september 2008

After each of the repeated mass shootings that now provide a tragic backbeat to American life, the same doomed dance of legislation quickly begins. As the outraged demands for action are inevitably derailed in Congress, disappointed gun-control advocates, and perplexed ordinary citizens, point their fingers at the influence of the National Rifle Association or the intransigent opposition of congressional Republicans. Those are both legitimate factors, but the stalemate over gun-control legislation since Bill Clinton’s first presidential term ultimately rests on a much deeper problem: the growing crisis of majority rule in American politics.

Polls are clear that while Americans don’t believe gun control would solve all of the problems associated with gun violence, a commanding majority supports the central priorities of gun-control advocates, including universal background checks and an assault-weapons ban. Yet despite this overwhelming consensus, it’s highly unlikely that the massacre of at least 19 schoolchildren and two adults in Uvalde, Texas, yesterday, or President Joe Biden’s emotional plea for action last night, will result in legislative action.

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.

It’s suddenly become acceptable to say that COVID is—or will soon be—like the flu. Such analogies have long been the preserve of pandemic minimizers, but lately they’ve been creeping into more enlightened circles. Last month the dean of a medical school wrote an open letter to his students suggesting that for a vaccinated person, the risk of death from COVID-19 is “in the same realm, or even lower, as the average American’s risk from flu.” A few days later, David Leonhardt said as much to his millions of readers in the The New York Times’ morning newsletter. And three prominent public-health experts have called for the government to recognize a “new normal” in which the SARS-CoV-2 coronavirus “is but one of several circulating respiratory viruses that include influenza, respiratory syncytial virus (RSV), and more.”

The most important thing you need to know about yesterday’s tragic school shooting in Texas is that absolutely no laws are going to change as a result of it.

In the 14 years since the Supreme Court found an individual right to bear arms under the Second Amendment in the landmark case of D.C. v. Heller, the federal judiciary has only grown more conservative. The courts will likely bar any meaningful restrictions on the possession of firearms for at least another generation.

Your fellow Americans, meanwhile, who collectively bought 40 million firearms in 2020 and 2021, have grown even less enamored with the various gun-control measures typically floated by politicians after such tragedies. In Texas, the same Republican lawmakers cruising to reelection this fall made relaxing the state’s already permissive gun laws a priority in the last legislative session.  

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.