Sunday, February 25, 2018

On banning High Velocity Weapons of Mass Murder.

First things first: I recently tweeted this about the 2nd Amendment.

With that in mind, there is no reasonable argument for a right to buy a high velocity weapon, and there's reasonable reason why we can't outlaw their sale.

Understanding why assault-like weapons should be banned came into focus with this editorial by a Florida radiologist who has seen assault weapon wounds that are pretty much impossible to repair. This should change your mind:
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,

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 … victims who arrived at the hospital that day survived.

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,

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 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. 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.

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. 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?

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.

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.

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