At the time of this writing, America is reeling from the news of a mass shooting in Las Vegas – 58 people killed and almost 500 injured, some still critically. By the time this editorial appears in the on-line edition of Surgical Innovation, odds are certain that at several more mass shootings will have occurred, and by the time it appears in press, several more again. In fact, the statistics are staggering: on average there is one mass shooting (>4 victims) every day in the US. Since Sandy Hook in 2012 there have been more than 1,500 mass shootings in the US. The US, with 4.4% of the world’s population, owns 42% of the world’s civilian firearms. We have 16 times the death rate from guns than Australia, Germany and other countries, etc. (data from https://www.vox.com/policy-and-politics/2017/10/2/16399418/us-gun-violence-statistics-maps-charts)

So why bring these tragic facts up in the context of a surgical journal? In fact there are multiple reasons. One is purely social. Those that publish in and read Surgical Innovation share common interest in a fairly specialized (some would say esoteric) field. That means that we are a social “unit” of somewhat similar backgrounds, interests and approaches to problems. In times of tragedy, in our personal shock, one tends to turn to those in our social sphere to express our feelings: outrage, grief, concern and even fear. We know that our own are likely to agree and understand our feelings and that this contributes to our and the collective’s healing. Surgeons in general, are frontline soldiers involved in these incidents. While the press presents to the public individual acts of heroism, the response of police or first responders and the villains themselves, it is in fact the ER personnel, and particularly the surgeons, who work long hours to try to salvage the affliction. It is a true tragedy that 58 people died in this assault, but without the efforts of the surgeons on call in Las Vegas that evening, the death toll would have undoubtedly doubled or tripled – resulting in a public tragedy a magnitude greater then we have. So we relate to those surgeons on call that cared for the wounded, we know the work they did and we respect their commitment.

The other reason for this editorial is to point out the rather obvious fact that America’s increasing epidemic of gun related violence must be addressed. Obviously the surgical community can do nothing directly about the social sickness that such mass murders are a symptom of. We can however, as a community, push our dysfunctional government to address some of the social stressors that lead to an environment of hopelessness and anger – issues such as income disparity and lack of access to affordable medical care are very germane to our job as surgeons – and we should vote to correct them. Finally, as a community of innovators, perhaps we should turn our collective mind on tackling the gun issue. While just the end-effector of a larger social sickness, none the less they are mechanisms of destruction and are modifiable by engineers. Surgeons have been active partners in many life-saving inventions, such as motorcycle helmets, air bags in cars, ATLS, safe hospital initiatives, etc. There are things we can do, there are things we must do. Personalized locks on weapons?, artificial intelligence for background checks or permits? Think about solutions, the next time you are called to the ER in the middle of the night to attend to a gunshot injury.….