- - Wednesday, December 26, 2012


Having more than 37 years of experience as a surgeon has taught me the importance of using common sense when it comes to health care. Any medical disorder is best treated by attacking the problem itself, not making policies that avoid the disorder. This is especially true in the case of mental health.

Now we have a president who wipes away tears over the Sandy Hook shootings while saying, “We’re going to have to come together and take meaningful action regardless of the politics.” Once again, this man, who mentioned in a debate that he was a supporter of the Second Amendment, thinks he can best handle America’s gun violence through legislation, through political action, through more government mandates, perhaps through another one of his famous executive orders.

President Obama could stamp out our Second Amendment tomorrow, and there still would be gun violence in America. Taking away our right to bear arms is like putting a Band-Aid on cancer. It might cover up the tumor, but the patient still will suffer.

We must attack the problem. One of the most neglected issues in this country is that of mental health. The Sandy Hook shooter reportedly had a “personality disorder.” Jared Loughner, the Tucson, Ariz., shooter, was described in the media as being “mentally deranged” and had to undergo treatment before his sentencing hearing.

James Holmes, the Colorado theater shooter, had seen a psychiatrist and had been referred to a threat-assessment team. Wade Michael Page, the Wisconsin Sikh temple shooter, was a loner with a history of “patterns of misconduct” while in the U.S. Army.

A recent report conducted by the Substance Abuse and Mental Health Services Administration revealed that almost 30 percent of adults ages 18 to 25 had some form of mental illness this past year. The report showed that just 60 percent of people with a serious mental illness received treatment.

When it comes to mental illness and gun violence, Bruce Link, an epidemiologist at Columbia University, was quoted in The Wall Street Journal saying that even if there are elevated risks from some people who are mentally ill, they are no higher than for other differences in society. “If you really want to protect yourself, go to England or hang out with old ladies,” he said.

Speaking of England, Home Office figures show that in 2006 and 2007, there were more than 40,000 firearm offenses. Some people died, including children. How can this be? Firearms are supposed to be illegal in England. According to the Home Office Statistical Bulletin for England and Wales, there were four times as many violent crimes using knives as firearms between 2009 and 2011 — 62,000 compared to 15,000. It’s true, England has fewer gun-related incidents than we do, but her citizens still manage to acquire firearms. Hanging out in a pub with old ladies would not guarantee your safety.

The United States is, in fact, a less violent nation than it has been in more than 40 years. Political scientist Patrick Egan has pointed out that murder rates have dropped to levels last seen during the Kennedy administration. The FBI Uniform Crime Reporting Statistics bear this out.

Also, a Gallup Poll survey indicates that ownership of firearms is declining. This, of course, may be driven by politics, because people were asked whether or not they kept a firearm anywhere on their property.

If we are, as a nation, less violent, the individual deviations from the norm have to be addressed. Blaming the tragedies of mass murders on the presence of firearms is a mentality not unlike that used in the Salem witch trials.

There also is a movement afoot to blend our American core values with those of other nations. This is true even in the area of mental health. Ronald C. Kessler, professor of health care policy at Harvard Medical School, is reproducing prevalence surveys of mental illness throughout the planet with the World Health Organization. A survey in 2007 and 2008 found the prevalence of mental illness in Iraq to be about half of what it was in the United States. This type of activity wastes time and money and does not help any American here at home. The focus should be on our daily lives and how we react.

We have criminals who use firearms. If they didn’t, they would use something else, perhaps knives, bombs or other incendiary devices. Our concern should not be the firearm, but the troubled soul behind it.

Our concern should be early identification and management. Our concern should be proactive in the event someone slips through the system. I know of no other way to say this, but a shooter entering a school should never be able to get off more than one shot.

Gun control will not control guns. Mr. Obama has the power to make us a country where guns are illegal, a country like Mexico, which is No. 7 in firearm deaths, or Colombia, which is No. 2. Switzerland, on the other hand, has more than 2 million public firearms, 600,000 of which are automatic rifles, and gun violence is so low the Swiss do not bother keeping statistics. Perhaps a society is truly safer when no one knows who’s armed.

Constance Uribe is a general surgeon and author of “The Health Care Provider’s Guide to Facing the Malpractice Deposition” (CRC Press, 1999).

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