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What do you think of when you hear the words, violence prevention?
Seriously, take a second and think about that.
Many of you are probably thinking law enforcement, right?
Well, my hope is that by the end of this talk, healthcare comes into your mind
just as quickly as law enforcement probably did, if not even faster.
So one question that some folks often ask is, why is violence so common?
Violence is a pretty widely agreed upon societal vice.
We all know it's bad and yet, it's everywhere.
According to the FBI's Uniform Crime Reporting Program, in 2016,
there were over 1.2 million violent crimes committed in the US.
Over 17,000 of these resulted in deaths.
Now that's the size of the entire student population here at Stanford.
So it's a fair question.
Why is violence so common?
Let me try and explain with a personal story.
When I was 12, I moved into the Sumner Housing Projects of Brooklyn, New York.
And I was actually really excited about this because there was a basketball court,
right in front of my new apartment.
I've been playing basketball for a while and still wasn't very good but
you see all that would change now because I could practice on this court.
I just remember going up to all my friends and
saying, hey guys, give me about a year practice and I am dunking on everybody.
I was pretty delusional back then, yeah. >> [LAUGH]
>> So one day I was out there on
the court, shooting around and as I said, I was not very good, so
most of those shots missed.
And on one of the misses the ball bounced off the rim and
rolled to the side of the park.
Another kid picks it up and walks off.
So I run up to him and say, hey man, hey, that's my ball!
And he keeps on walking.
And before I know it, I'm surrounded by about 20 other kids,
all with their fists clenched and eyebrows furrowed.
And they were yelling, yo, yo.
What you doing here, Sam?
What you doing here?
Who you with?
I was a fresh-faced, clueless 12 year old kid.
I didn't know what to say.
I got beat up pretty badly that day.
And as I eventually managed to push my way out of the crowd of sneakers and fists and
ran home eyes full of tears, I thought the next time something like this happens,
I need to have something to say.
Who am I with, who can defend me here and that's how you end up befriending some
pretty sketchy characters that introduce you to gangs, guns and before you know it,
you've been fully initiated into the vicious cycle of violence.
I was lucky in that I have an incredible mom.
Whenever I screwed up, she would put me in my place.
It's funny really, I'm a lot taller than my mom.
It didn't matter.
She would stand up on top of a chair if she had to, look down at me screaming at
the top of her lungs to make sure that I stayed on the straight and narrow.
But unfortunately, there are a lot of other folks in these kinds of communities
that don't have that influence and thus end up with this huge issue of violence.
Now I want you all to imagine yourselves growing up in Sumner right along with me.
To help you do that, let's paint a picture.
Sumner is actually a really lively neighborhood.
There are tons of beautiful parks and
trees, little kids running around as they play on pretty much every block.
Now, there is
loud music always blasting from someone's window behind you, barbecues.
You're surrounded by a whole lot of happiness.
But also, a whole lot of violence.
Growing up in Sumner, you saw gangs, drugs, fighting, shooting,
constant policing, the whole night.
Now, imagine the inevitable happens and
[NOISE] you get shot.
What happens next?
Someone calls 911.
An ambulance rushes down, picks you up and
brings you to the nearest emergency department.
There, you're treated, stabilized and
thankfully recovering in your hospital bed.
What do you see around you?
All kinds of tubes sticking in and
out of your body, loud beeping sounds that never seem to stop.
Unfamiliar faces in these bright, white coats coming in and out and in and
out of your room.
What's going through your mind in this moment?
Probably something like, wow, I almost died today.
I may have never seen my parents, siblings, boyfriend, girlfriend, anyone.
Again, I can't go back to this life,
someone, anyone help.
And in that moment,
you are probably more receptive to intervention that you've ever been before.
But that is also a huge window of opportunity that law enforcement just
doesn't have but unfortunately in many incidences these patients are treated and
then send right back to the same violent environment that spurn those injuries in
the first place with no means of preventing recurrence.
So you may be asking okay but what can we actually do for
these folks inside of a hospital?
Well, a lot actually.
I'm here at Standford for an MBA but I'm also a fourth year medical student
at Harvard, while there, I worked with the Violence Recovery Program or
the VRP at the Brigham and Women's Hospital.
The VRP is a hospital based violence prevention program that targets patients
who are victims and perpetrators of violence and provides them with
resources necessary to stop them from coming back to the hospital.
Now, at the VRP, this mainly took the form of counseling but our counselors
are unique in that they each have their own personal experiences with violence.
So often, let me add that that was
In the very same neighborhoods that these patients were from.
So where as more traditional counselors might have been trained at a graduate
program, these folks are trained by life and that enabled them to establish
a much more personal connection with our patients but it doesn't need to end there.
One can imagine, also including things like housing relocation, job training,
legal support, educational support,
really any number of services that would be the most effective for a given patient.
And the beautiful thing is that these services often already exist in
the communities that these patients are from.
And thus all a hospital based program would need to do, would be to connect
these patients to these services during this window of opportunity.
Imagine the impact this could have is skilled.
Now, there are a number of similar programs across the country and
they're all housed under a larger umbrella organization known as the National Network
for Hospital-based Violence Intervention Programs or the NNHVIP.
There are about 32 programs within this network and
they are all doing great work but again, just 32 programs.
There are far more than 32 hospitals in this country and
even more communities that struggle with violence.
Violence is a tremendous issue, according to the CDC, violence is listed
as the second and third leading causes of death among American youth.
Second being suicide and third, homicide.
But that places it higher than any of the more traditional medical disorders
you can probably think of.
Cancer, heart disease, diabetes, all of that.
So, for something that has such a large impact on the health and
mortality of patients.
I find it imperative that we in healthcare address this.
So, I want to ask you all to consider three things.
And before I say that,
I just want to stress this point that violence is a public health issue and
we can't leave it to law enforcement to deal with all alone.
So for those three things.
One, if you're a clinician in the audience or
watching online, if you work in a hospital that serves communities struggling with
violence, consider starting your own violence prevention program.
It could go a long way in improving the overall health of your patient population.
Two, if you're not a clinician, maybe you know one or
a hospital administrator, a policy maker, really any decision maker in this space.
Use those connections and convince those folks to try and
help create more of these programs.
And three, if you're not a clinician and don't know any decision makers,
that's okay too.
At the very least, think back to the question that we started this talk with.
What do you think of when you hear the words violence prevention?
I hope that now,
you can appreciate the impact that healthcare can have in reducing violence.
And the next time you talk about violence prevention,
I hope that healthcare is one of the first things that comes into your mind.
Thank you. >> [APPLAUSE]
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