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BY: FR. CHARLES BOUCHARD, OP, STD

If you want to avoid violence, stay away from hospitals. The first time I went to an emergency room, to pick up an elderly friar who had taken a fall, I was shocked to encounter armed guards, metal detectors, police officers and even a handcuffed prisoner sitting in the waiting area. Was I in a hospital or a jail? This brief, daytime experience changed my image of emergency care forever. Since that first visit, I have learned that things are even worse than they appeared that day. Hospitals are dangerous places.

I think about emergency room personnel every time I hear an ambulance or read about a shooting. I thought about them when I read that as of May 1, 2016, there already had been more than 1,000 shootings in the city of Chicago, an 88 percent increase over the previous year. Every one of those victims ended up in an emergency room. Murders in Chicago — 141 since Jan. 1, 2016 — are up by 72 percent over last year. Many of these murder victims, and sometimes their assailants, will be treated in our hospitals.

This intimate relationship between hospitals and violence doesn't end with the emergency room.

• Violence against health care workers, which is more likely to occur in emergency situations, is growing.¹ More than half of nurses report having experienced some kind of physical harm. Their risk of suffering violence at work is five times higher than other occupations.²
• Health care workers have to diagnose the hidden violence of domestic abuse. As the extent of such incidents grows, we have had to train health care workers to recognize signs of abuse of spouses, intimate partners and children. Then they have the even more difficult task of reporting suspected abuse, which in some cases can place victims at further risk.
• War brings another kind of violence into our hospitals. There is the marvelous work being done by health care workers across the country for victims of wartime violence. These angels of mercy welcome and treat soldiers with psychic and physical wounds that range from post-traumatic stress disorder to loss of multiple limbs or massive disfigurement. Health care workers do this in rehab hospitals as well as during inpatient and outpatient psychiatric care. Their healing work extends beyond the soldiers themselves to their families, who become secondary victims of the violence of war.

We live in a violent time, and easy access to firearms has made it worse. The level of violence may vary from one time and culture to another, but it seems to be wired into human existence. Philosopher Rene Girard has written widely on the human proclivity to violence and especially our tendency to try to identify a scapegoat — a person or group upon whom we can heap our anger and scorn, and then persecute them in the vain hope of ridding the world of evil. (The original scapegoat is described in the Bible, Leviticus 16:8, where a real goat is loaded with sin and sent away). Violence is a result of the human tendency to satisfy our passions — anger, grief, jealousy, fear, desire — by force. Theologically, we would say it is an effect of original sin, a human disease that can be treated but not cured (at least not in this life).

So what's the best treatment for violence? Like many other human afflictions, it has to be dealt with on at least two levels. On a social level, justice is a good start, since many violent acts result from a lack of basic human goods like education, public safety, and, yes, even health care. "No peace without justice," as the slogan goes.

I think education, especially in early childhood, is the most important of all. Sadly, our cities cannot provide basic public safety, and our politicians bicker constantly about whether health care — even for children — is worth the cost. Our public school systems often are unable to provide even basic skills in reading and writing, much less moral formation that might help children learn how to deal with loss and disappointment.

These kinds of violence require social transformation. We as a society need to see violence and be willing to grapple with it, but we can't do that unless we undergo personal transformation. Even a relatively just society — never mind the possibility of a Truly Just Society — requires citizens who face violence rather than walk away from it and who have the courage and hope to try to do something about it. This requires faith and spiritual discipline.

Jesuit Jason Downer says that we need to respond to violence in a new way, first of all, by not turning away. "Rather," he says, "turn towards. It can be something as simple as when reading articles about violence, go over them slowly, prayerfully. If a name is mentioned, either a victim or perpetrator, pray for that person by name. Use your talents to express your reactions, maybe writing a poem that no one will ever see. The reaction to violence is personal, and the more we examine it and pray with it, the more we will let it transform us."³

It may seem counterintuitive, and maybe even foolhardy, to turn towards violence; yet that is precisely what we ask our clinicians to do every time they encounter a victim or perpetrator of violence. They do so not just because it is part of their job, but also because they have a vocation. They are called to be first responders to these social wounds.

The rest of us are not often on the front lines of violence, but have a role too. We should recommit ourselves to justice. Even if we can't cure violence, we can help God cure it by working for more equitable distribution of the world's goods, which are, of course, given to all of us.

FR. CHARLES BOUCHARD, OP, STD, is senior director, theology and ethics, the Catholic Health Association, St. Louis.

1. James P. Phillips, "Workplace Violence against Health Care Workers in the United States," New England Journal of Medicine 374, no. 17 (April 28, 2016): 1661-69.
2. Pamela Thompson, "Addressing Violence in the Health Care Workplace," Hospitals and Health Networks (July 2, 2015), www.hhnmag.com/articles/3365-addressing-violence-in-the-health-care-workplace.
3. Jason Downer, "Responding to Violence in a New Way," The Jesuit Post, Aug. 5, 2014, http://thejesuitpost.org/2014/08/responding-to-violence-in-a-new-way.