{"id":2087,"date":"2016-08-19T15:59:15","date_gmt":"2016-08-19T19:59:15","guid":{"rendered":"http:\/\/blogs.nejm.org\/general-medicine\/?p=2087"},"modified":"2016-08-20T21:12:00","modified_gmt":"2016-08-21T01:12:00","slug":"orlandostrong-endgunviolence","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/","title":{"rendered":"#OrlandoStrong #EndGunViolence"},"content":{"rendered":"<div id=\"attachment_2058\" style=\"width: 135px\" class=\"wp-caption alignright\"><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Kashif-Shaikh.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2058\" class=\"size-full wp-image-2058\" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Kashif-Shaikh.jpg\" alt=\"Kashif Shaikh, MD\" width=\"125\" height=\"150\" \/><\/a><p id=\"caption-attachment-2058\" class=\"wp-caption-text\">Kashif Shaikh, MD, is the 2016-17 Chief Resident in Internal Medicine at the University of Central Florida College of Medicine.<\/p><\/div>\n<p>I\u00a0will never\u00a0forget Sunday morning, June 12. I was off that day.\u00a0I usually sleep with my cell phone on silent mode, and I slept late after binge watching some movie marathon the night before.\u00a0I was still\u00a0half asleep\u00a0when I picked up my cell phone to\u00a0see what time it was\u00a0\u2014\u00a0but what I actually saw on my\u00a0phone was\u00a0a jumble\u00a0of texts from friends and loved ones.\u00a0I knew instantly that it wasn\u2019t a good news. I opened the first text from a friend: \u201cAre you okay? I am worried about you. I am very sad to hear about Orlando.\u201d I thought at first that\u00a0my friend was referring to Christina Grimmie\u2019s heartbreaking incident, in which she lost her life at an Orlando concert. But that didn&#8217;t seem right \u2014 my friends wouldn&#8217;t be worried about my personal safety in relation to that event.<\/p>\n<p><div id=\"attachment_2091\" style=\"width: 246px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Christina_Grimmie.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2091\" class=\"wp-image-2091 size-medium\" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Christina_Grimmie-236x300.jpg\" alt=\"By Justin Higuchi (https:\/\/www.flickr.com\/photos\/jus10h\/15728670906\/) [CC BY 2.0 (http:\/\/creativecommons.org\/licenses\/by\/2.0)], via Wikimedia Commons\" width=\"236\" height=\"300\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Christina_Grimmie-236x300.jpg 236w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Christina_Grimmie-768x977.jpg 768w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Christina_Grimmie-805x1024.jpg 805w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Christina_Grimmie.jpg 1100w\" sizes=\"auto, (max-width: 236px) 100vw, 236px\" \/><\/a><p id=\"caption-attachment-2091\" class=\"wp-caption-text\">By Justin Higuchi.\u00a0[CC BY 2.0], via Wikimedia Commons<\/p><\/div>I had to swipe my phone for some news. The news that I read will haunt me for the rest of my life. The feeling that I had reminded me of the dementors that J.K. Rowling describes in her book. For the very first time, I understood the meaning of soul-sucking creatures. I felt as if every happy feeling literally was sucked out of my soul.<\/p>\n<p>I turned on the TV.\u00a0I was in a state of shock. I was in denial. I thought that this couldn&#8217;t be real, that this was just a nightmare, and that I was\u00a0probably still asleep. It couldn\u2019t be happening here. But, no, it WAS real. I\u00a0lost my appetite. I couldn&#8217;t sleep well for the next few days.<\/p>\n<p><div id=\"attachment_2090\" style=\"width: 583px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Universal_CityWalk_Orlando_Panorama.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2090\" class=\"wp-image-2090 \" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Universal_CityWalk_Orlando_Panorama-1024x303.jpg\" alt=\"By Crapuipui (Own work) [CC BY-SA 4.0 (http:\/\/creativecommons.org\/licenses\/by-sa\/4.0)], via Wikimedia Commons\" width=\"573\" height=\"170\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Universal_CityWalk_Orlando_Panorama-1024x303.jpg 1024w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Universal_CityWalk_Orlando_Panorama-300x89.jpg 300w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Universal_CityWalk_Orlando_Panorama-768x228.jpg 768w\" sizes=\"auto, (max-width: 573px) 100vw, 573px\" \/><\/a><p id=\"caption-attachment-2090\" class=\"wp-caption-text\">By Crapuipui (Own work) [CC BY-SA 4.0], via Wikimedia Commons<\/p><\/div>I\u00a0watched Anderson Cooper&#8217;s\u00a0coverage on the news. He was saying the names of the people who lost their lives, one by one. It was the most heartfelt coverage I have ever seen from a television journalist. It took me back to the tragedies of Sandy Hook, Charleston, and San Bernardino.<\/p>\n<p>I am still very upset when I think of how anyone, any lunatic, can buy guns without a background check.\u00a0Right after the Pulse incident, when I stopped at a gas station, I saw\u00a0advertisements for\u00a0gun shows. Gun sellers were trying to take advantage of this whole situation. It was shameful. There was no respect for the victims who lost their precious lives.<\/p>\n<div id=\"attachment_2095\" style=\"width: 310px\" class=\"wp-caption alignright\"><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Stop_Gun_Violence_Sad_Face_Sign.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2095\" class=\"size-medium wp-image-2095\" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Stop_Gun_Violence_Sad_Face_Sign-300x200.jpg\" alt=\"By Tony Webster from Minneapolis, Minnesota, USA (Stop Gun Violence) [CC BY 2.0 (http:\/\/creativecommons.org\/licenses\/by\/2.0)], via Wikimedia Commons\" width=\"300\" height=\"200\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Stop_Gun_Violence_Sad_Face_Sign-300x200.jpg 300w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Stop_Gun_Violence_Sad_Face_Sign-768x512.jpg 768w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Stop_Gun_Violence_Sad_Face_Sign-1024x682.jpg 1024w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Stop_Gun_Violence_Sad_Face_Sign.jpg 1280w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-2095\" class=\"wp-caption-text\">By Tony Webster from Minneapolis, Minnesota, USA (Stop Gun Violence) [CC BY 2.0], via Wikimedia Commons<\/p><\/div>\n<h2><span style=\"color: #333399\">Gun violence is a public health issue<\/span><\/h2>\n<p>The morbidity and mortality associated with gun violence is a serious problem.\u00a0 In a\u00a0<a href=\"http:\/\/Annu Rev Public Health. 2015 Mar 18;36:55-68. doi: 10.1146\/annurev-publhealth-031914-122444\">2014 paper by Braga et al.<\/a> about focused deterrence on the prevention of gun violence,\u00a0the authors stated,\u00a0\u201cPublic health researchers and practitioners have historically prevented many deaths and illnesses by applying public health\u2019s fundamental problem-solving capacity to develop actions such as water quality control, immunization programs, and food inspection regimes.\u201d<\/p>\n<p>In <a href=\"http:\/\/South Med J. 2010 Feb;103(2):151-3. doi: 10.1097\/SMJ.0b013e3181c9902e\">another review, from 2010, Narang et al.<\/a> noted that access to guns affects risk for death and gun-related domestic violence. Narang et al. based their review on data from the Centers for Disease Control and Prevention and\u00a0National Center for Injury Prevention and Control, and Internet-based injury statistics: They found that high prevalence of guns\u00a0is associated with high rates of suicide, accidental injury, homicide, and domestic violence. Suicide is the leading cause of death among gun owners in the initial years of acquisition. According to the authors, \u201cOut of 395 fatalities occurring at a family home where a gun was present, suicide accounted for 333 cases (84%); 41 were domestic violence homicides, and 12 were accidents, while only nine were shootings of an intruder.&#8221;<\/p>\n<h4><span style=\"color: #000080\">Do guns make others safe?<\/span><\/h4>\n<p><div id=\"attachment_2096\" style=\"width: 310px\" class=\"wp-caption alignright\"><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Grief.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2096\" class=\"wp-image-2096 size-medium\" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Grief-300x204.jpg\" width=\"300\" height=\"204\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Grief-300x204.jpg 300w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Grief.jpg 700w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-2096\" class=\"wp-caption-text\">Photo: Mikhail Evstafiev, [CC-BY-SA-3.0], via Wikimedia Commons<\/p><\/div>Presence of a firearm in the home reportedly results in death or injury to household members or visitors over 12 times more often than to an intruder. Trauma centers receive many people with gunshot wounds said to be \u201caccidents,\u201d but circumstances in some of these cases indicate that they initially were stress-related shootings, done with an intent to die. Self-inflicted gunshot suicides outnumber both homicides and fatal accidents combined.<\/p>\n<p>As Narang et al. note, guns are the most commonly used weapon in domestic homicides, accounting for about 65% of all such deaths. Risk\u00a0for intimate partner homicide is increased by fivefold.\u00a0 Gun ownership results in loss of life to women by suicide three times more often than where no such weapon is available.<\/p>\n<p><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Children.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-2106\" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Children-1024x748.jpg\" alt=\"Children\" width=\"552\" height=\"403\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Children.jpg 1024w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Children-300x219.jpg 300w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Children-768x561.jpg 768w\" sizes=\"auto, (max-width: 552px) 100vw, 552px\" \/><\/a><\/p>\n<p>The most remarkable statistic this review mentions is, \u201cIn 2005, it was documented that 5,285 US children were killed by gunshots according to data collected over a full year time period by the Centers for Disease Control; compare this to none in Japan, 19 for Great Britain, 57 in Germany, 109 in France, and 153 in Canada.\u201d<\/p>\n<p><div id=\"attachment_2092\" style=\"width: 497px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Children_and_teen_gun_death_rate.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2092\" class=\" wp-image-2092\" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Children_and_teen_gun_death_rate.png\" alt=\"By Delphi234 (Own work) [CC0], via Wikimedia Commons\" width=\"487\" height=\"365\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Children_and_teen_gun_death_rate.png 640w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Children_and_teen_gun_death_rate-300x225.png 300w\" sizes=\"auto, (max-width: 487px) 100vw, 487px\" \/><\/a><p id=\"caption-attachment-2092\" class=\"wp-caption-text\">By Delphi234 (Own work) [CC0], via Wikimedia Commons<\/p><\/div>This study also talks about how the consequences of gun-related violence, death, injury, disability, and\/or dysfunction have a powerful effect on our society and healthcare system. Loss of loved ones, economic hardship, and psychological trauma is devastating. Bereavement compromises the quality of life, specially for children. It results in spread of fear in communities. It also affects medical costs, which indirectly affects the general population, government, and the healthcare delivery system.<\/p>\n<h4><span style=\"color: #000080\">What is the cost?<\/span><\/h4>\n<p>According to Narang et al., \u201cIn 2005, approximately 30,000 Americans died of gunshots and nearly 70,000 received emergency treatment for nonfatal wounds. Emergency facilities are constantly burdened by the services required in such traumatic events. Medical care for these patients costs up to $4 billion per year. The overall economic cost due to these injuries in America, including healthcare, disability, unemployment, and other intangibles is about $100 billion per year.&#8221; This study also mentioned the case-to-fatality rate for gunshot trauma. It is about 30%, which is much higher than for other injuries. Death occurs following a shooting 18 times more often than after motorcycle accidents. Moreover, the hospital stays for patients with gunshot injury are in the range of nearly 2 weeks\u2019 duration. The disability from such events averages approximately half a year. This affects taxpayers. Each homicide results in approximately $244,000 of incarceration expenses for our taxpayers.<\/p>\n<p>In Kentucky in 2008, 73% of gunshot victims were uninsured, 10% were covered by government plans, and 17% were privately insured. Nationally, data reported in 2001 documented that government programs pay for about 49% of this amount, 18% is covered by private insurance, and 33% by all other sources.<\/p>\n<p><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Money_Cash.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-2098 alignleft\" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Money_Cash-300x199.jpg\" alt=\"Money_Cash\" width=\"300\" height=\"199\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Money_Cash-300x199.jpg 300w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Money_Cash-768x511.jpg 768w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Money_Cash-1024x681.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a>Gun violence costs about 2.4 billion dollars annually to the criminal justice system in America. Local governments across our country spend up to $100 million each year just on bulletproof vests. Most of these bills are then passed on to the taxpayers. Why have no reforms\u00a0been introduced after the mass shootings involving Sandy Hook, Charleston, and San Bernardino?\u00a0What new laws could have potentially prevented the mass shooting at Pulse Orlando?<span style=\"color: #333399\"><br \/>\n<\/span><\/p>\n<p>&nbsp;<\/p>\n<div id=\"attachment_2099\" style=\"width: 310px\" class=\"wp-caption alignright\"><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Sandy_Hook.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2099\" class=\"size-medium wp-image-2099\" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Sandy_Hook-300x201.png\" alt=\"By VOA (http:\/\/www.youtube.com\/watch?v=gAmr-A-F8K8) [Public domain], via Wikimedia Commons\" width=\"300\" height=\"201\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Sandy_Hook-300x201.png 300w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Sandy_Hook.png 636w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-2099\" class=\"wp-caption-text\">By VOA (http:\/\/www.youtube.com\/watch?v=gAmr-A-F8K8) [Public domain], via Wikimedia Commons<\/p><\/div>\n<h2 class=\"mceTemp\"><span style=\"color: #000080\">The U.S. has the highest rate of firearm homicides amongst developed countries<\/span><\/h2>\n<p>With less than 5% of the world\u2019s population, the United States has 35%-50% of the world\u2019s civilian-owned guns. As of now, no federal laws ban semiautomatic assault weapons, military-style 0.50 caliber rifles, handguns, or large-capacity ammunition magazines. In fact, gun sales increase\u00a0exponentially after deadly mass shootings.\u00a0Everyone knows how easy it is to obtain guns in the United States in the name of the Second Amendment.<\/p>\n<p>Japan which has the lowest\u00a0firearm homicide rate (1 in ten million) in the world. Here is how Japan does it. Most guns are illegal, and ownership rates are low.\u00a0 Japan\u2019s firearm and sword laws only permits shotguns, air guns, guns that have research or industrial purposes, or guns used for competitions. Before you can obtain such a weapon, you must obtain formal written instructions and pass a battery of written, mental, and drug tests and a rigorous background check. Furthermore, owners must inform the authorities of how the weapon and ammunition are stored and provide the firearm for annual inspection.<\/p>\n<p><em>Then of course, there is an example of Australia\u2019s Port Arthur massacre of April 1996, after which Australia prohibited automatic and semiautomatic assault rifles, stiffened licensing and ownership rules, and instituted a temporary gun buyback program. Since then, there have been no mass shootings in Australia.<\/em><\/p>\n<p>&nbsp;<\/p>\n<p><div id=\"attachment_2102\" style=\"width: 310px\" class=\"wp-caption alignright\"><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Candles.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2102\" class=\"wp-image-2102 size-medium\" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Candles-300x200.jpg\" alt=\"AutoCCD assumed (based on copyright claims). [CC BY-SA 2.5 (http:\/\/creativecommons.org\/licenses\/by-sa\/2.5)], via Wikimedia Commons\" width=\"300\" height=\"200\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Candles-300x200.jpg 300w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Candles-768x511.jpg 768w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Candles.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><p id=\"caption-attachment-2102\" class=\"wp-caption-text\">AutoCCD assumed (based on copyright claims). [CC BY-SA 2.5], via Wikimedia Commons<\/p><\/div>Gun violence is a public health epidemic that is on the rise. The AMA has called gun violence a public health crisis. It vows to overturn a decade-ban on studying gun violence research by the Centers for Disease Control and Prevention.\u00a0The NRA opposed the assault weapons ban in 2013, because, according to <em>CNN Money<\/em>, &#8220;the organization&#8217;s overall revenue, which includes membership dues, program fees and other contributions, has boomed in recent years\u00a0\u2014 rising to nearly $350 million in 2013.&#8221; According to a 2012 <em>Forbes\u00a0<\/em>article, &#8220;Over 50 firearms-related companies have given at least $14.8 million to the NRA according to its list for a donor program that began in 2005.&#8221;\u00a0In April 2016,\u00a0Forbes published another article on the NRA. It mentioned, &#8220;The gun industry says it has grown 158% since Obama took office. The total economic impact of the firearms and ammunition industry in the U.S. increased from $19.1 billion in 2008 to $49.3 billion in 2015.&#8221;<\/p>\n<p><div id=\"attachment_2094\" style=\"width: 449px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/GunViolenceVictimsComic.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2094\" class=\"wp-image-2094 \" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/GunViolenceVictimsComic-1024x724.jpg\" alt=\"By Jmaaks (Own work) [CC BY-SA 4.0 (http:\/\/creativecommons.org\/licenses\/by-sa\/4.0)], via Wikimedia Commons\" width=\"439\" height=\"310\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/GunViolenceVictimsComic-1024x724.jpg 1024w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/GunViolenceVictimsComic-300x212.jpg 300w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/GunViolenceVictimsComic-768x543.jpg 768w\" sizes=\"auto, (max-width: 439px) 100vw, 439px\" \/><\/a><p id=\"caption-attachment-2094\" class=\"wp-caption-text\">By Jmaaks (Own work) [CC BY-SA 4.0], via Wikimedia Commons<\/p><\/div>More than 17,360 American children and teens\u00a0are involved in firearm-related injuries\u00a0every year,\u00a0and 111,779 people of all ages\u00a0are hurt\u00a0annually.\u00a0One out of 3 homes with children contain firearms, and nearly 1.7 million children live in homes with at least\u00a0one unlocked, loaded gun, according to the Brady Campaign.<\/p>\n<p>I dedicate this blog to the victims and\u00a0families\u00a0of Pulse Orlando, Sandy Hook, Charleston, San Bernardino, and all other\u00a0gun-violence related mass shootings in the world. I would like to end this discussion on a quote by Albert Einstein:<\/p>\n<div id=\"attachment_2103\" style=\"width: 238px\" class=\"wp-caption alignleft\"><a href=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Einstein.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2103\" class=\"size-medium wp-image-2103\" src=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Einstein-228x300.jpg\" alt=\"Ferdinand Schmutzer [Public domain], via Wikimedia Commons\" width=\"228\" height=\"300\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Einstein-228x300.jpg 228w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Einstein-768x1008.jpg 768w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Einstein-780x1024.jpg 780w\" sizes=\"auto, (max-width: 228px) 100vw, 228px\" \/><\/a><p id=\"caption-attachment-2103\" class=\"wp-caption-text\">Ferdinand Schmutzer [Public domain], via Wikimedia Commons<\/p><\/div>\n<h2><span style=\"color: #333399\">\u201cThe world is a dangerous place to live; not because of the people who are evil, but because of the people who can\u2019t do anything about it.\u201d<\/span><\/h2>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>I\u00a0will never\u00a0forget Sunday morning, June 12. I was off that day.\u00a0I usually sleep with my cell phone on silent mode, and I slept late after binge watching some movie marathon the night before.\u00a0I was still\u00a0half asleep\u00a0when I picked up my cell phone to\u00a0see what time it was\u00a0\u2014\u00a0but what I actually saw on my\u00a0phone was\u00a0a jumble\u00a0of [&hellip;]<\/p>\n","protected":false},"author":1276,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[17,89,88,90,33],"class_list":["post-2087","post","type-post","status-publish","format-standard","hentry","category-miscellaneous","tag-chief-resident","tag-gun-violence","tag-orlandostrong","tag-public-health","tag-reflections"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v17.1.2 (Yoast SEO v20.8) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>#OrlandoStrong #EndGunViolence - Insights on Residency Training<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"#OrlandoStrong #EndGunViolence\" \/>\n<meta property=\"og:description\" content=\"I\u00a0will never\u00a0forget Sunday morning, June 12. I was off that day.\u00a0I usually sleep with my cell phone on silent mode, and I slept late after binge watching some movie marathon the night before.\u00a0I was still\u00a0half asleep\u00a0when I picked up my cell phone to\u00a0see what time it was\u00a0\u2014\u00a0but what I actually saw on my\u00a0phone was\u00a0a jumble\u00a0of [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/\" \/>\n<meta property=\"og:site_name\" content=\"Insights on Residency Training\" \/>\n<meta property=\"article:published_time\" content=\"2016-08-19T19:59:15+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2016-08-21T01:12:00+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Kashif-Shaikh.jpg\" \/>\n<meta name=\"author\" content=\"Kashif Shaikh, MD\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Kashif Shaikh, MD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"9 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/\",\"name\":\"#OrlandoStrong #EndGunViolence - Insights on Residency Training\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\"},\"datePublished\":\"2016-08-19T19:59:15+00:00\",\"dateModified\":\"2016-08-21T01:12:00+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/2d154451c82e25bd3ca6b66def3c32c2\"},\"breadcrumb\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/blogs.nejm.org\/general-medicine\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"#OrlandoStrong&nbsp;#EndGunViolence\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/\",\"name\":\"Insights on Residency Training\",\"description\":\"Observation of residents across diverse medical specialties\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blogs.nejm.org\/general-medicine\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/2d154451c82e25bd3ca6b66def3c32c2\",\"name\":\"Kashif Shaikh, MD\",\"description\":\"Kashif\u2019s inspiration in life comes from his family members who are educators, engineers, and physicians settled across England, the United States, Canada, and Pakistan. After attending the Aga Khan University Medical College in the coastal city of Karachi, he moved to Houston to become an Internal Medicine resident at the University of Texas Health Science Center. He decided to pursue hospital medicine at a health-underserved area in Central Florida and became a Chief Resident at the new Internal Medicine Residency Program at the University of Central Florida College of Medicine. He is a Harry Potter fan who grew up reading Jane Austin and Emily Bronte. He played chess and badminton avidly as extra-curricular activities in school. He enjoys listening to Billie Holiday, Ella Fitzgerald, Chopin, Beethoven, and Bach. He is a car enthusiast and loves road trips to nearby beaches in sunny Florida. Some of his interests include history, museums, art galleries, live theater, short films, historic cities, documentaries, charity events, and current affairs. His future plans include a rheumatology fellowship, a career in academic medicine, and charity and volunteer work.\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/author\/kshaikh\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"#OrlandoStrong #EndGunViolence - Insights on Residency Training","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/","og_locale":"en_US","og_type":"article","og_title":"#OrlandoStrong #EndGunViolence","og_description":"I\u00a0will never\u00a0forget Sunday morning, June 12. I was off that day.\u00a0I usually sleep with my cell phone on silent mode, and I slept late after binge watching some movie marathon the night before.\u00a0I was still\u00a0half asleep\u00a0when I picked up my cell phone to\u00a0see what time it was\u00a0\u2014\u00a0but what I actually saw on my\u00a0phone was\u00a0a jumble\u00a0of [&hellip;]","og_url":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/","og_site_name":"Insights on Residency Training","article_published_time":"2016-08-19T19:59:15+00:00","article_modified_time":"2016-08-21T01:12:00+00:00","og_image":[{"url":"http:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2016\/08\/Kashif-Shaikh.jpg"}],"author":"Kashif Shaikh, MD","twitter_misc":{"Written by":"Kashif Shaikh, MD","Est. reading time":"9 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/","url":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/","name":"#OrlandoStrong #EndGunViolence - Insights on Residency Training","isPartOf":{"@id":"https:\/\/blogs.nejm.org\/general-medicine\/#website"},"datePublished":"2016-08-19T19:59:15+00:00","dateModified":"2016-08-21T01:12:00+00:00","author":{"@id":"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/2d154451c82e25bd3ca6b66def3c32c2"},"breadcrumb":{"@id":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2016\/08\/orlandostrong-endgunviolence\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.nejm.org\/general-medicine\/"},{"@type":"ListItem","position":2,"name":"#OrlandoStrong&nbsp;#EndGunViolence"}]},{"@type":"WebSite","@id":"https:\/\/blogs.nejm.org\/general-medicine\/#website","url":"https:\/\/blogs.nejm.org\/general-medicine\/","name":"Insights on Residency Training","description":"Observation of residents across diverse medical specialties","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.nejm.org\/general-medicine\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/2d154451c82e25bd3ca6b66def3c32c2","name":"Kashif Shaikh, MD","description":"Kashif\u2019s inspiration in life comes from his family members who are educators, engineers, and physicians settled across England, the United States, Canada, and Pakistan. After attending the Aga Khan University Medical College in the coastal city of Karachi, he moved to Houston to become an Internal Medicine resident at the University of Texas Health Science Center. He decided to pursue hospital medicine at a health-underserved area in Central Florida and became a Chief Resident at the new Internal Medicine Residency Program at the University of Central Florida College of Medicine. He is a Harry Potter fan who grew up reading Jane Austin and Emily Bronte. He played chess and badminton avidly as extra-curricular activities in school. He enjoys listening to Billie Holiday, Ella Fitzgerald, Chopin, Beethoven, and Bach. He is a car enthusiast and loves road trips to nearby beaches in sunny Florida. Some of his interests include history, museums, art galleries, live theater, short films, historic cities, documentaries, charity events, and current affairs. His future plans include a rheumatology fellowship, a career in academic medicine, and charity and volunteer work.","url":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/author\/kshaikh\/"}]}},"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/wp-json\/wp\/v2\/posts\/2087","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/wp-json\/wp\/v2\/users\/1276"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/wp-json\/wp\/v2\/comments?post=2087"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/wp-json\/wp\/v2\/posts\/2087\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/wp-json\/wp\/v2\/media?parent=2087"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/wp-json\/wp\/v2\/categories?post=2087"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/wp-json\/wp\/v2\/tags?post=2087"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}