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I’ll be the first to admit, National Rifle Association, that your “stay in your lane” tweet about doctors not consulting you is correct. I did not stop to consult you the last time I had someone bleeding out from gunshot wounds on the stretcher in front of me. Before his arrival, I’d been far too preoccupied listening to the overhead alert from the emergency medical service: “Young male. Unknown age. Multiple gunshot wounds. Heavy bleeding. Becoming less responsive. Other victim on scene already pronounced dead. ETA, 3 minutes.” (Christopher Lee Bennett, 11/14)

Recent history shows that mass killings in the U.S. don’t follow a single script. But there is one common element shared by many of these tragedies: legal access to semiautomatic guns.Domestic terrorists such as the mass shooters in Thousand Oaks, Pittsburgh and Parkland, Fla., come from different demographic backgrounds and have different characteristics. Few reforms are likely to stop them all.i But all three killers used semiautomatic guns, which research has shown are more lethal on average in terrorist attacks than explosives or other weapons. And all three managed to kill and injure more people than the terrorist who mailed homemade pipe bombs to high-profile targets in October. (Benjamin Bahney, 11/15)

Perhaps the most important effect of viewing the opioid crisis as a multigenerational ecological disaster is that it offers a series of useful guidelines. In the litigation against BP after the Deepwater Horizon oil spill, for example, we saw corporate accountability. Although steps toward corporate accountability for the opioid disaster are now underway in some states, where litigation is being pursued against opioid manufacturers, we should support a broader understanding of accountability, one that holds drug makers responsible for developing new, non-opioid treatments for acute and chronic pain. (Maia Dolphin-Krute, 11/15)

Although SUPPORT is a step in the right direction, substantially altering the trajectory of the opioid epidemic requires a comprehensive, integrated, and public health–oriented response coordinated throughout all branches and levels of government. Every dollar spent on incarcerating a person who uses drugs is a dollar that is not spent on prevention or treatment, and every person removed from the Medicaid rolls is a person who is unable to receive evidence-based care. We have the tools and knowledge to reverse the unprecedented, and largely preventable, avalanche of overdose-related morbidity and mortality. The question is not how to end the crisis of opioid-related harm but whether we will choose to mount an effective, evidence-based, and equity-focused response. The lives of thousands of people depend on the answer. (Corey S. Davis, 11/14)

As anyone who’s gone on a diet knows, once you lose some weight, it gets harder to lose more. The “eat less, move more” mantra, as simple as it sounds, doesn’t help us deal with our bodies’ metabolic reality: As we shed pounds, we get even hungrier and our metabolism slows down. But findings from a new study I led with my colleague Cara Ebbeling suggests that what we eat — not just how much — has a substantial effect on our metabolism and thus how much weight we gain or lose. (David S. Ludwig, 11/14)

Despite an increasing emphasis on patient-centered outcomes in medicine, transplant centers do not systematically report information on health-related quality of life, nor are such measures incorporated into algorithms for organ allocation or program assessment. (Daniela J. Lamas, M.D., Joshua R. Lakin, M.D., Anil J. Trindade, Andrew Courtwright and Hilary Goldberg, 11/14)

A society is — or should be — judged by how well it protects its most vulnerable citizens. But when it comes to protections for those with intellectual and developmental disabilities, Massachusetts still has a long way to go. And by every statistic available, the problem of physical and sexual abuse is growing worse with every passing year. (11/14)

In our first Case Study in Social Medicine, a man presents to the emergency department reporting auditory hallucinations and suicidal thoughts. His case hinges on interpretations of whether his problems are medical in nature and within medical institutions’ scope of practice. (Joel T. Braslow and Luke Messac, 11/14)