You can’t keep guns out of medical practices

Allow guns into my practice-and yours? How could you not? If you think your practice is in a gun-free zone, you are wrong.

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I’ve had a concealed carry permit for around 20 years and made it a point to have a pistol in my desk or pocket several times in the last few years.

A few years ago, I was covering our small town emergency department when the police brought in a patient I knew all too well. An intoxicated paranoid schizophrenic who lives with his mother maybe half a mile from my home and another half a mile from my office. He had gone after his sister with a hatchet. She was able to lock herself in the bathroom long enough for the police to save her. When I arrived he was on a gurney handcuffed to an officer on each side. From time to time he would bang them together and explain to me what he was going to do to me if I didn’t have them release him. No psychiatric facility would touch him until his blood alcohol level was down, and he was deemed too dangerous for the local jail.

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After he was finally gone, one officer told me, “I know you’ve got a gun, doc. This guy is bad news and we’ll be lucky if they hold him for three days. He is very dangerous. He’s crazy. If you ever see him coming for you, shoot him. We’ll back you up.” 

I added a new pocket pistol: a Kahr Arms polymer 9mm that weighs about a pound loaded and looks like a wallet if you notice it in my pocket. I still see him driving by my house from time to time and once he stopped and asked me if I “was God or the devil.” I think he’s on medications under a court order, but I have no intention of seeing how well they work.

While I am taking the “pro” side of this argument, you might be surprised that I’d be very happy if there were no preach, “Eat less and exercise more. Stop smoking. Bring your blood sugar log.” We must realize that just isn’t going to happen. I’m one of around 700,000 North Carolinians with a concealed carry permit. I was going after squirrels with a .22 rifle my dad gave me when I was 12, quit deer hunting at 18, and haven’t shot anything but a few quail and grouse for 50 years.

I have a lot of long guns, shotguns, and a dozen or so pistols that are family heirlooms. I shoot skeet when I can and shoot the pistols enough to keep my hand in. I know guns pretty well.

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Rarely does someone openly carry a gun into my office. But last fall, a patient walked in carrying an old shotgun. “You’ve got to see why Fred’s late for his appointment,” said one of my staff. In the back of his pickup was a 10-point buck he’d shot getting ready to drive out of his driveway. That deer would feed his family for a while, and he wanted to show me the vintage shotgun that had belonged to his great-grandfather that had dropped the deer with one shot.

I’ll grant you that it is unlikely someone openly carrying a firearm will show up in your office. In my opinion, it is highly likely that at least one or two patients you will see this week will be armed. Posting a “No concealed carry” sign won’t discourage anyone.

In most states, to get a firearm permit you must take a course of several hours dealing with legalities and gun safety, pass a written test and demonstrate to your instructor that you can safely use a weapon.

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You also need a statement from your local mental health agency that you have nothing disqualifying,  in your background, you get fingerprinted, background checked, and you, doctor, will probably be asked to check the applicant’s records and submit a statement that you found nothing disqualifying as well. I get two or three such requests each month. That’s how I know where the guns are.

I almost never see a man with a concealed carry permit carrying in the office. They leave guns in the glove compartment in the car. Locked. Women are different. They buy smaller guns, put them in a purse, and you’d never know they were there.

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Easily half my gun clearance requests are coming from women now. Many have been battered, some severely. Many have restraining orders to wave the next time they are assaulted.

When I see someone I’ve written a permit letter for, I usually ask, “Did you get your permit?” Almost invariably they will open their purse or pocketbook and show me what they are carrying. This is, of course, after walking past the “No concealed carry” signs. Are you ready to start sending your patients through metal detectors, or having the front desk go through their purses? I doubt it.

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For reasons only they understand, women patients always leave their purses on my chair in the exam room. When I go to sit down, I pick it up and sit it on the scale. Sometimes I’ll say “Whoa, what do you have in there, a cannon?” They offer to show me the contents and out comes a Glock 19. I can work in a little “gun safety/trigger lock/kids in the house” education while we talk about mammograms and colonoscopies.

A few weeks after my encounter with the hatchet-wielding schizophrenic, my doorbell rang at 6 a.m. I recognized his girlfriend on my front steps. I waved, then stepped back in the bathroom and called 911. I opened the door a crack. “Can you give me a ride? He’s trying to kill me,” she said.
I pointed to the blue lights down the street. “I can’t, but they probably will,” was my reply. 

Later, the same officer who gave me advice about using my gun told me, “Thought you ought to know [she] had a 6-inch butcher knife in her sock.”

So my office might not be gun-free all the time when it comes to patients. I wouldn’t let it bother you. I’m perfectly comfortable knowing anyone carrying is at least minimally competent.