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Sunday 12 June 2016

And in America, Gunshot. Again, and again, and again. A repost.

Recent tragic events have reminded me of something.

In the late 1980s I briefly worked part time on a spinal cord injury rehabilitation unit. The majority of patients were young males – which, I understand, is common for these units. I worked with patients on adjustment to their injuries and the requirements of their altered lives.

The head of our service had worked there for a number of years. I asked him to tell me the most common accidents that would bring people to the unit. He said something that stuck in my mind.
Then I heard someone else, at another facility, say exactly the same thing. I began listening for the list, and heard it over and over again.

“Motor vehicle accident, work-related injury, sporting accident.  And in America, gunshot.”

And in America, gunshot. Those four words, repeated virtually verbatim, again and again.

I saw people injured in motor vehicle accidents. This was, far and away, the most common route of entry to our unit. I saw people who had been injured on the job. I saw two who had athletic injuries (one hockey, one diving). But I never saw anyone who had received the injury via gunshot.

An Ontario study of the epidemiology of spinal cord injury (Pickett et al, 2006) seems to bear out the Canadian impression.  Of patients aged under 65, 43% received their injury in motor vehicle accidents, 24% from falls of various sorts, 12% from accidents involving other vehicles (bicycles, ATVs, and so on), and 9% in sports-related incidents. Only 5% were injured as a result of violence of any kind; it was not mentioned how many of these were gunshot-related.

A review of US data (DeVivo, 2012) confirms a much higher incidence of violence-related spinal cord injury, though this appears to have been declining in recent years (12% since 2000, but 21% in the 1990s). Given that military personnel (at risk for violence-related spinal cord injury on the battlefield) are typically seen in their own hospitals, the actual figure may be somewhat higher. And the reduction in the percentage may not translate into a reduction in actual numbers, given that the overall incidence of spinal cord injury is increasing.

It sticks in the mind, that phrase.  And in America, gunshot.

Particularly when grown adults continue to stand on their hind legs and argue that arming high school staff will prevent school shootings.

Apparently not always. Columbine High School had an armed guard. And of course, most mass shootings don’t happen within schools. Restricting ourselves just to the ample list from the past few weeks in the USA, we’d have to arm cinema staff, retail clerks, and all homeowners as well.

Odd that despite the fact there are so many more armed guards and armed private citizens in the US, it continues to suffer so many incidents like these. We are not immune to them in other countries. Canada had an incident in Montreal in 1989, and there have been others. Even placid Norway has had a horrific example. But the rate does seem lower in developed nations other than the US.

A moment of opportunity seems to have arisen after the most recent school shooting. The NRA’s spokesman made his fatuous point and was widely and rightly ridiculed for it.

America may be ready to shake off its traditional explanation for these events: “We are simply worse people. More prone to violence, less able to solve matters like adults, less caring of one another’s welfare.”

Maybe it’s not true. Maybe it was never true. Maybe it was the guns after all.


DeVivo, MJ (2012). Epidemiology of traumatic spinal cord injury: Trends and future implications. Spinal Cord, 50, 365-372.

Pickett, GE, Campos-Benitez, M, Keller, JL, & Duggal, N (2006). Epidemiology of traumatic spinal cord injury in Canada, Spine, 31, 799-805.

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