Stop the violence: surgeon pioneers
program to prevent repeat victims

By LOIS BAKER
News Services Editor

Cuthbert O. Simpkins, an associate professor of surgery at UB, became frustrated patching up gunshot and stab wounds only to find the same patients back on his operating table months later. It left the physician feeling that he was treating the symptoms, not the disease. "If these were hernia operations," Simpkins said, "and the patients came back time after time, you would say, 'Something is wrong here!'"

His frustration led him to organize the Violence and Victimization Prevention Program at the Erie County Medical Center, where he has practiced since 1994. Eighteen months into the effort, only two of the 55 people in the program have been re-injured and none have been re-hospitalized.

Determined to conquer the disease of violence, Simpkins has attacked the problem with missionary zeal. He combines heavily applied reality-checks with dogged intervention and follow-up.

"I always tell my patients, 'You almost died. We can't save you every time you come in here.' Coming from the guy who just sewed them up, it means something. "As a trauma surgeon, even the most violent person is accessible to me," Simpkins says. "It's a strategic time to intervene."

Social workers talk with the patients and try to find out why they were in dangerous situations in the first place. They establish rapport and respect. They get to know the patient's family or other influential adults. Bonding is very important, Simpkins says.

Clinical coordinator Neville Francis, who holds a master's degree in sociology, develops an individualized intervention program for each participant. Earlier research has shown that unemployment is related to a violent lifestyle, so the program's ultimate goal is to get participants working. If drugs or alcohol are a problem, patients enter rehabilitation. If they aren't employable, they may be enrolled in a job-training program or receive job skills counseling. Social workers try to get them out of the violent environment or change the existing environment. "We do whatever is necessary," Simpkins said.

"It's sort of like trying to hit a moving target. There are always crises. We are always going to the home. Sometimes we have to go to the jail."

There is no set time-limit on intervention: The program ends when patients reach their individual goals and become self-sufficient.

Funds to support the program have come from a variety of sources.

A benefit concert was staged by the Satellites, a Toronto reggae band for which Francis is singer and guitarist. The hospital has been very supportive. Doctoral students in social work from UB and Buffalo State College provide manpower in return for field training and research experience. Volunteers perform a variety of jobs. Simpkins and other physicians have contributed their own money

Simpkins is trying to raise funds to provide part-time jobs for participants-"something of benefit to the community"-while they look for full-time work.

He also is hoping to generate grant money for research to find out if his approach is cost-effective and if it works better than less intensive intervention.

"There needs to be support for people who are injured in this way," Simpkins said. "If it works, it could save a lot of lives."