- - Wednesday, December 26, 2012


It is tragic for a parent to have to bury a child. We are lucky to live in a time and place where this occurs so much less often than it has throughout history. But our sense of security was shattered by the recent bizarre mass murder that took the lives of 20 children and seven adults in peaceful Newtown, Conn.

Within hours of the tragedy, the talking heads were already at it. I’m sure I would cry in private with any parent who has lost a child, but it is really unseemly to do it on television — especially when planning to exploit the grief to accomplish a long-standing political agenda, dusting off the prefabricated gun control remedy before anybody has even figured out exactly what happened. After all, a mass shooting is a crisis not to be wasted.

I don’t want my surgeon to be crying in my wound, or the forensic pathologist or detective to be sobbing instead of taking a clear-eyed look at the scene of the crime. In fact, I want him to be steely-eyed and angry about any policies that may have endangered the innocent, even if supposedly well-intentioned. I want him to delve relentlessly into every unanswered question, and not rush to “move on” as soon as a superficial narrative is agreed upon.

Some may find comfort in trying to “do something” that might (or might not) “save just one person,” but such effort eventually could cause harm or death to many.

The media has covered the incident nonstop, releasing all kinds of “facts” that turned out to be false, along with many facile opinions. “Good people do good things; bad people do bad things” — as if evil could be isolated to identifiable “bad guys.” Or they say, “crazy people do senseless things.” Maybe the perpetrator was the victim of bullying, a loner, wanted his 15 minutes of fame, played too many video games, or lacked sufficient free mental health screening or treatment. Worthy hypotheses, but still speculation.

The focus in all cases involving a gun turns immediately to the tool. If we banned everything that had ever been used as a mass murder weapon, we would have no tools, or even fire. What would we do about bare hands? Yet the only tool we seriously think about restricting also happens to be the most effective tool for self-defense. It does seem that all incidents like this occur in so-called “gun-free” zones.

We cannot solve the problem until we acknowledge the perpetrator: the human being. Why would anyone go on a shooting spree, especially against children?

Some people do have a reason for causing mayhem, like those who bomb buses and schools in Israel. They are taught that it is Allah’s will for them to kill Jews.

What do we teach children here — that human beings are an accident and of no intrinsic value? That humanity is actually a plague on Planet Earth? That there is no absolute moral law and no consequence for wrongdoing as long as you don’t get caught? Are children addicted to thrills that come from watching violence?

What are these mass murderers thinking as they prepare to commit their crimes? Too often, as in this case, they are dead and can’t be interviewed afterward. Why do they commit suicide? What do they fear more than death? Could it be that they are jarred out of virtual reality and horrified by what they did? Despite their mental derangement, were they able to make rational preparations all by themselves — or did at least some of them have help? Do perceptual problems, as have been reported in patients on the autism spectrum, contribute?

Was it lack of mental-health services that caused the problem? Or could the drugs many were taking have been a factor? Otherwise normal, peaceable people report aberrant, out-of-character behavior when taking psychoactive drugs such as selective serotonin re-uptake inhibitors, and there are many murder-suicides committed by those who take them.

Where are the grown-ups when young people have bizarre, violent fantasies and accumulate lethal paraphernalia? Where do they get the money for it? If teachers or parents notice a problem, what can they do? Do we need better laws for involuntary commitment for mental health assessment? Should we call for a revival of institutions for long-term treatment, instead of leaving dangerous people free, getting their periodic outpatient drug checks, often on their way to prison?

Sandy Hook shows how precious human life is — and how fragile. Such tragedies raise many questions, and those who grieve deserve better than shotgun remedies based on knee-jerk diagnosis.

Dr. Jane M. Orient practices internal medicine in Tucson, Ariz., and is executive director of the Association of American Physicians and Surgeons.



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