Opinion: On gun violence, follow the State Hospital example

A security officer stands by while an LNA works with mental health patients in a make-shift care area in a Concord Hospital Emergency Room hallway.

A security officer stands by while an LNA works with mental health patients in a make-shift care area in a Concord Hospital Emergency Room hallway. File photo

By NICK PERENCEVICH

Published: 01-23-2024 6:00 AM

Nick Perencevich is a semi-retired surgeon from Concord. He teaches Geisel/Dartmouth medical students and residents in Concord and Lebanon.

There have been several articles in the Concord Monitor about hospital safety in regard to guns since the shootings at our State Hospital in Concord which took two lives. The governor’s office quickly increased protection by having metal detector personnel there armed. The articles addressed whether our other 20-plus hospitals should step up in a similar fashion. The last article implied that there were concerns about doing so by the governing bodies of most of the hospitals.

Trauma surgeons in times past were trained to get information on the weapon used (velocity, caliber, and trajectory) but not to ask questions about how and why the incident happened. The explanation for this is that revenge and retribution can happen and getting the injured patient’s testimony about the incident could be used to hurt you, your staff and your family. That is still taught! 50 years ago doctors were assured that an armed police officer was both in the ER and outside the OR for you and your teams’ protection.

There has always been gun violence, but clearly, there is more now. After Sandy Hook 11 years ago, the American College of Surgeons appointed 21 active trauma surgeons from across the country to form a commission on gun violence. The majority of them were members of the NRA. Five years later they published and pushed for background checks, waiting periods and red flag laws. They went to all states and the federal government to testify. The NRA told them to stay out of the discussion and “stay in your lane.” The surgeons didn’t listen to the NRA and had some success in a few states, but not here in New Hampshire.

These surgeons were not only advocating for their trauma patients but also for the safety of all emergency room and hospital personnel. Yearly in our country physicians are killed or injured by guns at work. A study at Maine Medical Center in 2019 showed that the number of physicians killed 20 years ago has tripled in the last two decades. The majority of those are surgeons and emergency room physicians. It happens enough that most of us trauma surgeons know or know of someone who has been injured or killed.

The debate in the Monitor articles seems to be around the need for metal detectors at all entrance sites and/or the presence of an armed police officer in the ER or elsewhere in the hospital. Hospital security guards don’t carry arms, and if an incident happens they would have to get the police and/or get to the locked up arms in the hospital. Elliot Hospital in Manchester has had an armed policeman in its ER for years. It is the only hospital in the state to do so. Most big city hospitals have an armed policeman in the ER. Metal detectors at all hospital entrances would certainly make for a less friendly atmosphere when one comes into a hospital, but I think we’re at a point where it too should be seriously looked at, despite the inconvenience and unfriendliness.

Concord Hospital has a very busy ER and has a large and growing trauma service seeing more trauma patients each year. What happened across Pleasant Street and up the road can happen at Concord Hospital. At any one time, Concord’s ER usually has the highest number of mental health patients in our state awaiting transfer across the street. There is even a designated area in the Concord ER for these patients called the yellow pod. It’s not a less violable situation than across the street. Its existence in itself, as well as the gun trauma that comes to Concord Hospital, are good reasons for armed protection in the ER.

Sadly, in my mind it is not a matter of if gun violence will happen at Concord Hospital, it’s a matter of when. For all the reasons listed above armed police or armed security guard protection is needed in our ER and probably in most of the other ERs in the state. All the states’ hospitals should look seriously at Concord’s State Hospital experience and example.

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