In China, doctors live in fear of their patients. They're stabbed. They're beaten by crowds. They're threatened if anything goes wrong — or at least, if the patient thinks something is going wrong. The violence is mostly in the rural provinces, but the danger is everywhere: There were nearly 30 attacks on clinicians at the average Chinese hospital in 2012. In America, of course, doctors mostly deal with more mundane frustrations. Yes, there are mentally ill patients who attack staff with broken-off bedrails, with broken bottles, with whatever they can get their hands on. Yes, there are shootings — too many shootings, about 15 a year — on hospital campuses, as doctors and nurses sometimes get caught in the crossfire. But our caregivers are exalted, not assaulted. It's incredibly rare to see a doctor die at a patient's hands. Which is why Michael Davidson's murder in 2015 was so inexplicable, and so tragic. Davidson, on paper and by reputation, was a star. Degrees from Princeton and Yale, a residency at Duke, all leading up to a staff position at the Brigham & Women's Hospital in Boston, one of the nation's finest medical institutions. A 44-year-old cardiovascular surgeon known for "saving lives and improving the quality of life for every patient he cared for," the hospital said in a statement on Tuesday. Less than 24 hours ago, Davidson was shot twice outside his office at the Brigham. He was rushed to the hospital's operating room, where his friends tried to save him. He died after several hours of surgery. We don't know much about Stephen Pasceri, the fifty-five-year-old man who shot Davidson and killed himself in an exam room afterward. He was an accountant, and was active in his church. He was licensed to carry a firearm. His friends and neighbors described him as a "nice man." What we do know is that Pasceri was frustrated with the American health care system. We know that when his 79-year-old father died in 2011 — after a short, futile hospital stay — Pasceri was angry enough to go to the media. To publicly ask then-Senator John Kerry to conduct an investigation of his father's $8,100 medical bill. “Truth be told, [hospitals] do it because they can get away with it,” Pasceri said at the time. “If my father had had Medicare Part B, we likely never would have looked closely at the bill. I'm certain that Medicare is being overcharged thousands of times a day by hospitals that will have great difficulty justifying the costs they are passing on.” Two months ago, Pasceri's 78-year-old mother died. Davidson had been her doctor. And reportedly, there had been some complication. So when Pasceri came looking for Davidson on Tuesday, packing a pistol…it seems almost too simple, doesn't it? A tragedy brings questions. It can even lead to action. And some now ask: Why not add metal detectors at hospitals? Could that have saved Michael Davidson? One problem is that hospitals — in the world that existed before Michael Davidson was gunned down on Tuesday, at least — generally don't want them. Take Johns Hopkins Hospital, in hard-bitten Baltimore; the facility has more than 80 entrances. To have metal detectors at every entrance, constantly staffed by security, would be an unreasonable expense, Hopkins officials have said. The Brigham, like other Boston hospitals, does not have metal detectors either. Others are asking, could adding new gun controls better protect physicians? After all, one of the Brigham's most famous current doctors is Vivek Murthy — the nation's precocious Surgeon General. An official who almost didn't get the job because he dared to suggest that gun violence is a public health issue. (An opinion shared by many medical professionals.) But Murthy's troubles on Capitol Hill point to the sheer difficulty of turning any gun-reform proposal into reality. Instead, hospitals will likely focus on teaching their workers how to survive a shooting. To do the kind of scenario planning that the Brigham had trained for. To encourage staff to know when to flee, when to hide, when to fight. Perhaps answers will come in Davidson's sad death. Perhaps they won't. Almost certainly, his death will seem forever wanton, Pasceri's motives permanently unsatisfying, even if they're revealed. And in the meantime, the Brigham will mourn its loss. Hospitals will practice more active shooter drills. And doctors will live in a little more fear of their patients. Source
