A Modest Proposal

I was a mother before I was a doctor. As a mother, I was UNAWARE that children like my young daughter were being killed every day in this country. Child abuse was something that always seem to exist only at the periphery of civilization and even though I was aware that it existed, it had never touched me or my friends, or anyone I knew. 

Then, I started a career in pediatric medicine and I found out that the THING no one I knew talked about was a very real problem. At that time, the number 4 cause of death in children < less than 5 years of age in the United States was homicide. Today, firearms are the 2nd leading cause of death in children < less than 5 years of age. One statistic that has remained stable over the last 50 years is that childhood mortality continues to be higher in the United States than in most of its international peers, in substantial part, because of the excess mortality from injury and violence. In comparison to Japan and Sweden, childhood mortality from homicide, suicide, and unintentional injuries is about 2 – 4 times higher in the United States.

So, for those of you that are appalled that we are once again witnessing the aftermath of an event where young children were slaughtered in their classroom because “this is the United States, for God’s sake”. YOU. HAVE. NOT. BEEN. PAYING. ATTENTION. 

Please, allow me to repeat that – in this country, for a very, very long time, we have failed our children. Again and again.

In the early days of my career, I honestly believed that if people were made aware of how many children were being tortured and killed in this country, Americans would do everything they could to stop it. So, I went to PTA meetings and to school board meetings to talk about ways to identify abused children and how to intervene. I spoke to education classes at my local University on child abuse cases. I taught doctors in training on the injury syndromes suggestive of child abuse. I operated a weekly clinic that examined children referred from the Department of Human Resources as possible child abuse cases, in particular suspected child sexual abuse. I consulted with other physicians when they were concerned about the possibility of child abuse with one of their patients. My local district attorney began to rely on me as an expert witness on child abuse cases. Unfortunately, for every 10 cases he called on me to review, only one would actually go to trial. 

On and on it goes. I am ashamed to admit that despite all the years I testified in child abuse cases, it was not until very late that I realized why I was failing. For most people sitting in a jury box, the term we used to denote brain injury in abused children—Shaken Baby Syndrome—seemed to diminish the ferocity of the assault on a baby’s brain. The term came from medical literature and basically referred to a high-velocity acceleration and then deceleration of a baby’s head. But the term…there was not a single parent sitting in that jury box that did not remember a time when they had taken their child’s shoulders in frustration and shook them and I’m sure hesitated to convict an abusing parent because of a ‘there but for the Grace of God’ emotion. 

The term Shaken Baby Syndrome did not convey the violence of the attack on the child. So, the district attorney and I came up with another method to demonstrate to the jury how the child might have been injured. The attorney would hand me a doll, about the size of an 18-month human baby, and I would demonstrate the type of violent attack that might have produced the injury—swinging the doll by an arm or foot until the head contacted a solid structure (the floor, a door, a wall). That one little maneuver was more effective than all the words on the witness stand had been.

So, I have a modest proposal. Most Americans have not seen a gunshot victim. The only visual they have is the very unrealistic depiction of humans who have been shot in television or movies. Usually, the victim grabs the wound, sometimes realistic-looking blood pulses from the wound, and then they ‘die.’ Quietly.

That’s not how real gunshot victims die. They do not die quietly. They die in pain, minutes of suffering, and howls of anguish. The wound not only propels or gushes blood but the tissues around the wound are torn—red and jagged. The wound gapes, sometimes you can actually see inside the victim’s body. Humans, even young humans, cluster together in moments of terror. So, the victim’s bodies would pile on top of each other—a mountain of carnage encased in torn flesh and slick with blood.

Americans need to see the consequences of their failure to protect the youngest and most vulnerable of our society. We need to see the visual of their slaughter—not the pretty photos from their life shared in moments of silence on TV for the next few days and then we move on to the next news item. If we saw the gruesome deaths, would it change anything? I don’t know but without a doubt, a nation that cannot protect its children is doomed to failure. And somewhere—another shooter is planning an attack.