Yesterday, a gunman killed 19 children at an elementary school in Uvalde, Texas.

I have no words to express my condolences to the families who lost children to this atrocity.

I have no words to express my inability to understand why this is just the latest in a string of school shootings, not to minimize the non-school, mass shootings that occurred in other locations in the US as well.

I have no words to express my concern and sadness over this senseless loss of life.

I have no words to express my feelings any more eloquently than anyone else who has commented on this incomprehensible event that is yet another dark day in our nation’s history.

As a pediatrician and pediatric intensivist, I have been charged to protect the lives of children.

I have been trained, and continue to learn, how to protect children from all manners and severities of infections, treat children’s breathing problems during episodes of acute asthma exacerbations, support infants’ hearts before and after congenital heart surgery repairs, and manage any number of other acute medical issues that should arise in the pediatric population.

Yet, I cannot prevent or protect children from what harm comes to them by intentional acts of violence.

Unfortunately, I have seen more than my share of non-accidental traumas from child abuse in the pediatric intensive care unit during my career.

However, gun violence seems to raise the degree of senseless childhood suffering and death to a new level.

From a pure medical perspective, gun violence has a direct and indirect impact on children.

The direct impact is the obvious loss of life and physical trauma that is inflicted.

In 2020, firearm-related injuries became the leading cause of death in the US for children and adolescents.

The article states, “This change was driven largely by firearm homicides, which saw a 33.4% increase in the crude rate from 2019 to 2020…”

However, if one thinks that physical trauma and death are the only health issues on the table for children, one would be sorely mistaken. Another toll that community gun violence takes is on the mental health of children. One cannot overlook the anxiety and depression that are fueled by children wondering if they are going to be the next school shooting victims.

This is likely only reinforced by protective measures, such as school shooter drills and armed security, that are meant to safeguard them. But, drills and security may have the unintended effect of reminding children of what they fear and the terror that they have witnessed in-person or through news reports. I am in complete support of these safeguards, but deeply regret that they are required.

The direct and indirect impact of gun violence against children seems out of the control of many and, for this, I am appreciative of those people and organizations that seek to effect change.

I am grateful for how my professional organization, The American Academy of Pediatrics, directly advocates for policy changes to protect children from gun violence.

Yesterday, the president of the American Academy of Pediatrics published a statement on the recent gun violence in Uvalde. Dr. Moira Szilagyi stated that, “We should not grow accustomed to these acts of gun violence.”

I couldn’t agree more.

But, for whatever reason, the string of senseless shootings is viewed as just another news story and is as routine as watching cars drive by on a busy street.

We have become accustomed to gun violence and, unfortunately, it is likely to continue unless real changes are instituted.

While I have no words for much of the incomprehensible violence related to these school shootings, I do have words to reflect that it is not acceptable and we need to do better to keep our children safe from gun violence.