Saving lives and healing people makes up the image we generally have of doctors and other health care professionals. While they perform these admirable tasks, sometimes they do just the opposite, hasten someone’s trip to the grave. In 1999, the Institute of Medicine of the National Academies (IOM) released a Consensus Report (we all know how important consensus is) stating that
“At least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented,….
Note that that is just in hospitals.
To pretend to be fair, the American College of Physicians disputes this finding in an article titles “How Many Deaths Are Due to Medical Error? Getting the Number Right”. Curiously, they never come up with a number. I doubt they want to as the actual number may be worse than the one they dispute.
While 44,000 to 98,000 sounds really, really bad, Scientific American spotlighted a 2009 Hearst Corporation report that the number had doubled in the previous decade.
An estimated 200,000 Americans will die needlessly from preventable medical mistakes and hospital infections this year, according to “Dead By Mistake,” a wide-ranging Hearst national investigation,…
This report cites the IOM report as the basis for the doubling of deaths. Perhaps, the number of deaths was that high all along. If the IOM was flawed as the American College of Physicians claims, the number in 1999 could have been higher, not necessarily lower. Whatever the number – 44,000, 98,000 or 200,000 – it puts death by medical error in the top ten causes of death in the U.S. Indeed, doctors are much more likely to kill you than someone else with a gun. (Ironically, according to the linked article, you’re more likely to kill yourself with a gun than someone else kill you with a gun. Oh, the joy of statistics!)
But, at best, these numbers only include reported incidents and cases that meet the criteria needed to attribute the death to medical error. What about the unreported cases? I’m sure each of us can recount several such cases ourselves. My own brother’s death from AIDS was accelerated by by a personal physician who refused to test him for being HIV positive because the doctor just didn’t believe my brother could be HIV positive, despite the persistent pneumonia. Or, the woman my father knew who died of a brain tumor because her personal physician believed she was a hysterical woman having migraines. Or, this kid who committed suicide after becoming addicted to Adderall. How many of the 100 people who die from overdoses every day in the U.S. die from drugs legally obtained via prescriptions?
During 2010, “10,228 people were killed in alcohol-impaired driving crashes”. A number that we, as a society, get all riled up about. Yet a very small number when compared to death by medical error. In England/Wales, they estimate more people die from lack of hand washing by doctors and medical personnel than by “drink driving.”
“Given the existence of MRSA, not having clean wards and not washing your hands is the clinical equivalent of drink driving. It maims and kills.”
When I was in charge of admissions at a nursing home many years ago, we wouldn’t accept any patients with MSRA infections because it was so nasty and deadly. There’s no reason to believe doctors in the U.S. wash their hands more frequently than doctors in England/Wales. The article at that link says as many as 1 in 5,20%, don’t wash their hands between patients. Citing a study WebMD states:
Upwards of one-half of doctors don’t wash their hands between visits with hospital patients, a new study shows. It’s a big infection control concern in hospitals because dirty hands transmit germs to other patients.
It’s quite reasonable to assume death from medical treatment stands even greater than currently reported. This issue alone makes much of the hysterical gun violence freaks hysterical look like the Chicken Littles running around they are. In addition to the right to bear arms being an “unalienable Right” necessary for us to protect our lives and liberty, any danger to others resulting from the right to bear arms is not nearly as great as many would have you believe.
Well done, DADvocate: pitting the right to bear arms against the right to bear scalpels. Given those statistics, maybe we should make sure that doctors are trained, licensed, registered, supervised, and held accountable for the results of their…oh wait: we already do all that. Never mind. Anyway, I await your next post comparing gun deaths to deaths from natural causes: next thing you know, the liberals will want to outlaw natural causes. Freedom!
Given those statistics, maybe we should make sure that doctors are trained, licensed, registered, supervised, and held accountable for the results of their…oh wait: we already do all that.
I genuinely admire the above reply, it was succinct and witty.
However, I do join in with the folks pointing out that the supervision and accountability is lacking with respect to the medical community.
That’s not, in itself, an argument for keeping, or for that matter changing, the current gun regulation status quo but does suggest more should be done about bad doctors.
DADvocate–thanks for scaring me even more that I already was about doctors.
I’ve spent the past few nights going through the Texas Medical Board’s reports for 2012. There’s some scary stuff out there.
I recall an old episode of Saturday Night Live in which John Travolta (back when he was still a hunk rather than a scientologist) was running a telethon against the leading cause of death–Natural Causes!
WiredSisters: I fear that such a telethon could actually take place and rake in big bucks, though perhaps not with John Travolta in charge–George Clooney, maybe?
Shouldn’t you be watching TV or shopping some where?
Watching TV (basketball, Rachel Maddow) and then on the internet. Thanks for your concern.
Maddow actually had a good bit yesterday about the drones. Is that what woke up that small feeble, weak, and elderly body. I’m guessing you’re older than I, which quite likely makes you the oldest person blogging here. Maybe the only one to learn to type on a typewriter. Despite my advanced age, I didn’t learn to type until I had a computer in the house.
Played basketball in high school (MVP of my team) but can’t stand to watch it on TV. We’ve had some really good teams at my kids high school over the past 10 year though. 2 state championships in KY where there’s only 1 champion, none of those different classes for the schools. Darius Miller, who played on last years KY National Championship team and now NBA, played at the high school. Chris Lofton, All American at Tennessee 6-8 years ago, played there too. He still holds the state tournament record for the most 3-point shots taken, most made and highest percentage made. He could shoot your eyes out. He was in range once he crossed the mid court line. Had testicular cancer in college and still made third team All American.
I haven’t watched any TV tonight, yet. I’ll probably watch one show before hitting the sack. I’m guessing you’re retired at your advanced age, but I gotta work. Need money to buy more guns and ammo., plus backpacking equipment. My 19 year old son and I are going backpacking somewhere in the southern Appalachians in March. He’s a big, strong, offensive lineman on a college football team, I just hope I can keep up.
I had a high school civics teacher who was from upstate New York. So upstate he was really French Canadian, had the look and everything. Grew up within 10 miles of Canada. But, he came to the University of Tennessee to play football and ended up staying. Mike LaSorsa. Maybe you heard of him. He wouldn’t be that much older than you. He was one of the captains of UT’s team. Great guy.
DADvocate–I never heard of Mike La Sorsa, but that’s no knock on him. I’ve definitely heard of Darius Miller and Chris Lofton, though. Your guesses about me are pretty much on the mark: I’m retired, and I did learn how to type on a typewriter long, long ago. And yep, Rachel Maddow has been on top of the drone story, though I’ve been aware all along that our President has been conducting drone warfare and targeted assassinations without any oversight, much less public consent (though he’d probably get that if he put it to a vote–we does love killing us some bad guys overseas).
“Played basketball in high school (MVP of my team”
Must have been a hassle getting the ball out of the peach basket.
trained, licensed, registered, supervised, and held accountable for the results
BTW – I wouldn’t bet on that. My sister used to be the head attorney for the state health care professionals licensing – doctors, nurses, physical therapists, etc. Nothing happens if they aren’t reported. Doctors don’t report each other. She took plenty of licenses away, but it was usually after someone died, but there would often be a long trail of unreported malpractice. Take the case of a local doctor here, Dr. Milton Brindly, he was running a pill mill of major proportions. The FBI tracked him down via prescriptions being filled from over 100 miles away, but no local doctors turned him in. Trivia: MI mentioned the Emancipation Proclamation the other day. Dr. Brindley lived in the house in Augusta, KY where the original rough draft of the Emancipation Proclamation was written. You may recognize Augusta as the hometown of George Clooney.
But, you’re obviously too interested in being a smart assed old fart to engage in any serious conversation. You want to be taken seriously but don’t want to return the favor. I’ve read a lot to Twain, some Burke, never heard of Kirk that I remember. I don’t hate Obama as much as you hate Mitt Romney. Indeed, I don’t hate him at all – he might lob a drone at me.
I did finish college, even got a M.S., which made me average for my family (2 Phds, 4 MSs, 1 JD, 6 BAs.) 20 years after all that, I went back to college for a year to learn to be a computer programmer.
The one book I read, many times actually, that did make a difference in my life was Zen Flesh Zen Bones: A Collection of Zen and Pre-Zen Writings by Paul Reps (Compiled by), Nyogen Senzaki (Compiled by). Here’s a little story from it you might enjoy.
A Cup of Tea
Nan-in, a Japanese master during the Meiji era (1868-1912), received a university professor who came to inquire about Zen.
Nan-in served tea. He poured his visitor’s cup full, and then kept on pouring.
The professor watched the overflow until he no longer could restrain himself. “It is overfull. No more will go in!”
“Like this cup,” Nan-in said, “you are full of your own opinions and speculations. How can I show you Zen unless you first empty your cup?”
DADvocate–thanks for scaring me even more that I already was about doctors. I thought we had the best health system in the world, and now you’re telling me it’s riddled with quacks and unreported malpractice? Ah well…as for George Clooney’s birthplace being August, Ky, I did not know that; I actually know very little about George Clooney except that he’s a handsome man who’s made some fine films and who seems to have some left-wing political leanings. That’s all I’ve got on that topic.
Okay: “You’re obviously too interested in being a smart-assed old fart to engage in any serious conversation. You want to be taken seriously but don’t want to return the favor.” Geez, DADvocate, I’ve been here at Alexandria for all of, what, a week now? I’ve put up four posts of my own and have engaged in running conversations about them, and about other posts. I’m still trying to get a feel for who I can have a productive conversation with and who’s just going to keep repeating talking points at me. I’m not trying to dismiss or disregard you or anyone else; my smart-ass remarks are sometimes ill-considered attempts to keep the heat of a conversation down, although I admit sometimes I’m just amusing myself with them.
I get your Zen story and I’m sure it applies to me, and to you, and to H.M., and to Hyphenated American, and to…well, to everyone. Regardless, I don’t get the sense I’m any more full of myself than others on here, or any less willing to consider other opinions. I spend most of my days on websites I disagree with, and that my liberal friends wouldn’t touch with a ten-foot pole, because I see no point in keeping myself sealed in a left-wing echo chamber, and because I know that the “other side” has good points to make. But when it comes to dialogue here, or anywhere, I also choose my battles, as it were; sometimes I don’t feel like arguing the same point over and over again, so I make a joke and sign off. That seems to be my prerogative, wouldn’t you agree? Sometimes I think folks get upset when someone doesn’t take the bait and give them the argument they want–and I honestly don’t necessarily mean you, but I’ve seen it happen.
When it comes to gun control, which was the object of your post about the number of medical deaths, you and I aren’t going to agree–so what is it you want me to say? You’re an intelligent man and I bet you’ve heard every pro-gun control argument there is; none of them have swayed you, and I’m sure I wouldn’t sway you either. So why do you want us to publicly beat a horse that, if it isn’t dead yet, can’t be far from the glue factory?
Finally: when did I say I hated Mitt Romney? That would be a waste of hate; I’d rather save it for someone who actually deserves it, like Newt Gingrich.
I get your Zen story and I’m sure it applies to me, and to you,…
Absolutely. One of the last things I want to do is get mentally stuck in what I think.
My point with this post is simply this, there’s plenty of dangers in this life and often we worry about the wrong things. Kind of like snakes vs bees. Many people fear snakes more than bees, but bees kill more people, in the U.S. at least. Many people fear flying. But, if you’re flying commercial, the most dangerous part of the trip is driving to the airport. I disagree the issue is dead. You’re begging the question.
DADvocate–again, you’re quite right that our fears are often irrational, misplaced, and in clear defiance of statistical probabilities (snakes, bees). And sure, I’m statistically more likely to die from medical malpractice, or from natural causes, or from a household accident, than I am from being shot (especially since I don’t own a gun). But the existence of other dangers doesn’t preclude addressing the dangers of guns–and guns do present dangers. I’m not begging any question here; rather, you’ve introduced a red herring into the issue of gun control by saying, “Ooh, look, dangerous doctors over there!” Which is why I didn’t take your post seriously as a post on gun control; had you posted it to start a conversation on medical malpractice and the lack of supervision and accountability in the medical profession, I’d have gladly joined in (and still would). Steve2 has it right: whether it’s medical care, automobiles, guns, or anything else, we weigh risks, costs, and benefits, and we do what we can to minimize risks and costs of those things (including guns) whose benefits we value. It strikes me as common sense.
So why do you want us to publicly beat a horse that, if it isn’t dead yet, can’t be far from the glue factory?
The funny thing about this comment is that you make a point of trying to show you’re open-minded, etc and then say why don’t you shut up about this? Plus, as I said, you’re begging the question. And, public discussion is what matters most. My kids, and the huge majority of friends, already agree with me in principle if not every detail.
DADvocate: I already wrote you one longish reply that my server somehow spun off into cyberspace, but let me try again. First, the “funny thing” about my comment was actually the “can’t be far from the glue factory”: all my friends thought that was hysterical. I did not intend to suggest that you “shut up” on this or any other topic; I was suggesting that I didn’t think you and I had much to gain by pursuing it further with each other. Aren’t there other topics we could discuss (who’s Darius Miller playing for these days?)? Despite which, I’ve continued to weigh in when asked, because I think it’s rude to ignore folks. I’m kind of on the horns of a dilemma, here, DADvocate, and maybe you can help me: you want me to keep talking about this whole gun control thing (I think that’s what you want me to keep talking about), but H.M. has told me I have no right to an opinion and should go learn something about guns first. Now, I’ve just told H.M. that he’s being an arrogant prick, but still–should I go with your advice and continue to discuss guns, or follow H.M.’s orders and shut my pie-hole? That said: why do you need to pursue this particular topic with me when you’ve already got your kids and the huge majority of your friends on your side? Is it so hard for folks just to say, Okay, on this one we disagree? But in the interests of comity: tell me again, DADvocate, what question it is I’m begging, and I’ll do my best to reply.
Yes, doctors kill people. The actual number is hard to determine**. Looking at a case after the fact is hard (I am reviewing one now) and it is subject to the prejudices of those reviewing. A prominent academic who does reviews has publicly said he cites anything as a preventable death if a drug he dislikes is used, a drug most of use every day. That said, we still have way too many preventable deaths. Docs dont report other docs because they are afraid of getting sued and losing (which has happened) just for trying to get rid of a bad doc. Sometimes they are covering up for a friend, I have seen that happen also. Sometimes, a doc is working alone and is pretty isolated from the community, so we dont know much about what he/she is doing. Mostly I think we need docs to suck it up and do the right thing, but it would really help if the legal system would let us find some way to deal with problem docs w/o putting people’s personal savings at risk. Most hospitals also need to rewrite their bylaws so they can deal with docs before they have a catastrophe. This story of a rogue pilot fits very nicely with what we see with some problem docs.
http://ricks.foreignpolicy.com/posts/2013/02/01/how_a_rogue_pilot_misbehaved_for_years_in_a_b_52_squadron_and_so_killed_4_people
All that said, it still come down to risk vs benefit. If we find that there is no benefit to having doctors because the risk is too high, we should get rid of them. If there is benefit, what can we do to decrease the risk? That is the same kind of analysis we should use for guns.
** There is a very nice study out recently looking at post-op infections after total joint replacements. (The IOM and others tend to count all post-op infections as a medical error.) What the study found was that the rate of infection for patients who were obese and had diabetes was 10%. For those who had neither it was zero. So was it really medical error or is it that some patients are different and we dont know how to prevent infections for them?
Steve
Not sure I care for your risk/benefit analysis there. It’s not about whether or not to have doctors, it’s about whether or not to properly practice universal precautions. Do you object to washing your hands? How much would you approve of an auto mechanic or plumber being as careless as some of these medical personnel? Here’s a story I saw today doctor who counted at least 10 mistakes related to his father having cataract surgery.
Civil rights are not subject to cost/benefit analysis. That’s why slavery came it popularity in America. The cost/benefit analysis said it was very good. This cost/benefit approach is quite popular with the left wing. They use it to justify ever encroaching totalitarian controls. Obesity costs us money – no big drinks, no fatty foods. Smoking, drinking, etc. You like to play fast and loose with that rights stuff as you think you are the arbiter of rights and no one should have any rights of which you don’t approve, or you’ll take all your doctors and go home.
The cost benefit ratio was good from the POV of the slaves? I dont think so. From the POV of the owners it was ROI.
Steve
Two unconnected observations:
Firearms and medical practice are not comparably subject to facile (“Who needs a ______?”) cost/benefit analysis: the unburdened right to keep and bear arms, subject to current judicially upheld limitations, is constitutionally guaranteed prior to and irrespective of politically questionable “cost/benefit” analysis (event, not product, liability for manufacturers of cosmetically out of favor rifle platforms is currently being advanced in CA and CO); neither medical practice nor medical care is similarly guaranteed.
Of a population of Alexandria Authors still less than 150 total, at least 2 so far have already reported serious iatrogenic encounters:
http://www.aleksandreia.com/2009/06/12/malpractice-question/
http://www.aleksandreia.com/2011/04/09/politically-incorrect-comment-about-medicare/comment-page-1/#comment-31447
To the best of my knowledge none have reported similarly damaging encounters with firearms.
H. M. Stuart
Alexandria
H.M.: You’re right that medical care isn’t guaranteed in the Constitution, but I still think the question “Who expects to ever need a doctor?” would get a pretty good show of hands. Your “right to keep and bear arms” isn’t “unburdened” if it’s “subject to current judicially upheld limitations,” as well as future limitations, politically determined and judicially scrutinized. Even Constitutionally-guaranteed rights are and always have been subject to social cost/benefit analyses, as well as to reasonable common-sense restrictions and political/judicial interpretations. As for your tally of Alexandrian-specific iatrogenic encounters vs. “damaging encounters with firearms”: I believe your word “facile” applies nicely. I’ll repeat what I said to DADvocate: the policy discussion isn’t about guns vs. doctors, it’s about guns. If you’d like to introduce a separate discussion about medical malpractice, iatrogenic risks, and so forth, that would be useful, too; but don’t use that issue as a red herring to (deliberately mixed metaphor ahead) muddy the waters.
My good Jack,
Your “right to keep and bear arms” isn’t “unburdened” if it’s “subject to current judicially upheld limitations,”
But that is not what I wrote. The judicial standard most commonly used to weigh attempts to limit the rights spelled out in the Second Amendment is whether it will “unduly burden” the right to keep and bear arms.
You may find my tally facile, but at least 2 people out of a random sample of (I believe the actual total is 145 or 146) have not only experienced but felt compelled to write about the damage their loved ones suffered at the hands of medicine; none yet have done so about guns. Therefore, even in a random sample as small as less than 150, medicine is a greater active danger to a random population than firearms. Why then are we even discussing firearms instead of medicine?
DAD’s post is not at all a red herring and actually clarifies the waters: it quantifies where the current hysteria about firearms lies on a scale of other harms people suffer on a far more regular and statistically measurable basis. Let me add the qualifier psychotic to the term hysteria: none of the current discussions about firearm dangers and gun control are even literate on the subjects they purport to discuss.
To the contrary, the burden of proof is on you to show why a discussion about firearms has any place beyond its current hysterical reaction to news events and its prostitution to political ends. If you have any competence or even competent knowledge at all with respect to firearms, please reveal it and use it to substantiate your contention that putting the current hysteria about firearms into a rational, real world context is in any way illegitimate.
Along the way, please define what an “assault weapon” even is, what a “high capacity magazine” even is (hint: How high is the sky?), and why “banning” (because even that is not being proposed) either would have any relationship to greater safety even from the items themselves. Differently put, demonstrate with demonstrated competence in the subject at hand why the gun control policy debate as currently constituted does not desperately need to have its waters clarified in precisely the way DAD’s post attempts to do.
H. M. Stuart
Alexandria
” it quantifies where the current hysteria about firearms lies on a scale of other harms people suffer on a far more regular and statistically measurable basis. ”
Even worse, we invaded two countries, lost thousands of American lives, killed thousands of people and spent/will spend trillions over a few thousand deaths in NYC. Much less than the number of gun deaths in the US each year.
“none of the current discussions about firearm dangers and gun control are even literate on the subjects they purport to discuss.”
Boy is that true. People want to cite Chicago, w/o looking at homicide or rape rates in other US cities. Or, they want to cite the UK, while ignoring Japan and making no effort, AFAICT, to look at data easily available from other countries. Of course, it is difficult to get data that might be helpful since federal research has been pretty effectively banned.
Steve
H.M.: (a)you did write “unburdened,” not “unduly burdened”. (B) I do find your tally facile, and also irrelevant. (C) You know damned well what has occasioned the “current hysteria about firearms” and you’re merely being provocative, as is your wont, in pretending not to. And (D) I don’t know one damned thing about guns and wouldn’t know a cartridge from a casing or a trigger lock from a flintlock. So what? I’m not the one writing the laws, nor have I personally proposed any specific restrictions on your artificial penis–sorry,I mean “guns”. I also don’t know a damn thing about brain surgery or heart surgery, but I hope someone who does is regulating and supervising those on my behalf, too. Say what you will, DADvocate’s post remains a classic red herring: we’re not faced with a choice between either regulating guns, on the one hand, and addressing medical malpractice and iatrogenic harms on the other–we can do both, if we choose, and we should; I for one am all for it. Nor is “the burden of proof” about the merits of even having this discussion on me at all: the nation is having this discussion whether you like it or not. Finally–”demonstrate with demonstrated competence in the subject at hand”: jeez, you’re full of yourself, H.M., aren’t you? Were you born with that stick up your ass, or did you have it surgically implanted?
I don’t know one damned thing about guns and wouldn’t know a cartridge from a casing or a trigger lock from a flintlock. So what?
My good Jack,
So your opinion with respect to anything involving firearms is, in your own words, wholly uninformed and should be ignored on that basis. Since you are wholly ignorant of firearms, you will necessarily be unable to knowledgeably evaluate the value or damage ostensibly created by any regulation of firearms. Since your opinions on firearms regulation will thus be as completely stillborn as your opinions on firearms themselves, you necessarily have no basis on which to determine which topics place firearms, their dangers, and any attempted regulation of anything involving them in any meaningful context and which don’t.
H. M. Stuart
Alexandria
H.M.: I understood and already dismissed (you’ll find the rest of my dismissal following my “So what?”) the implication of your question–did you not notice? Next you’ll be telling me I can’t have an opinion about war because I didn’t serve in the military, or about abortion because I’ve never been pregnant. I suppose that if guns, gun safety and gun regulation only affected people who could “demonstrate with demonstrated competence” (I’m sorry, I just can’t get over that one) that they know one end of a rifle from the other, maybe you’d have a point; unfortunately, sometimes us civilians–and even kids, have you heard?–get caught in the crossfire, so to speak. In any case, good luck making your condescending “You, sir, have no idea of what you speak and therefore you shall not be heard” argument to the various law enforcement officers and groups who are in favor of stricter regulation.
My good Jack,
If there is indeed one, define and explain the current existential threat from firearms in America today.
Explain how the primary gun control proposals currently being advanced in legislation ostensibly to reduce such a putative existential threat- bans on rifles cosmetically resembling military fire capable M4s and AK-47s and magazines capable of containing more than an arbitrary number of rounds – are anticipated to function in reducing such assumed existential threat.
I won’t even attempt to endorse or rebut anything you offer, I’m simply offering you the opportunity to demonstrate you are even capable of forming and arguing an opinion on firearms. If you aren’t even capable of producing a coherent opinion with respect to the current firearms issue, our readers should know it so that they can budget there time with respect to your comments accordingly.
Madame Stuart and I are now off to the range to maintain our responsible proficiency with firearms, in the course of acquiring which we learned such useful things as how fast and easy it is to change a magazine, how many magazines a Tuff magazine pouch can conveniently hold, and other simple things useful in evaluating the gun control debate.
Now: you show us that you even have an opinion on firearms by showing us what it is.
H. M. Stuart
Alexandria
H.M: I’m pretty sure “our readers” can and will figure out how to budget their time on this site (and off it), as well as how to evaluate my comments, your comments, and everyone else’s comments; and if my opinions are incoherent, I assume folks on the site will stop reading them, or at least let me know. I’m not sure why it’s your role–did I miss it in the fine print when I signed on to Alexandria?–to order me peremptorily to “demonstrate…define…explain…show us” anything in order for me to weigh in on a topic or to be taken seriously; again, I think readers can decide that for themselves. In any case, I certainly don’t intend to jump to your tune, and truly don’t give a fig for whether you take me seriously on this or any other topic. You’re either quite the arrogant prick, H.M., or you enjoy impersonating one on this site. And then, to boot: “I won’t even attempt to endorse or rebut anything you offer, I’m just offering you the opportunity…” That, as they say, is mighty white of you. I thought I already got that opportunity when I joined the site–was I wrong?
My good Jack,
My apologies. After reading some of your earlier comments, I realized I had taken the wrong tack with you.
H. M. Stuart
Alexandria
H.M.: Apology certainly accepted, and my apology in return for some language I should have kept to myself…
And you don’t have to make an appointment to meet a guy with a gun!
WiredSisters: guys with guns even make house calls!