Art of Medicine
Jul 2020

Enough Is Enough

Hwa-Pyung (David) Lim, MS
AMA J Ethics. 2020;22(7):E632-635. doi: 10.1001/amajethics.2020.632.


In this cartoon, a guilt-ridden and heavily scarred surgeon prepares to self-flagellate to atone for his team’s failed attempts to save the life of an innocent child victim of a mass shooting. One of his nurses, carrying an assault rifle modified to serve as his whip, attempts to stop him by reminding him that the blame is not his to bear. We in the field of medicine can and must do more for our patients than simply treating their wounds and consoling their families and loved ones after tragic, senseless losses. Solving the gun violence epidemic won’t be easy, but we must try.

Figure. Enough Is Enough



Pencil, pen, and marker.


The idea for this piece came to me in February 2018 after I read a radiologist’s gory account of the havoc wreaked by military-grade assault rifles on the human body.1 Frustrated by the relentless inaction of politicians and deeply concerned about the normalization of mass shootings in the United States since Columbine, I felt compelled to frame the gun violence epidemic from the perspective of health care professionals who can’t help but feel guilty for what is ultimately a societal failure to curb the destructive power of firearms.

In the illustration, we see a scarred and bruised Dr Jerome Emiliani—named for the patron saint of orphans and abandoned children—hunched over a sink as he waits for a nurse to bring him a terrifying whip fashioned from an assault rifle and bullet fragments. The surgeon reminds the reluctant nurse that he has no choice but to punish himself with one lash of the whip for every innocent life lost. Nurse Maria Goretti—named for the patron saint of crime victims and other vulnerable groups, purity, and forgiveness—pushes back but ultimately cannot convince the doctor to stop punishing himself for the senseless losses.

The cartoon includes religious imagery and symbolism to draw attention to the fact that many of the most avid supporters of the Second Amendment are also devout Christians who fail to see the irony in their support for what is easily mankind’s most destructive invention. Next to the radiographs of the deceased child’s shattered torso and skull is a sign with an all-too-familiar message to health care workers (“wash your hands, think of their lives”) that takes on a whole different meaning in this scene. Like Pontius Pilate—the Roman governor who caved to the demands of the angry masses and condemned Jesus to the cross—guns rights activists would wash their hands of countless innocent lives and instead pin the blame elsewhere. Meanwhile, the despondent surgical team members could not wash their hands of the guilt even if they tried.

In the backdrop, we see another doctor doing the only thing she can for the distraught mother— comfort her and express regret. A lonely child struggles to fathom the permanence of the loss of his only friend as 2 tone-deaf bystanders carry on the popular yet ultimately fruitless debate on the semantics of gun control. Behind them, the TV broadcasts breaking news of “Yet Another Mass Shooting: US Politicians Give Thoughts and Prayers to Devastated Constituents” as the president shrugs and members of Congress sit on their hands.

Doctors and other first responders are not miracle workers, yet much of the burden of insufficient gun control falls unjustly on their shoulders due to the inaction of public leaders crippled by fear of political backlash. When we insist on politicizing gun control, we fail to recognize it as the public health issue that it is. We cannot ignore not only the obvious toll that gun violence has on its victims, but also the many detrimental effects it has on survivors, family members, first responders, health care workers, and average Americans who risk their lives simply by living in a country that seems to prioritize an antiquated right over the safety and well-being of its people. Maybe it’s time for doctors to push back and do more to tackle this issue once and for all.


  1. Sher H. What I saw treating the victims from Parkland should change the debate on guns. Atlantic. February 22, 2018. Accessed May 7, 2020.


AMA J Ethics. 2020;22(7):E632-635.



Conflict of Interest Disclosure

The author(s) had no conflicts of interest to disclose.

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.