One of the most formative years in my life was the time I spent volunteering as an EMT with the men and women of Montgomery County Fire and Rescue Service. There, I learned an important skill: problem solving in the midst of chaos.
Imagine being dispatched to the scene of a car accident. It’s one in the morning on Cinco de Mayo. There are two mangled cars just outside the Mexican restaurant, and the drivers are sitting in the grass. Your patient is a middle aged man with darker skin and a foreign accent. He smells of alcohol, is quite agitated, and his speech is slurred. He says he feels nauseous. The other driver has a M.A.D.D. sticker on her bumper, and irately demands the police arrest him for drunk driving — but not so fast. There are other factors to consider here.
A diabetic emergency could also explain this situation. If a diabetic’s blood sugar levels are too high or too low, they can act like they are drunk: their speech begins to slur, and they may become aggressive. Additionally, their breath can smell fruity, or like acetone. Fortunately, diabetic emergencies are generally slow moving, and are easy to treat.
However, there is another, more serious cause to consider. People with traumatic brain injuries can also become aggressive, feel nauseous, and have slurred speech. Though this doesn’t explain the breath smell, head injuries are far more difficult to treat, and can quickly become life threatening.
Already, this is a stressful situation. Two people are injured, valuable property has been damaged, and emotions are high. Making things worse, there are linguistic and cultural barriers that feed prejudices and cloud judgement. It’s easy enough to overlook a potential cause, especially when political causes get involved. However, if the patient has a brain bleed and you send them to jail in the back of a squad car, they might die in their cell overnight.
As a healthcare provider, it is critically important to quickly identify the problem and begin treatment— but an incorrect diagnosis is more than worthless. For this reason, we operated under a principle I learned from a Green Beret: slow is smooth, and smooth is fast. The idea behind this simple quote is that rushing to conclusions leads to costly mistakes. The time and effort it takes to fix that mistake is often far more costly than taking the time to get it right the first try.
Slow is Smooth, and Smooth is Fast
Like the scenario above, the first step in coming up with a solution to “mass shootings” is understanding the problem.
So far, we’ve done a terrible job at that. Groups like “Everytown for Gun Safety” and “Moms Demand Action” ply on emotions, waving pictures of dead children and demanding a immediate solution. They make exaggerated claims, like mass shootings happen every day in America, or that 100 people are killed every 24 hours by a gun.
These claims are misleading — and I can’t help but think this is deliberate. By lumping all problems under the banner of “gun violence”, you can inflate the size of the problem, and make your pet solution the panacea. However, this is simplistic. It’s like saying Advil is the solution for every pain. This approach only treats a symptom, and masks the underlying problems. To find a solution, we must first break “gun violence” up into categories.
Suicide
The majority of gun deaths are suicides (62%). I’m loathe to consider suicide a “gun violence” problem. Technically, suicide is violence unto yourself, but I think a more common understanding of violence assumes that there are two parties. However, suicide prevention is something I care about, so I will address it here.
Here are some statistics, according to the American Foundation for Suicide Prevention.
- 45,000 people die each year by suicide, 123 every day
- In the time it takes you to read this article, someone will have committed suicide
- Half of suicides are by firearm
- White males account for 7/10 suicides
- Most suicides occur between the ages of 45–54
Since we are interested in the tool instead of the act, what leads a suicidal person to use a gun? According to this study from Harvard, the primary factors that a suicidal person considers when choosing their means is how deadly it is, and how easy it is to use. Availability takes third place. (To understand this intuitively, consider that fire is universally available, but infrequently used to commit suicide in the US.)
However, this only addresses a portion of suicides. Are we not concerned with the rest of the suicides, simply because they chose different means? While Everytown happily uses suicide statistics to boost their statistics, they don’t call for gun control when someone commits suicide with a gun. At least, if they do, you don’t hear about it. (This is not to say that they would be pleased with a decrease in suicides, rather that their primary concerns are elsewhere. As much as I disagree with them, I don’t believe they’re total monsters.)
However, it is a startling statistic that 70% of suicides are white males. Maybe we should take this into consideration for later.
Homicide
The smaller portion of gun deaths (35%) are homicides. Here’s some statistics on homicide from the FBI.
Please note that this number also includes justifiable homicide — including police involved shootings. However, these are less than 1%, and no one calls for gun control legislation when police are accused of killing an innocent person.
- Homicide predominantly affects males
- 67% of homicides used a firearm, primarily pistols
- Victims are 50.4% black , and 47.0% white
- Only 20% of homicides have multiple victims. The majority of homicides are a 1-to-1 relationship.
- 85% of murders are related to “arguments”, romance, etc
- 9% of murders occur during felonies (robbery, rape, etc)
- 6% of murders are gang related
One interesting section of the document lists the circumstances that lead to the homicide. Unfortunately, it left me wanting more information. The largest category, “other arguments” is a pretty vague description. Clearly, these statistics are difficult to gather.
Regardless of the statistics, I want to highlight a single point. On average, Chicago has 60 murders a month. In June of this year, 52 people were shot, and 10 died in a single weekend. If all the shootings happened in 48 minutes, there would be immediate calls to “do something” — but since it was spread out over 48 hours, it slips under the radar.
Is this not of some concern? Sadly, these statistics are often met with a shrug, and few call for a solution with any sense of urgency.
Shooting Sprees
Finally, we come to the problem that I think we actually want to solve: shooting sprees.
As I discussed in a previous article, “mass shooting” is a bad term because it is subject to victim count. “Shooting spree” is a far more concrete term. For example, no one died in the Congressional Baseball shooting — which may mean it doesn’t qualify as a “mass shooting”. However, the term “shooting spree” succinctly defines what we’re talking about. Someone attempted to kill as many people as they could before they could be stopped.
It is important to understand that less than 1% of annual gun deaths are due to shooting sprees. This doesn’t diminish their importance — and hopefully this point reaches those that scoff whenever someone on the other side of the political spectrum discusses their concerns about terrorist attacks. Rather, I mention this only to say that with sparse data, it makes it difficult to understand the problem — especially when the perpetrator dies before an investigation can take place.
Shooting sprees can be divided again into three categories.
The first type of shooting spree, which people seem to be disinterested in, is terrorism. The best example I have to illustrate this is the Bataclan shooting in Paris, where 90 people lost their lives. Fortunately, this isn’t a problem we typically have in America, but it should be noted that France’s gun laws are strict. The cause here was that ISIL equipped, trained, and funded travel for three men to kill as many civilians as they could in retaliation for French airstrikes.
The second type of shooting spree, which people seem to be more interested in are by the mentally disturbed. One characteristic of these types of shootings is that the shooter seems to be incoherent, and more like a rabid dog. The best example I have of this is Sandy Hook, where a young man walked into an elementary school and murdered a classroom of children.
The third type of shooting spree, which people seem to be the most interested in are those motivated by hatred. In these instances, the shooter usually leaves a manifesto of sorts, indicating their hatred for a particular group. There have been several high profile shootings this year — at a mosque in New Zealand, and a synagogue in California.
Different Causes, Different Solutions
In the past, some shooting sprees were attributed to mental illness. In 2011, a man killed 77 people and injured 319 at a youth camp in Norway. In his lengthy manifesto, it became clear that part of this was due to hatred of Muslims. However, doctors diagnosed him with paranoid schizophrenia and psychosis. In 2014, another man killed 6 women and injured 14 more at a sorority because of his hatred of women. Doctors also diagnosed him with mental illness.
Some of my friends have told me they want to view all shooting sprees as terrorism. Consider that while the Bataclan had elements of hatred, there was something that separates them from the El Paso shootings. After the shooters were dead, there was still an evil to confront: the group that funded and organized the attack. After El Paso, who do we confront?
I think it is important to classify shooting sprees differently, because it helps identify which solutions are effective.
For example, some people say we shouldn’t print the shooter’s name because they seek infamy and the top place on a twisted “score board”. While there may be some truth to this statement (and please note that I’ve tried to adhere to it in this article), I think the El Paso and Sorority shooters hatred trumped any desire for notoriety.
Some people have argued that we shouldn’t publish the shooter’s manifestos, and should have the government censor them as prohibited information as they did in New Zealand. However, light is the best disinfectant. Without understanding their motives, would the recent El Paso shooting still be lumped in with “mental illness”? Can you imagine trying to solve hatred with psychiatric medication?
We Need More than a Band-Aid
With an understanding of the problem, we can begin a search for a solution. Clearly we aren’t trying to fix suicide, inner city violence, or terrorism. Our solution should be tailored towards shooting sprees. But this article is already too long. Whether you think America should ban guns or not, what should be self evident is that society has a serious problem. Gun control is no more than a band-aid.
Stay tuned for my next article. I have some ideas.
This is the fifth article in a series on Mass Shootings. To read more, please follow the links below.
