What We've Become

Finalist for the Tennessee Book Awards

A New York Times Book Review Editors’ Choice

A Kirkus Reviews Best Book of the Year


“We need this book now!” —Michael Eric Dyson, New York Times best-selling author of Tears We Cannot Stop: A Sermon to White America


A searing reflection on the broken promise of safety in America.


When a naked, mentally ill white man with an AR-15 killed four young adults of color at a Waffle House, Nashville-based physician and gun policy scholar Dr. Jonathan M. Metzl once again advocated for commonsense gun reform. But as he peeled back evidence surrounding the racially charged mass shooting, a shocking question emerged: Did the public health approach he had championed for years have it all wrong?

Long at the forefront of a movement advocating for gun reform as a matter of public health, Metzl has been on constant media call in the aftermath of fatal shootings. But the 2018 Nashville killings led him on a path toward recognizing the limitations of biomedical frameworks for fully diagnosing or treating the impassioned complexities of American gun politics. As he came to understand it, public health is a harder sell in a nation that fundamentally disagrees about what it means to be safe, healthy, or free.

In What We’ve Become, Metzl reckons both with the long history of distrust of public health and the larger forces—social, ideological, historical, racial, and political—that allow mass shootings to occur on a near daily basis in America. Looking closely at the cycle in which mass shootings lead to shock, horror, calls for action, and, ultimately, political gridlock, he explores what happens to the soul of a nation—and the meanings of safety and community—when we normalize violence as an acceptable trade-off for freedom. Mass shootings and our inability to stop them have become more than horrific crimes: they are an American national autobiography.

This brilliant, piercing analysis points to mass shootings as a symptom of our most unresolved national conflicts. What We’ve Become ultimately sets us on the path of alliance forging, racial reckoning, and political power brokering we must take to put things right.