Killing Fields

Ali Madeeh Hashmi, despite years of practicing psychiatry in the United States, struggles to come to terms with mass shootings

Killing Fields
“Things fall apart; the center cannot hold
Mere anarchy is loosed upon the world/and everywhere, the ceremony of innocence is drowned.”
(The Second Coming by William Butler Yeats)

It was March 1998 and I had been living in Houston, Texas, for almost four years. My psychiatric training was coming to a close and I had recently signed up for a job in a small town in Arkansas. The salary was considerably more than I had ever made in my life and I was happy that my long years of medical training were finally coming to an end. I could now officially begin my medical career as a psychiatrist. One evening a friend called me and asked “Where did you say you were going to go work again?” “Jonesboro, Arkansas” I replied. Jonesboro is a small farming town in northeast Arkansas, straddling the border of three states: Arkansas, Tennessee and Missouri. The town is located in what is called the Arkansas ‘delta’ (or Mississippi delta) – a flat plain located between the Mississippi and Yazoo rivers. This area had originally been forest land but in the hundred or so years before the American Civil War (1861-1865), it had been developed (mostly by black slaves) into one of the most fertile cotton-growing areas in the country. Jonesboro was the largest city of Arkansas in this area and in 1998 its population was around 50,000. The area was surrounded by lush cotton, rice and soya bean fields for hundreds of miles. I had never lived in a rural area before. From Lahore I had moved to Houston and when I was interviewed in Jonesboro for the job, I was not really sure how I would like living there. But my prospective employers were very eager to have me: they were in desperate need of more psychiatrists. They offered me a good salary and I said ‘yes’. Now, a few months later, my friend sounded really alarmed

“Turn on the TV” she said. I did and saw news flashes of Jonesboro with the words ‘School shooting in Arkansas town’ across the screen. The details when they emerged were harrowing. Two very young boys (11 and 13 at the time) had lured their fellow students and teachers out of the school building by pulling a fire alarm and as they streamed out of the building, started shooting them. They eventually killed four students and a teacher and wounded ten others.

The shooters from Jonesboro, where the author worked as a psychiatrist


This was in the years before school shootings had become so commonplace that they barely even registered with most people unless it was in their own community. When I saw the news, I was taken aback. What I was seeing on the television and hearing in the news just did not seem to align with the calm, laidback rural town that I had visited just a few months before. I called my employers and asked if anyone in our clinic had been directly affected by the shooting and thankfully the answer was ‘no’. But I couldn’t help wondering what I had gotten myself into “How can I go to that place?” I thought. “They’re killing children there.” I also wondered how to break the news to my wife of 4 months who had just arrived in the US.

All of these memories came rushing back when I saw the news of the latest school shooting in Florida. Shootings in schools and public places in America have now become so commonplace that it hardly even surprises anyone. Only the most vicious ones stand out in people’s memory: Columbine, Virginia Tech, Sandy Hook and now the most recent one in Florida. After saying a silent prayer for the victims and (once again) giving thanks that none of my children were studying in a US school or college, I started marveling, once again, about the extent of the denial that exists in America about this phenomenon. Following a mass shooting, there is a familiar pattern: outpourings of grief and sympathy about the victims, revulsion and anger towards the killer(s), speeches by politicians on ‘healing’ and ‘coming together’, warnings about not using the event for ‘politics’, musings on the nature of ‘evil’ etc and finally ‘thoughts and prayers’ before everyone moves on to something else.

There is also discussion about increasing policing and law enforcement in schools and some discussion about mental health services for survivors and families, but generally, no mention of any of the fundamental reasons for such depraved acts.


I did see many of the survivors of the attack, including the principal of the school where the massacre took place - a broken, devastated man whose life effectively ended on that day

While massacres happen everywhere in the world, the US is unique in that such acts are usually not perpetrated for political or ideological reasons (such as the Beslan school massacre in Russia or the Army Public School attack in Peshawar). Most of the school shootings (and other public shootings in the USA such as the Las Vegas concert shooting in 2017 which killed 58 people) are perpetrated by either solitary individuals, sometimes with a mental health history or occasionally by a pair of equally disturbed individuals. Many times (it later emerges), there were warning signs that were ignored at the time. Sometimes the individual has a history of mental health treatment which did not do what it was supposed to do. In every case – owing to the USA’s peculiar fascination with owning guns, the powerful gun lobby and laws protecting gun ownership – the shooter has easy access to massive amounts of weapons and ammunition including military-grade automatic weapons. In many cases, especially in cases of school- or college-age shooters, the perpetrators have been conditioned to kill by years of playing violent video games which essentially condition a person to shoot people without hesitation. The social factors which drive such individuals to a state where they commit mass murder also remain untouched: broken families and communities, lack of affordable housing and educational opportunities, a lack of jobs for young people which pay a livable wage, especially for those who do not have a college education, communities ravaged by alcohol and drug abuse and a never-ending culture of glorification of the military and war as the US lurches from one military adventure to the next. Already, the ‘war’ in Afghanistan (actually the occupation of Kabul by US forces) is close to becoming America’s longest military adventure after Vietnam. It’s ironic that as America lays waste to country after country from Iraq to Syria to Afghanistan to Yemen and prepares to confront North Korea and maybe Iran, its own schools, colleges and public places are becoming killing fields – proving the old American maxim: what goes around comes around.

I spent 12 years in Jonesboro before we came back to Lahore. Thankfully  there was never another school shooting there although, in my work as a psychiatrist, I did see many of the survivors of the attack, including the principal of the school where the massacre took place – a broken, devastated man whose life effectively ended on that day.

Every time I hear of another such incident, I do think, though, about that day 20 years ago and wonder when America will wake up and put an end to its nightmare.

The writer is a psychiatrist practicing in Lahore. He taught and practiced psychiatry in the United States for 16 years. He tweets at @Ali_Madeeh