{"id":9320,"date":"2019-08-11T17:27:11","date_gmt":"2019-08-11T21:27:11","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=9320"},"modified":"2019-08-13T14:17:24","modified_gmt":"2019-08-13T18:17:24","slug":"the-united-states-needs-stricter-gun-control-now-and-yes-this-is-an-id-issue","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/the-united-states-needs-stricter-gun-control-now-and-yes-this-is-an-id-issue\/2019\/08\/11\/","title":{"rendered":"The United States Needs Stricter Gun Control Now — and Yes, This Is an ID Issue"},"content":{"rendered":"

\"\"<\/a>In general, I’ve tried to keep this site a pretty happy place.<\/p>\n

It’s not been difficult. The ID and HIV community includes many smart, like-minded individuals involved in all sorts of interesting and challenging work, both domestically and abroad. As one of our ID fellows recalled, after he did a rotation in our ID clinic during his medical residency, \u201cI realized I’d found my people.\u201d<\/p>\n

Today, however, I\u2019m going to write about something on the sadder side, an issue tearing up our country.<\/p>\n

We need stricter gun control in the United States. And we need it NOW.<\/i><\/b><\/p>\n

Yes, this is a departure from prior controversies here, such as should doctors wear white coats<\/a>, estimating the infectious risk of food tongs<\/a>, or whether the correct abbreviation for P. jirovecii<\/em> pneumonia is now PJP instead of PCP.\u00a0<\/a><\/p>\n

I\u2019m venturing into this more contentious* issue because it\u2019s just too painful to ignore.<\/p>\n

(*But to my dear readers of the ID persuasion, there’s an excellent chance you’re in complete agreement. And how do I know? Easy.<\/a>)<\/em><\/p>\n

How many of you thought, Oh no not again<\/i>, when you heard the news of last week’s shooting in El Paso? And then less than 24 hours later, Oh no not again<\/i>, with the news from Dayton?<\/p>\n

And we could go on and on listing these mass shootings — sadly, we even have a Wikipedia page<\/a> cataloguing them for us. It’s getting so bad that voices outside of the usual crowd feel compelled to weigh in — here’s sportswriter Joe Posnanski taking a break from his usual (brilliant) baseball coverage to write a poem describing his heartbreak.<\/a><\/p>\n

It’s very moving. But a sportswriter writing a poem?<\/em> Must be time to do something.<\/p>\n

And lest some think this isn’t a problem related to Infectious Diseases, that I should “stay in my lane” — how wrong to think that. It’s a problem for all of us in healthcare, and, for several reasons, especially for us ID-specialists.<\/p>\n

Crystal Zheng and David Mushatt, two ID doctors from New Orleans, astutely make the case<\/a>:<\/p>\n

During the initial hospitalization, gunshot wounds can become infected, causing skin and soft tissue infections, as well as intra-abdominal, thoracic, and brain abscesses ….Long after the initial event, gunshot survivors with spinal cord injury face a lifetime of disability, marked by recurrent infections due to autonomic dysfunction, decreased airway clearance, sensory loss, and paraplegia. These patients are at increased risk for urinary tract infections, pneumonias, infected sacral ulcers, and chronic osteomyelitis. Infection is the leading cause of death in this population.\u00a0<\/b><\/em><\/p><\/blockquote>\n

(Emphasis mine.)<\/p>\n

Most of the cases we see, of course, aren\u2019t from mass shootings. Events like El Paso and Dayton (and Gilroy and Newtown and Orlando and Parkland and Charlotte and Pittsburgh and …) get the big news, but there are way more injuries and deaths from individual shotgun wounds happening every day and night somewhere in our country.<\/a><\/p>\n

For the victim, it doesn’t matter if the injury is from a mass shooting, an unfortunate urban skirmish, a heated domestic squabble, or the result of a deranged individual who has ready access to a gun. Their lives are irrevocably changed if they survive, often with infectious complications.<\/p>\n

Yes, if<\/em> they survive. If they don’t, those left behind suffer unbearable sadness and trauma at the loss — family, friends, colleagues. We have personal recent experience at our hospital when, in 2015, one of our rising stars in cardiac surgery was shot during an outpatient clinic session.<\/a><\/p>\n

Oh no not again.<\/em><\/p>\n

But look — it doesn’t have to be this way.<\/p>\n

After last weekend\u2019s events, I tweeted about the New Orleans perspective piece cited above, and received this response:<\/p>\n

\n

I\u2019ve not seen gun shot wounds in Australia, despite 35+yrs of clinical ID practice. But I looked after the Bali bombing burns\/multi-trauma victims that were evacuated to Perth, in Australia. I\u2019ve also seen every other type of multi-trauma & injuries that I can think of…<\/p>\n

— Christopher Heath (@Christo37020634) August 7, 2019<\/a><\/p><\/blockquote>\n