With back-to-back-to-back incidents of mass gun violence killing almost three dozen children, women, and men, can this nation muster the political courage to treat this lethal scourge as a public health menace?

Can it, finally, green light and fund rigorous research that could inform public policies that both could protect Americans’ Second Amendment rights while also reducing the estimated 40,000 or so firearm deaths that occurred in 2018 alone?

For what it is worth, there is considerable and (what should be) convincing evidence that:

• No, video games — violent, sexist, racist, and demeaning of human life that many of them may be — have not caused sick men to go on armed killing sprees. There is much to be discussed and condemned about these “entertainments.” Video games, however, are so globally ubiquitous that it defies logic why they would influence shooters only in this nation and not elsewhere to large-scale slaughter. Tagging them, reflexively, as a key talking point by certain partisans undercuts important, difficult, and hard thinking that would be helpful after mass gun violence incidents.
• Mental health always merits greater attention and less stigmatization. It would seem fundamental and logical to say that anyone who would use a weapon to kill many others is mentally ill. But millions of Americans struggle with mental health — without inflicting senseless harm of numerous people around them, especially strangers. And, in a nation where mental health services are in unacceptable short supply and funding for this needed care is woeful and neglected, how helpful is to offer knee-jerk responses to mass gun violence that focus with little more than a shrug on mental illness?

In the last century, Americans decided it was unacceptable for another type of fast-moving consumer mechanism — our vehicles — to maim and kill so many of us. Prodded by crusaders like Ralph Nader, and facing down wealthy and powerful industrial interests, researchers discovered ways to make vast improvements in cars, trucks, and buses, and in streets and highways. Countless lives have been saved and injuries averted or lessened. Would it not be worthwhile to deal with the consequences of mass shootings with similar vigor?

But still on the books is the 1995 Dickey Amendment, which handcuffs the nation’s leading public health agency, the Centers for Disease Control and Prevention, from doing rigorous research into the public health aspects of gun violence. Congress passed that law and could unpass it in a minute.

Would it be good to test the evidence as to whether an assault weapons ban would reduce gun violence and fatalities? Should we examine what experts know already as to whether background checks could be helpful, or if they need fixes before enacted? Should we dive deep into the effectiveness of measures that allow officials to step in and take weapons from individuals known to be unstable and at sudden heightened risk?  Could politicians and policy makers calmly consider, for example, building research that implicates bullets and their size in the lethality of gun violence. As the evidence-based Upshot column in the New York Times described what experts have found in these studies:

“Over recent decades, the size of bullets fired by the typical handgun has increased. Changes in design have made it easier to fire big bullets from concealable weapons, and manufacturers have marketed more powerful guns as better tools for self-defense. In the 1970s and 1980s, the guns most commonly used in crime tended to be revolvers or small, inexpensive pistols that fired .22-caliber rounds, so-called for their 0.22-inch diameter. But regulations meant to reduce crimes committed with these cheap, disposable guns, sometimes called ‘Saturday night specials,’ pushed them out of gun stores. And advances in gun technology caused a new generation of weapons to hit the market — and eventually the streets. The newer guns, which started to become common in the 1990s, were semi-automatic. They could fire multiple rounds more quickly and tended to be able to store more bullets in their magazines, meaning they required less reloading in long shootouts. And instead of buying guns that fired smaller bullets, people started purchasing ones that fired rounds that were 9 millimeters wide, about 0.35 inches, then 0.40 and 0.45 inches. Guns that fire big bullets used to also be big. But improvements in technology have meant that large-caliber weapons are now available as pistols that can be more easily carried and hidden. These advances, intended for the legal self-defense market, have spread to the criminal one, too.”

What’s the net effect? As the newspaper reported: “A study last year, published in JAMA Network Open, examined the type of weapon used in every fatal and nonfatal shooting [in Boston, 2010-15]. It found that — regardless of the time of day, the number of wounds or the circumstances of the crime — the size of the bullet affected which gunshot victims lived and which ones died.”

The Upshot experts, separately, considered evidence on how youngsters’ lives could be protected and saved with relatively small changes and little intrusion in weapons owners’ rights: encouraging or even requiring them to store their guns with greater care. As the newspaper reported:

“In the last decade, guns killed more than 14,000 American children. A startling number of those deaths — more than a third — were classified as suicides, and around 6% as accidents. Many more children were injured. Nearly everyone agrees that children should not be able to buy guns, and no state lets them do so on their own. When children die by suicide in this way, it’s a result of being able to get hold of a gun that someone else already obtained — often legally. How guns are stored matters. A study published … in JAMA Pediatrics has found that even a modest increase in owners who lock up their guns would pay off in an outsize drop in gun deaths.”

Many gun owners, of course, want fast access to weapons because they say they would provide them needed protection from criminals. But many owners, particularly if policy makers provide them with solid information and incentives to lock up their weapons, such as providing special boxes at low cost, accept the safeguard, particularly if they have children in the house.

Public health officials have already warned Americans that the nation is gripped by a suicide crisis, with 45,000 Americans 10 and older taking their own lives in 2016 alone. It is unhelpful to the nth degree, NPR reported, that the federal Centers for Disease Control and Prevention (CDC) and other groups like it must tiptoe around guns’ role in suicide. The respected Brady Center to Prevent Gun Violence estimates that 50 suicides a day involve guns, amounting to 20,000 annually or half of all self-inflicted deaths and two-thirds of all firearm-related fatalities. (If you or someone you know is considering suicide, confidential and free help is available 24/7. Please consider calling the National Suicide Prevention Lifeline: 1-800-273-8255).

Sixty-two Americans have been killed in 2019 alone in mass incidents of gun violence, and the year’s far from over. Statistics about these incidents can differ and be controversial, depending on the criteria used to tally them.

The magazine Mother Jones set up an open-source database and it describes its incidents included since 1982, thusly: “Our research focused on indiscriminate rampages in public places resulting in four or more victims killed by the attacker. We exclude shootings stemming from more conventionally motivated crimes such as armed robbery or gang violence.” The publication says seven mass shootings have occurred in 2019 so far, with recent cases in El Paso, Texas, Dayton, Ohio, and Gilroy, Ca., bringing the nightmare tally to 115 incidents in roughly four decades.

Time magazine uses different criteria, estimating 253 U.S. cities now have suffered through mass shootings — and its cover (shown above) offers a painful and striking illustration of the sad consequences.

The Washington Post on Sunday published a 12-page special section with its tally and the names of 1,196 victims of mass shootings that have occurred since 1966. In a separate graphical analysis, the newspaper found that “public mass shootings are occurring more frequently in recent years, and they are claiming more lives.”

Is it past time, as Time pleads, to say enough is enough?

In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, effective, and excellent medical care. This has become an ordeal with the soaring cost, complexity, and uncertainty of medical treatments and prescription medications, too many of which prove to be dangerous drugs.

The U.S. health care system already is a $3 trillion-plus mess, burdened by lesser outcomes than its counterparts in other western industrialized nations. The excellent, compassionate care givers in the system already battle institutional profit-seeking and problematic practitioners and practices that see medical errors claim the lives of roughly 685 Americans per day — more people than die of respiratory disease, accidents, stroke and Alzheimer’s. That estimate comes from a team of researchers led by a professor of surgery at Johns Hopkins. It means medical errors rank as the third leading cause of death in the U.S., behind only heart disease and cancer.

With all the formidable challenges they must deal with already, doctors, nurses, other medical staff, and hospitals should not be forced to deal with medical calamities caused by mass shootings. They do so in painful but sadly practiced, outstanding, and praise-worthy ways. So, too, should we salute police, fire fighters, paramedics, and other first-responders. All these pros, alas, do not see their labors cease when calamities come to their stop and the nightmares continue for victims and communities.

We can and must do more to honor them and the dead, as well as protecting the living. We should consider how we can encourage free speech and refuse to abide extreme, racist, terrorist, and white supremacist views. And, as mentioned, we need to push ahead and pay for important study that will help the nation heal, advance, and say never again to mass killings with weapons.