When tragedy strikes close to home

I live in Denver.

I work in Aurora.

I know exactly where the Century 16 theater is located; I live approximately 8 miles from there.

When horrific scenes like this unfold as they did last night and this morning, it reminds us of how precious life is and how none of us can fully be protected at all times. It reminds us that there are people out there who are sick and need help.

There is a very interesting thing that happens mentally when violence occurs near you. For me, there was an unnerving feeling. This feeling was followed pretty quickly by a thought of “wow, who really is safe?” and “what can I do?”

What can I do?

There is a feeling of helplessness that washes over you when you see all the information coming in about the incident. I can remember the same feeling two other times in my life.

The first was September 11. Everyone has there stories about that day, and we all wanted to unite and do something to help our country. I was no different.

The second was less about one incident and more about a whole series of incidents. You see, one of my first jobs after I graduated college was working at a special education school. The school itself was really created to help children who were given the classification of being “severely emotionally disturbed.” These kids had many issues, but they were my kids. I was there to teach them and to help them; to protect them.

But, as I learned almost immediately, I could only protect “my kids” when they were with me. From 8am to 3pm these kids were under my protection and I gave them all that I could. However, after 3pm, many of these kids left my protection and entered into an environment that was anything but safe.

This was the second time in my life I felt utterly helpless.

I saw how poverty impacted families, how families impacted kids, and how kids impacted each other. I saw how a system that was in place to help was often under resourced and ill-equipped to manage the complexity of many of these families.

I heard stories.

I still hear some of those stories.

I saw fear.

I saw hope.

Why am I telling you all this on a website that is about healthcare? Because folks, if you think any of these events are unrelated, disconnected, or isolated, you are wrong. Everything comes back to our families, our systems, and our health. You cannot tease apart one from another, and attempts to do so will likely prove to be futile and ineffective.

I do what I do in healthcare because I believe that we can create a better system that can help those who need help the most. I believe that I can create a system that can be just as effective at prevention as it can at treatment. I believe I can reconnect what has been disconnected.

I believe we must.

So as we read the stories about the shooting, let’s not forget that it is never just one thing that leads a person to commit such horrific acts of violence.

What will you do in response to this event?

I know what I will do.

I will work harder.

I will work smarter.

I will be successful.

I will change the system.

Dr. Miller has his doctorate in clinical psychology and is an Assistant Professor in the Department of Family Medicine at the University of Colorado Denver School of Medicine where he is the Director of the Office of Integrated Healthcare Research and Policy. His core task is to integrate mental health across all three of the department’s core mission areas: clinical, education, and research. Opinions expressed here are his own and not those of his employer.

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  • Mark

    Ben: I too am struck by this horrific tragedy. It is too soon for me to weigh in on the why I can only watch and read.

    9|11 happened four blocks from my office and 5 from my home. I saw the jumpers. I was on the street when the north tower went down and ran from the debris. A triage site was set up next my home but was never activated because you either lived or died. There was no middle ground. What remained in my memory of that day was how services like medical, fire, police were relentless in their work and professionalism. That speaks directly to what a well trained healthcare professional brings to the table in both times of crisis and daily. We cannot afford to allow how we train our HCPs and how they do their work to become encumbered by selfish self-interest.

    The head of the ED department at Aurora medical center was being interviewed. I was impressed and struck by the professionalism and skill she demonstrated and how a hospital can react quickly and effectively to a tragedy of this magnitude so well. It speaks to what we have in America and what we may loose unless we all work to have the healthcare system we deserve. Like you Ben I agree we need to consider this tragedy in it whole but work to maintain and improve our healthcare systems to both blunt this shit from happening and react as effectively as humanly possible when it does happen.
    .

  • Mark

    Tragedies of this sort are impossible to accept, impossible to understand, impossible to come to terms with. These events leave wounds in the soul that are slow to heal, and often never fully close.

    I hope that this horrible event leads to productive dialogue and change within our system. The US has a strong and efficient trauma response system. As strong is it is, though, by the time it swings into action much harm and evil has been done. We will need to review what led to these events, and determine if there were other parts of the healthcare system that fell short. If primary care or mental health services were needed but unavailable, might that have contributed to this event? If there were other health issues (substance abuse, addiction, etc), were they effectively addressed?

    I hope we learn from this. We owe it to the victims. However, I am not wholly optimistic. After Columbine, there were no meaningful changes to the nation’s gun laws to address loopholes that make guns more available to those who would use them to harm others. Instead, we still have the gun show loophole, and the ban on assault weapons has been lifted. In Virginia, after the Virginia Tech shootings, we have now lifted the state’s restrictions that limited individuals to purchasing only one gun a month.

    Tragedies of this scale call for action. They scream for a response, and in our anguish and confusion we look for a way to act and we state that this can never be allowed to happen again.

    We must make sure we put actions to our words.

  • http://flavors.me/collaborativecare Ben Miller

    Thanks to both of you for your comments. In times like these, I am reminded of the story of the town by a river that noticed one day people were floating down the river. Like any good town would, the townspeople reached out to save these people every time they saw someone new floating down the river. This happened daily; over and over again, until finally one person in the town asked why no one was going up the river to see who was throwing these people into the river.

    Today’s events should be a reminder that while we can continue to pull people out of the river, we really should take a look at how they are getting in there. In the midst of all the political jockeying, let’s not lose sight of the community who has been impacted by this tragedy; and as we focus on the community, let us also start to look upstream at the root cause of some of these issues.

  • http://www.lisafieldsassociates.com/testimonials/ Lisa Fields

    This tragedy is so horrific it’s heartbreaking. I listened today to the description of a young woman who physically survived the shooting and tears just began streaming down my face. She attempted to help a gentleman as he was dying but was forced to leave in order to save her own life.

    I listened to an interview with Police Chief Dan Oates last night. The manner in which his expressed his respect and appreciation for his officers was touching. Toward the end of the interview I was pleasantly surprised when he shared that he will ensure that this officers receive the counseling services they may need.

    Publicly acknowledging the need for mental health services for our emergency responders is a clear demonstration of a culture change that has occurred within these ranks.

    Ben, thank you for the reminder to change the things I can~this is my goal.

  • http://mttoolsonline.com Kathy Nicholls

    Ben, what a great piece here. I live in Pueblo and have watched yet another tragedy unfold in our state, just on the heels of the Waldo Canyon fire. As I watched both of these, indeed I have been struck with what “what can I do?” With the fire, we organized a donation day for fire fighters. I haven’t even began to get my arms around this one yet. What I do know is that it is just what you said–what are the things I can change and how can I go about doing that.

  • Carmen

    Ben,

    I gritted my teeth watching another tragedy unfold, just we saw in last year’s shooting of Congresswoman Gifford, and before that at Virginia Tech. While people are entitled to their guns, we can tax bullets. No one should be able to hoard the ammo the assailant had in his possession. Let’s at least reduce the chances of mass graves. As you said, “Everything comes back to our families, our systems, and our health.” Let’s safeguard them with wiser policies.