For years, Dr. Sue Bornstein tried to persuade policymakers and politicians to tackle one particular epidemic: gun violence. But politicians didn’t seem to take the threat seriously, and body bags continued to fill.
Now, as Texas Republicans barrel forward with a series of gun-related bills in the Legislature, many doctors and gun reform advocacy groups fear the bloodshed will get worse.
Bornstein, a Texas-based internal medicine doctor, knows what she and other reform advocates are up against. In 2018, she coauthored an article in the Annals of Internal Medicine that enraged perhaps the most notorious gun rights group in the industry: the National Rifle Association.
The group took to Twitter and placed doctors in its crosshairs. “Someone should tell self-important anti-gun doctors to stay in their lane,” the NRA tweeted on Nov. 7, 2018. “Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves.”
Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves. https://t.co/oCR3uiLtS7— NRA (@NRA) November 7, 2018
Doctors around the country shot back, firing off a series of tweets aimed at the NRA. Some posted images of blood-splattered operating rooms. Day in and day out, doctors treat gunshot victims, and the hashtag they used delivered a pointed message to the NRA: #ThisIsOurLane.
The NRA had chosen an inopportune moment to lash out at doctors worried about gun violence. Bornstein’s Annals of Internal Medicine article ran between two deadly mass shootings. In the month leading up to the tweet, the country had experienced more than two dozen mass shootings, including a massacre at a Pittsburgh synagogue that left 11 worshippers dead. A few hours after the NRA blasted the “self-important doctors,” a gunman opened fire in a bar in Thousand Oaks, California. By the time the attack was over, 13 people were dead, including the shooter.
“For them, it was very unfortunate because they sort of interjected their comments between two horrific mass shootings,” said Bornstein, who also chairs the American College of Physicians’ Health and Public Policy Committee. “So, it sparked a movement like I’ve never seen before.”
In 2019, firearms killed 3,683 people in Texas, according to the Centers for Disease Control and Prevention. In August that year, an anti-immigrant gunman drove from Allen to El Paso and murdered 23 people at a Wal-Mart.
Born and raised in Dallas, Bornstein first became interested in the gun debate on Nov. 22, 1963, when she was 10 years old. She remembers the devastation when President John F. Kennedy was assassinated in her hometown; in many ways, the watershed moment was the “end of innocence” in the United States, she said.
Later on, another event in Bornstein’s life would bring the firearm debate into even sharper focus: One of her patients, 17 years old, used a gun to attempt suicide. The attempt left him alive with a disfiguring injury to his face, and she anticipated he’d be physically and psychologically disabled the rest of his life.
“This physical, mental, emotional, social toll that firearms can take is just really beyond our understanding sometimes,” Bornstein said.
She may not have won over anyone at the NRA, but Bornstein is no armchair quarterback, either. When she’s not in Dallas, she lives on a ranch in the Hill Country and owns guns herself: a revolver, two bolt-action rifles and a shotgun her dad passed down to her. Occasionally, she’ll use them for target practice; otherwise, they remain in a safe, locked and unloaded.
Bornstein doesn’t want to scrap the Second Amendment. She wants to see fewer people killed or injured by guns.
“I am not against the Second Amendment,” she said, “but I think it has to be interpreted with some latitude and with some recognition that in the 1700s, people didn’t have semiautomatic weapons that were capable of killing hundreds of people or 50 people at once.”
Bornstein doesn’t understand why gun owners oppose comprehensive background checks for gun buyers. Research suggests the checks work to mitigate gun violence, according to NPR. According to The Texas Tribune, nearly 80% of Texans support the idea, and even arch-conservative Lt. Gov. Dan Patrick spoke in support of it in 2019. But two years later, Patrick and other Republicans are fighting proposals to expand background checks. As many doctors and reformers continue to push for regulation, Republican state lawmakers are gunning to relax restrictions.
In August 2019, Texas was rocked by a pair of mass shootings that killed more than 30 people and injured dozens. The El Paso shooter had murdered 23, while another gunman in Midland-Odessa killed seven before police officers shot him dead. Afterward, Gov. Greg Abbott seemed to express a willingness to support tighter regulations, including background checks, less access to assault weapons and red flag laws, which allow courts to temporarily take guns away from those considered dangerous, The Texas Tribune reported.
But in early 2021, when the Republican governor outlined his priorities for the legislative session, whatever willingness had been there was gone. “We need to erect a complete barrier against any government official anywhere from treading on gun rights in Texas,” he said, vowing that he would work to make Texas a so-called Second Amendment sanctuary state.
Once the legislative session started, Republican lawmakers launched a campaign to make the governor’s wishes a reality, filing bills that would further loosen gun regulations. State Rep. Justin Holland, a Republican from Heath, introduced HB 2622, a bill that would turn Texas into a Second Amendment sanctuary state. Once codified in law, that bill would prevent agencies or political subdivisions from enforcing new federal gun rules.
Contacted by the Observer, Holland offered no comment, but during a House Committee on State Affairs session, the representative made his case for the sanctuary state bill. He argued that the federal government’s gun control measures “have threatened and aimed to infringe on the constitutional right of Texans.”
“Over 50 Texas counties have adopted some form of a Second Amendment sanctuary county resolution, including both Rockwall and Collin counties, which I represent," Holland said. "Nationally, over 400 municipalities and counties in 40 states have adopted such initiatives to date, and four states have passed similar laws to House Bill 2622: Alaska, Idaho, Kansas and Wyoming.”
Others introduced their own gun-related bills. State Rep. Kyle Biedermann filed HB 1238, providing for “constitutional carry” in Texas, which would allow Texans to carry weapons in public without a permit.
Another bill in the Senate proposes expanding a 2015 law that allows Texans to carry concealed weapons on school campuses. Filed by state Sen. Bob Hall, a Republican from Canton, SB 514 would open the door for adults to be armed on public and charter school campuses.
Bornstein sees no good coming from guns on school grounds. Gun rights advocates insist good people with guns can prevent crimes like shootings, but Bornstein worries that such a situation could only leave more people harmed or dead. Besides, she says, there’s no evidence that campus carry measures make schools any safer. “To me, that’s going in the wrong direction,” she said. “I don’t think that’s where we want to be in Texas.”
Democratic lawmakers agree. That’s why they’ve introduced their own bills which would further restrict gun ownership. Along with her colleagues, state Rep. Vikki Goodwin, an Austin Democrat, filed a bill to tighten background checks, as has Democratic state Rep. Ron Reynolds. Goodwin, who sits on the House Homeland Security and Public Safety Committee, criticized Republican legislators for attempting to allow people to carry guns at voting stations and to walk around armed without a permit.
“There is a need for tighter gun laws in Texas,” she said by email. “Think about the Midland-Odessa shooting, the El Paso shooting, and the Santa Fe shooting, to name a few. More people die of suicide by gun than by mass shootings, so that is an issue, too. We should be working on widely agreed upon background check measures and encouraging safe storage and a higher level of safety training.” (In 2018, a mentally ill teenager killed eight students and two teachers and wounded 13 others at Santa Fe High School near Houston.)
As guns become easier to procure, Goodwin said, “schools teach children how to react to an ‘active shooter’ and teachers can carry firearms.”
Earlier this year, Democratic state Sen. Sarah Eckhardt introduced a bill that would criminalize going within 500 feet of a protest with a firearm, and state Rep. Lina Ortega, a Democrat from El Paso, filed multiple bills that would add additional regulations to gun ownership and purchasing guns. One of those, HB 127, seeks to make it illegal for someone to openly carry an assault weapon or a long gun.
To Ed Scruggs, a board member at Texas Gun Sense, a nonprofit advocacy group, the bills seeking tighter restrictions on guns are a step in the right direction. “There is progress in that we continue to talk about these bills,” he said. “We see them authored every session. There's some good common sense legislation out there, but then we always see the bad bills popping up.”
Doctors aren’t just speaking out in Texas. Take Dr. Joseph Sakran, who was hit by a stray bullet in the throat when he was 17 years old and living in Virginia. That night, Sakran and his friends left a football game and headed to a nearby park to hang out. A fight broke out, and someone fired a gun. The bullet struck Sakran, injuring his vocal cord and carotid artery.
Though the accident was “devastating,” Sakran chose to turn it into something positive, eventually becoming a trauma surgeon with Johns Hopkins Hospital in Baltimore. After the NRA posted that 2018 tweet, Sakran founded the viral Twitter campaign @ThisIsOurLane.
Too often, the narrative surrounding firearms turns to whether guns should be “taken away,” Sakran said. But he thinks that line of argument misses the point. Rather, Sakran and other advocates say they merely want responsible ownership.
Sakran thinks the heavy politicization of the issue of gun control is unfortunate. Firearms violence should be looked at like “any other public health problem,” such as when the medical industry began warning of the dangers of tobacco. Another example, Sakran said, came when years of deadly car accidents led to seatbelts becoming mandatory in 1968.
Without action by lawmakers, Sakran continues to see a steady stream of gunshot victims, and he dreads delivering bad news to families. “I just realize that I’m about to rock their world, that I’m about to change their life,” he said. “And if you could imagine how devastating it must be of course to lose your loved one, to lose your baby boy, [who] that morning left your house. … It is just heart-wrenching and it never gets any easier.”
In many neighborhoods, especially marginalized communities, shootings are a regular occurrence, said Dr. Arkaprava Deb, a psychiatrist and co-chair of Doctors for America’s Gun Violence Prevention Committee. While mass shootings may grab headlines, other forms of gun violence get less media coverage but consistently plague communities of color and minorities.
Black people make up around 13% of Texas’ population, yet the Kaiser Family Foundation reports they’re far more prone to face gun violence: 19.1 Black Texans die by firearms per 100,000 population by race and ethnicity, compared with 15.3 for white Texans.
Deb fears fewer gun restrictions will lead to more physical and mental danger. Those living in neighborhoods hit hardest by gun violence, especially young African American males, are often left to cope with psychological disorders, Deb said. When someone experiences a traumatic incident, they then must deal with the fallout from PTSD, and laws loosening restrictions could make it even harder for them to recover.
“We have complete communities throughout America where kids are growing up with PTSD because of the gun violence epidemic,” Deb said. “And just seeing weapons more in public would be more triggering toward PTSD for a lot of people.”
Bornstein knows the drill. In the wake of a mass shooting, the public discussion zeroes in on whether the gunman had a mental illness, a fact that makes little sense to the Texas doctor. People with severe, persistent mental illness are more likely to be victims of gun violence. Suicides make up nearly two-thirds of firearm deaths in Texas, according to thePrevent Firearm Suicide
project. Bornstein fears easing restrictions could exacerbate the problem.
Another major issue is safe storage, especially in homes with children and people with dementia, she said. If a gun is unlocked and loaded, the risk is higher for an accidental shooting.
But doctors are sometimes rebuffed when they ask patients about safe storage, Bornstein said. Many simply don’t want to discuss it. In the same way physicians will ask whether a patient wears a helmet or a seatbelt, though, they want to make sure their patients are protected by ensuring household guns are secured.
“To me, it’s part and parcel of the physician trying to help patients and their families live in a healthy environment to ask about firearms,” Bornstein said. “It’s something that some people are more or less uncomfortable with, but it is well within our rights to do that.”
Often, people shut down during gun debates, with staunch Second Amendment supporters and anti-gun activists tuning the other side out. Bornstein worries that solutions will remain elusive if Texans don’t take time to reason with one another in a cool, level-headed manner.
In the meantime, Bornstein goes on hoping that Texans on both sides of the debate find a way to come together and have an honest conversation. “Because right now, people are just in their own corner,” she said. "That’s not going to help us. We need to find common ground.”
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