We must cultivate our garden.  — Voltaire, “Candide”

What do we do now?

After all, don’t we want to do something?  Isn’t it one of those straws we are all frantically grasping at, hoping against hope to find some tiny reed to cling to that will pull us out of this quagmire of impotent sorrow?  Surely, surely there must be something we can do.  We can do nothing for the lost children and their brave teachers, except brace ourselves to face their pictures when they are released any minute now.  But we must find some way of making a change that will keep this from happening again.

Isn’t everyone thinking this?  Or is it just me, trying to find some footing in the fathomless depths of sadness?

Of course we must ask ourselves this.  Of course we must ask ourselves how many more pictures of anguished parents and devastated loved ones we’ll have to see before some kind of answer is found.  Of course we must raise hard and serious questions about how easy it is to obtain weapons designed for no purpose other than to destroy human life.  Of course we must determine if our priorities are set properly when shattered man after shattered man can find ways of enacting his poisoned fantasies on the innocent, or if perhaps the needs of the mentally ill are not being met as well as they must for us to live in a safer society.

Of course we must ask.  And with all the hope in my heart, I pray that we find a better way of living together.

But it is hard to know what, exactly, we can do.  It is hard to know what solution we can engineer that will make this kind of thing as rare as possible.  Which laws, which safeguards, which services will work?  I don’t know.  I am skeptical that those answers that seem most conveniently at hand when we reach out in our horror and grief will be the best ones, however.

But of course we must ask.

For myself, I have one small answer.  If I have a little garden of my own to tend, I know that I must tend it a little more diligently now.

Some time back, I wrote somewhat aloofly about why it is that doctors might ask their patients if they have guns in the house.  I did this to counter an argument made over at Popehat, premised on the notion that doctors are reflexively anti-gun.  Not so, I wrote.  Or at least not in my case.

It is with all due (and very sincere) respect that I heartily disagree with Ken’s assertion that doctors ask about gun ownership because they have a political agenda.  I don’t actually ask about it on a regular basis, but I consider that a deficit, not a credit.  For my part, I have absolutely zero problem with responsible adults owning guns, and would not be in any way inclined to use my professional position to dissuade anyone from owning one.  (I have some qualms with the relative ease by which assault weapons can be obtained, but that’s not the same thing.)  Asking if a family has guns in the house has nothing to do with a political agenda, and everything to do with knowing safety risk factors for my patients.

I am having a hard time finding any recent data on firearm-related deaths in the United States, with most of what I can turn up at least a decade old.  Perhaps the recent numbers are much lower, I can’t say.  However, in 1994 22% of the 1107 reported firearm-related deaths in children were unintentional.  When I ask if there is a gun in the house, I want to know if it is appropriately stored and locked, and that older children have been educated about gun safety.  That’s it.    Of course I have an agenda, but it’s not anti-gun.  I have the same agenda that every medical provider should have, which is to know about her patients’ lives with regard to factors that might compromise their health and safety.

In these moments now, I can’t say that I’m not feeling more “anti-gun” than I was when I wrote the above lines.  Frankly, at this very second I would happily see every assault weapon ever bought and sold in this country tossed into a bottomless well.  But that’s one of those visceral responses that is unlikely to be helpful in the long run.  I’ll certainly lend my voice to whatever national conversation about gun control ensues, but it remains to be seen if anything concrete will be done and how effective it will be.

But there is a small thing I can do now, and do better.  Though there is still a maelstrom of unknown information swirling around the details of the killer’s life and home, it seems that the guns he used were his mother’s (a victim herself) and presumably obtained legally.  It is hard to know what legal measures might have prevented her obtaining them, if she herself was no criminal and had no mental health issues of her own.  She might well have passed the most stringent of background checks.

Further, we don’t know much about the psychiatric history of the killer.  We may reasonably infer that it was not normal, and that he was deeply disturbed.  We don’t know what conversations about his health and safety were had, and what services were offered to him.

All we know for certain is that he got hold of those guns, and what followed.

Did anyone who took care of his physical or mental health ever ask his mother if there were guns in the house?  If so, did they ever ask how they were secured?  We’ll never know.  We can only guess.  Maybe advice was given and ignored.  Maybe the subject never came up at all.  Maybe it never even occurred to complacent professionals to ask.

Well, I am in a position to ask.  And I haven’t been.  Not nearly often enough.  Because of course something like this could never happen to anyone I know, right?  Certainly not in the community where my practice is situated, not so very different at all from Newtown, Connecticut.  Except now we have the bleakest reminder possible that of course it can.

And so I will tend my little garden better.  I do not know how much possibly better this world can get, but I have my little row to hoe.  I intend to do so with just a little bit more care.  Perhaps there are some who will bridle or take offense that I am asking, and in some cases reminding parents to secure their firearms as tightly as they can.  It is little matter; I am often called upon to cause offense when doing my job the right way.  So I’ll be asking, because doing so is quite obviously part of my job.

I do not flatter myself that it will make an appreciable difference in the world.  I am only one man in one office in one town, with a small garden of patients to look after.  But it is the best I can do with what I have.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. Russell, Good source of all things criminal here:

    Thank you for asking your patients, for thinking of asking your patients, about firearms. I was never asked this question.

    And we can do something: we can write to our legislators and senators and tell them what kinds of gun laws and mental health programs we’d like to see in our states, our nation. It doesn’t really matter if we all agree or not, it matters that we add in our voices.

    • I know there is more than just this that I can do, particularly with regard to those other actions you mention. But this is the thing I can do most directly that might possibly have some benefit to the people I come into personal contact with.

      • It’s an amazing opportunity to change lives pediatricians have.

        Those few moments in the office shape families in thousands of small ways. A gift, and a burden. Thank you for shouldering it.

        (My sister did pediatric intensive care at Maine Med. for many years; she watched too many babies die. And she saw miracles.)

  2. I share your concern, but I don’t think guns are really the problem.
    Firearms are an old technology. They’ve been around for a long time.
    But there has been a shift in attitudes, for whatever reason, that inclines people to do things with them that simply weren’t done before.

    This sort of reminds me of a phone call from my brother several years ago (we haven’t spoken in some time).
    He was complaining about how terrible people’s driving is in the area where he lives.
    He said something like, “I don’t know why some people suddenly become complete jackasses when they get behind the wheel of a car.”
    I told him that the people were jackasses anyway, and it probably shows itself in other aspects of their personal relations; getting behind the wheel of a car only enables them to express that more quickly and vividly than they would otherwise.

    I believe that is the case in this instance.

    Even more than complaining about people being jackasses behind the wheel of a car, it intrigues me as to why we should tolerate so broadly that very same dynamic expressed in other interactions.
    What changed in us? Or is this what we really are?
    Are we becoming more of ourselves?
    Or is it something other than ourselves which we are becoming?

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