1. #1

    Why the CDC is prohibited from studying gun violence

    As I opened the CT scan last week to read the next case, I was baffled. The history simply read “gunshot wound.” I have been a radiologist in one of the busiest trauma centers in the nation for 13 years, and have diagnosed thousands of handgun injuries to the brain, lung, liver, spleen, bowel, and other vital organs. I thought that I knew all that I needed to know about gunshot wounds, but the specific pattern of injury on my computer screen was one that I had seen only once before.

    In a typical handgun injury that I diagnose almost daily, a bullet leaves a laceration through an organ like the liver. To a radiologist, it appears as a linear, thin, grey bullet track through the organ. There may be bleeding and some bullet fragments.

    I was looking at a CT scan of one of the victims of the shooting at Marjory Stoneman Douglas High School, who had been brought to the trauma center during my call shift. The organ looked like an overripe melon smashed by a sledgehammer, with extensive bleeding. How could a gunshot wound have caused this much damage?

    The reaction in the emergency room was the same. One of the trauma surgeons opened a young victim in the operating room, and found only shreds of the organ that had been hit by a bullet from an AR-15, a semi-automatic rifle which delivers a devastatingly lethal, high-velocity bullet to the victim. There was nothing left to repair, and utterly, devastatingly, nothing that could be done to fix the problem. The injury was fatal.

    A year ago, when a gunman opened fire at the Fort Lauderdale airport with a 9mm semiautomatic handgun, hitting 11 people in 90 seconds, I was also on call. It was not until I had diagnosed the third of the six victims who were transported to the trauma center that I realized something out-of-the-ordinary must have happened. The gunshot wounds were the same low velocity handgun injuries as those I diagnose every day; only their rapid succession set them apart. And all six of the victims who arrived at the hospital that day survived.

    Routine handgun injuries leave entry and exit wounds and linear tracks through the victim's body that are roughly the size of the bullet. If the bullet does not directly hit something crucial like the heart or the aorta, and they do not bleed to death before being transported to our care at a trauma center, chances are, we can save the victim. The bullets fired by an AR-15 are different; they travel at higher velocity and are far more lethal. The damage they cause is a function of the energy they impart as they pass through the body. A typical AR-15 bullet leaves the barrel traveling almost three times faster than, and imparting more than three times the energy of, a typical 9mm bullet from a handgun. An AR-15 rifle outfitted with a magazine with 50 rounds allows many more lethal bullets to be delivered quickly without reloading.

    I have seen a handful of AR-15 injuries in my career. I saw one from a man shot in the back by a SWAT team years ago. The injury along the path of the bullet from an AR-15 is vastly different from a low-velocity handgun injury. The bullet from an AR-15 passes through the body like a cigarette boat travelling at maximum speed through a tiny canal. The tissue next to the bullet is elastic—moving away from the bullet like waves of water displaced by the boat—and then returns and settles back. This process is called cavitation; it leaves the displaced tissue damaged or killed. The high-velocity bullet causes a swath of tissue damage that extends several inches from its path. It does not have to actually hit an artery to damage it and cause catastrophic bleeding. Exit wounds can be the size of an orange.

    With an AR-15, the shooter does not have to be particularly accurate. The victim does not have to be unlucky. If a victim takes a direct hit to the liver from an AR-15, the damage is far graver than that of a simple handgun shot injury. Handgun injuries to the liver are generally survivable unless the bullet hits the main blood supply to the liver. An AR-15 bullet wound to the middle of the liver would cause so much bleeding that the patient would likely never make it to a trauma center to receive our care.

    One of my ER colleagues was waiting nervously for his own children outside the school. While the shooting was still in progress, the first responders were gathering up victims whenever they could and carrying them outside the building. Even as a physician trained in trauma situations, though, there was nothing he could do at the scene to help to save the victims who had been shot with an AR-15. Most of them died on the spot, with no fighting chance at life.

    As a doctor, I feel I have a duty to inform the public of what I have learned as I have observed these wounds and cared for these patients. It’s clear to me that AR-15 or other high-velocity weapons, especially when outfitted with a high-capacity magazine, have no place in a civilian’s gun cabinet. I have friends who own AR-15 rifles; they enjoy shooting them at target practice for sport, and fervently defend their right to own them. But I cannot accept that their right to enjoy their hobby supersedes my right to send my own children to school, to a movie theater, or to a concert and to know that they are safe. Can the answer really be to subject our school children to active shooter drills—to learn to hide under desks, turn off the lights, lock the door and be silent—instead of addressing the root cause of the problem and passing legislation to take AR-15-style weapons out of the hands of civilians?

    But in the aftermath of this shooting, in the face of specific questioning, our government leaders did not want to discuss gun control even when asked directly about these issues. Florida Senator Marco Rubio warned not to “jump to conclusions that there’s some law we could have passed that could have prevented it.” A reporter asked House Speaker Paul Ryan about gun control, and he replied, “As you know, mental health is often a big problem underlying these tragedies.” And on Tuesday, Florida’s state legislature voted against considering a ban on AR-15-type rifles, 71 to 36.

    If politicians want to back comprehensive mental-health reform, I am all for it. As a medical doctor, I’ve witnessed firsthand the toll that mental-health issues take on families and the individuals themselves who have no access to satisfactory long-term mental-health care. But the president and Congress should not use this issue as an excuse to deliberately overlook the fact that the use of AR-15 rifles is the common denominator in many mass shootings.

    A medical professor taught me about the dangers of drawing incorrect conclusions from data with the example of gum chewing, smokers, and lung cancer. He said smokers may be more likely to chew gum to cover bad breath, but that one cannot look at the data and decide that gum chewing causes lung cancer. It is the same type of erroneous logic that focuses on mental health after mass shootings, when banning the sale of semi-automatic rifles would be a far more effective means of preventing them.

    Banning the AR-15 should not be a partisan issue. While there may be no consensus on many questions of gun control, there seems to be broad support for removing high-velocity, lethal weaponry and high-capacity magazines from the market, which would drastically reduce the incidence of mass murders. Every constitutionally guaranteed right that we are blessed to enjoy comes with responsibilities. Even our right to free speech is not limitless. Second Amendment gun rights must respect the same boundaries.

    The CDC is the appropriate agency to review the potential impact of banning AR-15 style rifles and high-capacity magazines on the incidence of mass shootings. The agency was effectively barred from studying gun violence as a public-health issue in 1996 by a statutory provision known as the Dickey amendment. This provision needs to be repealed so that the CDC can study this issue and make sensible gun-policy recommendations to Congress.

    The Federal Assault Weapons Ban (AWB) of 1994 included language which prohibited semi-automatic rifles like the AR-15, and also large-capacity magazines with the ability to hold more than 10 rounds. The ban was allowed to expire after 10 years on September 13, 2004. The mass murders that followed the ban’s lapse make clear that it must be reinstated.

    On Wednesday night, Rubio said at a town-hall event hosted by CNN that it is impossible to create effective gun regulations because there are too many “loopholes” and that a “plastic grip” can make the difference between a gun that is legal and illegal. But if we can see the different impacts of high- and low-velocity rounds clinically, then the government can also draw such distinctions.

    As a radiologist, I have now seen high velocity AR-15 gunshot wounds firsthand, an experience that most radiologists in our country will never have. I pray that these are the last such wounds I have to see, and that AR-15-style weapons and high-capacity magazines are banned for use by civilians in the United States, once and for all.
    https://www.theatlantic.com/politics...n-guns/553937/

    I'm sure this doctor is wrong because reasons no one but the alt-right understands.
    ☭Politics Understander and Haver of Good Takes☭Posting Is A Human Right☭
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    If I was in his boots (and forced to join the SS in 1939 or whenever he joined), I would have tried to liberate the camp myself or die trying. He did not. He traded his life for the life of thousands of people, thus he should face the consequences
    Quote Originally Posted by Proberly View Post
    Oh would you now? It truly is amazing how many heroic people we have wasting their time on internet.

  2. #2
    The NRA owns republicans.

  3. #3
    Quote Originally Posted by Priestiality View Post
    https://www.theatlantic.com/politics...n-guns/553937/

    I'm sure this doctor is wrong because reasons no one but the alt-right understands.
    Something something George Soros, something something Communism, something something Obama.

  4. #4
    Quote Originally Posted by Priestiality View Post
    https://www.theatlantic.com/politics...n-guns/553937/

    I'm sure this doctor is wrong because reasons no one but the alt-right understands.
    It's not the bullets that cause damage, it's the people with ill intent! A gun could never ever cause somebody to die.

  5. #5
    This doesn't really seem to have anything to do with the title of your post - it's a weird tack-on to the end of an article that has little to do with the CDC.

    The article also seems written to appeal to people that are technically illiterate when it comes to firearms. No one should be surprised that rifles have more power than handguns. There's nothing particularly remarkable about the AR-15 in that regard - rounds used by standardly equipped AR-15s don't have more kinetic energy than any other typical rifles. Bringing up kinetic energy of AR-15 shots seems like something that would only appeal to people that are really ignorant about weapons.

  6. #6
    Not letting the CDC study guns is a propaganda mistake, it makes you look like you're afraid of the truth.
    .

    "This will be a fight against overwhelming odds from which survival cannot be expected. We will do what damage we can."

    -- Capt. Copeland

  7. #7
    Quote Originally Posted by Hubcap View Post
    Not letting the CDC study guns is a propaganda mistake, it makes you look like you're afraid of the truth.
    Aside from political strategy, it's also just plain bad policy. Even the rep that the Dickey Amendment was named after says that he regrets it. Keeping it on the books is plainly extremist.

  8. #8
    Quote Originally Posted by Spectral View Post
    This doesn't really seem to have anything to do with the title of your post - it's a weird tack-on to the end of an article that has little to do with the CDC.

    The article also seems written to appeal to people that are technically illiterate when it comes to firearms. No one should be surprised that rifles have more power than handguns. There's nothing particularly remarkable about the AR-15 in that regard - rounds used by standardly equipped AR-15s don't have more kinetic energy than any other typical rifles. Bringing up kinetic energy of AR-15 shots seems like something that would only appeal to people that are really ignorant about weapons.
    1, He discusses kinetic energy to point out that rifle rounds in fact do more damage than handgun rounds, which might be logical, but isn't clearly obvious to everyone, as one of the common gun advocate strawman is that handguns are just as deadly as rifles.

    2, The author mentions that the combination of a high capacity magazine with the power of rifle bullets is the problem. Your average hunting rifle or even more bolt action hunting rifle simply cannot cause as much damage as something as an AR15. At this point I would even be comfortable with a restriction on magazine sizes. Sure, keep your AR15, but restrict magazines to 5 rounds.

    3, If the CDC would be allowed to study gun violence, we would have data on the association of things like high capacity magazines, weapon types, criminal activity and mass shootings, and we could have data driven regulation on models, magazines, accessibility etc.

  9. #9
    Quote Originally Posted by Mihalik View Post
    1, He discusses kinetic energy to point out that rifle rounds in fact do more damage than handgun rounds, which might be logical, but isn't clearly obvious to everyone, as one of the common gun advocate strawman is that handguns are just as deadly as rifles.

    2, The author mentions that the combination of a high capacity magazine with the power of rifle bullets is the problem. Your average hunting rifle or even more bolt action hunting rifle simply cannot cause as much damage as something as an AR15. At this point I would even be comfortable with a restriction on magazine sizes. Sure, keep your AR15, but restrict magazines to 5 rounds.

    3, If the CDC would be allowed to study gun violence, we would have data on the association of things like high capacity magazines, weapon types, criminal activity and mass shootings, and we could have data driven regulation on models, magazines, accessibility etc.
    1. He does so in a fashion that comes across as technically illiterate. Repeatedly referring to AR-15 wounds as though the distinguishing factor is the model of weapon rather than the simple fact that rifles are more powerful than handguns is a huge turnoff for people that didn't start out completely ignorant of weapons. The "handguns are just as deadly" isn't a strawman - it's a reference to the reality that the vast, vast majority of murders are committed with handguns. The relevant property that results in a weapon being used for murders is obviously not the kinetic energy of the bullets.

    2. If this is the core of the argument, it makes more sense to get straight to that core rather than opening with credentialism combined with something that should be obvious to anyone that's familiar with weapons in the first place. It makes it clear that he's preaching to the choir rather than trying to convince anyone - gun rights advocates aren't surprised that wounds from rifles result in injuries that are consistent with substantially more kinetic energy than shots delivered by handguns.

    3. This data already tracked. Maybe CDC personnel would do a better job looking at it from an epidemiology perspective, but it's not obvious why they'd be better at this than criminologists. Treating gun models and features as though they're just epidemiological factors would be an exercise in point-missing when it comes to causality. As mentioned above, I believe the Dickey Amendment is extremist and ridiculous, but I also think people are wildly overestimating how much it actually matters.

    I genuinely cannot fathom a study from the CDC on gun violence that would change any significant number of people's minds on gun violence. Try it as a thought exercise - what sort of evidence do you think would convince gun rights advocates to abandon their position? What sort of evidence do you think would convince gun control advocates to abandon their position? The number of people whose positions are actually based on whether something would be likely to cause a marginal increase or decrease in violence is trivial - nearly all arguments on the matter are either based on principles or emotion.

  10. #10
    Probably a funding issue within the CDC.

    Peace

  11. #11
    Quote Originally Posted by Allybeboba View Post
    Probably a funding issue within the CDC.

    Peace
    Nope, the CDC is prohibited from researching it. Guess who is behind that :-)


  12. #12
    Quote Originally Posted by Allybeboba View Post
    Probably a funding issue within the CDC.

    Peace
    Funding issues only exist if you let them happen.

    Like say, if the NRA puts pressure on politicians to stop any and all gun-related research, up to and including passing legislation to that effect, because they know the results are unlikely to be favorable to their fetish.

  13. #13
    So the guy wants to take away something that is legal because some people misuse it, wonder if he feels the same about alcohol that when misused can lead to a family being wiped out in a crash(neither should be outlawed imo). I also thought it was obvious that rounds that have more kinetic force behind them cause far more damage to organs.

    https://www.quora.com/What-firearms-...rs-use-instead Good article talking about how there are other options out that could easily cause more damage.

    I think a lot of people calling for the ban on an ar-15 is just because the weapon looks like an Assault Rifle. A good comparison below of the same rifle but one looks far more intimidating. The weapon is a Ruger Mini-14




    Both images are the same rifle. Fires both .223 and 5.56 NATO rounds, is semi-automatic, and can put exactly the same number of the same bullets on a target at the same distance. It's perfectly legal in all states where ARs are banned.

    Then you have the Ruger Mini-30, which fires the same round as an AK-47 which would cause far more damage.


  14. #14
    Quote Originally Posted by Eggroll View Post
    Nope, the CDC is prohibited from researching it. Guess who is behind that :-)
    Well, considering they are a government controlled entity I can only presume the government. And considering we have Presidential elections every four years and we just changed from being a Democratic controlled Administration. And for a period during that time, Democrats controlled Congress similar to how Republicans do now I suppose both parties are to “blame”.

    Peace

  15. #15
    Perhaps it best to not view gun violence as a communicable disease. I’d say the CDC has important work to do and should avoid being politicized like pretty much every other 3 letter agency.

  16. #16
    Moderator Crissi's Avatar
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    We have so many gun threads that we don't need more. Use the Megathread

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