Summer 2018
Vol 116.1

Following every mass shooting, there is no shortage of solutions from ideologically opposed groups, including but not limited to:  an “assault weapons” ban; banning all firearms; banning semi-automatic firearms; banning the AR-15; banning large capacity magazines; banning bump stocks; repealing the 2nd Amendment; arming teachers; passing National Concealed Reciprocity; passing “campus carry”; repealing the gun free zone act; firearms confiscation without due process by extreme risk protection order; and raising the age to purchase a rifle to 21.  While these various “solutions” deserve discussion, scientific data is lacking.  The Columbine massacre in 1999 occurred during the previous assault weapons ban, and 1 of the firearms used, the Tec-DC91 was on the banned list.2  Banning all firearms, a group of firearms (i.e. semi-automatic), or a type of firearm (i.e. AR-15) presents a significant logistical problem due to the high volume of ownership.  Prior to the Las Vegas massacre, few people ever heard of a bump stock.  Repealing the 2nd Amendment is not tenable.  It would create a slippery slope towards repealing other parts of the US Constitution.  The Bill of Rights is fundamental to our republic, is sacrosanct and must not be tampered with or altered.  Raising the age of purchase to 21 is arbitrary.


The University of Texas tower shooter (1966) was 25, the Stockton school shooter (1989) was 24, the University of Iowa shooter (1991) was 28, the San Diego State University shooter (1996) was 36, the Appalachian School of Law shooter (2002) was 42, the Conception Abbey shooter (2002) was 71, the University of Arizona shooter (2002) was 40, the West Nickel Mines School shooter at an Amish school (2006) was 32, the Virginia Tech shooter (2007) was 23, the Louisiana Technical College shooter (2008) was a 23 y/o female, the Northern Illinois University shooter (2008) was 27, the University of Alabama in Huntsville shooter (2010) was a 44 y/o female, the Oikos University shooter (2012) was 43, the Hazard Community and Technical College shooter (2013) was 21, the Santa Monica shooter (2013) was 23, the Umpqua Community College shooter (2015) was 26, the North Park Elementary School shooter (2017) was 53, the Rancho Tehama shooter (2017) was 43, and the Aztec High School shooter (2017) was 213. (Table 1) Arming teachers and other school personnel is controversial.


Cities are now identified by a mass shooting.  Just mentioning the name of a city, e.g. Orlando, San Bernardino, Las Vegas, et. al, and one is immediately reminded of the carnage that occurred there.  When the city is mentioned, the reference is clear.



Elliot L. Ames, DO

Past president, New Jersey Association of Osteopathic Physicians and Surgeons


The views expressed in the manuscript are those of the author

There are no conflicts of interest or financial disclosures



“Assault rifle”4 is defined as a rifle that fires an intermediate cartridge from a detachable magazine, and is capable of selective fire (fully automatic).  This means that the rifle can fire continuously with a single pull of the trigger.  A semi-automatic firearm on the other hand requires a single pull of the trigger for each cartridge fired.  An AR-15 style rifle is a semi-automatic firearm and therefore by this definition is not an assault rifle.

“Assault weapon” is a mercurial term defined by cosmetic features of the firearm and is based on the whim of state and/or federal legislatures.

 “Assault”5 is an unlawful attempt or threat to harm another.

A person commits assault and can do so with or without a weapon.  Firearms, knives, blunt instruments, baseball bats, fists, feet, motor vehicles can and have been used as dangerous weapons.  All of these items are potentially “assault weapons” when used to commit harm.


The terms “assault rifle” and “assault weapon” have been conflated and are now often used interchangeably.  Whether or not a particular firearm such as the AR-15 style rifle is considered an assault weapon, assault rifle, or modern sporting rifle is immaterial when used by a miscreant to commit mayhem. It is disingenuous for both sides of the debate to argue terminology to their advantage.  It will not solve the problem.  Rather, it will perpetuate it.




The Rand Corporation, in a review of the literature, found that there was inconclusive evidence that minimum age requirements and assault weapons bans had an effect on mass shootings.


While the debate rages on, there will be more mass shootings.  It should be perfectly clear that a new paradigm is indicated.  This essay will offer an approach to school shootings, a subset of mass shootings.


“Mass killing” is defined by the FBI as “three or more killings in a single incident”.7 By this definition, there were 40 mass killings by shooting at schools since 1940; 23 of these were perpetrated by shooters age 21-71 (58%).  In some of these, the shooter was also killed.    There have been numerous school shootings since then which do not qualify as a mass killing.


The modern era of mass school shootings began in 1966 at the University of Texas by a 25 y/o male.  However, it was the shooting at Kent State University on 5/4/1970 that shattered the national consciousness of school safety. Here, a total of 13 unarmed students were shot, 4 fatally, by the Ohio National Guard.  “Four dead in Ohio”8.  The firearm used was the M1 Garand chambered for the .30-06 cartridge.  The M1 Garand, designed by John Garand in 1928, is a semi-automatic rifle used in WW2, and therefore is a “weapon of war”.  General George S. Patton has been quoted referring to the M1 Garand as “the greatest battle implement ever devised”.9 The .30-06 cartridge is a 30-caliber developed by the US Military in 1906, hence the “.30-06” (pronounced “30 ought 6”) nomenclature.  Depending on the bullet weight, muzzle velocity ranges from 2500 ft/sec to 3500 ft/sec,10 resulting in considerable kinetic energy.  This was the cartridge utilized by the 1930s era gangster Clyde Barrow11 in his firearm of choice, the Browning Automatic Rifle (BAR).  The Kent State massacre is consistent with the definition of mass shooting.


Horrific mass school shootings followed in Stockton, California (1989), Columbine High School (1999), Newtown, CT (2012), and more recently in Parkland, FL (2018) and Santa Fe, TX (2018).  Despite numerous federal and state firearms laws, the National Criminal Instant Background Check System (NICS), a 10-year ban on “assault weapons” (1994-2004), school shootings continue.  Therefore, it should be clear to any reasonable person that the current approach is a failure.  A new paradigm is needed.


Perhaps a better approach would be to consider the problem of mass school shootings as an emerging infectious disease.  The pathogen is the shooter.  The host is the school and its occupants.  Preventing the pathogen from infecting the host is the key.  This can be done by following the model used in airports, court houses, and other Federal buildings.


A single point of entry to each school building, with metal detectors (magnetometers) and a scanning machine for bags, staffed by trained personnel and armed law enforcement officers (LEOs), would be, in my humble opinion, the best prophylaxis to the emerging infectious disease of school shootings.  It is a common sense, proactive solution to an enigmatic problem.  It works at airports and Federal buildings.




Suicide contagion has been identified as a risk factor for suicide in adolescents.12 Contributing to this contagion are newspaper and television reporting of suicide.12 More recently it has been theorized that media coverage has been responsible for an increase in mass shootings, the so-called “media contagion effect”.13 Most mass shooters are white males between the ages of 20 and 5014.  Other common characteristics include depression, social isolation, and narcissism.15 “A cross-cutting trait among many profiles of mass shooters is desire for fame”.16 Johnson and Joy have theorized that a subcategory of the media contagion is the copycat effect.  “Media contagion indicates that all coverage of mass shooters combined has an effect on potential shooters, seeding the belief that they will be rewarded with fame for their crime.  The copycat effect refers to a would-be killer’s emulation of a specific mass murderer and his methods”.17 “Don’t name them”, No notoriety, don’t share the writings of mass murderers, and giving equal time to the victims have been proposed to mitigate the media contagion.18.  Fame and infamy are the same to the twisted mind of a mass shooter.

It’s always the same story.  A troubled youth, usually male, suicidal, homicidal, or both, acquires firearms, sometimes legally, other times illegally by theft or straw purchase, and goes on a rampage.  In every instance, the perpetrator had access to the school, despite warning signs known to the authorities.

Clearly, if the concept of media contagion is accepted, then approaching the problem of mass school shootings as an emerging infectious disease has merit.  If the pathogen is isolated and prevented from entering the host, then the pathogen cannot infect the host.  In other words, if the potential school shooter is prevented from entering the school, then the chance of a mass shooting is significantly diminished.  Metal detectors will also screen for other weapons, such as knives, in addition to firearms.  Armed LEOs will have the capability to neutralize a potential threat.  On the other hand, without metal detectors, the pathogen (shooter) can gain entrance to the school and wreak havoc before being stopped.




The use of metal detectors and scanning in schools is not a new concept.  It has been utilized in New York City for 30 years19.

Hankin et. al in a review of the literature reported that “approximately 10% of middle and senior high schools use metal detectors, and the proportion of elementary schools using metal detectors more than tripled between 2000 (1.2%) and 2006 (4.4%)”.  Their conclusion was that there was “insufficient evidence” regarding the use of metal detectors providing a beneficial effect on the behavior and safety perception of students and staff.20 However, this study was done in 2010, and preceded the Newtown, Parkland and Santa Fe tragedies.


The pros and cons of using metal detectors and scanning in schools can be summarized as follows in Table 2:




 The frequent news reports of school shootings are having a cumulative stress effect on the population, resulting in emotional hyperbole and divisive ideology, without any hope of common ground.  Current and proposed gun control laws will not stop evil intent.  Therefore, it is imperative to stop the action and not allow the miscreant access to the school.  It is the author’s opinion that the paradigm suggested in this essay will mitigate school shootings and better inform solutions to this enigmatic problem.

 Following the Columbine massacre in 1999, when my daughter was in high school in New Jersey, I sent a letter to the school superintendent offering to purchase an airport style metal detector for the high school.  My offer was declined.  Imagine if such a system had been in place in Stockton, Columbine, Virginia Tech, Newtown, Parkland, and Santa Fe.



1. Wikipedia.  Columbine High School massacre.

2. Wikipedia.  Federal Assault Weapons Ban.

3. Wikipedia.  List of school shootings in the United states.

4. Wikipedia.  Assault Rifle.

5. Black’s Law Dictionary. 6th ed.  St. Paul: West Publishing Co, 1990.  Pp114-115

6. “The Science of Gun Policy”.  The Rand Corporation 2018, pages 157 and 66.

7. A study of active shooter incidents in the United States between 2000 and 2013.  U.S. Department of Justice, Federal Bureau of Investigation.  Published September 16, 2013.

8. Young, N.  “Ohio”.  Recorded by Crosby, Stills, Nash, & Young.,_Stills,_Nash_%26_Young_song%29

9. Wikipedia.  M1 Garand.

10. Wikipedia.  .30-06 Springfield.

11. Wikipedia.  Bonnie and Clyde.

12. Suicide contagion and the reporting of suicide:  Recommendations from a national workshop.  Centers for Disease Control and Prevention website.  Published April 22, 1994.

13.  Johnston J, Joy A.  Mass shootings and the media contagion effect.  Western New Mexico University 2016.

14. Ibid, pp. 12-13

15. Ibid, p. 14

16. Ibid, p. 17

17. Ibid, p. 24

18. Ibid, pp. 29-31

19. Scanning in NYCDOE schools – A collaboration between the New York City Police Department (NYPD) and the New York City Department of Education, page 1.  Effective July 21, 2016.

20. Hankin A, Hertz M, Simon T.  Impacts of metal detector use in schools:  insights from 15 years of research.  J Sch Health 2011; 81:  100-106. also:

21. Toure M.  Use of metal detectors in New York City schools under scrutiny amid Parkland shooting.  Observer 3/9/2018.


© 2018 New Jersey Association of Osteopathic Physicians and Surgeons

The Journal is the official magazine of the New Jersey Association of Osteopathic Physicians and Surgeons (NJAOPS). NJAOPS is the sixth largest state affiliate of the American Osteopathic Association. NJAOPS represents the interests of more than 4,700 active osteopathic physicians, residents, interns and medical students. Founded in 1901, NJAOPS is one of the most active medical associations in New Jersey with 12 county societies.