Daniel Rubin: Drexel program tackles invisible trauma of street violence

August 23, 2010|By Daniel Rubin, Inquirer Columnist
  • John Rich , an internist, is a director of the effort.

Every day, on average, a victim of violence is wheeled into the emergency room at Hahnemann University Hospital. He has been shot or stabbed, jumped or clubbed with a bat.

The odds are that he is young, black, and male and has wounds that run deeper than is apparent. A novel program tries to do something about that ugly fact.

When the patient is stitched up and stabilized, Dionne Delgado goes to work.

Her voice is easy, her questions pointed:

Do you have a safe place to go?

Do you know who did this to you?

Do you want to retaliate?

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It's likely the patient lies to her.

Each patient is in "such an emotional crisis," as the Jamaican-born social worker puts it, that trust is hard to build. So she talks.

She explains about emotional trauma - how when sleep finally comes, nightmares are to be expected, how he may startle easily, and how his heightened anxiety may take a while to quiet.

Her hope is that a relationship begins to grow, one that lasts long after the patient is released. The aim is to treat all wounds, physical and psychic.

The program is called Healing Hurt People, created in late 2007 by Drexel's School of Medicine. Last year it expanded to St. Christopher's Hospital for Children, where such conversations about safety, pain, and reprisal are conducted with about 25 kids a month.

I sat with two of the program's directors one day last week - Ted Corbin, an emergency medicine physician who grew up in Yeadon, and John Rich, an internist and MacArthur Award recipient who grew up in Flushing, Queens.

"We treat them, we 'street' them - that's pretty much what we did in my residency" in Washington, Corbin said. "But there's also a sense of responsibility we have as health-care providers that we don't want them to come back."

The problem is, they often do come back. Rich spent hundreds of hours following 20 young African American men for a project that became Wrong Place, Wrong Time, published by Johns Hopkins Press last year.

In it, he writes about a conversation with a doctor friend at Boston City Hospital. The friend had saved a man who had been shot. Now the man had been shot again. This time he died.

"We need to do something," the friend said. "These guys just sit up here in the hospital for days recovering. They literally do nothing! They just lie there in the bed. Someone needs to talk to them."

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