august 1965

Thoughts and prayers. It began as a cliché. It became a joke. It has putrefied into a national shame.

If tonight, Americans do turn heavenward in pain and grief for the lost children of Uvalde, Texas, they may hear the answer delivered in the Bible through the words of Isaiah:

“And when ye spread forth your hands, I will hide mine eyes from you: yea, when ye make many prayers, I will not hear: your hands are full of blood.”

We will learn more about the 18-year-old killer of elementary-school children: his personality, his ideology, whatever confection of hate and cruelty drove him to his horrible crime. But we already know the answer to one question: Who put the weapon of mass murder into his hand? The answer to that question is that the public policy of this country armed him.

“I knew it was rotten, but it’s astonishing and infuriating. This is a denomination that is through and through about power. It is misappropriated power. It does not in any way reflect the Jesus I see in the scriptures. I am so gutted.”

That’s what Jennifer Lyell, a survivor who was an executive at the Southern Baptist Convention and whose story of sexual abuse at a Southern Baptist seminary is detailed in a devastating 288-page report by Guidepost Solutions, told The Washington Post.

The report concludes that for almost two decades, the men who ran the SBC’s executive committee, which oversees the day-to-day operations of the nation’s largest Protestant denomination, lied, engaged in cover-ups, sided with those who were credibly accused of abuse, and vilified victims of abuse. Past presidents of the convention and a former vice president allegedly protected and supported accused abusers. A Southern Baptist pastor who had been a senior vice president of the SBC’s missions arm was credibly accused of assaulting a woman, the report finds. The trail of horrors goes on and on.

Some propositions are so obvious that no one takes the time to defend them. A few such propositions are that human life is good, that people can and often do provide more benefits to the world than they take away, and that we should design society to support people in leading lives that are good for themselves and others.

These ideas came under attack, sometimes subtly and sometimes overtly, by environmentalists in the 20th century who were worried about overpopulation. Although major organizations have abandoned population management as an explicit policy goal, the underlying fear that too many people are running up on the limits of too few resources and Well shouldn’t someone do something about that? has never fully been rooted out of American political thought. It is alive and well among NIMBYs. Of all the objections people raise to new housing and infrastructure, perhaps the most risible is that their community is already too crowded. Some even suggest that municipalities should limit housing supply explicitly to combat population growth.

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The teenagers are not all right, but then again, neither are the adults. Pandemic life has been profoundly jarring, and every generation has felt it. I hear about people fighting on airplanes and an increase in violent crimes, then I attend my Alcoholics Anonymous meetings on Zoom and try to figure out why going back to “normal” is so hard. My 80-year-old mother never got COVID-19, but more than two years of sitting at home seems to have hastened her descent into dementia. Meanwhile, many young children are struggling to keep up with their education or even learn how to socialize.

Now imagine what this moment must be like for teenagers. In December, U.S. Surgeon General Vivek Murthy issued a warning: Pandemic-related death, fear, loneliness, and economic uncertainty have worsened “the unprecedented stresses young people already faced.” It makes sense. Between unfamiliar hormones and trying to figure out who you are in the world, being a teen has always been incredibly hard. Pandemic teenagehood is even worse. Recently, I was reading a story in The New Yorker about child suicide when I learned that a friend of a friend’s teenager had died by suicide. I felt sick.

As I opened the CT scan last week to read the next case, I was baffled. The history simply read “gunshot wound.” I have been a radiologist in one of the busiest trauma centers in the United States for 13 years, and have diagnosed thousands of handgun injuries to the brain, lung, liver, spleen, bowel, and other vital organs. I thought that I knew all that I needed to know about gunshot wounds, but the specific pattern of injury on my computer screen was one that I had seen only once before.

In a typical handgun injury, which I diagnose almost daily, a bullet leaves a laceration through an organ such as the liver. To a radiologist, it appears as a linear, thin, gray bullet track through the organ. There may be bleeding and some bullet fragments.