It actually felt a little lonely in 1999. It was before school shootings had become a regular event in the U.S., and my experience treating victims at the scene at Columbine was relatively unique. There weren't many in emergency care who had responded to the scene of such an incident at a school with multiple victims of a powerful semi-automatic weapon. Now there are. Over 10 years later, I cared for victims in the Aurora theater shooting in the emergency department at Denver Health. I was horrified that I had the opportunity to compare and contrast the remarkable similarities and differences in these two multiple casualty incidents from high-powered semi-automatic weapons, one from the scene and one from a hospital perspective. At the time, it felt like an impossible coincidence worthy of a feature story on the ABC News show "20/20." Now it doesn't.
My family was waiting for me when I got home from work last week on Tuesday, May 24. They knew the impact the shooting at Robb Elementary School in Uvalde would have; they and those I work with have had to be there for me far too many times. When I walked through the door, I hadn't actually heard about Uvalde yet as it had been a tough shift and I had chosen music over the usual news podcasts on my commute home that night. But I knew as soon as I saw them waiting for me. Their expressions reflected back the memories they knew would soon hit me so hard, yet again.
The faces of the victims from Columbine are still so vivid 23 years later. The fear and horror that was still so apparent, even hours after they were killed. Hiding under desks, many desperately seeking safety in the school library, a place we used to consider a calm and safe space. Something no human should ever have to see. Yet, so many now have. The spot where the shooters lay and the remarkable arsenal they had with them when they died. At least it was remarkable to me then. There is now a far too large generation of healthcare professionals who have had to do the unthinkable. So many who have seen the victims of these horrible events and the impact on families and communities. Like me, other responders now live with those visions and the seemingly endless reminders.
It does not feel lonely anymore. What a tragic thing to say.
Outrage, thoughts, and prayers can only be a starting point. They cannot be where we stop. They are not enough. The epidemic of gun violence in this country needed to be confronted years ago. The impact on our communities, the disproportionate impact on communities of color, and the impact on healthcare are unacceptable.
It's a national disgrace that in many ways, we are now in a far worse situation from a gun reform perspective than we were in 1999. In 1999, there was a federal assault weapons ban. Now just seven states (California, Connecticut, Hawaii, Massachusetts, Maryland, New Jersey, and New York) and the District of Columbia that ban guns classed as assault weapons, a term generally applied to semi-automatic firearms with detachable magazines -- the preferred weapon for acts of devastation (). And when you see the devastation these weapons cause, you know exactly why they are the weapon of choice. So many victims are either unrecognizable or have such obviously devastating injuries it appears they didn't even have the time to try and protect themselves. Unfortunately, there are currently challenges to those assault weapons bans in several states including California, and there is before the Supreme Court that could significantly reduce restrictions on concealed weapons licenses in New York. We have to ask ourselves, why is the Second Amendment protecting the right for the general public to use weapons with devastating consequences that those in could never have imagined? While we have certainly seen devastating injuries from devices that are not assault weapons, the ease with which assault weapons can cause devastation defies comparison.
I cannot comprehend why a member of the general public can purchase an AR-15 in so many states. Then again, maybe I shouldn't be surprised -- U.S. gun laws crossed the absurd barrier long ago. Our elected leaders are clearly far more worried about the wrath of gun lobbyists than the outrage and anger of the rest of us. This has to change. Most of us, myself included, have at some point voted for a policymaker who has not been clear about a rational and meaningful stance on gun reform or who has failed to back their stance up with action. This has to change.
We, as healthcare professionals, can make a difference. As people who have dedicated our lives to health, we understand how much more effective prevention is than mitigation, and yet, hospital and community violence intervention programs are horribly underfunded and notoriously underappreciated. This too has to change. Now. may not have the same impact on perpetrators of mass shootings at places like schools, but they most certainly can impact other areas of interpersonal gun violence also so rampant in this country. These efforts will not stop gun violence, but they are steps we can take to make a difference. There are meaningful things we can do that go beyond outrage, thoughts, and prayers. We have a far more powerful voice then many of us realize. It is time we use it.
is chief of emergency medicine at Zuckerberg San Francisco General Hospital and Trauma Center, and a professor and vice-chair in the Department of Emergency Medicine at UCSF.