Doctor works on healing urban wounds

Dr. Edward E. Cornwell III, a prominent associate professor of surgery at the Johns Hopkins School of Medicine, elaborated on an affliction that has been plaguing the nation for decades in the final lecture of the spring 2004 Voyage and Discovery Lecture Series.

The speaker series attempts to bring physicians of diverse backgrounds to campus, and while Cornwell detailed some of his on-the-job experiences as chief of the Adult Trauma Center at the Johns Hopkins Hospital, he focused his speech more on the issue of youth violence, a national problem that he described as "responsible for more deaths than wartime in the past quarter century."

He started off by describing a medical case that comes too many times to his doorstep at the Level One Trauma center, a 24-hour facility fully committed to treating the most severe injuries: "A young unidentified black male, with a gunshot wound, pronounced dead within 15 minutes of arrival."

Cornwell further detailed the drastic emergency procedures that were applied while attempting to save the patient, designated for the time as "Male X."

"We have to rush into surgery, open the abdomen, or the chest, or crank open the ribs to stop any delayed retard bleeding," hes aid. "But by this time, from the first shot to the ambulance to the operating room, the patient has lost three fourths of their blood volume, and it's a completed blood bath."

While the doctor related that 95 percent of the wounded entering the center left the center alive, he also related that 75 percent of all gunshot cases are dead on arrival. "There are way too many sad stories across the country than should occur in a civilized society," he said.

Cornwell said the hardest part was the long walk out into the waiting room, where the nameless faceless "Male X" became a story behind the numbers, and where he had to tell a grief stricken mother or sister that their brother or son would not be coming home.

"There is just no easy way to do it, and I always feel like I'm either dropping the news like a bomb or dragging it out with unneeded medical terminology," he said sadly, adding that he brings an intern with him on this duty, so that they can see the reality of emotions that accompany being a physician.

"One thing that strikes me," noted Cornwell ,"is the fact that there are no fathers in those waiting rooms. You see fathers on happy proud occasions like graduations but never in moments of utter despair and grief."

According to Cornwell, this absence of a nonviolent male role model is one of the major problems in the issue of youth violence.

At the Hopkins Adult Trauma Center, which is dubbed by Cornwell as part of a national urban "knife and gun club," including cities such as New Orleans and Los Angeles, a 15 year-old is considered an adult due to the high number of victims.

Of all the incoming patients, one third fall between 15 and 24. This age group, which Cornwell describes as "the crime prone years where testosterone risk activity is highest," also makes up two thirds of all gunshot victims.

In the late '80s, the Surgeon General even called gun violence a national epidemic, as urban violence was responsible for more deaths than the Vietnam or Korean Wars.

Cornwell said the height was a demographic outcome since the baby boom generation was just hitting the "crime prone years" at the time.

He forewarned of another such population boom in the upcoming years, one consisting of a generation more exposed to direct violence and media, with easier access to guns, and with fewer nonviolent male role models than any other generation in history.

"I see the social fabric of this country decaying, drugs infiltrating our neighborhoods," he said. "Differences which used to be played out in after-school three o'clock fist fights are now resulting in kids dying."

While the other 12 major U.S. cities have experienced a reduction in gunshot cases and homicides over the past decade, Baltimore, the 13th largest, has not shared this decrease. The city is also home to the largest percentage of babies born to unwed mothers.

"Babies are having babies, and it seems now that even 15 years-old is too late for prevention," said Cornwell, who is an active mentor and community role model to young people in Baltimore's Police Athletic League. "We take kids 12 to 13 years of age and have them observe emergency operations and show them graphic slides of a blown away heart or of the suffering of a pregnant woman shot in the abdomen."

David Chang, who works with Cornwell as a research associate, applauded. Dr. Cornwell's efforts outside the hospital.

"Its important to take away that medicine is not a scientific skill," he said, "but more an interpersonal skill. It's very rare to see a doctor outside the hospital. [Dr. Cornwell] is the only surgeon at JHU who does this."

Cornwell sees the society that kids are being brought up in today as "fragmented" and "glamorized," and advocating a "culture of violence."

According to him, one of the biggest promoters of this trend is the media. "I hear kids saying that the rap artist 50 Cent has more "credibility' than, say, Ja Rule, because he got shot, and I refuse that definition," said Cornwell, attempting to fathom its meaning. "He walks around with a band-aid and an armful of girls. That doesn't look so unattractive. But those rap artists aren't at our trauma center; they aren't portraying what really goes on."

Cornwell expressed frustration at the failures of involving discourse on youth violence and preventive measures into a national debate.

"The discussion would have to bring up words like access to healthcare, criminal justices. Race...yikes! Guns...uh oh! Those are very socially and politically explosive topics that make people uneasy."

He admitted that there would be no pay-off other than positive changes, and left audience members three recommendations that they could take away from his speech.

"One, don't believe or create the hype of pop culture--which is really made by a few people with megaphones, Two, try to engage your talents in affecting your sphere of influence, this is a multifaceted problem and three, don't be afraid to speak your mind," he said.

After the speech, audience members agree that he left a lasting impression.

Junior public health student Daniel Habtermariam said, "When [the lecture] first started, I though it was going to be a clich??d, 'ER dramatized' version of what goes on in hospitals, but I was pleasantly surprised because the speaker turned out to actually have a lot of depth and substance behind what he was saying."

Sophomore biology pre-med Ashland Brown was similarly impressed with Dr. Cornwell's words. "You're here studying biochem," he said, "and you totally miss all of the truth. These lectures are healthy refreshers to what we will be dealing with in reality in the medical world."