Deadly Resentment: The Grudge Motive and Murder of Medical Professionals

The Prevalence of Medical-Related Shootings

Despite the increasing risk of violence that health care workers face, there is limited research and data on how to resolve this grave issue. Violence in health care settings is believed to go unreported in 70% of instances, leading to escalating incidents in the future and exacerbating the problem of limited data being available, states Phillips. Without data, finding ways to effectively decrease shootings with a grudge motive is nearly impossible.

Following a hospital shooting, personnel tend to pressure administrations to install metal detectors to prevent weapons coming into hospitals. However, the study by Johns Hopkins University concludes that fewer than half of weapons used inside hospital shootings would have been detected this way. People coming into and going out of hospitals cannot feasibly be restricted to just one or two portals. Data by the study shows that armed guards throughout hospitals, including those manning metal detectors, are sometimes the very source of weaponry used in shootings, having their guns taken right from their holsters by the shooters.

Profiling Grudge-Based Healthcare Shootings

Healthcare-related shootings with (and without) a grudge motive are difficult to profile. Most involve a determined shooter against a specific target; hence, a motive classification as one of the main reasons for these shootings must be deduced. Because of this, cities and towns with higher rates of violence are at no increased risk compared to lower-crime areas. Impenetrable hospital security in an open society represents a complex, almost unworkable challenge, and zero risk just does not seem achievable. ³

In addition, the unpredictable nature of this type of event presents unreliable warning signs and undetectable precursors of an impending shooting; there is no way to accurately predict them. Hence, the situation hinders effective deterrence practices not only because most perpetrators seemed “normal” and proved to be determined, but also because a significant number of shootings occur outside of hospitals. [Ann Emerg Med. 2012.]

In this recent case involving Pappas and Dr. Hausknecht, it isn’t clear why the suspected shooter chose to act so many years after the death of his mother.

“Never underestimate how deeply people care about and feel the loss of a loved one,” explains Edward Poa, a forensic psychiatrist at The Menninger Clinic. “If they blame someone for that loss, they can really want retribution, an eye-for-an-eye sort of thing. They can see their act as righting a wrong.”

Dr. Douglas Curran, President of the Texas Medical Association adds, “Sometimes the hardest part of our job isn’t diagnosing or treating the disease but communicating the gravity of the patient’s circumstances. It’s a struggle. Loved ones can have a hard time comprehending that we can’t fix everybody.”

¹ https://www.hasc.org/sites/main/files/03-hos1_0.pdf

² From the Johns Hopkins Office of Critical Event Preparedness and Response, Johns Hopkins Institutions, Baltimore, MD (Kelen, Catlett); the National Center for the Study of Preparedness and Catastrophic Event Response, Johns Hopkins University, Baltimore, MD (Kelen, Catlett, Hsieh); and the Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (Kelen, Catlett, Kubit, Hsieh).

³ Joint Commission. Sentinel event alert. Preventing violence in the health care setting. 2010;45:June 3. Available at: http:// www.jointcommission.org/assets/1/18/SEA_45.PDF.