How can physicians prevent gun violence?

Hundreds of thousands die by firearms each year, but NRA has blocked organizations from researching deaths

When Roger arrived at Ben Taub Hospital’s Trauma Center, he had been shot — twice. One bullet had torn through his lung and narrowly missed his heart. Another ripped holes in his intestines before exiting through his back. Tragically, he was only 1 of 5 victims of violence my surgical team operated on that night. And we would repeat the ritual the next night and the next in what seems a never-ending stream of tragedies.

Was Roger’s injury that night inevitable? Could it have been prevented? He was only 20 years old. Will he be one of the many repeat patients we see with barely healed scars from past gunshot wounds, until one day we won’t be able to save him? We don’t know the answers to those questions because research into the causes and prevention of gun violence is hard to come by. We know how to make automobile crashes less deadly, how to prevent the ravages of smoking, and how to stop the spread of dangerous infectious diseases because solid research gives us the tools. When five people died recently from E. coli contamination of Romaine lettuce, the Centers for Disease Control and Prevention launched a massive investigation into its source in an effort to stop its spread and prevent future outbreaks. Yet little is being done to find out how to prevent a staggering 36,000 firearm related deaths in the United States every year — two people every 33 minutes.

Why is there so little information about gun violence? It’s simple. Because the National Rifle Association and its friends in Congress don’t want us to know that guns are the key to gun violence. Beginning in the early 1990s, researchers examined whether having a gun in the home was more likely to protect occupants from crime (e.g., self-defense) or more likely to increase their risk of violent crime. Several studies showed that individuals with guns in the home were nearly three times more likely to die from homicide or suicide than those who did not.

This research was so damning that the NRA sent lobbyists to strong-arm politicians to stop it. Since several of those early studies had been funded by the National Institutes of Health, the NRA demanded that Congress eliminate all funding for gun violence research from the NIH budget. They succeeded, but only in curtailing NIH research.

CDC continued to fund studies despite pressure from pro-gun groups. Again, the gun lobbyists descended on lawmakers and convinced them to put the industry’s profits first. In 1996, Congress passed the Dickey Amendment, which effectively banned the CDC from funding any research on gun violence as a public health issue. In the 22 years since, more than 600,000 Americans have died from gun violence.

Private organizations have stepped in to fund some research. But these efforts lack the power and reach of NIH and CDC. And they are hampered by a shortage of reliable data. While motor vehicle deaths are carefully researched, there is no equivalent funding for gun deaths. And the NRA has managed to make the work more difficult by pushing Congress to block the Bureau of Alcohol, Tobacco, Firearms and Explosives from distributing information from its national database on guns used in crimes.

The inability of legitimate research institutions to weigh in on the public health impact of gun violence has left an information vacuum that has been filled by the NRA and its assertions that a gun in the home is the best protection for families; that arming teachers will protect students; that the best defense against a bad guy with a gun is a good guy with a gun. Despite the NIH’s research to the contrary, a recent Pew Research Center poll found that 57 percent of Americans believe that owning a gun protects them from crime while only 38 percent believe that it endangers their safety. This is a tragic failure of our representatives to safeguard their constituents.

As a surgeon who repairs the damaged organs and torn blood vessels left in a bullet’s wake, I want to know how to keep it from happening in the first place. Just as primary care doctors help control their patients’ cholesterol and blood pressure in an effort to prevent heart attacks and stroke, those of us who care for traumatic injury need to know where to focus our efforts.

Lifting the ban on firearm related research is one step in the right direction. With more reliable information, I may see fewer 20-year-old gunshot victims in the trauma center, and parents will be able to send their children to school with some assurance that they won’t be shot and killed.

Vera is a trauma and acute care surgeon at Ben Taub Hospital and director of the surgical simulation programs for the Michael E. DeBakey Department of Surgery at Baylor College of Medicine.