By Alexa P. Soult, MD –
For a trauma surgeon, one of the worst feelings is to see the victim of a shooting, stabbing, sexual assault or domestic violence incident return with similar injuries – sometimes on several occasions.
Thankfully, efforts are growing nationwide to involve physicians and hospitals in violence prevention and community outreach programs. Those aim to improve public safety and long-term health outcomes for patients by breaking dangerous cycles of violence.
Locally, Sentara Norfolk General and Sentara CarePlex hospitals are part of a Hospital-based Violence Intervention (HVIP) grant initiative from the Virginia Department of Criminal Justice Services, in hopes of helping our patients see that they can change their lives.
Such programs add specially-trained therapists, medical social workers and nurses to connect hospitalized patients with educational opportunities, job training, counseling and support groups, youth organizations, or other needed resources after they go home.
HVIP also encourages community-based partnerships to teach de-escalation techniques, anger management skills, and alternatives to violence at churches, schools and other gathering spots, especially places that attract teenagers and young adults.
Physicians at all levels of care can be part of this complex effort. For pediatricians and primary care providers, for example, violence prevention would be a beneficial addition to routine screenings that already incorporate topics such as substance abuse and mental health.
A few possible questions to get young patients talking: How safe do you feel at home? Is there a gun in your house, or do you know of a friend who has a gun? Are there any needs you have that aren’t being met?
Existing initiatives such as “Stop the Bleed” from the American College of Surgeons, which teaches laypersons to control life-threatening bleeding, could be another opening for dialogue on violence prevention. The American Psychological Association also publishes information on warning signs of youth violence that would be useful for any physician to review.
This will not be a quick or easy fix, as exposure to violence – whether involving a stranger, acquaintance, friend, intimate partner, or family member – unfortunately has become very prevalent in our communities, regardless of income level.
To give one local snapshot, SNGH’s Level 1 trauma program treated more than 570 injuries from violent acts from June 2019 to June 2020. Gun violence is now the second-leading cause of death among American children and adolescents, trailing only car accidents.
As a Hampton Roads native who spent five years as an EVMS Surgery resident and another year doing Trauma and Critical Care in Chicago, I feel strongly that health care providers should be regularly involved in discussions on prevention moving forward.
Patients are lucky to survive even one violent episode. Part of trying to heal them should be doing whatever we can to keep them from facing such steep odds again – or from considering the threat of trauma a “normal” part of life.
Dr. Soult is an Assistant Professor of Surgery at Eastern Virginia Medical School and recently completed a trauma critical care fellowship at the John H. Stroger, Jr. Hospital of Cook County in Chicago. evms.edu