Wrong Place, Wrong Time

Marian Wright Edelman, President of the Children's Defense Fund, is part of Change.org's Changemakers network, comprised of leading voices for social change.

When young black men are the victims of violent injuries in urban neighborhoods, what happens next? This question haunted Dr. John Rich, a Harvard, Dartmouth and Duke-educated primary care doctor at Boston Medical Center. In addition to his work at Boston Medical Center, Dr. Rich was the founder of the city's Young Men's Health Clinic. Both locations brought him in constant contact with young men who were victims of violence. But as a black doctor dealing with the aftermath of violence in young black men day after day, Dr. Rich wasn't satisfied to simply treat their physical scars. He wanted to know about more than just the medical effects of the gunshot and knife wounds he was seeing. He wanted to understand their emotional and psychological impact.

Dr. Rich and his colleagues kept asking themselves why they were seeing so many victims of violence and what they could do to try to break the cycle. To find out, Dr. Rich began interviewing young men in the hospital as they were recovering from their injuries -- often following up after they returned home and sometimes staying in touch for months or years. These stories and their lessons are shared in his powerful new book, Wrong Place, Wrong Time: Trauma and Violence in the Lives of Young Black Men.

In the book's preface, he explains that though violent murders often grab headlines, with violence, deaths are only "the tip of the iceberg." The Centers for Disease Control and Prevention, for example, estimates that for every homicide, there are about 100 nonfatal violent incidents. According to Dr. Rich, studies find that as deadly as guns are, "for every person who gets shot and dies, another four get shot and survive." And yet society doesn't pay much attention to these surviving victims, or the impact of violence on their communities.

When Dr. Rich started collecting his patients' stories, he realized that although little research had been done on trauma affecting young black victims of violence, their experiences were mirrored the kinds of traumatized behavior shared by groups like rape survivors and soldiers returning from combat. These behavior patterns include hyper-vigilance and the constant feeling of being in danger; being unable to feel at all and exposing themselves to more danger in an attempt to feel something; returning to danger to prove to themselves they had mastered their fears; or using alcohol or drugs to try to ease pain. It became painfully easy to connect the dots and see how these common responses to trauma play out in the lives of many survivors of inner-city violence -- and why, in many cases, they lead to more violence. Particularly when many survivors are concentrated in a single area, it's also clear how these cycles of trauma and violence repeat themselves and infect that entire community.

Dr. Rich also came to understand more about why violence made sense to some of the patients he was treating. One epiphany occurred after 17-year-old Jimmy explained that his friends were anxious to have some sort of "rep," purely "to be known. People don't like to be nobodies these days...." As Dr. Rich realized, sometimes, violence isn't as senseless as it seems: "Jimmy's argument, when I laid it out front of me, told me that violence made sense to him. Violence worked in his world to accomplish something that all of us wanted -- to be somebody -- but that Jimmy could not find any other way to do."

Dr. Rich believes we all need to better understand why young men like these are getting caught up in the cycle of violence -- not to excuse their behavior, but to help change it. He is now the Director of the Center for Nonviolence and Social Justice and Professor and Chair of Health Management and Policy at Philadelphia's Drexel University School of Public Health. The Center's goal is to change the dialogue about violence -- away from "blame and dehumanization" and toward a language of "injury and healing." The Center's goal is to help health, mental health, juvenile justice and education systems understand the relationship between trauma and violence, as well as the critical role healing plays in serving young people. For example, one key program reaches out to injured youths through the Philadelphia emergency department. The program pairs them with professionals who can help with their trauma, as well as a community outreach worker who helps with basic needs like enrolling in school or getting a job.

The program has now been so successful that it's starting to be replicated in other cities. In 2006, Dr. Rich's work on these issues was recognized with a much-deserved MacArthur Foundation "Genius Grant" Fellowship. Scholar-practitioners like him are helping find the answers we urgently need to better understand the cycle of violence and save our children from being its next victims.

Photo credit: Gideon Tsang