ST. LOUIS, MO — "What the hell is going on here?" Those were Susie Schaffer's last words, spoken just before she was murdered one afternoon in December 2008, as she interrupted a burglary at her home in St. Louis. Her mother, Lois Schaffer, is haunted by those words. Even almost a decade later, it's a question she desperately wants an answer to. And with St. Louis on track to crack its record for gun homicides — there have been 165 so far this year — she's not alone.

Schaffer gave a talk on gun violence Oct. 25 at Washington University's Institute of Public Health, on the medical campus. She was joined by a panel of experts, activists and community members to discuss the city's — and the nation's — growing public health crisis. More than 30,000 Americans are killed by guns every year and twice that number are injured, according to the Centers for Disease Control and Prevention. About 13,000 are murdered. The rest take their own lives or are victims of accidents. Almost half are children or young adults. To put that into perspective, there are 58,318 names etched into the Vietnam War Memorial Wall, for a conflict that lasted nearly 20 years.

Schaffer blames easy access to guns for her daughter's death and singles out the National Rifle Association for its inordinate power in lobbying against sensible gun safety legislation. Though she's never been shot, she considers herself a gun violence survivor, and calls the young men who shot her daughter "thugs." Charles Mayo, an activist, grassroots organizer and former gang member, who sat on the panel, said those young men reminded him a lot of himself at that age, explaining that guns are just a symptom of more systemic issues plaguing poor, urban, mostly African-American neighborhoods. Those issues cause many young men to think they need guns just to survive. "I was 17-years old when I caught my first gunshot to the leg," he said. "Let me explain something to you, if you get shot at or get shot, and if you don't die, it's going to turn you into one thing. You're either going to be a shooter or a victim."

Mayo said he's been to more wakes than weddings, and he's tired of cute, feel-good meetings that get nothing done. "I've been shot twice," he said. "I lost my brother last year, April 29. In August of that year, I lost my brother-in-law. I've got to see his child every day. This year, I lost my friend April 4. What you see on the news doesn't affect you like it affects us." Mayo organized protests in the wake of the police shooting of Michael Brown in 2014, but said he's also tired of protests without progress. The law isn't written to protect people like him, he explained, and resources are being taken from the neighborhoods that need them most. "We only talk about gun control when Sandy Hooks or Columbines happen. But, we have mass shootings every day in our communities. Now we're talking about the opioid epidemic. Ever since '91, people been popping percs in my neighborhood, but now that it's spread to St. Charles, it's an epidemic."

Mayo said he is open to dialoguing with police. "I'm not angry at the police, but I will get right on them," he said. "They talk about a no snitching code in our neighborhoods, but guess what, they have a code as well. And kids see that."

Erica Jones agreed. Her daughter Whitney was killed last August in a drive-by shooting. "Lawmakers do not understand the inner cities," she said. "There are so many programs that have been closed down, money taken from them. And we also have to deal with the code of no snitching. My daughter was shot standing on the sidewalk. Her 5-year-old son watched her die. People don't want to speak up because the system is broken. There is no trust in law enforcement. They're supposed to serve and protect, but they also hurt and harm us. How can we put something back into our cities when everything has been stripped away from them?"

Elizebeth Matoushek, a crisis intervention councilor and former police officer, spoke about a facet of the gun debate that gets far less attention: suicide. She challenged critics who say that someone who is determined to kill themselves will just find another way if they don't have access to guns. Most people who decide to take their lives act within 20 minutes, she explained, and guns make that decision immediate and final. "What I would like to see for gun laws are mandatory waiting periods, so when that crisis and emotional event is going on, you have time to deescalate and reach out to your community and get help from other people," she said. "If you have a firearm in your home, everyone in that home is four times more likely to die by suicide, even if the gun is locked up. I don't talk about taking guns forever. I talk about making the guns safe for now, while the crisis is going on. But, if we're able to get guns out of people's hands while they're experiencing mental health crises, we can save so many lives." Washington University surgeon Laurie Punch moderated the panel, and stressed that gun violence is a vast topic, with every shooting involving a domino-like chain of causes and effects, from the bullet and the gun to the shooter and the shooter's environment. Guns are currency in the drug trade, with guns flowing in from suburban, mostly-white America, some on the panel argued, while others blamed an insular, desensitized society trapped in social media bubbles that leads people to fear and mistrust one another.