Posted by Brigham and Women's Hospital May 2, 2012
It started on a July Fourth weekend, when a 17-year-old who had been shot in the neck a few days earlier returned to the hospital with a bullet in his stomach. “That’s when I knew there was something wrong with the system,” recalls Dr. Selwyn Rogers, now chief of the Brigham and Women’s Hospital Division of Trauma, Burn, and Critical Care Surgery.
The problem, Rogers realized, is that violence – whether experienced as the victim or the aggressor – needs to be addressed as a disease. “For diabetes, you take insulin and glucose every day, not just when you don’t feel well,” Rogers notes. “We find ways to manage other diseases and prevent them – we need to work with victims of violence in the same way.”
That’s where David Crump – a Boston streetworker who has worked throughout his career to support victims of gang-related and other forms of violence – comes in. Last fall BWH recruited Crump to help launch a new Violence Intervention and Prevention Program.
“We want to support patients who are affected by violence and figure out how we can prevent them from winding up in the hospital again,” says Crump, who meets with victims of violence as they are treated, opening up a dialogue about their situations and connecting them with psychological support and resources in the community.
“Some victims of violence are simply in the wrong place at the wrong time,” says Crump. “Some are not, but our place is not to judge, it’s to help them heal and break the cycle of violence.”
The program is a collaboration between BWH’s Division of Trauma, Burn, and Critical Care Surgery and Center for Community Health and Health Equity, which addresses health issues within Boston neighborhoods, including violence – the leading cause of death for black and Latino men between the ages of 15 and 35. While Crump works with patients in the hospital, Samantha Wright Calero, a violence intervention specialist, develops programs to educate youth in the community about healthy relationships and domestic violence, and she connects them with the BWH Passageway program.
Crump meets with patients who are victims of violence within 72 hours of their admission, or what was coined by another trauma physician as the “second golden hour” for trauma patients.
“The first golden hour is responding to these patients medically within an hour to save their life,” notes Mardi Chadwick, director of the Violence Intervention and Prevention Program. “The second golden hour refers to the fact that people are more likely to be open to changing the factors in their lifestyle that made them susceptible to this injury. If we can reach them within three days, we have a greater opportunity to help them.”
Already, Rogers has noticed a change in the way clinicians discuss patients who are victims of violence. “On rounds, we had a group of care providers talking about how we could get a patient to a situation where he would be safe,” notes Rogers. “David [Crump] wasn’t even there – these were direct care providers thinking about the care of this patient in a transformative way. This program has already changed our dialogue about these patients.”
– Linda W, Liz M