libertarianlunatic

You pissed me off with your bullshit pseudo-science in all fields of medicine already. You pissed me off again by not backing down, endangering the health of children, by, instead of admitting a flaw in prescribing healthy children stimulants, covering it up by telling half-truths in your research procedures.* And you've finished the job by taking the wrong stance on gun control. Your numbers are shrinking, you're a dying institution, and as a medical student starting this fall, I will do everything in my power to encourage fellow students not to join either.

Like any good Organized Crime establishment, the AMA has several fronts, including DAHI (Doctors Against Handgun Injuries), PSR (Physicians for Social Responsibility), and others. Through these various 'organizations' they disseminate blatant leftist political posturing bereft of any actual medical reasoning. Although they are quick to use the term Doctor or Physician in their title, they do not pontificate in their capacity as medical professionals but just as any other leftist talking head, and no more credence should be given to their arguments than any other because of their day jobs. The stethoscopes were not worn during such position taking.

I'm not going to rant about the fact that the AMA took a political stance on gun control, because that'd be entirely too hypocritical of me. I'm extensively political, and my personal philosophy, even as it pertains to medicine, is inextricably linked with my political philosophy. I'd challenge any doctor to honestly tell me that the same is not true for them. It's certainly true of every doctor or biomedical researcher I've ever met, and it's pretty easy to tell a doctor's political stance based on their professional philosophy alone. Personal responsibility (what silly liberal psychologists call 'empowerment') is the cornerstone of my developing professional philosophy toward Psychiatry, the field I intend to practice. Without looking at my URL, could you guess my political leaning? Yeah, it's just as blatant for most. What bothers me is the AMA's rhetoric with regard to guns and gunshot wounds. It resorts to emotive universalities like 'horrid effects' and 'should never be tolerated'.

Contrary to popular opinion, "First do no harm" appears nowhere within the Hippocratic Oath. With good reason. If a doctor were to follow that, they'd be pretty useless. The truth is that the medical practice is full of tradeoffs, of procedures that you know may harm your patient or definitely will. Yet the AMA in their anti-gun position and reports have failed to look at the tradeoffs involved in the legal use and ownership of guns, instead focusing on the horrific injuries (I won't deny it) caused by guns and their incidence. Nowhere in their reports do you find mentioned the number of rapes, murders, and assaults prevented through the judicious use of a legally owned firearm. They don't mention the number of outdoorsmen (and women) who've saved themselves from snake bites, bear attacks, and other risks of wild america through the liberal application of 12 guage shot or .357magnum to their dangerous targets. Furthermore, the AMA did nothing to evaluate the validity or efficacy of handgun bans (their proposed solution) in limiting gun violence. The AMA's reports on gun violence were not medical inquiries or scientific investigations into the impact of firearms on public health but a thinly veiled political diatribe. A puff piece with the authority of the long white coat and stethoscope that their political allies could wave around as 'justification' for their position. What follows is a closer look at how the medical field actually works, and how a non-hypocritical medical report would analyze gun ownership, crime, and proposed solutions (treatments) for reducing the prevalence of victims.

The pain and anguish of a child on chemotherapy is not a pretty thing to behold. While volunteering at the Ronald McDonald House I saw more than a few of them. The sickness, the weakness, the pure helplessness, purposely inflicted upon the patient that they may live to see as many birthdays as their more healthy peers. Harm to cure. It's actually one of the easier tradeoff decisions a doctor makes, believe it or not. Chemo and radiation therapies are last ditch efforts. It's that or death. And the side effects suck, but not breathing is much much worse. But in many other forms of therapy, from lifestyle to drugs and surgery, doctors play a numbers game. Few treatments have a 100% efficacy, with 0% risk of side effects. In fact, I couldn't think of any. A quick call to mom, a doctor for close to 20 years, yielded none either. At first we both shouted "Penicillin!!" across the Atlantic at each other, but no. Even within our immediate family, Dad's allergic. With any treatment either of us could think of, there are four basic classes of responses you get: 1) Successful treatment, no side effects 2) Unsuccessful treatment, no side effects 3) Successful treatment, side effects 4) Unsuccessful treatment, side effects.

"I will apply, for the benefit of the sick, all measures which are required, avoiding those twin traps of overtreatment and therapeutic nihilism.--From the real Modern Hippocratic Oath, penned by Dr. Louis Lasagna in 1964.

A medication makes it past the FDA, a surgical procedure used, a lifestyle modification recommended, because the number of people who fall into class 3 and 4 are far outweighed by the number of people who fall into classes 1 and 2. Medical utilitarianism, greatest improvement in prognosis for the greatest number of people. Doctors knowingly cause harm to their patients, a percentage of whom they know will have class 3 and 4 responses. They walk that tightrope Dr. Lasagna alluded to, between overtreatment and nihilism. Doctors have to play the numbers game if they're going to do their job effectively. Again, it's a cross they all bear because, ultimately, it's the only way to get results. Personally I'd rather save 90% of my patients than lose 100% of them. Even if I signed the prescription that hastened the death of that remaining 10%.

"I will prevent disease whenever I can, for prevention is preferable to cure." Another quote from Lasagna's widespread version of the Hippocratic.

The AMA's stance on gun control lies under the domain of preventative medicine. Their goals are honorable, to prevent the death and horrible physical trauma of children and innocent adults. I applaud that, it's a noble goal that I believe most second amendment supporters share with them. But they fail to abide by their own established methods of scientific inquiry and risk analysis with regard to this particular issue, as I've already mentioned above.

Preventative medicine is even more speculative than responsive therapy. In the latter case, you have a patient with a medical problem, whom you have the potential to either cure or possibly hurt even more; you play the odds and hope for the best. In the former case, you have a healthy patient, and you have a disease or condition that might possibly affect them at some point in the future. Here you don't work with cures but with vaccines. Vaccines, like other treatments have known risks of side effects. Here, a doctor or public health official, in addition to balancing the potential for cure (prevention or successful immunization in this case) with the potential for side effect, as well as the individual's likelihood for contracting the illness in the first place.

Those who've had the flu vaccine are particularly well-informed about this form of medicine. Here you have a choice in the matter. You and your physician weigh your risk factors of contracting the flu (age, immune health, risk of exposure) to the risk factor of the vaccine (namely getting the flu from it). A lot of people get the flu from the vaccine as a side effect, up to 1/3 get a mild fever, 10% get a high fever. Guys like me, who typically get it once if at all during season, forego the vaccine. There's little point in it since it has a high enough probability of inducing that limited period of sickness. For people who have compromised immune systems, are very young or very old, or work in the health profession, the likelihood of being sick for a long time and/or multiple times is high enough that the risk of getting the flu from the vaccine (which is typically less severe) is worth it.

The AMA reports didn't cover both risks of the gun 'vaccine'. Guns kill, wound, or cripple innocent adults and children (some 12,000 people in the year 2000, according to the anti-gun CDC), like the flu, or hepatitis. But as 2nd Amendment supporters point out everyday that the gun is a valid tool of self-defense, and proves itself literally thousands of times a day (between 5000 and 7000 times daily according a study done at Florida State) as a prophylactic against Extraneous Orifice Distribution. 12,000 (deaths)/2,000,000 (lives saved) = .6% That's some pretty good odds. there. Even my pessimist ass would take those numbers. In my second installment, you'll see the odds get even better when proper medical and scientific process are applied.

Vaccines can make you sick, cripple, or even kill you. Yet where was the AMA report banning vaccines? Guns, like diseases you can be vaccinated against, cause medical problems. But guns can also be viewed as effective vaccines, and like all vaccines, they can potentially have regrettable side effects (namely those homicides and accidents).

Instead of looking at their positive side, the AMA resorted to grabbing sound bites from sobbing ER surgeons who tell you about 8 year old Little Abby, who'll never walk again. With tears in their eyes they'll ask why we let the madness continue, why we knowingly do this to children when its in our power to ban those evil black weapons of destruction forever.

I am Little Abby, crippled not at the hand of a maniac with a gun but by the decree of public health researchers and officials. I was 14 at the time, and a state-qualified swimmer. I was hit by what's known as Chronic Regional Pain Syndrome, type II. The disorder is actually known to be triggered by vaccination. It's an atrophic nerve disorder. The pain that started in my triceps (the site of injection) soon spread down my arm and up to my neck. A little over 7 years later it's working it's way down to my lower back, where it will eventually quit, giving me a lovely case of early arthritis to go along with the nerve and muscle pain.

Those self-righteous doctors of the AMA who penned that stance on gun control spoke in ultimatums and outright condemnation: "Not one child injured by gun violence should be tolerated." I want you to dwell on that for a bit. Where was the outcry when the needle-wielding white-coated morons crippled me at the ripe old age of 14? There was none--because they cripple and kill children in similar ways every damn day--the incidence of CRPS remains 'within parameters'. To this day the only tears I've seen shed by doctors over my illness have been from my mom and her sister. And certainly not in their capacity as health professionals. Doctors knew, not that I personally, but that some of their patients, would develop this atrophic nerve disorder and other known side effects of vaccinations. Those who approved the widespread use of this vaccine willingly accepted that they'd cause a number of individuals intense pain everyday of the rest of their lives. To boot, we aren't even sure the vaccination took. That's right, I may still be able to contract Hepatitis...I'm a Class 4, the ugliest kind. Apparently a white coat abrogates ones responsibility toward the 'Not one child' mantra.

That rather personal illustrative example wasn't meant to demonize doctors or their decisions regarding widespread use of potentially harmful preventative medicine. When their coats are on and their 'mother figure' emotions removed, Mom and Aunty still support the Hepatitis Vaccine. Truth be told, I do to. I am 'acceptable collateral damage', 'friendly fire', or 'necessary loss'. I understand that, and as I've said before, I support such logic in the field of medicine. I'd like to see the medical establishment treat guns and their legislation with the same callous (a nonpejorative in this case) playing of the numbers game. They don't use one-sided statistics looking only at the side effects of preventative treatment, they don't look only at who'll contract disease, and they certainly don't trot out anecdotal 'Little Abby' stories as either proof, corroboration, or persuasive elements.

"I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm."--Another line from the Modern Hippocratic...another part of their oath they evidently forgot.

The AMA started out with a political position when they wrote their position on gun control, and then they worked outside the scientific method to form support for their stance. They ignored that medicine, at its roots, is a scientific and statistical endeavor (this means unbiased), that its ultimately a utilitarian pursuit in which costs and benefits must be accurately assessed and then a decision made. In short, they ignored the BA, MD, and MPH (masters of public health) on their wall while they were writing this statement, then tacked those titles on at the end to add an air of (empty) authority to a report that was neither medical,nor scientific, nor about public health. They exploited our trust in them, and for that they have lost what little respect any of us should have had for them.

This will be continued with a true scientific and medical analysis of guns in the US and the efficacy of proposed measures to end gun violence.

Endnotes:
*(see also the neurologist Dr. Frank Baughman's site as well as the words of psychiatrist Ron Leifer, and another psychiatrist Thomas Szasz...these men are my honest to god heros)