In 2015, eight major medical organizations and the American Bar Association issued a joint announcement calling gun violence a national health crisis and calling for more aggressive intervention on the part of the medical profession.  Conspicuously absent from the list of medical organizations was the AAST, or American Association for the Surgery of Trauma, whose 1,200 surgeon members are on the front lines when it comes to doctors dealing with gun violence, because they happen to be the physicians whose skill and training come into play just about every time that someone is shot with a gun and at least is still alive when they are wheeled through the Emergency Room doors. And while the AAST called for restrictions on the sale of assault rifles after Sandy Hook, some of their fellows in the American College of Surgeons, which endorsed the manifesto in 2015, are now promoting an ingenious method to reduce gun injuries, or at least making it more likely that when someone is shot they won’t wind up dead.

bleed            The program, called ‘Stop The Bleed,’ was actually a brainchild of someone in the Department of Homeland Security (DHS) under the Obama Administration.  It is both an ‘awareness campaign’ and a ‘call to action.’ It encourages the public “to become trained, equipped and empowered to help in a bleeding emergency before professional help arrives.” This effort grew out of the Boston Marathon bombing in 2013, when the quick action of bystanders at the finish line may have prevented many badly-injured onlookers from ending up dead.

Most of these bystanders who swung into action after the bombs went off weren’t just Tom, Dick, Harry and Louise.  In fact, for the most part they were medical students and doctors, not necessarily with any trauma experience but certainly knowledgeable enough to understand that the bright, red liquid coming out of someone’s mouth was blood.  There were plenty of thing that non-medical personnel could do: moving barriers so that ambulances could arrive, keeping onlookers away from spaces where necessary emergency equipment was set down, and so forth.  But the bottom line is that there are six major medical centers in downtown Boston and staff from those hospitals happened to be either running or watching the marathon that day.

But this is America, and in America you can bet that any government program promoting anything will always be an opportunity for some entrepreneurial bunch to figure out how they can make a fast buck. And if you want to spend a fast buck on what you need to ‘equipped and empowered’ to lend a helping hand, take a look at the products offered by a company, Tactical Medical Solutions,’ and notice the picture which adorns their site.  What this crude attempt to cash in on how the military patrols a street in Afghanistan or Iraq has to do with whether a civilian can help a crash or burn victim is beyond me. But for just $29.95 you can buy a Tactical Tourniquet or the SOF Tactical Tourniquet for just $26.78.  And don’t worry about being prepared – for every product on the website you can download an instructional video that shows you everything you need to know in 4 minutes or less.

The guiding hand behind the idea that civilians can provide medical assistance in cases of trauma is Lenworth Jacobs, M.D., who directs the Trauma Institute at Hartford Hospital and got the American College of Surgeons on board to support this effort as well. Too bad that nobody in the First Baptist Church in Sutherland Springs didn’t have some of these life-saving products on hand, but I don’t notice Dr. Jacobs saying anything about what Americans need to do in order to respond to the next mass shooting event.

I always thought the role of physicians was to identify and reduce medical risk, at least that’s what the Hippocratic Oath tells them to do. The real risk at Sutherland Springs wasn’t the lack of tactical tourniquet kits – it was the existence of an AR-15.