I've been able to  bring insight and perspective to the task force  gained from doing the work we do in our individual hospital based programs, and our collective efforts and  work in the NNHVIP. When I have shared the work and mission of the network and what we see in our programs, task force members seem fascinated by it. I've been able to articulate the importance of looking at violence from a bird's eye view-then making a 360 degree intervention, assessing individual victims and addressing everything that has contributed to their present state, and determining what will be necessary for them to heal and move forward. This includes family, education, mental health, life skills, employment, etc.  You have to analyze every single component. For example, when a victim comes in [to the ED] with a stab wound we do a needs assessment to determine what is going on, and then we address the needs we have identified. But if you send the victim back to the same environment that bred the situation, nothing will change.  There would be nothing to support and nurture new life skills learned by the  victiim. A 360-degree intervention includes working with parents, and whoever is in the victim's life to provide them with services as well.

We've heard nine or ten year-olds talking about what they want their shrines to look like. Other kids think about school and about college, but some of the children that come into the ED think that death or injury is in their life trajectory. Lately I've started paying attention to tattoos. They tell a story about [the patient's] trajectory-"Living is hard, dying is easy" or "Born to be hated, dying to be loved". One can imagine a connection between that tattoo and who that person was at nine years old, and what happened as they developed a perspective about life over the years.

I've been able to bring that kind of perspective [to the task force] about defending children from exposure to violence, but I also try to convey that it is not some impossible, unknowable thing. Just as you have negative influences in a community you have things like schools and hospitals that can screen kids from the very beginning. There could be mandatory programs like ours working and mentoring with every kid that comes in who has been shot or stabbed.