Skills & Science of Doctoring
By now images of horror and shock like the one of students and teachers crying at Buell Elementary have become all-too-common. As we reel once again from the terrible thought that an innocent life has been taken and it was a child who pulled the trigger, we should be vigilant for the next event, which is becoming equally predictable… As public health professionals, we are trained to ask important questions so we can treat both the symptoms and root causes of a sickness. We will give a child medicine for a fever, but also antibiotics for the microorganism causing the illness. The question to ask when diagnosing this tragedy is a simple one: Where did a seven-year-old boy get a loaded gun? (“Physicians”)
Many physicians feel that they do not have a direct influence on preventing violence. Yet, as patient advocates, it is often physicians who have the best opportunity to intercede on the behalf of patients in potentially violent circumstances. Numerous paradigms of violence exist, and it may be difficult for the physician to cover the range of issues productively and efficiently in a single visit. Instead, the physician may wish to confront these topics over a series of visits to best assess the patient’s willingness to discuss these issues and act in the recommended manner. This paper serves not only to bring to light issues of violence with which a physician may be presented, but also provides a model for discussing these issues with patients to best provide preventative techniques.
Historically, violence has been dealt with by local communities and governmental agencies. However, recent studies show that the propensity towards violence begins in one’s childhood. Specifically, individuals who have had a history of previous abuse as a child, whether it is from abusive parents or others, are more likely to commit violent acts as an adult (Rosenberg, 15). There are a few theories that might explain why abused children have a greater likelihood to grow up into violent adults. According to the social learning theory, behavior is learned through the imitation of role models (Rosenberg, 25). Children most often imitate the behavior of their parents, and it is therefore not surprising that abused children would consider abuse (and violence in general) as acceptable forms of social behavior. Alternatively, some investigators believe that abused children need some assurance that they will not be abused again (Newberger, 66). This assurance manifests itself as violent and abusive acts as adults. Finally, adults who were abused as children are searching for a sense of mastery. They have experienced vulnerability and helplessness as abused children and feel that further abuse would prevent such feelings from emerging again (Newberger, 66). One final theory states that the quality of the parent-child relationship can decrease the likelihood of violent behavior in the child (Rosenberg, 25). Given...