Why Should Doctors Ask Patients About Guns? Here’s Why.

Over a period of three days in June 2014, an agitated and obviously extremely upset young man named Christopher Hampton showed up seven times at hospitals in Fargo, ND, claiming that his roommate, who was also his cousin, was trying to poison him.  During one of the visits, Hampton was tested for poisons in his system but the tests showed only traces of marijuana and amphetamines.  He was told on several of these visits to seek psychiatric care but was not considered to be a danger to himself or anyone else.

On June 26, shortly following his last encounter with medical practitioners, Hampton went back to his apartment, grabbed a gun and shot his cousin to death.  At his trial, which is going on right now, Hampton had obviously regained his composure to the point that he was claiming self-defense and may testify that a series of arguments led up to a serious fracas in which he was victim, not assailant, and had no choice but to defend himself with a gun.  But the last witness to testify for the prosecution was a pathologist, Dr. Mark Kaponen, who noted that the entry wounds were in the back of the victim’s head, which is a pretty interesting way to shoot someone if you’re using a gun in self-defense.

docs versus glocks                The way things are going, it looks like there will be somewhere between 11,000 and 12,000 homicides committed this year with a gun.  And most of these shootings will involve perpetrators and victims who not only knew each other, but had been engaged in an argument or a series of arguments for hours, days or weeks leading up to the fatal event.   As Dr. Lester  Adelson put it in a classic article: “With its peculiar lethality, a gun converts a spat into a slaying and a quarrel into a killing.”  I actually prefer Walter Mosley’s more prosaic statement:  “If you carry a gun, it’s bound to go off sooner or later.”  Either way, the bottom line is that what we have in the Fargo homicide is a classic mixture of drugs, an argument and a gun.

But there was something else about this case that needs to be addressed and understood.  The fact is that the shooter, Christopher Hampton, certainly tried to draw attention to himself in the days leading up to the tragic event.  He visited health facilities six or seven times, he made it clear that he was concerned about his own welfare and safety, he may have made some pretty nutty statements about his cousin, but that was exactly the point.  People who walk into a medical facility under their own free will and say crazy, delusional things need to be taken seriously, not just told to ‘go home and relax.’ In fact, Hampton had previously been diagnosed as having bipolar disorder but stated that he had stopped taking his prescribed meds. How many red flags did this young man need to wave?

In fact, he waved one more, the reddest flag of all, because he told a cop just before the shooting that there were guns in the apartment and asked the cop to take them away.  The police officer decided there was no criminal activity going on and declined Hampton’s request to seize the guns. Two hours later, Hampton shot his cousin to death.

According to the NRA, there’s no reason for physicians to even ask patients about gun ownership unless the patient poses a clear health risk.  But how does a clinician know that a patient has stepped across that line?  How could anyone know for sure that Christopher Hampton’s delusional behavior would lead to a life-ending event?  The point is we don’t know, which is why doctors need the widest possible latitude in asking questions about the presence and use of guns.  And anyone who truly believes that physicians should not be concerned about guns is as delusional as Christopher Hampton the night he ended his cousin’s life.

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