A kind, big-hearted, gentle person

Daniel Mongiardo, a physician in Perry County, Kentucky, and also Lieutenant Governor of that state, recently described his colleague Dr. Dennis Sandlin as “a kind, big-hearted, gentle person.”  Dr. Sandlin had been in practice for over thirty years at the Leatherwood-Blackey Medical Clinic in southeastern Kentucky when a disgruntled patient showed up with a gun and shot him dead.  The dispute was reportedly over a prescription for narcotic drugs.

I was amazed at the vehement responses submitted as online comments to a recent editorial in the Journal of the American Academy of Physician Assistants which advocated that healthcare professionals counsel their patients on firearm safety.  Here are a few choice reader remarks:

Cars, swimming pools and tobacco can certainly be blamed for far more deaths than firearms. Quit being a nanny and do your job.

Since you seem to know nothing about firearms or their owners, I suggest you stick to practicing medicine.

You’re trotting out all the tired old anti-gun arguments in your text and you advocate disarmament.

Doctors should really advise us not to exhale, as the EPA has listed carbon dioxide as a dangerous pollutant. It certainly would cut down on all the hot bags of wind that try telling us in crappy little articles that they know better than I do when it comes to my safety.

The most amazing thing about every one of these emotionally charged comments is that their authors seem to have missed the entire point of the editorial, which advocated counseling patients on gun safety in the interests of keeping a safe environment in the home.  (Note:  All of these comments have been deleted by JAAPA editors because they did not adhere to comment guidelines and were deemed to be outside the scope of professional discourse expected on the journal’s website.  As of this writing, comment posting on this editorial has been closed to discourage members of the public from pursuing private agendas at this site.)

When I was a boy growing up in Pennsylvania, adolescents were required to complete a rigorous hunter safety course as a prerequisite to obtaining a hunting license.  The state was not advocating gun control or restricting the use of firearms—it merely wanted to insure that those who used firearms would do so in a safe and responsible manner.

Outside of the first year of life, the number one cause of mortality in the pediatric age group is accidents—deaths related to automobile accidents, drowning in backyard swimming pools, accidental poisoning by mouth, falls, choking hazards, burns from hot liquids and house fires (including smoke inhalation), and accidental deaths from firearms.  A good part of primary care pediatrics is centered on prevention of morbidity and mortality.  Included in this armamentarium of preventive medicine are the timely administration of childhood vaccines, monitoring the growth and development of young children, and counseling parents on how to keep their children safe.

Although I am not an advocate of carte blanche gun control, as a practicing pediatric clinician I do spend time counseling parents about how to keep their children safe.  Firearm safety is one piece in the accident prevention paradigm, and counseling patients on how to stay safe—regardless whether the issue is sexual practice, drinking and driving, substance abuse or proper handling of firearms—should remain an integral part of preventive medical practice in primary care.  The American Academy of Pediatrics has issued a policy statement on office based counseling for unintentional injury prevention which includes firearm safety.

Could gun control have prevented the death of Dr. Dennis Sandlin, a kind, big-hearted, gentle clinician, revered by his patients and the members of his community?  Perhaps; perhaps not.  But regardless of how an act of violence is eventually carried out, it is first formulated in the psyche of the perpetrator.

While we can all agree that when it comes to divisive issues, spirited debate is healthy and perhaps even desirable; those who resort to the use of threatening, abusive and demeaning language should be granted no voice in professional forums.