An open letter to the National Rifle Association

Malachi Sheahan III

I think it is time we talked about guns. I know you don’t like to discuss these things after a school shooting, so I waited. It has been four months since Uvalde. It seems there have been three more since, but I had to look that up. Some school shootings don’t even make the news these days. 

I have spent a lot of time trying to figure out what happened to you, and if there is a way forward. Look, you were never really easy to talk to, but at least there was debate. A chance for compromise. When you were formed in 1872 by Civil War General Ambrose Burnside, the goal was to promote rifle practice and improve marksmanship on a scientific basis. Burnside was pretty annoyed by the horrendous aim of his Union soldiers. It was estimated they fired 1,000 shots for every Confederate soldier struck. And this was in the days you couldn’t pick up a gross of armor-piercing shells at Walmart with the groceries. The charter goals of the NRA were to promote shooting, hunting and conservation. 

Fifty years after your formation, gun-wielding gangsters such as Al Capone and John Dillinger committed a rash of brazen crimes. Addressing the situation, your president Karl T. Frederick stated: “I do not believe in the general promiscuous toting of guns. I think it should be sharply restricted and only under licenses.” The NRA then lent its support to the National Firearms Act of 1934 and the Gun Control Act of 1938. 

The 1960s saw a series of public assassinations, including John F. Kennedy, Robert Kennedy, and Martin Luther King, Jr. In response, Congress passed the Gun Control Act of 1968. California Governor Ronald Reagan, who would go on to become the first U.S. president endorsed by the NRA, supported the law. You opposed the bill, but mildly. Your statement read, “…the measure as a whole appears to be one that the sportsmen of America can live with.” 

This tempered approach continued for the first 100 years of the NRA’s existence. A fundamental change occurred in the 1970s when Neal Knox led an insurgence culminating on May 21, 1977, with the “Revolt at Cincinnati.” Knox used bylaw provisions to vote out the NRA old guard and replace them with men such as Harlon Carter. Carter was a colorful character and holder of many national shooting awards. At 17, he had been convicted of murder for shooting another youth, but this was overturned on a technicality. Carter was a former U.S. Border Patrol director who led an operation along the southern border with a title too racist to print in my family-friendly publication. Let’s just say Carter was not a fan of Mexicans. He was, however, a skilled lobbyist and authored the “No compromise. No gun legislation” ethos that the NRA carries to this day. 

Behind its new activist leadership, NRA membership soared. Your goal became the rollback of the 1968 restrictions and the abolition of the Bureau of Alcohol Tobacco and Firearms (ATF). By increasing your lobbying pressure, the NRA compelled Congress to pass the Firearm Owners Protection Act of 1986. This law eased restrictions on interstate firearms sales and prohibited the creation of a national database of gun ownership. Complaining about the NRA’s new tactics, Republican Senator Bob Dole stated, “You have to have a litmus test every five minutes, or you’re considered wavering.” 

The spirit of the NRA became increasingly anti-government. A mailing to members declared a proposed assault rifle ban “gives jackbooted government thugs more power to take away our constitutional rights, break in our doors, seize our guns, destroy our property and even injure and kill us.” 

After anti-government sentiments drove the April 1995 federal building bombing in Oklahoma City, many NRA members became uncomfortable with this rhetoric. Former U.S. President George H.W. Bush was one. He resigned in protest. 

The April 1999 Columbine High School massacre proved to be your litmus test. I am sure it would have been great to lay low and offer empty platitudes to the dead. Unfortunately for you, the NRA annual meeting was scheduled to occur 10 days later in Denver, a few miles away. Just one day after the shooting, the NRA held a conference call to discuss the options. Respectfully cancel or delay the convention? Or defiantly press on? 

Luckily we don’t have to guess about the substance of this conversation as it was secretly taped and obtained by National Public Radio. On the recording, NRA top official Jim Land made the argument for continuing with the meeting: “I got to tell you, we got to think this thing through because if we tuck tail and run, we’re going to be accepting responsibility for what happened out there.” PR consultant Tony Makris delivered the counterargument, “…it’s far worse to go out there and be painted as a bunch of insensitive, disrespectful turds than it is to say we’re sorry it happened and we’ll bow out.” 

Remorse or defiance? I guess you decided the show must go on, and what a show it was. The final lines were delivered by your president Charlton Heston: “The dirty secret of this day and age is that political gain and media ratings all too often bloom on fresh graves.” This statement summed up a brilliant strategy that would condemn anyone who would bring up our gun problem after an event that obviously illustrated our gun problem. Unfortunately, it was a tactic you would have to rely on frequently in the ensuing years. So instead of meaningful discussion after a school shooting, we got thoughts and prayers. 

If Columbine was your turning point as an organization, Sandy Hook was ours as a nation. A moral reckoning, and one that we failed. Could we accept the vision of 20 first graders crumpled dead in their classrooms? Tiny bodies shredded by an AR-15 that had been modified by the manufacturer for close combat in confined spaces, such as a grammar school. A gun that had been advertised by the slogan “Consider your Man Card reissued”. The horror of Sandy Hook was so great that most gun advocates knew there was no logical way to debate. Out of desperation, some even resorted to calling it a hoax. Could our nation stomach all of this and do nothing? Apparently so. 

People often think the NRA does the bidding of the firearms industry, but I am certain the opposite is true. After Sandy Hook, the only significant legislation that came close to passing was the Manchin-Toomey Proposal, which would have strengthened and expanded background checks for firearms sales. The NRA was even involved in the negotiations to prepare the bill. The National Shooting Sports Foundation (NSSF), the firearms industry’s trade association, signaled their endorsement of the proposal. But, unbelievably, the NRA withdrew support and declared that the vote would be “scored.” Meaning if a senator did not vote the way the you wanted, their precious NRA grade would be affected. Senator Joe Manchin saw his A grade plummet to a D, just for voting for the legislation that the NRA helped to draft. The NSSF, predictably, fell in line and financed commercials opposing the bill. Manchin-Toomey failed to get the required 60% vote and was defeated on April 17, 2013. The threat of an NRA score even scared five democrats into voting no. 

Why do you have such a hold over politicians? Most of your members support common-sense measures. That must be inconvenient for you. To be truly valuable you need a unified voting base. Politicians love single-issue voters. No need to worry about fixing things or making anyone’s life better. Just vote a certain way on a certain issue. I bet if asked, “Should a guy who beats the crap out of his wife and kids be able to buy a gun?”, most of your members would vote no. Inconvenient. Ask any member of a high school debate team the key to a good faith debate, and they will tell you—defining the terms. So, to obscure a good faith debate, you appeal to emotion. Everything is a slippery slope. You label these “red flag laws” and convince your members that if some lunatic can’t buy a gun, they will be next. 

Politicians are also afraid of the fruitcakes and wackos in your organization. These are the folks most likely to show up at a town hall and scream at their representatives. Those pejorative terms aren’t mine, though. They’re yours. In the recorded call leading up to the Denver convention after Columbine, your leadership expressed fear that “The fruitcakes are gonna show up,” as PR consultant Tony Makris put it. Marion Hammer, your first female president, seemed to agree, “…you’re gonna have the wackos… dressing like a bunch of hillbillies and idiots…” Maybe it is ironic that your leadership has disdain for some of its most politically valuable constituents. Although I think irony may be lost on an association that opposes all efforts to curb gun violence while garnering tax-exempt status as a social welfare organization. 

The NRA’s tactics have caused a sea change in conservative opinion over the past 40 years. Before becoming an NRA darling, Ronald Reagan actually passed strict gun control measures as governor of California. Conservative Chief Justice Warren Burger said, “The Gun Lobby’s interpretation of the Second Amendment is one of the greatest pieces of fraud, I repeat the word fraud, on the American People by special interest groups that I have ever seen in my lifetime.” Even Justice Antonin Scalia said, “The Second Amendment is not a right to keep and carry any weapon whatsoever in any manner whatsoever and for whatever purpose.” 

Today the U.S. is awash in guns. More than one for every person. Despite your best efforts to curb research on gun violence through stripping the Centers for Disease Control and Prevention (CDC) of research funding and the Tiahrt Amendment, the facts are pretty damning. Guns are involved in 51% of suicides and 73% of homicides. Since 2015, toddlers have killed more Americans than terrorists. Worldwide, 97% of children four and under killed by guns happen in the U.S. More children die in a year by gunfire than on-duty police officers and active military members. The explosion of AR-15 purchases happened after the Assault Rifle Ban expired in 2004. A weapon formerly used mainly by law enforcement and the military was now marketed to the public by over 500 manufacturers. To compete, they would make improvements, which, in this context, means making the rifle more lethal. 

Many people from urban areas underestimate the emotional connection individuals from more rural regions can have to guns. Some of their fondest memories can be hunting and going to shooting ranges with their family. Heck, I live in Louisiana and work with a surgeon who unironically owns a cannon! Interestingly though, while the number of guns is increasing, the number of homes with a gun has actually decreased. So who is buying all of these AR-15s? Somehow I don’t think these purchases are driven by a love of the Great Outdoors. 

A 2020 study by the National Shooting Sports Foundation (NSSF) labeled the fastest-growing segment of customers Urban Defenders, or those likely to buy guns because they “don’t trust others around them.” So while gun advocates often bristle at the suggestion that the AR- 15 is a weapon of war, the industry clearly promotes it as such. Consider this advertisement from gun manufacturer Daniel Defense: “whether you’re on the battlefield … or protecting your family in the middle of the night.” 

It’s time to put to rest all of the myths about protecting kids from guns. Uvalde ended the notion that “good guys with guns” can save us. And please Google “Triangle Shirtwaist Factory” before suggesting schools should have a single entry and exit. But I don’t really expect a good faith argument here. The Protection of Lawful Commerce in Arms Act of 2005 protects gun manufacturers from civil lawsuits resulting from the “misuse” of their products by others. NRA president Wayne LaPierre called it the most significant piece of pro-gun legislation in 20 years. I agree. Let’s roll it back. Holding gun manufacturers once again responsible under the 1972 Consumer Product Safety Act may be the best recourse the public has. 

Finally, gun advocates often make the bad faith argument that “cars are dangerous too, maybe we should ban them.” Well, if Honda decides to start equipping Civics with Mad Max style flamethrowers, then, yes, we must take action. But maybe we can start addressing gun violence in the same manner as we did car fatalities. The formation of the 1970 National Highway Traffic Safety Administration led to a number of improvements and hazard-mitigating regulations in the automotive industry. Motor vehicle casualties have steadily fallen among children and teens. In fact, firearms now surpass vehicular accidents as the number one cause of death in children. It is time to establish a national, safety-driven organization with complete access to all gun-related data. We need to know where to put our resources. Smarter policing? Gun regulations? Improved mental and social services? It is far past time to launch a data-driven campaign to end gun violence. Oh, I almost forgot to mention that I saw that you are having a myriad of financial problems. Sending my thoughts and prayers. 


  1. Nicholas Kristof. Preventing Mass Shootings Like the Vegas Strip Attack. New York Times. Oct 2, 2017. 
  2. Melinda Wenner Moyer. More Guns Do Not Stop More Crimes, Evidence Shows. Scientific American. Oct 1, 2017. 
  3. David Frum. Mass Shootings Don’t Lead to Inaction—They Lead to Loosening Gun Restrictions. The Atlantic. Oct 3, 2017. 
  4. Antonio Cediel, Amber Goodwin, Michael McBride and Ciera Walker. Why Do We Ignore Initiatives That Reduce Gun Violence? New York Times. Oct 6, 2017. 
  5. Ron Elving. The NRA Wasn’t Always Against Gun Restrictions. NPR. Oct 10, 2017.

Malachi Sheahan III, MD, is the chief medical editor of Vascular Specialist. His opinions do not reflect SVS policy or positions.


  1. It is hard NOT to agree vehemently with the statements in this editoral. Dr. Sheahan has done is homework and I am proud that he has taken a stand…but the worse part of the entire editorial is the statement at the end that the “opinions do not reflect SVS policy or position”. My question is WHY NOT? The SVS has for years talked the talk but it has NEVER walked the walk…and now would be a great time for this organization to take the lead and take a stand. As if have heard during the mid-term election advertising, “our legislators have allowed guns to become more valuable than our kids!” To even hear such a statement is unacceptable but in reality, it is hard to refute that concept. We ALL need to take a stand here and stop the epidemic of gun related violence in our country…NOW!!!

  2. Just another anti-gun manifesto, feebly disguised as a “letter” to the NRA to justify it coming from the editor of a “journal”. The premise is completely wrong, but the writing is commendable. Kudos on that.

  3. A well compiled bunch of facts with a clear personal opinion. Congrats to the editor. This issue is certainly made more controversial than it needs to be and a reflection of several issues with the current political climate that is driven by crude ideology rather than well being of the nation as a whole!
    Yes- it is reasonable for SVS and other professional societies to take a stance rather than stay in the sideline to avoid being political….. it is time for the common citizens and professional organization to call ‘ gun as a gun’!

  4. At the end of this editorial, it is stated: “What is the SVS policy or position?” I am asking as an SVS member. Dr. Sheahan’s article is logical, compassionate, and good for families, communities and our nation. A response by SVS leadership would seem to be appropriate if his editorial has value.
    If Dr. Sheahan were running for office, he would have my vote.

    M. Mark Melin, MD, FACS
    Minneapolis, MN

  5. Thank you Dr. Sheahan. We’ll written, thoughtful, factual – could not agree more. This abSolutely SHOULD reflect the position and policy of the SVS.


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