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Wed Apr 18 16:43:20 BST 2007

Hi everyone,
I live in Canada, in Kingston, ON, a border town; I moved from Toronto
about 1+ year ago.
There are many guns here. They get into the country illegally; you're
all correct about lots of things; we do have very strict gun laws and we
don't really have many places to purchace a gun. None in my little town.

I agree that a very disturbed individual must be recognized as such, and
get help. Apparently, a professor noticed his behaviour/depression and
advised him to seek help. He didn't, and he had a gun. 
In Canada, it could happen, yet no one really has guns in their houses
(except maybe hunters). Who knows what was going through his head.
You're also correct about common cultures. Still, in our EDs, we only
see a few gunshot victims a year. 

We do travel to the States, work there, vacation there. Buy cheaper gas
there. We are quite familiar with the culture and enjoy being your
neighbour!

 So, this disturbed student  had a gun. What would have happened if he
didn't have a gun? Who knows.  I have a cousin who graduated from VT in
Engineering; he doesn't have a gun because he doesn't want to (lives in
Georgia).

A couple mini-thoughts from Kingston.
cathy

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of Krin135 at aol.com
Sent: Wednesday, April 18, 2007 11:31
To: trauma-list at trauma.org
Subject: Re: Root Causes

In a message dated 4/18/2007 10:11:07 AM Central Daylight Time,
artlam at u.washington.edu writes:

It would  have affected the shooter in the Virginia Tech tragedy.  He
walked into the gun shop, during regular business hours and legally
purchase a weapon. I might point out that no one is an outlaw until he
or she commits his first offense.  Unfortunately the results of the
first offense  can be so tragic!

and this is a system failure...where folks at the school who recognized
that the young man was troubled were not able to get him to understand
that  he needed help...and for what ever reason, they were not able to
figure out the procedures to get him help without his consent.

It's always a difficult situation when a patient is gravely disturbed
but has not yet committed a significant act or become gravely disabled.
In Tennessee  and Louisiana, any licensed physician was authorized to
evaluate a patient and  refer them for an involuntary psych eval
(generally a 72 hour hold). Here in  Missouri, we have to present the
information to a judge who then does a 96 hour  judicial commitment. In
all three cases, the standard is that the examination is  done and
opinion is issued in 'good faith,' and does not require formal  psych
training.

I don't know what the situation is in Virginia, but I suspect that the
student health system, if they had been fully aware of the situation,
might  have been able to arrange some sort of an evaluation even under
uncooperative circumstances. At this point, sadly, we will never know if
that would have  helped.

ck
Charles S. Krin, DO FAAFP

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