A scene from the action thriller “Reacher” shows the hero, a former military policeman turned vagabond vigilante, luring a group of assassins to an abandoned house where he finishes them off one by one.
The first villains fall easily, but the last, according to Hollywood protocol, is the hardest. The villain repeatedly hits Reacher with a crowbar. All is almost lost until Reacher takes blows to the face with the crowbar, falls into a pool, and is held underwater by his enemy. But he’s the hero, so he finds his gun and shoots three bullets into the villain’s chest. A few minutes later, Reacher is running all over the place, no worse for wear.
I don’t need to tell a readership of ER doctors what really happens when a man sticks a crowbar in the face: the person dies. If this wasn’t some sort of life-ending event, it certainly is a life-changing event: long-term cognitive issues and massive facial trauma.
Violence in real life
This brings us to the 18-year-old armed with an automatic weapon who killed 10 people in Buffalo on May 14. (AP News. May 18, 2022; https://bityl.co/CtwA.) Ten days later, another 18-year-old with an automatic weapon killed 19 fourth-graders and two teachers at a Texas school. (New York Times. June 9, 2022; https://bityl.co/CtwD.) About a week later, a 45-year-old man with automatic weapons killed his orthopedic spine surgeon and three others at a hospital in Tulsa, OK. (New York Times. June 1, 2022; https://bityl.co/CtwN.) Two days later, a man with a history of violent behavior walked into a Los Angeles emergency department asking for treatment for anxiety, then stabbed a doctor and two nurses with a knife. (Los Angeles Times. June 7, 2022; https://bityl.co/CtwS.)
I didn’t know Preston Phillips, the orthopedic surgeon killed in Tulsa, but those who knew him describe a wonderful person. (The Harvard Crimson. June 12, 2022; https://bit.ly/3IsqK74.) The same could surely be said of 77-year-old Pearly Young, who was running a food pantry and shopping for it when she was killed in Buffalo. (NPR. May 16, 2022; https://bityl.co/CtwY.) I couldn’t find anything about the CM1 students in Uvalde because it’s too upsetting.
Most of us cry, but an angry subset of us know it’s okay. The Tulsa community was in a shocked daze after these people were murdered at St. Francis Hospital, but just three days later, at a second Tulsa hospital, a man with back pain in the ER was loudly praising the first shooter and threatened to imitate him. . (KWGS Public Radio Tulsa. June 7, 2022; https://bit.ly/3bAZTtr.)
Less than a week after that, staff at a third Tulsa hospital said a patient told his doctor and staff, “You have a few seconds before I bust some corks on both of you.” , and began counting to 20. (Fox News. June 12, 2022; https://bityl.co/Ctwi.) He also said he would come back to shoot everyone in the hospital. He took a hit on security and was arrested. Three days later, staff at a fourth Tulsa hospital called police, who arrested a patient who had threatened to shoot them because he was upset with his food tray. (ABC. June 14, 2022; https://bityl.co/Ctwm.)
Horrors in and out of ED
You might be thinking, “What’s going on with Tulsa?” but it happens in all health care settings. The only difference is you’re getting busted for it in Tulsa right now. There’s no doubt that the doctors and nurses there have zero tolerance for the usual abuse and threats, so they call the cops and press charges.
Violence, including gun violence, is central to emergency medicine. Not only do we see the consequences and treat the victims, but we, our colleagues and our patients are targeted.
Emergency physicians have been passionate advocates for gun violence reduction. (ACEP. https://bityl.co/Ctwq.) That said, emergency doctors cross the political spectrum: over 40% of us own a gun at home, and we can be just as divided as the rest of the country on gun politics. fire. (West J Emergency Med. 2021;22:257; https://bityl.co/Ctwu.)
This brings me back to Jack Reacher shaking a crowbar in the face. EPs see the horror of all kinds of violence – stabbings, shootings, utterly reckless and avoidable vehicle crashes. Then we are offered in our spare time – on TV, in video games, in the movies – the dumbest and most pointless celebrations of that same violence.
An extended marketing campaign
The entertainment industry is too lazy to write plausible scripts. Every plot difficulty is handled by someone getting cracked on the head and conveniently rendered unconscious, left just to get rid of a mild headache.
Every movie hero can engage in a high-speed car chase, causing all of their opponents’ vehicles to crash spectacularly, but somehow no innocent people ever get hurt? But a movie is a fantasy with no consequences, so we applaud. It’s good fun when a handsome man races a hot-blooded car through a herd of panicked pedestrians.
And Hollywood makes having and using a gun incredibly sexy. The movie industry is practically an extended marketing campaign for Glock, Inc. President Biden expressed exasperation over assault rifles after the Uvalde shooting, saying, “Deer don’t run through forests with Kevlar vests, for God’s sake!” (White House. May 24, 2022; https://bityl.co/Ctx1.)
But people own assault rifles not because they’re useful, but because they’re made to be awesome. We were shown it by movie heroes gliding through the movies, effortlessly wiping out evil, never accidentally killing, say, a nice orthopedic surgeon or a woman shopping for the pantry. The hero can be shot in the shoulder and will briefly wear an arm sling to signal, “I got shot too, but I’m so tough so that’s just an inconvenience.” »
No Hollywood hero ever ends up with a colostomy bag.
It’s time for ER doctors to start voicing their exasperation and contempt for Hollywood’s sanitized, glorified, inconsequential violence. It’s clearly a driver for some of society’s worst trends. This leads to mental illness: the plot of too many films is the lonely good guy who is pushed too far and now takes violent revenge. It’s what drives gun culture: Hollywood makes guns glamorous and seductive. He invites viewers with a smile to applaud the most reckless behavior without ever showing the terrible costs.
Dr Bivensworks in Massachusetts emergency departments, including St. Luke’s in New Bedford and Beth Israel Deaconess Medical Center in Boston. Follow him on Twitter@matt_bivens.