A student perspective on the American Medical Conference
by Destiny Marquez
The phrase “violence as a public health issue” is a recent transformative statement. According to the CDC, thirty years ago, there was rarely a time that the word “violence” was associated with “health.” Thirty years later, it is not only integrated in the same phrase, but it is taught in schools and conferences all over the United States.
Associating violence as a public health issue takes violence out of the realm of politics and frames it in such a way as to force people to view violence as more than crime. In fact, violence is an epidemic, spreading like a virus or an infection. Viewing violence as an infection, it is obvious that those affected most are the poor. Living in environments where there is inadequate education, food, job availability, etc., violence, for many, is viewed as the next step for survival. Like the flu virus which mutates, violence can take any form to sustain itself. Whether it be gun violence, drug wars, theft and burglary, etc., violence is mutated in the individual in a way that will ensure the individual’s survival. With that said, the individual plagued with the violence is not the only one suffering from this public health issue. Community members, family members, and society are similarly affected by this.
How it comes to be that one person can spread violence as if it were, in fact, the Black Plague, may be attributed to many factors. The first is social reproduction. Similar to a parent that carries a recessive allele for a deadly disease, violence is perpetuated throughout the generations. This is reaffirmed by Stephen Ginn, who discusses how “incarceration also causes disability, just like disease, and is passed on to future generations, just like disease” (2012, 1). Though he specifically mentions incarceration, this can be attributed to all types of violence. Another reason that violence is spread is from the idea of ‘reciprocative violence.’ This was actually demonstrated in a video surrounding the organization of CeaseFire and their efforts to intercept violence prior to it spreading to somebody else. Though violence already spreads through communities like wildfire, without organizations such as this, there would be little to no way of extinguishing even some of it. Lastly, society is affected in several ways with the most evident way being through healthcare. It is the hospitals that see the end result of the violence. It is the hospitals that provide the tertiary prevention — prevention meant to ameliorate the harm already done.
Though this is a hot topic already, I speak about it because of my recent experience of hearing a physician speak about his experience of treating violence in the workplace. This past week, I was fortunate enough to hear a physician named Dr. Selwyn Rogers speak about violence as a public health issue at the American Medical Conference in Chicago, Illinois. Enlightening us students with his own perspective on violence, what causes it, and how it affects us in our practice, Dr. Rogers taught us medical students was that being a doctor is more than just saving lives on a hospital bed. It also requires prophylactic measures outside of the hospital. Essentially, Dr. Rogers gave a message of prophylaxis against violence, something that provides the vaccine — if we are still following the infection analogy — against violence.
To give a slight introduction about Dr. Rogers, he is a top trauma surgeon and public health expert at the University of Chicago. With sixteen years of experience under his belt, he has quite the library of stories to speak about. At the conference, he began his discussion by relaying a story of a family who had recently lost a son to gun violence. The man was brought into the hospital but had little time to live. In the waiting room for the man was his mother and a young girl. Dr. Rogers relayed the unfortunate news to the woman and she demanded — against Dr. Rogers recommendation — to let the child see the man. After finally giving in, the mother and child walked into the room. What Dr. Rogers observed was no screaming, no crying, no emotion in a way. When Dr. Rogers asked the woman what gave her such strength, she relayed to him the story of how she lost her other son just a few weeks prior to losing this son. For some reason, it was engrained in her — the violence that would plague her neighborhood and her family.
Sharing this story, Dr. Rogers wanted to let us know that we will encounter violence in our lives; and, we must be proactive towards it. We need prophylaxis against this infectious plague that runs rampant in cities across the country, lowering the life expectancy of individuals within not even 5 miles of each other. We need to take up the fight against violence as healthcare workers, ethicists, politicians, and policymakers. What measures can be taken are primary preventative measures, which Dr. Rogers mentions is medically educating the individuals — reframing the dialogue of violence as this public health issue. Secondary preventative measures should then be pursued if violence seeps through and affects individuals. Finally, what we are all familiar, if one falls susceptible to violence, treating the damage should be undertaken as tertiary prevention.
Hi everyone! My name is Destiny Marquez. I am a first year medical student at Temple and dual degree student in the Master of Urban Bioethics program! Some things about me — I am from Philadelphia, Northwest to be exact. Being from Northwest Philadelphia was a huge impetus for me to join the MAUB because I felt it gave me an opportunity to learn more about the underserved populations that I have been a part of all my life and to assist them in ways that take into consideration numerous aspects of their lives that are not very commonly brought into light. Currently, I am completing a summer course for the MAUB — very interesting, I may add, traveling, doing a bit of research, and will end my summer by participating in a medical service trip over the summer that will help take care of populations in Kerala, India. I hope that I will be able to use some of my knowledge of the Urban Bioethics program to enhance my cultural competence and interactions with them!