He’s 78 now – an age when most successful surgeons are sitting back, enjoying what’s left of the good life and leaving it to the younger docs to treat whatever ails the world around them.

Not Bob McAfee.

“When a hollow-point bullet crashes into soft tissue, it explodes into the tiniest little sharp pieces imaginable,” McAfee told a rapt audience of 150 fellow physicians, residents and medical students Thursday morning at Maine Medical Center in Portland.

He was just getting warmed up.

“And as you run your finger around (inside the wound), even though it’s double-gloves in the O.R., I guarantee you will penetrate both gloves — and end up sharing blood with a population that has a higher-than-normal incidence of blood-borne disease.”

No, this hour-long lecture wasn’t some dry recitation of the do’s and don’ts for treating gunshot wounds. McAfee, a former president of the American Medical Association who was an attending surgeon at Maine Medical Center for 31 years, had something more far-reaching in mind.

The title of his lecture: “Families, Firearms, Films and Physicians.”

The message behind it: If ever there was a public health crisis facing this community, this state and this nation, it is the culture of violence that deposits a dizzying array of patients at the doorstep of our health care system day … after day … after day …

“Like any public-health problem, you identify it, you treat it,” said McAfee, who hasn’t stopped pushing back against societal violence since he made it his signature issue with the AMA way back in 1994. “But most importantly, you prevent it in the first place.”

His targets over the 60-minute presentation were many – from a film industry that desensitizes all of us (especially young children) to violence, to a medical community that must embrace its role as a safe and trusted haven for victims of domestic abuse and other forms of violence.

(McAfee recalled routinely asking one female patient — “a member of a very affluent part of the Greater Portland community” — if she had experienced any violence in her life. After a long pause, she told him, “I thought I was hiding it better.”)

But most of all, McAfee came to talk about guns.

“We the people of the United States of America, in order to form a more perfect union, will manage to kill 31,000 people by firearms this year in this country,” he said. “Nineteen thousand of them will be by suicide.”

Cribbing from the preamble to the U.S. Constitution to make a political point? Who but the National Rifle Association would dare such sacrilege?

A doctor who calls the NRA “a perpetrator and ambassador of fear and intimidation and a shill for the gun manufacturers of this country” and maintains, without apology, that the Bushmaster assault rifle that was used in the massacre at Newtown “has no place in civilian society.”

A doctor who now looks back on Newtown and wonders, loudly and publicly, “Will it be another Pearl Harbor and awaken us to what’s going on? Or will it be just another day in America?”

A doctor who held up the latest copy of the weekly classified publication Uncle Henry’s, flipped through the 13 pages containing hundreds of (no-background-check-required) firearms ads and unabashedly declared Maine “the gun-running state of the Northeast.”

“We’ve gone to the people at Uncle Henry’s,” McAfee said, “and they have no intention of stopping this very lucrative part of their business.”

McAfee has lived in Maine a long time — he began his surgical residency at Maine Medical Center in 1965. A hunter himself, he owns a a single-barrel, pump-action shotgun and a .30-30, lever-action deer-hunting rifle.

That said, McAfee has grown accustomed to howls of indignation (see the online reader comments at the bottom of this column) not from average gun owners like himself, but from that special breed of Second Amendment zealot “whose waking hours are dominated by fear.”

“Fear of being shot,” he continued. “Fear of not being macho enough without the newest firepower. Fear of having their gun confiscated by our government.”

He also foresees all-out political warfare in the coming weeks as 30 or so bills involving firearms come up for legislative hearings in Augusta. A founding member of Maine Citizens Against Handgun Violence, McAfee has his hopes pinned on legislation that would at least expand background checks to include private gun sales and outlaw high-capacity magazines like the six (each with 30 rounds) that Adam Lanza used on Dec. 14 to mow down the schoolchildren and teachers in Newtown.

“You’re welcome to come up and testify,” he told the roomful of young healers. “It will be a busy time.”

Talk about preventive medicine. If the next generation of surgeons and emergency room doctors isn’t qualified to speak to the consequences, intended or not, of this country’s gun mania, then who is?

And if they can’t convince lawmakers it’s far better to prevent a gunshot wound than to treat one, who will?

That, concluded McAfee, is where the rest of us come in.

Reaching back almost 2,500 years to the Peloponnesian War in ancient Greece, McAfee told of the combat-weary soldiers who one day asked the historian and philosopher Thucydides if, after decades of war, peace and justice would ever come to Athens.

Replied Thucydides, “Justice will not come to Athens until those who are not injured are as indignant as those who are.”

“It’s so appropriate today to ask the same question,” McAfee said. “I hope, because of Newtown, that more of us are indeed indignant.”

And, just like the good doctor, not afraid to say so.

Bill Nemitz can be contacted at 791-6323 or at:

bnemitz@pressherald.com