Early intervention turns some from violent ways

November 27, 2005|By C. FRASER SMITH

A few floors below the soaring atrium lobby, you will find - if you are a skilled navigator of large institutional buildings - the University of Maryland Hospital's Violence Intervention Program.

Location may be a symbolic statement. The community may not wish to contemplate who goes down there.

But VIP probably would not be going on at all without caring commitment from the hospital. So it's time for the city and state to look hard at what's being learned at VIP to see if any of it can be expanded. The violent death rate among Baltimore children will continue, if we let it.

We might think of work being done in this subterranean labyrinth as investigative social work. In pursuit of its major objective - saving lives - the VIP staff is looking for a new language, a way to communicate with young people bent on a destructive, if not fatal, way of life.

For several years, under the supervision of Dawn Eslinger, director of the program since it started, and Dr. Carnell Cooper, a shock trauma surgeon, the VIP team has been working with repeat gunshot wound victims. They've been shot on the streets of Baltimore, not once, but two, three or four times.

Before the war in Iraq, Baltimore was one of the places U.S. Army surgeons came for training in the treatment of gunshot trauma. Some of the hospital's permanent surgical staff literally recognized their handiwork - stitching they'd done - on the patients in front of them.

A thought occurred to these healers: Maybe a new direction could be urged on people while they're close to the pain they've inflicted on themselves.

VIP finds encouraging results as well as harsh reality.

The pain of a wound subsides quickly. In its place comes fatalism: "`It's just a cost of doing business. What I have to go through in my line of work' - we hear this all the time in our group therapy meetings," said George Stallings, who tries to connect kids with healthy alternatives to street life.

That violent computer games stimulate violent behavior is unarguable for these front-line workers. There is no debate about freedom of expression because the consequences seem too obvious to deny.

"They play these games, they watch TV and they go out and live the life they've been seeing" on the screen, says Sharon Moore, one of the counselors who helps persuade young people to get in the VIP program.

At the same time, they are often so young and so oddly innocent that they don't absorb what has happened to them. "Some are remorseful," said Vikki Logan, the program's clinical director. "Some are bitter that they got shot. Some are fearful of what may happen next. And they're shocked. This couldn't have happened to me."

It's a lesson to be studied, not turned away from. And the program's results - data collected over the last three years - suggest that intervention saves lives. Measured against a control group that got no help, those who accept the intervention have been wounded far less often.

"Eighty percent of our group got jobs vs. 16 percent of the control group," Dr. Cooper says. "Two of our group were back in the hospital [for gunshot wounds] but 20 of theirs came back and a couple were murdered."

"We don't have rose-colored glasses," he says. "Some of these guys are beyond us. But a significant number want to move forward."

Dr. Cooper and his team know they're not working with people who can expect a lot of sympathy. So they offer the pragmatic facts: Virtually 100 percent of the patients are uninsured. And the care of one high school senior on his way to college with a music scholarship who was shot during a robbery? It cost him a year of his life and cost taxpayers nearly a half million dollars.

So far, the VIP data shows that intervention much earlier would be better. The game of changing lives can be over before VIP or the surgeons arrive.

It's a high burnout occupation, but the VIP team continues because some young kids get it.

"I thought about retaliating but I worried about what you would think," one young man told Ms. Eslinger, the director. The program asks its participants to "Think - For a Change."

Public officials, city and state, might consider the same advice.

C. Fraser Smith is senior news analyst for WYPR-FM. His column appears Sundays. His e-mail is fsmith@wypr.org.

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