Contrary to ubiquitous media depictions, the United States overall is not experiencing ever-increasing levels of violence.1 Yet rates of violence are more concentrated in certain communities, and the severity of that violence is more lethal. African American men bear the brunt of assaults and homicides in our cities, and this is very much related to the widespread availability of firearms among youth. A pair of books helps us make sense of this pattern of violence in America. Geoffrey Canada, educator and founder of the Harlem's Children's Zone, has been widely lauded as a hero in his own time. Canada's seminal work, “Fist Stick Knife Gun,” was first published in 1995 and remains a riveting instructional read for anyone working with inner-city youth. Canada uses his own life and work to starkly portray the realities of life, death, and violence in our cities. Illuminating the hard concrete environment and severely limited choices in which some children are raised, Canada speaks harsh truths. “Most young people are interested in surviving the war, but the price they pay is being prepared to kill or be killed . . . young people have figured out that the best way not to be shot is to shoot first . . . especially if adults, police, and parents seem incapable of protecting you.” The lessons start early, and they start at home. Canada tells of his own upbringing in the south Bronx of the 1950s and 1960s. He was the third of 4 boys raised by his mother. His first lesson in how to face an affront came when he was 4 years old. His brothers, 5 and 6 years old at the time, came home after a bigger kid took one of their coats. To the boys' disbelief, their mother, by Canada's account a strong and nurturing woman, sent her 2 older sons back to the playground with orders that they return with the coat. When they returned, she explained that she could not let them be victims and that they could not let people think they were afraid. Canada's “history” acknowledges that violence has always been present in poor urban neighborhoods. You either fight or are taken advantage of. Any indication that you will not fight (eg, ignoring an insult, not facing a drug dealer who hit your brother, or turning the other cheek) reveals weakness. The logic goes that, since that weakness will be targeted, it is not a real alternative. The difference in the last few decades is the easy availability of guns, making death far too common an outcome. In the next-to-last chapter of his book, Canada describes yet another gun death in his neighborhood and admits that even as an adult he fears getting caught in the “wrong place at the wrong time.” Canada implores us to help the children and families caught in the web of violence, not by demanding more police and longer prison sentences, which has not worked, but by investing the time and energy in particular neighborhoods. His work in Harlem remains a beacon for others to emulate. John Rich, a practicing primary care doctor and a researcher at Drexel University College of Medicine in Philadelphia, Pennsylvania, picks up where Canada's story ends. In his 2009 book, “Wrong Place, Wrong Time,” Rich interviews young black men who had been shot and received treatment at Boston City Hospital. Like Canada's autobiography, the stories provide a window into the experiences and emotions of black youth who are both casualties and survivors of the warlike existence of growing up in neighborhoods like Dorchester and Roxbury. Rich describes his encounters with these young men, first in the hospital and later in their neighborhoods, where they struggle with the aftereffects of their trauma: hypervigilance against being “finished off,” numbing of emotion that accompanies chronic trauma and acceptance of retribution, loss of their place in the social hierarchy among peers and family, and physical disabilities that leave them unprotected against the return of the assailants. To say that these young men were in the wrong place at the wrong time does not mean that they were all innocent. Nor does it confirm the assumption that they are all “hardened drug dealers.” In examining the lives of Boston youth injured violently and the incidents in which they were injured, Rich posits that there is a large “in between.” He challenges health care professionals, in particular, to avoid stereotypes about victims of violence, and to instead imagine the space between absolute innocence and predatory violence: a space where so many youth struggle to survive, living with the near constant threat of victimization. Ray's story is illustrative. Both highly intelligent and street smart, Ray was finishing up a prison term when he met Rich. Ray's insight and straight talk make him a near partner in writing the book, clearly mentoring Rich as much as he is mentored by him. Although gifted in school, Ray could not escape larger forces: a part-time father and a drug-addicted mother; he was homeless by 11 years of age and slept in abandoned animal cages. In one particularly poignant exchange, Ray helps Rich (and the reader) understand that what motivates a young man to choose violence might be similar to what motivates someone, like Rich himself, to become a doctor: the common human need for identity and for relationships. This insight elevates the book into the realm of literature and makes it well worth reading. In sharing these individual stories, Rich confirms Canada's key insights about inner-city life in the United States. Common to all the stories is the experience of growing up with significant violence on the streets and, for some, in the home as well. Both authors conclude that the perception that these young men need to protect themselves is well-founded; they are living in virtual war zones without basic securities. Rich implores us to “focus on their safety: the very people we have blamed for making the community unsafe.” He concludes: “The same safety that we desire, they desire.” Until we provide for the security and healthy development of all our children, the violence will continue. Rich and Canada are leaders in developing strategies and implementing programs to create safe neighborhoods; these books are a different part of that agenda. Rather than dwell on statistics or prescribe policy, the stories reveal the human toll of violence and help explain the seemingly inexplicable levels of violence in particular communities. And like all good stories, they are both entertaining and edifying. Correspondence: Dr Schaechter, Mailman Center for Child Development, University of Miami Miller School of Medicine, 1601 NW 12th Ave, Miami, FL 33101 (email@example.com). Author Contributions:Study concept and design: Schaechter and Brosco. Analysis and interpretation of data: Brosco. Drafting of the manuscript: Schaechter and Brosco. Critical revision of the manuscript for important intellectual content: Schaechter. Administrative, technical, and material support: Schaechter and Brosco. Financial Disclosure: None reported. References 1. Bergman AB Our society is not more violent. Pediatrics 1996;98 (6, pt 1) 1198- 1200PubMedGoogle Scholar
Archives of Pediatrics & Adolescent Medicine – American Medical Association
Published: Feb 7, 2011
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