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OPINION

Gun violence inflicts more than bullet wounds

By DOROTHY R. NOVICK | Special to The Washington Post | Published: March 27, 2019

The news that two survivors of the school shooting in Parkland, Fla., have taken their own lives, one year after a normal day turned into a violent massacre, is staggering. So, too, is the news that Jeremy Richman, father of one of the first-graders killed in the 2012 massacre at Sandy Hook Elementary School, died by apparent suicide.

We will never know the extent to which the unimaginable trauma of the school shootings contributed to these suicides. But stories such as these remind us that trauma has far-reaching and devastating effects. It reminds us that the victims are not only the deceased but also the survivors. And not only the deceased and the survivors, but also each member of their families. And not only each member of their families, but also every person who loves each member of their families. And so on.

In children, the effects of trauma are magnified. As a pediatrician, I care for countless children who have come face-to-face with life-threatening violence. Many have witnessed domestic abuse. Many have witnessed shootings in their communities. Many have lost loved ones. As I care for them, I bear witness to their penetrating wounds. I see the profound ways that trauma affects them over the course of their lives.

Groundbreaking neuro-biologic research over the past two decades has detailed the unique ways that trauma affects the developing child. Studies show that the “fight or flight” response, while protective in certain situations, can be toxic to children if intense or prolonged. It can lead to alterations in the immune and endocrine systems and in the architecture of the developing brain. These changes are strongly associated with long-term psychological problems such as depression, anxiety and addiction. And with suicidal ideation.

Not surprisingly, there is a dose-response curve: The more intense or prolonged the traumatic experience, the more significant the effects. And to make matters worse, the stress response itself often becomes overactive, creating a self-perpetuating cycle.

This is how unadulterated fear and helplessness can permanently scar children. When one moment they are sitting in class, focusing on everyday questions such as homework and whether basketball practice will be canceled and the next moment they are witnessing bloody carnage and their best friends are being torn to shreds, they are forever changed.

According to an in-depth investigation by The Washington Post, more than 187,000 children have been present at school during a shooting since 1999. This includes not only mass shootings but the far more common targeted, individual attacks. Some refer to children who have witnessed school shootings as the “silent victims.” Their pain can be intense and severe. For each child who takes his or her own life, countless others are suffering.

Therapies help enormously. Support from loved ones, grief counseling and teen support groups help enormously. But nothing can take away what has been seen, heard and lost. Nothing can return a child’s mind, heart and body to their original states.

And that is why we must focus on prevention.

Many have promoted arming teachers and other school personnel to protect students from mass shootings. But teachers are not trained law enforcement officers. And even if we did believe that armed teachers could interrupt mass shootings, would we believe that losing half as many classmates to a bloody massacre would have reduced anyone’s trauma at Parkland that day? Or would have saved Parkland parents from losing their babies last week?

We must focus on gun violence prevention. Laws that make schools “gun-free” zones have been shown to significantly reduce gun violence in schools. Conversely, 90 percent of high fatality gun massacres on college campuses have occurred where civilian guns were allowed or where there were armed personnel present.

The effects of trauma ripple out from each individual in ever-expanding concentric circles — out across towns and cities and states and countries, and down through generations. New Zealand has banned military-style semiautomatic weapons to protect citizens from a permanent state of irreparable trauma. The time has long passed for us to do the same.

We must protect our children not only from dying violent deaths but also from witnessing violent deaths. We must save not just their generation and all those who love them but the next generation and the one after that. We must prevent the next Columbine, the next Sandy Hook, the next Parkland. To do that, we must find a way to strengthen our challenge to the National Rifle Association’s lobby and keep guns out of schools. We must pass common-sense gun control laws before the traumatic effects of gun violence on our children ripple any farther.

Dorothy R. Novick is a pediatrician in Philadelphia.

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