Dr. Roach writes: As I write this, another gun tragedy has taken place in the United States. By the time it gets published, about 1,500 more people are likely to have been killed by guns, many accidentally. Doctors have a responsibility to protect the health of their patients and the public, and I can't be silent on this any longer.
Gun violence is a major cause of morbidity and mortality in the U.S. With more than 10,000 deaths yearly, including accidental deaths and suicide, gun violence is a more important cause of death than many of the conditions I discuss in this column.
Unfortunately, the U.S. Congress has repeatedly failed to fund research on gun violence by the Centers for Disease Control and Prevention, the best-placed U.S. agency to follow what can reasonably be described as an epidemic.
This has prevented research on the best ways to reduce gun deaths.
Governments have attempted to keep doctors silent on gun violence.
Florida passed a law preventing doctors from discussing gun safety with their patients (this was struck down in 2017 by a federal appeals court).
The goals of discussing gun safety with patients are to educate and to consider a means of reducing risk of injury (such as trigger locks, gun safes and storing weapons and ammunition separately). This is particularly important in a patient who has a history of violence, mental-health problems, or drug and alcohol abuse.
As a doctor, it鈥檚 not my place to discuss changes in the law or in public policy. However, it is a doctor鈥檚 place to make recommendations to responsible gun owners for reducing risk.
As gun violence continues to escalate, it鈥檚 particularly important for doctors to be part of the solution to reduce gun injury.
It鈥檚 still up to politicians to write laws to protect the public. Until that happens, a doctor鈥檚 brief discussion on gun safety certainly won鈥檛 stop all gun violence, but it can reduce gun injuries, especially accidental ones, and especially in households with children.
Dear Dr. Roach: I just read your article on the various types of flu vaccines. I need your opinion on whether I should get one of the vaccines. I am a 79-year-old woman in good health and not allergic to eggs.
I know the flu virus is dead and you can鈥檛 get the flu from a shot. But when it first became available in the 1950s, I had it in two doses and became very sick for about two weeks with flu-like symptoms.
So, I avoided it and, throughout the years, I had the flu a few times 鈥� once, when I was in my 20s, very bad with type A, and it attacked my nervous system. I was not able to drive for three months. I also got sick after a flu shot in the 1980s.
I am hounded to get the flu vaccine, but I am afraid. Now that there are various kinds available, I wonder if I should try one.
M.T.
I鈥檇 certainly recommend it.
I normally would recommend a high-dose version for a woman in her late 70s, but you clearly have a robust immune system and I suspect that is why you have had a strong reaction.
However, vaccine technology has dramatically improved in recent years, and I would recommend you get a standard-dose flu shot.
You also might take a Tylenol right after having the vaccine.
(There is some evidence that this may reduce the effectiveness somewhat. However, I still think it鈥檚 better than no vaccine at all.)
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
