair and sometimes parents suck in ways I can’t even begin to tell you about. I studied the effects of childhood trauma on adult outcomes, I worked in both inpatient and outpatient psychiatry, and earlier, I specialized as an MD in forensic pathology. I’ve studied the traumatized and addicted brain. It hurts. And our society does not care. Smile. It will all be okay. Or, YOU are wrong and YOU are broken. Booo her. BOOOO HER! (Thank you, Princess Bride.)

But something went bonkers, and now it’s normal for people to think that a shopping mall filled with strangers deserves to feel the pain and fear that you keep shoving into some dark corner of your spleen, because damn it, you are important.

So, Mr. or Ms. Personality, you wake up one morning and decide that today, everyone will pay. You are on a mission to create mass harm, hysteria, and destruction. Lucky you, the country is your oyster, and you have your pick of any pearl. The illegal (and legal) gun trade has slowed down about as much as drug trafficking or illicit border crossing. You can also buy one. It is simple to lie on the “Do you have any history of mental illness or hospitalizations?” question because there isn’t a background check to speak of. In some states, there isn’t a waiting period. In other states, you can sell someone a gun in the parking lot of a used gun store with only a text message as proof of receipt. I do not know this from personal experience.

God made man.

Colt made men equal.

Browning made them civilized. 

Yay. Imperialism. Ask China about the Opium Wars. I mean, choosing to trade Britain for the good Bengali stuff over guns and cannons to defend yourself against the British drug lords when you stopped wanting opium was a choice you could make…OOOOF. Hubris is a kicker. Side note: I’m half Chinese, which is a super complicated story for another time as I will talk your ear off, and half American, the “my ancestors have been here since the 1600s and fought the Revolutionary War, The War of 1812, and both great wars and I am damned patriotic about it” kind of American, so I am allowed free license to talk smack.

Gun control is clearly the answer

So, then, let’s cut off the supply. Gun control must be the only way to bring the recent uptrend and total normalization we see with mass shootings to a grinding halt, correct? I wish it were that simple. 

Unfortunately, the glaring fact remains that guns cannot load and shoot themselves. I also happen to be a firm believer in the spirit of the Founding Fathers and I like the original purpose of the Second Amendment.

Blame has been defined as the discharge of uncomfortable emotions onto a person or issue when one does not know what to do with their feelings or how to address a problem. Assigning blame to one entity is far easier than critically examining a highly emotional, complicated, multifactorial matter with an equally convoluted answer far too difficult for anyone but we crazy scientists to willingly want to deal with. It has become politicized and is more than any politician wants to deal with. A scapegoat is a lot easier. It rallies people, and it is low-hanging fruit. Super easy to rile them up and get you the vote of approval of the masses (that don’t like critical thinking.) Just ask Hitler! So, it makes perfect sense to blame the legal sale and availability of these weapons for the surge in mass shootings. Occam’s razor. The simplest solution is the best solution, right?

Sorry, not this time. Is ANYTHING truly that simple? If you say yes, we need to talk.

“But why a SPOON, Cousin? Why not an axe…”” Because it’s dull, you twit, it’ll hurt more!”

-On why the Sheriff of Nottingham wishes to cut Robin of Locksley’s heart out with a spoon. Duh.

Those determined to impart terror and death upon others possess a morbid imagination, and if they intend to destroy, they will carry out their mission whether they have access to firearms or not. (Also, you can get a gun illegally. It’s not hard. But never mind.) Case in point, one White Supremacist concocted the perfect plan to murder a LOT of Black men, as a “declaration of global total war on the Negro race,” men specifically of the “thug” variety that corrupted young white women by dating them.

How, might you ask? How did he plan to ignite this global “political terror attack,” a call to action for concerned White Supremacists everywhere? With a sword. A Roman-style one, it has been said. Thankfully, the young man did not get the memo that he was to train like a Spartan for the Peloponnesian War, and he was quickly stopped, though not before killing an elderly gentleman and traumatizing a crowd of people. I guess we are lucky he didn’t take the Medieval-style sword theme and simultaneously release the bubonic plague.

This is not an isolated incident. If you are bored, and want to gawk in horror at some bizarre clusterf*ck of “reverse racism” (As they say, because it was directed against a White Devil. But to me, racism is just racism.) and a sick form of poetic justice directed at random at a rehabilitated school shooter, this not only proves my point but makes you really wonder how our society became so…just read it.

So get on with it, woman.

Point being, people hell-bent on acting out their deep-seated pain by inflicting harm upon others will find a way. They will take LARPing a step too far, or as seen in other countries, find alternative uses for kitchen knives or other stabby items, utilize neurotoxins like Sarin or Novichok, manufacture explosives (we are far too familiar with this one), procure illegal firearms, or, as I have witnessed working trauma surgery on the weekends, screwdrivers and pencils will work just fine.

But why? Why is this now a trend? And why is there so much heat on guns? They are more destructive, and the death toll is far higher, and I get that. If you want nightmares and anxiety, here is this for you.

Why have so many people, particularly juveniles, concluded that the indiscriminate slaughter of innocents is an appropriate way to express their hurt, fear, and anger to the world? With firearms, in particular?

Well, we don’t really know. Specialists in psychology, education, development, human cognition, medicine, and other areas of study propose a broad spectrum of etiologies, ranging from childhood trauma to the increase in global terrorism. The experts can't even decide if a mass shooting is defined as 3 or 4 people or more, and researchers have yet to agree upon any clear evidence-based conclusions or insights into this issue. Given the drastic escalation of these events throughout an eyeblink, why have we not figured out why this occurs and developed a way to temper the violence?

Thanks, Dick.ey.

Well, we weren't allowed to study mass shootings for decades. We weren’t allowed to study gun violence in any capacity at all. A 1993 CDC (Center for Disease Control) funded study published in the well-known New England Journal of Medicine found that home gun ownership was more closely correlated with the risk of homicide by a family member or friend than offering self-protection. In the 80’s, the CDC began to consider gun violence a public health concern, as in 1983, the two types of frequent injury deaths were motor vehicle accidents and gun violence. This was under the jurisdiction of the CDC’s National Center for Injury Prevention and Control, and the champion of gun violence research was Dr. Mark Rosenberg. He was calling for more research to understand the factors that led to gun violence from an epidemiological, or public health, standpoint.

This infuriated the NRA, so they turned the volume up to eleven on their lobbying game and partnered with an Arkansas congressman named Jay Dickey (R-AK) to counter what they took as a CDC bias towards gun control. There were some very awkward meetings between Dickey and Rosenberg over the budget, and the CDC was attacked for hating the Second Amendment. And freedom.

Don’t take our guns. Even if they are clutched in our cold, dead hands.

Chaos and hilarity ensued. Rosenberg was fired, and Dickey and the NRA garnered enough support to stick a rider onto the Omnibus Consolidated Appropriations Act, Pub. L. No. 104-208 (1996) to counter the CDC findings and defend gun ownership, known as the Dickey Amendment. In all honesty, it was a loosely worded budget thing, a provision on the 1996 spending bill that stated, “None of the funds made available in this title may be used, in whole or in part, to advocate or promote gun control.” *Note that it doesn’t explicitly say anything about RESEARCH.*

But people were mad. Congress, with a Republican majority, reallocated $2.6 million of the CDC budget to study traumatic brain injuries. This mysteriously matched the amount spent on gun violence research the previous year. As nobody else at the CDC wanted to risk losing their jobs or any more funding, they caved to pressure from the NRA and its supporters. They interpreted the amendment to mean that they were banned from funding any research on the subject of gun violence. I am not sure if anyone in the government can read, or has any common sense.

Then, the amendment was extended in 2011 by the Consolidated Appropriations Act, Pub. L. No. 112-74 (2011) to include the NIH (National Institute of Health), a major source of funding for scientists everywhere. NIH-funded research discovered a link between gun possession and assaults. This was unacceptable to the NRA. Guys, this should be obvious. Really? Yes, really. But it’s a touchy subject. People make assumptions. The effects even reached sources of private funding, as nobody wanted to deal with the wrath of the NRA. But as I said before, guns do not load and shoot themselves. Guns + People = Death. Don’t just focus on the gun part. That is idiocy, and yet we do it. People are the problem here.

We don’t want to take your guns. Don’t take our research!

So, research about gun violence in any capacity ground to a halt. Researchers had nothing but empty datasets spanning decades, information that would be crucial to understanding the period when mass shootings (no pun intended) blew up the news. The funding ban had far-reaching effects, halting progress in areas that weren’t even focused on the correlation between gun ownership and violence. For example, emergency rooms could not research and develop better ways to assess, classify, and treat gunshot wounds.

The 2012 Sandy Hook shootings prompted President Obama to ask the CDC to ease up on the amendment. Perhaps the matters at hand (scores of dead children) could sway their dear hearts to interpret it less literally, and it did not have to mean a complete ban on funding gun violence prevention research. Buuuuut, nope. Crickets from the good ol’ Center Which is Responsible for the Study and Prevention of Public Health Emergencies.

The President pretty-pleased Congress to allocate funding to the CDC for this purpose, and despite the power of Obama’s super-smooth, silver-tongued moxie, they said NO. They remained squeamish on the matter and refused to release funding for years, and the NIH followed suit. The NIH finally began to request and receive funding on a small scale around 2017, while the CDC continued to skirt the subject. More people died. We sat around, doing nothing.

They reached critical mass

The federal government finally re-addressed the necessity for research and data collection after the February 2018 Florida school shooting left 17 people dead. In March 2018, Congress passed a $1.3 trillion budget, and President Donald Trump signed an omnibus bill to clarify that the CDC and NIH cannot use federal funding to promote gun control (This should have been obvious that it would be blatantly unconstitutional if they did, but nope.), but this in no way implied that funding research on gun violence was prohibited. The Secretary of Health and Human Services stated that the CDC had the authority to research the causes of gun violence. The budget for Injury Prevention and Control doesn’t specifically put aside funds for gun research, but it can fall into categories like intentional or unintentional injury.

More frequent and larger funding awards and more effective investigations have taken root over the last few years, but we still don’t know very much. Ongoing studies of the negative effects of this ban and study of the subject itself call for the continued need for research funds and interested parties. The matter has been reviewed as recently as February 2024, by the Journal of the American Medical Association – Surgery.

The ordeal is saddening, as some of the most devastating events occurred during the ban, and we were forced to look the other way. It was forbidden by the government to delve deeply into the “why,” so we couldn’t figure out a “how.” The “how” was buried, lying stagnant at the bottom of a pool of political mud. It was a veritable political sh*t show, a very real issue that never gets solved because the kids won’t stop fighting. But in the words of Vonnegut, “So it goes”.

What once horrified and shattered our hearts has become so commonplace that it is just another bit of daily news that might raise an eyebrow. Active shooter drills have become as normalized as fire drills. And as we do not know “why,” we continue to stumble to find a preventative “how.”

When you ASSUME, you make an ASS out of U and ME

The worst part of this entire ordeal is that it was all based on a misunderstanding. So, the wording of the amendment did not say the CDC could not fund research on gun violence to figure out why it was a thing, or why mass shootings were becoming a bigger and bigger thing. There was no limit placed on funding these kinds of studies. It stated the CDC could not call for specific legislative proposals that would restrict people from buying or using firearms. The rider in and of itself was protecting the Second Amendment. Nothing wrong with that. The CDC was trying to find out why people had such a problem with gun violence. Nothing wrong with that.

The politicians and lobbyists ran amok, people freaked out, the CDC freaked out, assumptions were made, and the whole thing became politicized. Like every other hot button, nobody bothers to read the damn statute, people don’t talk to each other, and emotional decisions are made. People stopped thinking. It was no longer about figuring out why people were shooting and killing each other or protecting our rights. It was about money, egos, and red vs. blue. THIS IS WHY WE CAN’T HAVE NICE THINGS.

It was a mistake. The NRA and Dickey took the CDC research to mean that the CDC was against the Second Amendment and was plotting to enforce gun control laws based on their research. Dr. Mark Rosenberg, in those early meetings with Dickey, didn’t understand why he thought this was his agenda. In the 80s and 90s, as I’ve mentioned, the CDC had just begun to look at gun violence as a public health issue, as even a kind of epidemic. They couldn’t explain why it caused 70,000 injuries and 30,000 deaths a year, and most of these were accidents and suicides. So, they started to look into it.

There are always two sides to understand

The landmark CDC 1993 study was the shot heard ‘round the world. Rosenberg was not anti-gun, as the NRA and Dickey accused. He promised Dickey that the CDC did not want to take anyone’s guns. The Injury Prevention team just wanted to know why America seemed to have such a marked propensity for gun violence as compared to other countries, so they could…prevent injuries. Doing something about it didn’t mean imposing gun laws, the CDC doesn’t do that. They look at people and their habits, and factors that affect their physical and mental health, lifestyle choices, demographics, and behaviors that lead to disease or injury. We have already shown that people will hurt one another no matter what. Preventing violence, whether doled out by swords, knives, kitchen implements, school supplies, suicide bombing, poison, or guns was the goal. But, to get to the prevention or intervention part, we needed to study why it occurs in the first place.

Looking at it from the other side, the Second Amendment is important for many reasons and is constantly under attack. Both sides will not accept reason one way or another and it often ends up being black or white. There is seldom any logic or discourse. If I look at it from this vantage point, I can see how the NRA and Dickey might think the CDC was siding with the left. If their research continued to show that GUNS + PEOPLE = DEATH, It would be easy for a politician who can influence legislation around gun restrictions to jump all over the GUNS part, ignoring the PEOPLE part. And this is exactly what happens every day. The Dickey amendment was fair. Constitutional, even. No. A federal government agency should not be able to use federal funds to promote gun control and screw with the Second Amendment. How that translated to “BAN RESEARCH!” baffles me, and it also doesn’t. Fear, I suppose. Fear that “the other side” will use it against you, because they will. It hasn’t been about the American public in a long time. It isn’t about us, our welfare, or our rights. It is about politics and votes. And it has become so polarized that it is us vs. them.

“We won’t know the cause of gun violence until we look for it”

Dickey regretted the backlash of his crusade. He didn’t know that it would put us into the stone age regarding the issue of mass shootings, and wished that the consequence of the 1996 debacle had not been “U.S. Scientists cannot answer the most basic question: What works to prevent firearm injuries?” Rosenberg didn’t know that his crusade would be misinterpreted, would cause so much trouble on both sides, and wished that he had proclaimed from the mountaintops on day one that the CDC had zero intention of banning guns.

Rosenberg and Dickey did something unheard of. They began to talk. They just started talking. Neither can explain it. People told Rosenberg to avoid Dickey, but one day, the congressman wanted to review some data, and Rosenberg couldn’t slink out in time. And then, they used their words without an agenda to harm. They asked about their kids. Normal human stuff. They hit it off, and they kept talking, and talked honestly. After more of this talking thing, they became friends. And they began to talk about guns.

Dickey told his new buddy how it looked like the CDC was anti-gun, especially since they’d backed down and appeared to lose interest in response to his amendment. D’OH! Rosenberg told his new buddy that it wasn’t guns but injury prevention that he was interested in and had planned to study the problem while protecting gun rights, but he realized he never made his intentions clear. D’OH! The bromance grew. They understood the problem. They went public after the Aurora, CO 2012 theater shooting. They wrote an opinion piece together, “We won’t know the cause of gun violence until we look for it.”

Neither of them feels they have made a difference in the debate. Rosenberg and Dickey understand the duality and agree that science must take over the research and remove it from politics, but the research also must be clear that there should be no policy implications. They suggest funding the studies with the Dickey amendment in place. IT MAKES SENSE.

Dickey says, “I wonder if anyone is paying attention. The debate has become so polarized, the language so extreme, that our efforts to be reasonable don't seem to break through the noise.”

And so it goes.