As For The Mandalay Bay Shooting, What Happens In Vegas Stays In Vegas.

So the mountain moved (to paraphrase Phaedrus) and out came a mouse in the form of an 81-page report from the Las Vegas Police Department covering the events of October 1, 2017 when Steve Paddock barricaded himself in a hotel room and set a new American record for the number of people killed and wounded in a rampage shooting event. You can download the report here but save yourself the trouble because there’s really nothing we didn’t know about the how’s and the why’s of this horrific 20-minute shooting spree that we didn’t know within a couple of days after the volleys that poured from the 32nd floor of the Mandalay Bay Hotel came to an end.

LV2             Paddock did what just about all rampage shooters do in the months and weeks leading up to the event. He stockpiled lots of guns and lots of ammunition, he knew the venue well, he behaved in a normal way to the point that even his live-in girlfriend claimed that nothing appeared to be amiss, and he made a point of not telling anyone about his specific plan. These four elements – building an arsenal, scouting out the terrain, acting just like everyone else, not divulging the specific plan – was exactly what happened at Virginia Tech, Aurora, Isla Vista, Orlando, Sutherland Springs, Sandy Hook and just about everywhere else where a rampage shooting has occurred since 1966 when Charlie Whitman took a bunch of guns up to the top of the University of Texas Tower and began blasting away.

Paddock also shared one more feature with most, but not every rampage shooter, namely, that when the blasting away ended, so did his own life. Which creates an immediate problem in terms of figuring out why rampage shooters commit rampages, because few of them are around who can then tell everyone why they did what they did. But for the several shooters who have survived their own rampages – James Holmes in Aurora, Anders Breivik in Norway – it appears they simply want to become notorious and well-known and choose this particular type of behavior to gain notoriety, even if they spend the rest of their lives in environments which don’t give them much opportunity to cash in on their new-found fame.

One other issue with rampage shooters that remains completely beyond any understanding at all. The fact that they devote serious time to developing a game plan, stocking up with weapons, casing out the venue, and so on and so on, doesn’t reveal the ‘trigger’ event or moment which makes them decide their plan is now good to go. Paddock evidently wanted to blast away at a large crowd attending a public event, but his computer searches indicate that Vegas was one of a number of such events which might have provided him with the scenario he would use. Deciding that you want to plan a rampage shooting is simply not the same thing as carrying it out. The shooter at Sandy Hook was on his computer studying other shooting rampages for months before he drove over to the elementary school at Sandy Hook. How come he chose that particular day?

One thing the Las Vegas timeline reveals is that it took the cops close to 75 minutes to get to the room where Paddock was located and breach the door. First responders on the ground began helping victims almost immediately. How come it took so long to get into where the actual shooting was taking place?  And by the way, we still haven’t learned how a member of the team that first entered Paddock’s room took personal pics of the crime scene, including a dead shooter, which then showed up on various internet sites. The chief, Joseph Lombardo, promised a thorough investigation of what can only be described as a complete contamination of the crime scene. A thorough investigation. Yea, right.

Know the old saying, what happens in Vegas stays in Vegas? As far as figuring what happened on October 1st, 2017, that saying is still ringing true.

Know What Ben? It’s Time For You To Shut Up.

Ben Carson isn’t the first physician to run for President and, in fact, isn’t the only doctor trying to get into the White House in 2016.  He may be the only board-certified doctor, because it’s not clear whether Rand Paul is certified or not.  Carson certainly is.  All the more reason that when he says something which violates the Hippocratic Oath we should ask whether he has the credentials even to claim that he’s a bone-fide physician, never mind credentials to be the next President of the United States.

Let me make one thing clear about the Hippocratic Oath.  It’s not mandatory either to subscribe to it or to follow it.  There are some medical schools that don’t, in fact, administer the oath to new graduates, there are also various versions of the oath floating around.  But the Hippocratic Oath is a reminder that medicine is a profession whose effective practice requires attention not just to science and learning, but to compassion and ethics as well.  After all, we vest the responsibility and often the authority for making life and death decisions within the medical profession.   So it’s heartening to know that this profession expects its members to think and behave according to certain basic and well-tested rules.

hippocratic                And rule number one is: Do No Harm.  Now these words aren’t, in fact, found in the text of the oath itself.  But ask any physician to tell you what it means to subscribe to the Hippocratic Oath and he or she will state either those exact words or words to that effect. Which brings us to the recent statements made by Ben Carson following the slaughter at Umpqua Community College that produced a sickening amount of harm.

The first statement was on Ben’s Facebook page, although he scrubbed it when the responses began pouring in.  Nevertheless, here’s the exact quote:  “I never saw a body with bullet holes that was more devastating than taking the right to arm ourselves away.”  In other words, if Carson was practicing in a locality that had very strict gun-control laws like, for example, Washington, D.C., he would claim that the inability of a D.C. resident to carry around a handgun was a greater medical risk than if that same individual was brought into the ER with a bullet lodged in his head. So much for Carson’s ability to stratify gun violence risk, adopt the proper medical response and thereby reduce harm.

Just to make sure that ol’ Ben keeps his bone fides alive with the pro-gun crowd, he then went on CBS and said that if he were facing a mass shooter, the first thing he would do is put up a fight.  He would also advise other people in the vicinity to do the same thing. Of course macho man Carson has absolutely no idea of the degree to which such behavior increases risk, and if you don’t believe me, just take a look at the active shooter guidelines issued by the Department of Homeland Security: Run, hide, if all else fails, fight.

Every time Carson opens his mouth about gun violence, he says something that increases risk.  If he wants to say something stupid, that’s fine.  But when he advises people to do something that increases risk, he’s not just being dumb, he’s violating the Hippocratic Oath.  The Coalition to Stop Gun Violence has posted a petition asking Carson to apologize to the survivors and victims’ families at Roseburg because of the comments he made on Facebook and ABC.  The petition says that Carson’s remarks are “offensive and beyond the pale.”

I think it’s now time for the medical community to tell their colleague Ben Carson that he should stop putting the initials ‘M.D’ after his name. Because no doctor who takes his work seriously would make statements like that. Ben doesn’t  just offend the Umpqua survivors, he offends the profession which he claims to represent.  Shut up Ben, just shut the f***up.