The medical community has been no match for the National Rifle Association for decades. By the time Congress leaves town for the holidays, we’ll know if senators have shown an ounce of courage or if the NRA has bagged one more trophy. Either way, we won’t get the high-stakes discussion we need about guns.

At issue is the fate of Dr. Vivek Murthy, nominated over a year ago to be surgeon general but consigned to limbo due to his completely unremarkable view that gun violence is a public health problem. Murthy’s pre-nomination Twitter feed attests to his passion for the tighter gun laws that he, like most doctors, believes would cut down on deaths and injuries. But if Murthy lands the job, don’t expect him to talk about any of that. He told a Senate committee in February that he wouldn’t use the post as a bully pulpit for new gun laws.

So much for the surgeon general’s role as “the nation’s leading spokesman on matters of public health.” And so much for standing up to the NRA.

The group blasted out of the box charging that Murthy supported “radical gun control measures” and would use the office of surgeon general to advance “his pre-existing campaign against gun ownership.” Kentucky Sen. Rand Paul, an ophthalmologist and 2016 presidential prospect, said Murthy would attack the constitutional right to own firearms “under the guise of a public health and safety campaign” and said he would try to block his confirmation.

The 2014 campaign, with its band of skittish red-state Senate Democrats vulnerable to NRA attacks, put Murthy’s future on hold. His pivotal moment — vote? no vote? failed vote? — has finally arrived, and it happens to coincide with the Dec. 14 anniversary of the murder of 26 children and educators at Sandy Hook Elementary School in Newtown, Connecticut. The juxtaposition is illuminating.

One rap against Murthy is that, in Paul’s words, he would encourage doctors to “use their position of trust to ask patients, including minors, details about gun ownership in the home.” To which I say, if only. If only the health professionals who examined and treated Adam Lanza had asked him and his mother those questions and managed to get that home arsenal out of reach before he went on his Sandy Hook rampage two years ago.

Paul also said he was concerned that Murthy considers guns “a public health issue on par with heart disease and has diminished the role of mental health in gun violence.” But in a lengthy study of Adam Lanza’s “psychological deterioration” released last month, Connecticut’s Office of the Child Advocate said repeatedly that guns are the critical factor in mass shootings.

“The conclusion that access to guns drives shooting episodes far more than the presence of mental illness is inescapable. Those countries that have tight gun controls in general experience less overall gun violence and have fewer episodes per capita of mass shootings,” the authors wrote. They said mental illness “plays only a small role” in mass murder while guns, “especially assault weapons with high-capacity magazines,” play a “ubiquitous role.” Widespread access to such weapons and ammunition “is an urgent public health concern,” they wrote.

Medical professionals agree. The American Academy of Pediatrics website lists eight priorities in its federal advocacy section, and No. 1 is “Keeping children safe: Gun violence prevention.” Banning assault weapons is the top item on its state advocacy page. The American Medical Association favors an assault weapons ban and closing loopholes that allow gun buyers to avoid background checks.

Gun safety activists marked the second anniversary of Sandy Hook by releasing a study that found at least 95 school shootings in 33 states have occurred since that tragedy. Sen. Chris Murphy (D-CT) called Congress “complicit in these murders if we continue to sit back and do nothing to reverse this trend.”

There was never a more complicit moment than in April 2013, four months after Sandy Hook, when the Senate tried to pass a bipartisan bill to require background checks online and at gun shows. Supporters needed 60 votes to break a filibuster, and only mustered 54.

Under Senate rules for nominations, Murthy needs only 51 votes. If he prevails, he told senators he’ll focus primarily on obesity, “the defining challenge of our time.” In other words, he’d be another Michelle Obama, who chose obesity as a worthy but relatively non-controversial First Lady cause. He wouldn’t be another C. Everett Koop, the Reagan-era surgeon general who crusaded against tobacco and mailed sexually explicit AIDS information to every household in America.

Restraint could get Murthy confirmed. To make real progress against gun violence, he’d need to channel Koop.

Follow Jill Lawrence on Twitter @JillDLawrence. To find out more about Jill Lawrence and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

Photo: brian.ch via Flickr