Why don’t doctors trust women? Because they don’t know much about us – An Analysis

“It’s frustrating to have questions that don’t get answered. It’s altogether disturbing to find out that those questions haven’t even been asked. When I was diagnosed with endometriosis at age 23, I didn’t know enough to ask the right questions. I assumed my gynaecologist had all the answers…”

“That these conditions are all beset by delayed diagnosis; that a high proportion of women and gender-diverse people eventually diagnosed with these conditions will first be told they have a mental health condition, or are too concerned about their health.”

I find articles like this quite difficult to dissect and rationally discuss because the points raised are so wide-ranging and cover so many topics. Sometimes this approach to addressing problems or projects is termed “trying to boil the ocean.” I also noted a slight undercurrent of hostility toward the field of medicine. I don’t know enough about the author (Gabrielle Jackson) to have an informed opinion as to why this is. For my purpose, I will only address and bring context to some of her points that I feel are truly relevant to the topic of women achieving better care.

Absolutely, women’s health is less understood than men’s. It is because there have been so (comparatively) few clinical studies on women’s health. This of course, is because of sexism in science. And it directly affects healthcare because allopathic medicine is firmly-rooted in evidence-based science. That science comes from observation and hypothesis formation, followed by basic research (think molecular, biochemical and genetic), followed by pre-clinical (animal models) and then clinical (human) studies. This is indeed a very solid framework because it has screened out many horrid and harmful former “medical” practices and treatments (think: leeches, dirty scalpels, and anti-freeze as cough syrup) and brought us innumerable cures. We have increased average Western lifespans by over 30 years in the last century, alone.

Since over 99% of scientists and physicians were, historically, men (who indeed didn’t understand women), they were not deeply curious about the medical conditions of women. The oppression of women and deeply-rooted sexism combined with the typical behavior of women (as so beautifully described by Anna Margolina in her comment) to make the situation even worse.

Thankfully, medical schools are doing a much better job now of training physicians to be more interactive with, respectful of, and responsive to their patients. Many of the personalities, mostly men, who filled those schools (extremely high test scores, poor social skills) decades ago, are no longer admitted, or they are diverted into medical research (a special MD-PhD track) where they are unlikely to have a practice of clinical patients.

Yet there is also real connection between many of the chronic conditions the author mentions (particularly fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome, painful bladder syndrome, migraine headache, and chronic tension headache) and mental health conditions. Arguably, those conditions beg addressing for those patients to achieve real healing. So those physicians are not wrong to illustrate that connection. The real challenge here is that physicians do not know enough about mental health and they certainly do not know how to treat it, aside from prescribing certain drugs. And of course as a society, we still have much stigma and shame around mental health, its diagnosis, and treatment.

On top of that, the mental health professions are primarily rooted in the social science system with a very wide range of practitioners and far less rigorous research (mostly observational) supporting their practices. There is very little consensus on the specific and appropriate treatments for specific conditions found in the DSM-5. There is also massive range and variation in the training (and credentialing) of mental health practitioners from rigorous and comprehensive to inadequate and undisciplined with little oversight, nor even basic consensus on what that oversight should be. The fact that mental health conditions manifest differently in every person doesn’t help the situation. And so, the effectiveness of mental healthcare varies accordingly. In my view, we have a lot of reform, cleaning up, and standardization to do to get ourselves to a reliable state of a system of care for mental health.

The other true challenge is that, as our culture continues to become ‘more woke,’ or more aware, we as patients are quite often, putting doctors on the defensive. In increasing numbers, educated and ‘empowered’ patients now go to a medical appointment armed with much research and sometimes memories of past inadequate care. It has become a delicate balancing act for the doctors; working collaboratively with informed patients when some are quite sure that Dr. Google has given them a full diagnosis to their health complaints. They would appreciate confirmation of that and a prescription or treatment for it, thank you very much.

This dynamic is also at the root of the anti-VAX cult; that reliance on the all-powerful Internet to give us answers, facts, and truth. The rest of us need to consider these things and remember that physicians, while extremely well-educated and usually very well-trained, are still human beings, like us. The vast majority are just doing the best that they can; working in the very same broken healthcare system that we rely upon.

Source article: Why don’t doctors trust women? Because they don’t know much about us | Gabrielle Jackson | Books | The Guardian

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Leading scientists call for global moratorium on creating ‘CRISPR babies’

Eighteen scientists from seven countries have called for “a global moratorium on all clinical uses of human germline editing” — that is, changing DNA in sperm, eggs, or early embryos to make genetically altered children, alterations that would be passed on to future generations. They say a moratorium should be in place for at least five years.

In a statement, Dr. Francis Collins, director of the National Institutes of Health, said that “NIH strongly agrees that an international moratorium should be put into effect immediately.” The authors calling for a moratorium include Feng Zhang of the Broad Institute and Emmanuelle Charpentier of Berlin’s Max Planck Institute for the Study of Pathogens, two of the scientists who, separately, led the development of CRISPR for genome editing; Harvard University’s David Liu, who invented a precision form of CRISPR; and Broad director Eric Lander, who was co-chair of President Obama’s council of science advisers.

The Chinese scientist who created “CRISPR babies,” He Jiankui, sincerely believed that the research violated neither his country’s laws nor the guidelines of the international scientific community, according to his friends and colleagues. Though researchers forcefully condemned He’s work as unethical and a breach of a scientific red line — and while the Chinese government has since accused him of breaking their laws — He clearly hadn’t gotten the memo.

The call divided scientists over whether a moratorium would stop rogue research without stifling what could one day be a safe and beneficial technology. Even before its publication Wednesday in Nature, the paper had scientists lining up for or against what they call “the M word”: whether a moratorium is the best way to prevent another “He” without stifling what might one day be a safe and beneficial technology.

“We have consciously not used the word ‘moratorium’ because people mistake it for a permanent ban and it would be hard to reverse,” said David Baltimore of the California Institute of Technology, who chaired the organizing committees for both summits. Baltimore calls the disagreement semantic, and denied that he and Lander, with whom he discussed the Nature paper before its publication, differ in a fundamental way.

Source Article: Leading scientists call for global moratorium on creating ‘CRISPR babies’

Read more on the topic:
The CRISPR shocker: How genome-editing scientist He Jiankui rose from obscurity to stun the world
He took a crash course in bioethics. Then he created CRISPR babies

Massive Pacemaker Recall by Medtronic – Class I Means FDA is Involved

FDA has slapped the most serious designation on a recall of approximately 156,957 Medtronic (NYSE:MDT)  dual-chamber pacemakers. A lack of pacing could result in patients experiencing slow heart beating, low blood pressure, and symptoms such as light-headedness, fainting, and even death.

The company issued a recall in January on pacemakers and this week FDA upped the recall making it Class I; the most serious. The model names are Adapta, Attesta, Relia, Sensia, Sphera, Versa, and Vitatron. The issue is  a software error that can result in “a lack of pacing”which could result in patients experiencing a slowed heart beat, low blood pressure, and symptoms such as light-headedness, fainting, or even death.

Medtronic said the root cause for the issue is related to a design change to an integrated circuit in a subset of devices distributed between March 10, 2017, and January 7, 2019. The recall includes 13,440 devices distributed in the U.S. If you know anyone with one of these devices, they should immediately check with their cardiologist.

Patients and physicians cannot predict whether and when this software error might occur. The company said two patient experienced a pause in pacemaking, but that no deaths were reported.

Source: FDA gives massive Medtronic recall Class I designation – MassDevice

A complete cure for cancer?

Accelerated Evolution Biotechnologies (AEBi) has just made this announcement: “We believe we will offer in a year’s time a complete cure for cancer.” Before everyone breaks out the champagne and writes blank checks, let’s look at what that actually means.

“The company has concluded its first exploratory mouse experiment, which inhibited human cancer cell growth and had no effect at all on healthy mouse cells, in addition to several in-vitro trials.” The company will soon begin “…a round of clinical trials which could be completed within a few years.” Actually, with three phases of trials each lasting typically 1.5-3 years, that will likely be 5-8 years for full market approval, even with an accelerated and humane-use pathway.

So what’s the big deal? Most modern anti-cancer drugs are antibody-based and attack a specific target on or in the cancer cell, but these cannot account for downstream mutations which can change those targets making the drug ineffective.

As for the science, this new approach is based on SoAP technology, which belongs to the phage display group of techniques. It involves introducing DNA coding for a protein, such as an antibody, into a bacteriophage – a virus that infects bacteria. That protein is then displayed on the surface of the phage. Researchers can use these protein-displaying phages to screen for interactions with other proteins, DNA sequences and small molecules.
In 2018, a team of scientists won the Nobel Prize for their work on phage display in the directed evolution of new proteins – in particular, for the production of antibody therapeutics.

AEBi is doing something similar but with peptides, compounds of two or more amino acids linked in a chain. The rationale is that peptides have several advantages over antibodies, including that they are smaller, cheaper, and easier to produce and regulate.

Specifically, their treatment, which they call MuTaTo (multi-target toxin) is more like a cancer antibiotic – a novel approach.  It combines three cancer cell-targeting peptides along with a strong peptide toxin,  while mitigating mutations that can compromise the effectiveness.

Just to get started on the topic of how cancer cells can be killed without affecting healthy tissue, try this article.

So this is exciting news indeed, but it has been hyped up quite a bit. Looking for new investors perhaps? That would be my bet.

I wish them well as they navigate the regulatory gauntlet that ultimately, reduces our risk of a) being experimented upon without our consent, b) enduring costly and unproven treatments, c) drug developers not being accountable for what happens after their products reach the market. Think: Thalidomide.

Sources:

How can cancer be targeted without killing healthy cells?

Climateer Investing: “We believe we will offer in a year’s time a complete cure for cancer”

A cure for cancer? Israeli scientists say they think they found one

Tiny Israeli firm touts cancer cure

From Single- to Multi-Target Drugs in Cancer Therapy: When Aspecificity Becomes an Advantage

Wikipedia – Phage display

AEBi website description of their technology

Living Normal Abnormally

Re-posting this blog from a young athlete in hopes that others with similar symptoms (second part of her post) lose their shame. See a doctor that works with gastroenterology, get a diagnosis. Learn more about your condition. Follow the treatment plan. If, after a sufficient period of time, you are not experiencing a reduction in symptoms, get another opinion. Consider consulting a qualified naturopath and learn what their treatment model would look like. Pursue that if it seems right for you.

The point is, embrace your reality and seek care. You do not have to just suffer in shame and muddle along. You can be in charge of your health and change your status. One cautionary note. If you are experiencing any kind of severe symptoms that regularly disrupt your life, reach out and get professional help. Just ‘Googling’ your condition and trying remedies by yourself is actually risky and could lead to permanent impairment or worsening conditions. Being empowered as a patient means educating yourself and taking positive action; frequently, this means getting help.

Behind the Madness

In a world where most people only speak about the “good”, it can sometimes make you feel alone when you’re experiencing the “bad”, abnormal, weird, and scary things within your natural body. I know I have felt alone and questioned, thinking that I was the only one to had ever experience these things. One morning, in 2008, I woke up to a strange, shiny, hard circle on my left bicep. IMG_4652-1.jpegScared and alarmed, I went straight to my mom. Neither of us had ever seen anything like it so I went to a dermatologist and got a biopsy, where they cut a piece out, and tested the skin to see what it was. They found out it was rare skin disease called granuloma annulare and told me it would go away within three years. Here I am, in 2018, with the same circle on my left bicep along with many…

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MDR and IVDR in 2019: up or out, sink or swim

If you have any kind of medical product that you sell (or plan to sell) in the EU, read this post by Eric Vollebreght of Axon Legal. If you provide these products to patients in the EU, this is very good information.

medicaldeviceslegal

sink or swimHappy new year and welcome to 2019, a truly decisive year for the medical devices industry with interests in the EU. If you haven’t spent any time so far getting ahead of events relating to the MDR and IVDR, this is the year that reality will start catching up with you. This year will determine if a manufacturer goes up, or potentially out.

Why is 2019 so important? Read on, and you’ll agree with me that it is. First, take a look at the below diagram with the transition timelines, to which I have added my own embellishments (the red and orange rectangles):

schermafbeelding 2019-01-06 om 20.28.45

IVDs

IVD companies will be like: 2022 – so far away! Actually – no. 85% of the IVDs will need to be evaluated by notified bodies compared to 7% currently under the IVDD. This means that 85% needs to be IVDR certified by a notified body…

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How to Read and Understand a Scientific Paper for Non-Scientists

Reading and understanding research papers is a skill that every single doctor and scientist has had to learn during graduate school. You can learn it too, but like any skill it takes patience and practice. First, it’s important to form a truly educated opinion on a scientific subject of interest and become familiar with current research in that field. This is the beginning, before being able to distinguish between good and bad interpretations of any research, on any topic.

Reading your first couple of papers may take a very long time, but be patient with yourself. The process will go much faster as you gain experience. Reading a scientific paper is a completely different process from reading an article about science in a blog or newspaper. Be prepared to take notes and re-read. Primary research is the main focus here; each article is a peer-reviewed report of new research on a specific question (or questions) in that field. They are typically published in a well-regarded journal in that field. Most articles will be divided into the following sections: Abstract, Introduction, Methods, Results, and one or more Discussion/Conclusions/Interpretation.
This article has a nice 11-step process How to Read and Understand a Scientific Paper: A Step-by-Step Guide for Non-Scientists.  The author, Dr. Jennifer Raff worked it into a convenient .pdf, here How to read and understand a scientific article.

Importantly, this is not the only method to determine the validity and rigor of peer-reviewed science. We now have Retraction Watch; a site developed by science and medicine reporters that is gathering and evaluating the science papers that have been retracted from the journals (or experienced other negative actions) in which they were published. Until this site, there was previously no central repository of such things. They are working on a searchable database, but building that takes time.

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FDA seeking to stop procedures at two unregulated stem cell clinics

Federal health officials filed Federal injunctions Wednesday to stop two clinics from continuing to offer unproven stem cell therapies to patients, the most aggressive action taken in years. Two clinics — US Stem Cell, based in Florida, and California Stem Cell Treatment Center — were warned by the FDA in August that they had violated manufacturing procedures.

FDA seeking to stop procedures at two unregulated stem cell clinics – STAT

At US Stem Cell, a 2015 procedure led three women to go legally blind, California Stem Cell Treatment Center was involved in making an experimental cancer treatment from smallpox vaccine without any oversight. Another corporation (with over 100 clinics) Cell Surgical Network will also be affected by the CA injunction.

This issue has been building since Celltex, a Houston-based company received an FDA warning letter in 2012 because they were manufacturing stem cells without approval or inspection, not just mixing and administrating them (what clinics are allowed to do). Something called a BLA is needed to make a biologic drug (what stem cells are).

Next, they went after other clinics doing the same things (making products): Irvine Stem Cell Treatment Center, Miami Stem Cell Treatment Center, and Manhattan Regenerative Medicine Medical Group. As they investigated, the scope of the problem just kept building. Arriving at a Federal injunction (let alone two) takes a long time and a lot of evidence for an agency; the bar is set high to prevent government overreach.

Watch it with the stem cell therapies, folks. I know there’s a lot of excitement out there because of all the possibilities. Just because the proprietors of those clinics say they are within their legal rights and licensing to offer whatever therapies (and products) they see fit, does not make it necessarily so. Compounding pharmacies got into a whole lot of trouble (and killed and sickened a whole lot of people) a few years back for the same types of sloppiness and assumptions. Money and greed can induce people to do bad things; even doctors, even when a product is very cool and promising.

Duped patients crowdfund for bogus medical care

As stem cell scientist Paul Knoepfler puts it: “You should start getting worried if the clinic tells you that one kind of stem cell such as fat, bone marrow, or amniotic stem cells can treat many different conditions. There’s no science behind that kind of claim. Stem cells are not a panacea.”

If you’re truly interested in the evolving science and compliance behind all of this, here is some information.

Products under scrutiny: fat stem cells (adipose stem cells) and stromal vascular fraction (SVF).

In response to the fast pace of evolution on all things cell-based therapy, FDA created a Regenerative Medicine Policy Framework  they have issued several ‘guidances’ related cell-based therapies. There is one ‘draft guidance’ focused on commercial stem cell clinical products. Don’t listen to the folks with twenty-year-old gripes about how FDA doesn’t care about sick people or is in the pockets of industry. No large government agency is perfect or is completely immune to the industry they serve.

Some good sources of education:
Stem Cell Assays: Promoting Rigorous Reproducible Research on Stem Cells

The Niche: Knoepfler Lab Stem Cell Blog   SCOPE: What Are Stem Cells?

 

Boys Will Be Boys — Sex and The Perennial Supplement Recalls

 

You’ll see this over and over; ‘natural product’ companies promoting and selling “natural male enhancement” or “libido support” supplements, pills that really aren’t natural at all. They always have a secret ingredient. FDA calls them “undeclared active ingredients.”  So what’s the problem with getting a little boost in libido?

The big risk is that men with high blood pressure, high cholesterol, diabetes, or heart disease, or who may be on medications that, taken with one of these products, could lower blood pressure to dangerous levels that could be life-threatening. And the secret-ingredients are almost always adulterated, counterfeit or unlicensed erectile dysfunction drugs, typically produced in China or India by disreputable manufacturing shops.

counterfeit-drug-manufacturing-1024x576

Desmethyl carbodenafil, acetildenafil and hydroxyhomosildenafil  are all derivative of the blockbuster drug Viagra® (sildenafil citrate) that was being researched for relief of another indication (condition), angina pectoris, or chest pain–through relaxation of smooth muscle and increase blood flow. Also marketed as the lower-dose Revatio®, the drug’s effect on erectile dysfunction was an accidental discovery during an early clinical trial for chest pain. Cialis® (tadalafil) is a me-too drug that can be taken on a daily basis, rather than as-needed like Viagra. Both drugs work through activation of the nitric oxide (NO)–cGMP pathway which causes an inflow of blood which supports penile erection.

This is mechanism is somewhat similar to the illegal “poppers;” inhalants containing alkyl nitrates that also boost blood flow for the same effect (or a nice rush). These are typically volatile compounds initially intended for leather cleaners and industrial solvents have become popular recreational drugs; the dose is impossible to control. There are many reported incidents of overdose, especially among men with recent head trauma, bleeding into the head, glaucoma, or heart disease.

Want to get your groove back? There are some legitimate possibilities. There is some research (still a bit early, weak, or fuzzy) supporting aphrodisiacs and testosterone production enhancement. There are many testosterone booster products on the market, some may be legitimate, naturopathic doctors may know more about that. There are also physicians that will prescribe testosterone, natural or synthetic. There may be limited, long-term-use value from some herbs.

Any man that is interested in trying out an erectile dysfunction drug should mention it to his doctor. That will give him better information on risks and if they, in particular, have risk factors to think about before taking the drug. Once there is a prescription in-hand, check out the marketplace! There are brand names and Teva Pharmaceuticals plans to release its generic of the “little blue pill” as early as December. All can be ordered over the internet from reputable online pharmacies.

The obvious issue with most of these ‘natural male enhancement’ supplements or nutraceuticals is that they are NOT natural; in fact, no one knows what’s really in them because the undeclared drug might be impure, fake, or toxic, since they’re illegally produced. Even if the drug portion is pure, if you have risk factors and are unlucky, it can kill you. Young guys need to think about all this too. Have you been hearing about all the fentanyl overdoses? These are happening for two basic reasons. Addicted persons unknowingly using heroin laced with the incredibly-powerful drug and folks intentionally taking fentanyl but it’s a fraudulent/illegal version that is far more concentrated than the legally-produced version.

For the male enhancement fraud scheme, it’s not just FDA that is getting all up in their business. Australia’s TGA and Canada’s HC both are putting resources and attention into this issue, but with only marginal success. This is just part of a bigger scandal of adulterated supplements, mostly weight loss,  hair loss and erectile dysfunction. And that is just a fraction of the massive global crisis of counterfeit medicines.

So why is all this stuff still on the market? It’s about money of course; product demand versus agency testing and enforcement budget. “Remember, FDA cannot test all products on the market that contain potentially harmful hidden ingredients. Enforcement actions and consumer advisories for tainted products only cover a small fraction of the tainted over-the-counter products on the market.”

money supplements

A search for such products (male enhancement supplement) for sale today on Amazon  showed 1,758 results, many of them the very same banned products on recall by the various regulatory agencies. There were also 64 results for male enhancement coffee, if you can believe that. And watch out for websites that purport to be consumer watchdogs like Supplements Watch, Male Health Review, The Supplement Reviews, or even Consumer Health Digest. All of them are clearly promoting products; they provide links to purchase them (always the kiss of death, pardon the pun).

As with all things dietary supplement, buyer beware. The U.S. has no regulations for supplement purity or potency and that is a big reason why we have this wild west market situation.

Other Sources:

Vegetable Vigra/Vegetal Vigra by Natures Supplement: Recall – Undeclared Drug Ingredient

Rhino 7, Papa Zen, Fifty Shades, and Grande X Dietary Supplements by Gadget Island: Recall – Undeclared Drug Ingredients

Tainted Sexual Enhancement Products – FDA

Sexual enhancement products seized from stores – Health Canada

Counterfeit medicines and medical devices – Australia TGA

Oh well, these things just happen

We just had 59 people killed and over 500 injured at an outdoor concert with many more traumatized by the event. The guy who did this had purchased between 20 and 30 guns and no ‘background check’ flagged him from buying more. He was an ‘average guy.’ So now what?

Twenty children and 6 staff were killed at an elementary school in December 2012. Since then more than 150,000 people in the U.S. have died from gunshots. An average of 33,667 people die per year, including 1,520 mass shootings, that killed at least 1,715 and wounded 6,089.

It’s too hard to solve this, so let’s not really change anything.

Hey, as Bill O’Reilly says mass shootings are “the price of freedom.” Congress seems to agree. Congress Has Basically Done Nothing on Gun Control Since Sandy Hook Shooting. In fact, they have recently enacted legislation that could make events such as yesterday’s even more deadly.

Yes, other democratic advanced societies have mass-shootings occur. Scotland and Australia in 1996; Norway in 2011, France in the last few years. But only in the United States do they come again and again and again and again. No other society on the globe allows massacres to happen without a concerted government response.

If the founders of this country had been this gutless, we would still be an English colony.

If the Abolitionists of the 19th century were less courageous, we would still have legal slavery. If Suffragists in 1890-1920 had given up, women would not have the right to vote. If FDR had caved to massive political pressure and government and economic complexity, we would not have Social Security. I could go on, you know.

We can find a path to significantly reduce gun violence and fully-support the right of individuals as declared in the Second Amendment
  1. who can pass a national background check with all states complying,
  2. and obtain a license to purchase a standard handgun or rifle for personal or family protection and hunting,
  3. if he/she employs technology and physical barriers to prevent unauthorized users (children, mentally ill, intellectually disabled) from accessing the weapon.
    Federal laws should address all of these caveats.

Patriotism? How about we work to end these thousands of unnecessary violent deaths every year? Our gun violence is completely out of control; just look at this chart.

So what would it take?

Ask the Brady family, they started the fight.
  • If we had sensible national gun laws that required registration and a background check, that limited the number of guns a single person could accumulate (unless a registered gun dealer), and put more limits on the types of guns (ex. no semi-automatic) sold to the public.
  • If we had a national gun registry with purchase limitations that was linked to a universal database.
  • If all states participated in and contributed their law enforcement, purchase, and gunshot injury data to that database, equally.
  • If we allowed the nation’s public health system to collect and analyze gun injury and gun death data instead of defunding CDC and NIH research. The Docs are asking, begging for more gun violence data.
  • If we properly funded sufficient and qualified mental health care. Guess what? It’s Mental Illness Awareness Week. In Florida they even made it illegal for doctors to ask patients about guns in the house during a check up.

Speaking of rampant and difficult problems, we now have an integrated food safety reporting system and invigorated standards (thanks to the 2011 Food Safety Modernization Act) that holds food manufacturers and produce suppliers accountable and allows for rapid recalls to prevent massive outbreaks of food-born illness. Are the major food companies going bankrupt? Are their stocks all in the toilet? Have there been massive layoffs? The easy answer is NO.

Yet the system is in jeopardy at the moment; there are clearly not enough inspectors to deal with rogue companies creating more food hazards. What is the legislative response to this? Slashing the FDA budget while they double the defense budget seems to be the answer. In terms of your family’s health and well-being, which budget do you think is more likely to have an impact?

None of reforming our current gun violence epidemic is “impossible.”

When such a tragedy happened in Australia, they did something about it. So what about Australia? What do the data show? Do citizens there still own guns for hunting and self-protection? Yes, somehow they still seem to be operating as an open, democratic and ‘freedom-loving’ society.

It does take the will of the people and the fortitude of legislators to stand up to the intimidation and threats of the NRA and their funders. It would also be helpful if the average citizen could put just a little more effort into detecting ‘fake news‘ by just checking on the facts; they’re out there. Don’t count on social media and search engines to do it for you. As Thomas Jefferson wrote “an informed citizenry is the bulwark of a democracy.”

Don’t count on the Supreme Court doing the right thing.

Even though the 4th U.S. Circuit Court of Appeals in Richmond, Virginia, in an overwhelming Feb 2017 ruling upheld the Maryland assault weapons ban, saying they aren’t protected by the Second Amendment. Want to bet how the Supremes will vote with Gorsuch now on the bench?

The “Second Amendment has been the subject of one of the greatest pieces of fraud, I repeat the word ‘fraud,’ on the American public by special interest groups that I have ever seen in my lifetime.” -Chief Justice Warren Burger

That means if we actually value “freedom and democracywe might have to put forth some effort into staying informed. I’m betting most of you won’t, but I’m hopeful that you might change your mind.

I just hope that another 150,000 don’t have to die (quite possibly someone that you know), before we stop shopping, browsing, and playing games long enough to get informed, take a position, and hold our legislators accountable. Skeptical and still not convinced? Read this.

The links are fact and data-based articles, here are some other resources.
The Brady Campaign To Prevent Gun Violence is still one of the best non-partisan resources on policy strategy. (I hope you all recall that James Brady (R) was President Reagan’s first Press Secretary when he was shot in 1981.)
In lieu of adequate public health data being collected,