COMMENTARY

Mass Shootings and the Ethic of the Open Heart

James Knoll IV, MD

Disclosures

December 20, 2012

In This Article

Introduction

   - From the poem "Holes" by David Kaczynski[1]

I believe there is reason to be optimistic. News media are focusing on emotions and healing. Politicians are saying only that they have no words to respond to the tragedy. These actions suggest an attempt to face the utterly unacceptable with an ethic of the open heart. The open heart "weeps with compassion for itself and others."[2] I'll not address here any details from the recent tragedy in Newtown, Connecticut. At this point, I, too, have no words when it comes to the jagged hole that was recently left in our hearts. I also have no details, nor access to the facts of the case, and have a policy of not commenting on these tragedies in their wake.

I've adopted this policy because I worry about distracting from the critical, solemn work of grieving and community healing. I also wish to refrain from speculation and do not want to give attention to the perpetrator at this point in time. Instead, I would like to address the subject of mass murder generally, and in a way that I hope will lead to constructive discussion. Having done some research in this area, I am often contacted in the wake of these tragedies. In this article, I will address some of the most common questions that are asked of me by the media, in addition to some of my own open-hearted reflections.

Unpredictable, but Possibly Preventable

Mass murder is not new, but in recent decades it has taken on a different tone. The tone has been affected by a cultural shift, easy access to high-power weapons, social media, and 24/7 media coverage of the tragedies. Although research had previously indicated that its incidence was not increasing, the data will now need to be reconsidered in light of the past several years. Each time another mass shooting happens in the United States, the response is entirely predictable. After the media coverage subsides a bit, a familiar sequence unfolds: Who is this person? Why did he do it? How did the "mental health system" fail him? How did he get his hands on such a powerful arsenal? Would that the actual tragedy was so predictable beforehand.

Mass murder predictable? Not likely. Preventable? Here is where I believe we have a bit of a chance. But it depends -- how much do we really want to prevent mass murder? And by "how much," I mean: How much responsibility are we willing to take on in an effort to make a meaningful difference? We can talk about it for a few more decades, and in the meantime we will probably have a few more Auroras, Virginia Techs, or Columbines. I cannot mount an argument against those who proclaim that these tragedies are impossible to predict or prevent solely with psychiatric efforts. I can't and I won't, because I agree with them. But I do believe that there are other ways that are far more effective and, ultimately, far more beneficial for society.

It turns out that recently, Bolivar, Missouri, narrowly avoided becoming the next Aurora. How? The mother of a potential mass murderer contacted police because she was worried that her son, Blaec Lammers, had intentions of shooting people during the opening of the final film in the popular Twilight vampire movie series. Predictably, the mother was right to be concerned. When Tricia Lammers' son was questioned by police, he said that he had already bought tickets and "planned to shoot people inside the theater." Upon investigation, police found that Lammers "did have the weapons; he did have the ammunition...and then he made the statements to the officer about what his plans were."[3]

This leads me to one of my first suggestions on how to prevent mass murder. The mayor of Bolivar, or better yet, the governor of Missouri, should give Tricia Lammers a medal. In fact, if neither party will do this, I will personally have one made and sent to her. The medal will be engraved with the words:

For Brave, Humane, and Lifesaving Action

How many can say that they saved potentially dozens of lives, while also saving the life and mental health of a family member? Tricia Lammers, I applaud you, and others should as well. Am I making too big a deal out of this mother's actions? I do not believe so. I think her act represents one of the strongest methods of prevention available. Third parties, particularly family members, are the most likely to have preoffense knowledge or significant concerns.[4] In other words, potential mass murderers often "leak their intent"[5] to third parties who, in turn, remain quiet for various reasons.[6] But it is important for family members to know that help and resources exist. Tricia Lammers was able to rely on some of these resources, most notably the National Alliance on Mental Illness, which has offices all over the country.[7,8]

In contrast to Ms. Lammers, the silence of third parties seals the fate of both their loved ones and scores of innocent people. Need another example? They are not difficult to find. Take the relatively recent case of Anders Behring Breivik who, on July 22, 2011, obliterated more than 70 innocent people in Oslo.[9] Breivik's sister had been concerned enough to warn her mother at least 2 years prior to the tragedy.[10]

At this point in time, most authorities agree that preventing mass murder requires measures well above and beyond the "mental health system."[11] For example, after Jared Loughner perpetrated the tragic mass shooting in Tucson, mental health experts concurred that "homicides perpetrated with firearms against strangers by individuals with mental disorders occur far too infrequently" to predict or prevent with mental health efforts alone.[12] Yet after the Tucson tragedy, there was still the familiar media refrain: "Did the system fail Jared Lee Loughner?"[emphasis added][13]

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