What's going on, everyone? Sam here with late sports cards. We are ripping. 20. No, 10 box Tuesday. 10 box national honors, photo, football mixer, number 164, random team style. So look again at your random results, as always. Combine those on the website, under the results tab, as well as the link that's in chat. So we're going to start with 23 leaf metal hobby. 23 leaf metal hobby. Sit, oh, of course that's true. So there we go. You know what I'm going to say, Donnie? Let's get, say, no randoms on any in either of the metals. That would be amazing. Can we do it? Can we do that? Is that possible? It might be too modern. Trace McSorley had reps for the third team. Let's go. Trace McSorley season again. We've got Tray Palmer. Three of five. Tray Palmer. Tray Palmer. Draft and combine profile. He is Buccaneers. Tampa Bay Buccaneers. There you go. Tampa going to the Saints. We've got Jake Hayner. Four of five. Grats Saints. Jake Hayner. Going to the Chargers. That is going to be Isaiah Spiller. Nine of 10. Congrats, Chargers. Mr. Isaiah Spiller. I'm just going to double check. I think he's a pretty confident he's a patriot. Yep, going to the Patriots. That is a Christian Gonzalez. Grats on that. Patriots. And nice one here. Going to the Texans. CJ Stroud. Five of 10. Congrats, Houston. Who had the Texans in this one? That is awesome. That is going to be going to Texans, Texans, Texans. Michael L. Grats, Michael. All right, we'll do Trinity now. There's Trinity, right? Empty, empty, empty. Travis Dye. I think he's a jet, I believe. Jet or giant, one or the other. Going to the Jets. That is 24 of 75. That is going to be a Josh Job. He sounds like he's still in college. No, Eagles. Nice. He must have been drafted this year. Josh Job, two of 12. Next up is going to be a Troy Franklin. Troy Franklin. Yep, he is still in college. So that'll be a random at the end. Two of 30. Nice one here. For the Colts is going to be Alec Pierce on the two-color RPA. Grats, Colts. And then this one will be a random between these two teams. One of five. Kenny Pickett, Matt Corral. Christopher Jay. I don't know, Bradley R. with the Panthers, Browns, and Eric P. with the Steelers. So that will be a random to those two teams. Congrats, and good luck, both of you guys. All right, so on there we'll do 23 Legacy. Next, 32 Legacy. Two 100 is Aaron Rodgers. Underlights, Travis Kelsey, two at 149. Tim Brown, Michael Strahan, Basem Days. Oh, you should have seen how pissed Vaughn was with the Marish John True as a raider in this. That gave him Tom and his Jerry Rice. Vaughn not happy about MJD. And this one points random to all at the end. Our third random we have to do. Let's see it dare to tear. Yellow, Chris Carter to 150. A Bryce Young prize prospects. Winston, base, base, base.  There's Marvin Mims for the Broncos under the lights. Was very much not needed. Oh man, that's funny. Mini Jerry Judy to 75. Peyton Manning. Josh Jacobs to 50. The Raiders. Drew Pearson. It's Randy Moss and Abonte Adams. Both on the Raiders there. Like Raiders, Randy Moss, a little weird too. Like that's kind of random. That was like that random one-year stop in between... Oh, Dana Hampton. Nice one there. Great Iron Grades for the Bears. Well, for being silly. Oh, that's funny. Red is War and Moon as a sea hawk to 299. The lights patch my homes. Peyton Manning under the lights. Tyree Kill to 50 on the red slash bronze. And hard to tell which color that is exactly. I'll do it for the legacy. And guys, five to go. Mega Dual Case, five to go. Let's get that filled on up. Here we go. All right, on to 22 Donner's Optic Retail. This is a Josh Pascal for the Lions. Rising Suns patching my homes. There you go, sheets. That is a patch my homes, light it up. Hollow, Tyrion Davis Price for the Niners. Traylon Birch Rookins. Titans. Adam Thielen Hollow, Trayvon Walker-Rookie. Legendary logos, Kenny Pickett. What? I'm not even mean. That's Tom Brady, My House. Newfangled Lingo. Ty Chandler. Blue Stars, Von Miller. And Sam Williams. I'll let you think about what you did. I'll let you sit in the corner. Oh, Blazers. Lamar Jackson on the short print. There you go, Ravens. Nice one, Baltimore. Let me go to Michael L. Congrats, Michael. You can toss that in the recap too. Avenue. Blue Stars, Darren Waller. The Raiders. Born Moon for the Oilers. Blue Stars. Eric Azucanma. There's Chris Olava. Blue Stars, Montez Sweat for the Commanders. Kyle Phillips. Blue Stars, Rashad Whites. And Blue Stars, Kenny Pickett. Nice one there. Grat Steelers. That was a good box. Not with the greetail right there. The Blazers short print and the Blue Stars. Oh, Pickett. It's not bad. Let's do Optic Teemall now. Laftis, Derek Henry. Hollow, Aaron Jones. Hollow-rated Rookie, Jalen Naylor. A Dexter Lawrence. Red Stars. And Kyler Gordon, Red Stars. Nice one there. Got Select Asia Teemall now. Cole Comet for the Bears. Dragon Scale, 289. Got nice. Tom Brady, Dragon Scale. One of you of 89 for the Bucks. Grats Bucks. And Kyren Williams, 289 for the Rams. Base of Russ. And Dicut Silver, Deontay Johnson. Uh, we'll do Chronicles Hobby now. 22 Chronicles Hobby. George Pickens. Dave Antibiotto, Sam Williams Hollow. Bailey Zappi, Dynagon, Nick Chubb. Kenny Pickett Luminance. Kenneth Walker. There's a Jamison Williams Photogenic to 199 for the Lions. Congrats, Lions. That's a Nick Chubb, 2199. Damian Pierce, Prism Black. And Joe Burrow. Algeer, Drake London, Tariq Wollin, David O'Jabbo. Derek Carr. Nice one there on the Paramount, 6 of 15. Gonna be going to the Raiders. Congrats, Raiders. Christopher J. Got a Kavon, Tibiotto Orange, to 75 for the Giants. Sam Williams and Saucer Gardener for the Jets. Kittle Tua, Kavon, Trey McBride, Calvin Austin. Saquon, Blue, Color Match for the Giants to 99. Christian Watson, Flux and Garrett Wilson. Ritter Rookie, Purdy Rookie, Alec Pierce. Chris Olave, Breeze Hall. Blue, Derek Stingley Jr. to 99. The Texans, Bailey Zappi. Nice one there for the Patriots. And Isaiah Spiller, Bailey Zappi. That is Breeze Hall, Central Autographs Purple. Going to the Jets. There you go, New York Jets. Scrats on that one there. Christopher J. With the Breeze Hall. Bailey Zappi, Silver Dynagon. A. George Pickens and Aidan Hutchinson. On to 22, Select H2. J. Jettus, Cooper Cuck, Marvin Leal. There's Roquan Smith, Blue, Sweet Level to 25 for the Raiders. Trey Lance and C. D. Lan. A. J. Brown, Eric Azucanma. Silver Rookie, Red, Gikwan Brisker for the Bears. 12 of 49, congrats, Chicago. Jelani Woods and Kyler Murray. Willis Rookie, Eric Azucanma. Silver Gabe Davis, Red, Dylan Parham to 49 for the Raiders. Jeremy Rocker and Marshawn Lattimore. Last pack of Select H2. Christian Watson Rookie, Tray McBride. That is going to be a Christian McCaffrey. Disco going to the Niners. Amon Ross St. Brown and Charles Cross. All right, I guess I'll probably go honors photo first here, I'd think. 20, oh no, no, that's a 2020 honors photo. All right, what are you doing at 21? I thought that was 22 this entire time. So, 21 NT hobby. Good luck, everybody. Whoops. There's a Trayvon Digge Treasured Moments with 11 interceptions. Nice one there too, 25. As well as A, Mark Brunel, 66 of 99. Going to the Jags. What's up, Ryan? How you doing, buddy? You guys still got five to go. Joe Mixon, nice one there. Treasured Patches, 35 of 99. That is Player Worn, Mixon for the Bangles. Two-color Patch Mat, Ryan. 19 of 25 for the Falcons. Player Worn on that as well. Brats Atlanta. Got a 32 of 99. Rookie Jersey, Rashad Bateman. Going to the Ravens. Going to Bradley R. Two-color Rookie Patch, 18 of 25. Trevor Lawrence. Congrats on that one. Nice tealaw. Got RPA, 25 of 25 for the Vikings. Kenan Wangwu. Nice one there. Congrats, Minnesota. I'll be going to DW. Hey, that's awesome, Brian. Hell yeah, man. I remember that. That was great. That was really sick. Quentin Johnson Gold from Select Draftpicks. Oh, yeah. That was awesome. 22 of 35. Going to the... That's nasty. Going to the Chargers, Antonio Gates. That's really freaking cool. Congrats, Chargers. That is James D. Who's got this team? This thing's freaking awesome. Going to Mathiasen. National treasures, prime pairings. Russell Wilson, DK Metcalf. 17 of 49 on the dual auto. That's pretty sweet. Dude, that is freaking awesome. Hell yeah. Russ and DK. So awesome. Congrats on that. I'll bag the next one, too. I'll bag this on the next one, yeah. 18 of 99. Javante Williams on the crossover RPA. Congrats Broncos. Bradley R with Denver. He comes back healthy, man.  North Carolina legend, Javante Williams. Nice one there. Congrats on that. Mathias. I know. That was Bradley. That was Bradley. Mathias had the DK. All right. 2020 honors first off the line, dude. This is kind of insane. 2020 honors photo. Good lord. What might be in here, Donnie? There can be a lot of stuff in here, don't you think? Well, who's the Aerts? That'd be sick. Oh, this guy's back again. I thought we got rid of you. Shoe, shoe, shoe, shoe. All right. We've got Cam Newton. Nice one there. Six of 10 for the Patriots. That's actually sick. I like that. And rookie Jacob Eason. That is five of seven first off the line exclusive. Oh, boy. Okay. That's enough. Got me. You got me. We got three colored patch autos. Sterling Sharp. One of one. That is game used. 2017 impeccable. Congrats, Packers. Dude, that's so awesome. Congrats, Green Bay. Oh, absolutely. Great use of getting booted. I agree. Kevin W. Nice one there. And nice one here. Rookie Otto to a tag of my Loa. Two of four. Going to the Dolphins. Greg L. Greg, congrats, man. Hell yeah. Nice short printed to Rookie Otto for you, buddy. I know Greg was in chat earlier. Greg, that is awesome. Congrats, buddy. Very happy for you, man. Awesome to us. So sick. All right. We got a couple of randoms to do. Got one going to everybody. Troy Franklin. One between the Steelers and the Panthers. And then the 400 points. You got it, Greg. Thank you, buddy. That was awesome, dude. And the Picket Corral Duel. It's going to be Steelers, Steelers, Panthers. All right. Let's start off with the points. Going to roll the dice. Top team after 11 times will get 400 points. One, two, three, four, five, six, seven, eight, nine, 10, 11. I'll be going to the Bears. I'll be going to the Bears. Congrats, Bears. We're going to do dice roll. Kai just named it College Cards. It's just the Troy Franklin. So we're going to roll the dice and go just five times on the Franklin. One, two, three, four, and five. That'll be going to the Cardinals. Congrats, Cardinals. And then the Picket Corral Duel. Again, twice for the Steelers and twice for the Panthers. That'll be going six times. One, two, three, four, five, and six. I'll be going to the Steelers. Congrats, Steelers. All right. Six, six, five, five, 11, 11. Good luck. Or do a quick recap here, guys. We had Lamar on the Blazers. Trevor Lawrence to 25. Rashad Bateman, Matt Ryan. Joe Mixon, Jameson Williams. And Tonyo Gates, Kenan Wangwu, Brice Hall. Derek Carr, Dan Ampton, Alec Pierce, Josh Job. Travis Dye, CJ Stroud, Christian Gonzalez, Isaiah Spiller, Jake Hainer, and a Trey Palmer to finish off our Magstuff. We had Javante Williams on the crossover, RPA to 99. The dual pairings, Russ and DK. We had one-of-one Sterling Sharp. Game used, a patch auto from 2017, Impeccable. And then rookie auto, two-of-four, two-attacker by Loa. I'll do it for the break, guys. Thanks again for the fill. Coming up next is Megadool K.


Those of you who have been on one of these closings before know how this works here. The rest of the people speaking on this closing did not know they were going to be speaking on this closing until a few hours ago, nor did I. But what I did was asked around to see who were people who were making a real impression with what they said, whether on a panel or from the audience. People had not had a chance to speak on a bigger stage yet. And so a half dozen people are going to come up here. And each one of them knows they got six minutes to say what they want to say. The first person I'm going to call on is a student from the University of West Indies in Jamaica, Vicky Hansen.  I'd like to thank DPA for inviting Jamaica to the table, to the conversation today. I mean, it's really important for us to be here, not just for Jamaica, but for the Caribbean. It's given a voice, but I don't want you to hear my voice. I want you to hear the voice of the growers. The voice of those in this industry who has been criminalized. I know our Minister of Justice was given award for creating a new framework, a new approach to drugs in Jamaica, decriminalizing five plants, two ounces, removing the criminal records for persons who have been given charges for possessions of small amount. But I think we need to go further. It's more than decriminalizing. It's liberalizing. It's giving social justice. I mean, you still have, even this week, there was a young lady who was given 12 months in prison for trying to export one pound of ganja cannabis because she wanted to pay her school expenses. She now has to serve time in prison just for one pound. I mean, we need to change the framework to stop the harm to that young lady who is just trying to build a better life for herself. The issue of reparation and social justice came up in our session, and I raised the issue of access to land, access to capital, because we're talking about persons who engage in growing cannabis and going on an illegal plant because they want to survive and they're criminalized. They're seen as drug traffickers because of just trying to survive. And we need to change that discourse. We have a placard that says stop the harm, United Nations and members. We need to raise our voices here in this conference and go home and raise that pressure on our various governments to change the entire approach. The reform doesn't stop here. It has to go further. It has to go further to protect the lives of the growers. Growers, for me in Jamaica, they are important because it's not just about growing for wealth. It's going to support your community, to support your family.  And I want us to really pause it to leave here, to go home and change the way we look at persons who are involved in planting drugs, as they call it. For me, it's a herb. Last month, it's a herb. Herb. And let us truly stop the harm. Let us be genuine in our approach to stop the harm, not just for ourselves or for our community. And what you do here in your various states, I was proud to be a part of Lobby Day because what happens here in the United States impact us in the Caribbean. And you need to recognize your importance in that space and challenge your government to go to Ungas to make serious change and truly stop the harm and reform drug policy. Thank you.


Going on everyone Sam here with lane sports cards. We are doing the random for the WWE prism blaster box giveaway from the Instagram We have 57 participants gonna roll the dice whatever username is on top after seven times We'll win the blaster box and I believe Halle will get in touch with you guys. So good luck everybody. We got one two three four five six and seven going to heads up sports cards heads up sports cards Congrats, buddy Like I said, we'll get in contact with you for your information and you will have yourself a prism blaster WWE prism blaster. So congrats on that one. Thank you again everybody for the support over on that post and We'll get group breaks started in a few minutes here


Good afternoon, thank you so much for coming today. On behalf of the McClean Center for Clinical Medical Ethics and the New University of Chicago Trauma Center, I'm delighted to welcome you to the first lecture in our 2017-18 lecture series. The title of the series is Ethical Issues in Violence, Trauma, and Trauma Surgery. The series will consist of 24 lectures and will meet during the fall, winter, and spring quarters. The lectures will focus on violence and trauma and how they can be addressed and reduced in cities and neighborhoods throughout the United States. Our special focus will be on the city of Chicago. Speakers in this series will include next week Dr. Julie Morita, who's the commissioner of the Chicago Department of Public Health, talking about the city's efforts to reduce violence. Several weeks after that, Pastor Chris Harris from the Bright Star Church in Bronzeville will speak. Brad Stolbeck, who's here today from our Department of Pediatrics and who runs the Healing Hurt People program will be part of the series. Arnie Duncan, the former U.S. Secretary of Education, who's come back to Chicago to work on the issue of violence and many other representatives from Chicago. We also, in the course of the series, will host many of the leading trauma surgeons in the United States, and that brings me to our distinguished speaker today. We're delighted that the keynote speaker in the series is Dr. Selwyn Rogers. Dr. Rogers is the founding director of the University of Chicago Trauma Center, which is scheduled to open on May 1st of 2018. Dr. Rogers is professor of surgery, chief of trauma and acute care surgery, and executive vice president for community health engagement. Dr. Rogers and the University of Chicago Trauma Center are co-sponsoring this lecture series with the McLean Center. Dr. Rogers will also serve as the co-editor of the book that will be based upon this lecture series that Springer International will publish in early 2019. Dr. Rogers graduated magna cum laude from Harvard with a degree in biology, received his MD from Harvard Medical School, and completed his general surgery residency followed by a critical care fellowship at Brigham and Women's Hospital. Dr. Rogers also holds a master of public health degree from Vanderbilt. Dr. Rogers served as chief of trauma, burn, and surgical critical care at Brigham and Women's for eight years, and prior to coming to the University of Chicago, Dr. Rogers had been chair of the Department of Surgery at Temple University in Philadelphia, and also as vice president and chief medical officer at the University of Texas Medical Branch in Galveston. Dr. Rogers is published widely on health disparities and the impact of race and ethnicity on trauma care and surgical outcomes in underserved populations. He's a nationally distinguished trauma surgeon and has a deep belief that trauma surgery is a necessary technical answer to the underlying and more fundamental question of how to reduce trauma and community violence. Today, Dr. Rogers talk is titled, as you see, intentional violence as a disease bending the moral arc toward justice and healing. Please join me in giving a warm welcome to Selwyn Rogers. Good afternoon. I apologize, because I was commenting to Cal-West earlier, a few minutes ago, that I'm not my best self. I'm not my best self because I'm recovering from a viral syndrome I picked up in Italy. Don't feel sorry for me. It was a great trip, but I got back on Sunday. Got sick in Rome, but continued on to Florence and Venice, and for those who get a chance to, it's all good. However, I am going to, I'm gonna move this up a little bit. I think there's a little control in the back as well. So I give you that as a framework because my voice is not gonna project very well, so I appreciate the volume control that Matt just did up in the booth. I'm gonna try to do something in the next 50 minutes and then we have about, I hope, 30 minutes or so of Q and A, where the singular, I think, will moderate the challenge that I'm gonna put before changing the hearts, minds, and souls of people in this room about intentional violence as a disease from whatever framework that you've walked into the room with today, and to share a perspective and an opportunity to tackle this incredible problem in a different way, and the opportunity to do that does require an all-hands-in-a-perch that hit a four we may or may not have done. So with respect to any talk, it's important to know your audience and I need to get a quick sense of who in this room has an affiliation to the University of Chicago making the distinction between University of Chicago and University of Chicago Medicine. University of Chicago, University of Chicago Medicine, the community, the communities, everybody's a member of a community, so that's all actually all hands. That was a trick question. So it's gonna be a bit of a whirlwind tour, but bear with me an all along the way, think about the questions that you wanna ask to enrich this dialogue even more than the thoughts I'm about to share. So this is the guideposts. I hope to frame violence as a complex disease. Secondly, I'm gonna use Chicago as an example of the interplay of socioeconomic and other factors that lead to the outcome of violence. And lastly, I'm gonna frame that in an ethical framework. Any one of those objectives by themselves should take more than an hour. I'm gonna try to do that in 50 minutes, but really be enriched by the dialogue that happens afterwards. Violence is a disease. It's important, I think, to first start with definitions because I think it's easy to actually not be on the same page with what we're talking about. But before I define violence, I think it's important to define health. So if I walk across this floor, I don't have one of those clickers, but I'm gonna ask this room, show our hands. Yes or no? Am I healthy? At least one person thinks I'm healthy. Nobody, everyone else thinks I'm sick. So with this definition of health, I'm gonna say to this room that no one in this room is healthy. This is an aspirational goal because who in this room has a complete 100% state of physical, mental, and social well-being and not just the absence of disease or infirmity? I don't think anyone can make that claim and if you can, you would just be born. Because we all struggle every day with some component or many components of this definition. But this larger definition of violence is even more challenging because we all can recognize violence when we see it. Well, at least we think we can. And these are both definitions of health and violence defined by the World Health Organization in 1948, decades and decades ago, and there's still the definitions that are applied today. So if you take violence as intentional use of physical force or power, threatening or actual against oneself, another person or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation, that's a very all-encompassing definition of violence. And so in some ways, when we see economic disinvestment in some communities over others, that's a form of violence too. We often think of violence in one and one, one person and another person. Well, as I showed early today with the McClain Ethics Fellows, my six-year-old punching my nine-year-old at the time 10 years ago in the mouth because he kept calling him Velcro Boy. That was created because at the time, my six-year-old was now 15, couldn't tie his shoes so he had Velcro sneakers. And he got teased over and over again and he got mad. And the response in a hotel room actually a hotel lobby to that being teased was to punch his nine-year-old brother in the mouth and lead to significant bleeding on the lobby floor with blood everywhere. And I, the trauma surgeon, just wanted to shrink and disappear. But it also was a teachable moment about how you resolve conflict, a teachable moment about what violence is and how it affects people because he felt sorry afterwards. But it was not the end of that story because the story continues and they still spat but it still spats now. It's not physical. The challenge is when there is a presence of violence, how can one possibly be healthy? It can't even be an aspiration because it's a hard state to get to if you're surrounded by violence. So that's a first premise. This is a complex model that I'm gonna leave out, not to walk through, but it's just one model of the interplay of many factors that can lead to the outcome of violence. Individual, social, economic, availability of guns, laws, policies, racism, social structures, disparities, segregation. All of these things are interplaying, interconnecting aspects, factors, that can lead to an end result of violence. But overwhelmingly our narrative in our society hardly ever mentions any of these things in the context of the outcome. I'm actually a comfortable enough speaker and staying on time, if people want to interrupt, I'm good with it. And if not, I'll keep going because I know where I'm gonna end up like in a good talk, I know where I'm going. So we have put together an incredible, I think just incredible series of talks over the next year. And I gotta give the Seagler credit, he and Dr. Angelo sitting up there, it was literally day two. I showed up January 5th, 2017 and I'm out in my own business trying to figure out where the next bathroom is because I still was getting confused about the offices, did I go left or right to get to the newest bathroom? There was a request for a meeting and I'm thinking to myself, no one should know me. Why does anyone want to meet with me? I just got here. And turns out I had to do all of this onboarding stuff that everybody knew through the institution. Anywhere you go has to do onboarding. And it was a lot of things. And so I showed up on a, I flew in 70 degree Delta between Galveston, Texas where it was 75 degrees Chicago where it was five degrees. And I said to myself, I am committed because I was on the beach two hours ago and here I am in Chicago. And I forgot that your feet get cold if you're not wearing boots. And I had to go get some boots. I also didn't have a pillow because my furniture hadn't arrived. So I was looking for a bad night of sleep. And I said I can't meet, but Dr. Siegler persisted. And so Friday we met. And I knew he was committed when it wasn't Friday at eight a.m. at noon. It was Friday at five p.m. because that's the only time that I had a bill. And he and Dr. Angelo showed up and told me that he was actually trying to sell me something. And the pitch was I have this great idea. You don't know me. You don't know about the McLean Center for Clinical Maths College. You don't know anything about the institution. You still say, but I got this great idea. And the pitch was this, but it was just an idea. And that idea is what you're gonna see over the course of the next year, focusing on violence, trauma surgery, and the ethics of trauma care. And I can't think of a more important series on the framework of ethics with respect to trauma care than this one at this time of this context. And I hope those who are local, and I think all of you are, if you get a chance to come back for some of these distinguished speakers from across the country and locally, you're gonna have an incredible intersection from faith healers, to legal, to advocacy, to public health, governmental, non-governmental, to address what I hope to this point, you all believe is a complex problem. And it's really these interlocking circles are the only real way forward to sustain a goal of no harm from intentional injuries. So I gotta frame this in the local context because I think many people in this room are aware of the local context, but it's important to kind of start from that framework. Point of works, perfect. So this kind of got national attention once it kind of did.  In the gestation of a child in the past nine months, I've had some interesting interviews, talks, meetings, dialogue. One of the most interesting ones to me was LaMoune, which is one of the world's national, I mean global newspapers, Paris, Parisian newspaper, flew over here to interview me about violence in the city of Chicago. And my initial response was, I don't wanna be interviewed. I know nothing, I'm humble, I'm just here, I just showed up. But they wanted to interview from the perspective of trauma as a disease, violence as a public health issue, and I said, this is a great opportunity to change the narrative, I thought it was, would add value. And at the time, Lorna Wong, who may not be here, she was like one of my early, and I have a lot of them now.  So I said, okay, fine, I'll do whatever you tell me to do. That's kind of what I do in my fiancee background. We're going to Italy, yes, honey. And he wanted me to introduce them to gang bankers. And I said, what? She said, yeah, go take me to some gang bankers, I wanna interview. And I said, yeah, and by the way, this was after me giving a framework of process disease complex into play, public health, all of that. His line, a story that was never written, was he wanted me to facilitate his interview with gang bankers. So it turns out that story was never written, which is why you haven't heard about it until today. But the narrative is so powerful because it dictates everything. The words we use, how we use the words, they have meaning and that meaning transforms into actions, those actions transform into policies every day. And this became very powerful because it became part of a national narrative during the presidential election. I don't know how many tweets there were about Chicago and violence, but the city of Chicago became emblematic of violence in urban America. So much so that people became associated with it too as if they were unique to the city of Chicago. But I challenge this room to say, why was this number any more powerful than this number, this number, this number, this number, those numbers? Because each of those numbers represent a lost life to homicide, 97% gun violence, and not just the individual who was lost, but the impact that had on every single one of their family members and their close contacts. And that story is often not told about the impact to individuals, close contacts, secondary contacts, what happened in schools. February 14th this year, Valentine's Day for some, there were two homicides of kids less than the age of 10. And the thing that was just incredible, sad about that is that in classic fashion, obviously the kids had nothing to do with it, right? They were just bystanders, but they weren't really bystanders. They were victims of their setting. They were victims of their neighborhood, their community, their proximity to violence, and the both traversed them and ended their lives. But we don't hear those stories beyond the sensational day or two or three. About a month later, there was a story about three young men all in the early 20s, three, all found dead a day later after their homicide in the back of a car. One was found in the front seat, bolt went to the head, the other was found in the back seat, and one was found in the trunk with a bolt went to the head, three young men. That was a powerful story. I don't know how many people in the room remember that story. Next week, Chicago Tribune ran a story about one of those men. And the story that they ran was about the fact that that young man, who's now dead, you know, as a February, 10 years before, a decade before, wasn't in the news. But he wasn't in the news for a different reason, because he lived in Cabrini Green, and his younger brother, two years younger than he, fell to his death at the hands of two other teenagers when he was let go on a candy shakedown.  I really wanted to know what happened in those intervening 10 years. What mental health counseling, what services, how to use school, what's the social connection. I really wanted to know that, but I never got that story. And the challenge that this story, and this number has, is that we're on a pace to do the same thing this year in this city. The problem is, in my mind, is that if this was isolated in Chicago, maybe we could do the wall thing. We'll just bury up a wall. No, I was kidding, that's a joke. But the reality is, Chicago is not unique. Before this talk, would people in this room know that the murder capital in the United States of America is indeed St. Louis, by rate. That's suburb, four hours south of us. Actually that's what Chicago thinks about St. Louis, I understand, the Cubs and the Cardinals. But that is amazing to me, but look at Detroit. By the way, I lived in New England for 30 years of my life, and until I really got into this work, living in Boston, I would not have put Hartford, Connecticut in the top 20, and it is. So the problem is not unique to Chicago. The challenge, and I think the reason why this became such a national story, is because it seemed to be new. If you could read the caption here, published September 17th, 1985. Croming the ghetto, everybody pays a price. Blacks suffer the most, but urban terror touches us all. September 2017, Chicago hit 500. October 4th, or is it 5th? Today's October 4th, I'm pressured, I wonder if I had October 4th, we had 530 homicides. So how do we respond to that? One of the opportunities going beyond patching people up and sending them back into the same environment in which they were shot, stabbed, or assaulted. We often focus on this element, to traumatic event. In many ways, that's what the trauma center here at the University of Chicago Medicine will address. But oftentimes, that focuses on pre-hospital care about Chicago Fire Department and inpatient care, post-acute care. We have some element, some impact upon rehabilitation, because at the end of the day, from the perspective of someone who's been a victim of trauma or violence, the outcome is not measured by whether or not you survive. In fact, many people think that survival is actually sometimes worse, because of what else happened to a victim, losing an arm, losing a leg, losing function, losing the capacity to think, to feel, to love. Beyond that, the other person that was injured and how that affected that person who was left with nightmares and post-traumatic stress disorder and hyperarousal and never the same again. The question is, how can you actually focus on that recovery? And that's really hard work, because that's not restoring physiology. That's not fixing damaged blood vessels. That's not repairing the iliac vein. That's restoring someone's soul. That's really hard work. I actually gonna go back for a second, because I focus right away on this. And that's what myself, Dr. Vrakash, Dr. Wilson, Dr. Bendick's left, Dr. Cohn, our new trauma faculty, Dr. Anna knows away, but that's what we got trained to do. And we're very good surgeons. But what if you spent all that emotional, physical, psychological investment restoring someone's physiology and the outcome after they walk out the door is that they get returned to the morgue. Have you done anything? Have you made any impact? Have you made any difference in that person's life? And that's often driven by the built environment and lived experiences. So when you look at the built environment, that means where you live, work, and play. And some, when you look at the aspect of healthcare disparities and disparities in mortality, if you live in Chicago, within the loop, your average life expectancy is 85 years of age. If you live in Washington Park, half a mile from where I stand, your average life expectancy is 69 years of age. 16 years, eight miles in a great city called Chicago. But that doesn't even tell you anything about the lived experience, the quality of one's life. It just tells you a number. And there are so many overlapping parts of the lived experience. If you look at elevated blood levels and housing, they parallel the western south sides of the city of Chicago. And one would say from the lived experience, this is the highest level of mouth-thoves hierarchy of needs, self-actualization. However, you can't get to self-actualization if you don't have physiological stability, blood pressure, heart rate, ability to think. But the next one is safety. Nobody would be in this room unless you felt safe. It's foundational to this aspirational goal. And if you look at the impact of poverty, and if you accept that poverty is not random, and poverty is a marker, socioeconomic determinant of one's health, those who are poor are affected in their reading achievement. Intentional intelligence quotient. And disproportionately, black and Latino people, black and brown people of the city of Chicago are poor. And this is what I shared earlier, that the distribution of health slash illness is not random. Geography matters. And with a traumatic event, this is a framework I'm gonna share with you, so you take, and this example gets repeated over and over and over again in every urban setting in the United States of America. You can change the age of 17, you can change the ethnicity from African-American to Hispanic, usually male. Change to 25, 35. Cigarette wound to the neck, posterior triangle for those non-autonomous, it's a kid that took care of what it was in Nashville. And he kept screaming for mommy. After he screamed for mommy, I'm not scaring your dog, am I? So after he screamed for mom, he actually checked it okay. He had one of those magic bullets, it was fine. But was he? And I'll share with you that, I actually decided to admit this kid because at the time my kids were teenagers and I just had the soft spot. I couldn't just imagine, just send this kid home. We didn't have healing hurt people, there were no psychologists or therapists, but I just knew that I just didn't feel right if I just sent this kid home, even though he was physiologically fine. And I thought I built a relationship with him and we had a discussion, I was looking forward to seeing him and follow up on clinic and I really, I felt like I'd done something as a doctor. And the question is, after all of the classic things, you gotta find and let him go, right? I can't adopt him, am I gonna bring him into my house?  So he went home, what should have happened? That's a rhetorical question, don't answer it. We'll do it out of Q and A. But nothing else happened. What interactions should have had with his family? Again, this is a true story. It's still down to bullets. Six weeks later, up until those six weeks, I actually had forgotten about the kid because I went through a whole bunch of other stuff, right? Trauma surgeon, busy, work, writing papers, doing grants, getting a massive public health advantage, blah, blah, blah, blah, blah. And then the kid's on my schedule. I recognized the name, but didn't remember the face. But as soon as I saw the face, I remembered the kid. It just all came back to me, oh, doop. And I went back to that place and I remember the bond that I felt I was baking. I said, hey, you hear the, get me to take a look at your neck. You know, I thought you would be here like two weeks ago, I mean, actually four weeks ago. I thought, well, you know, anything going on? I said, hey, I mean, what are you talking about? That's what he said to me. What are you talking about?  He said, I'm here to get my staples out. In those intervening six weeks, you've been shot again in the abdomen, in the liver, in the small bowel, and I said to myself, have I done anything to make a difference in this kid's life? And how many times do we repeat that story across country? And the outcome is actually not as gratuitous this kid. But actually, I don't know what happened to this kid. So with respect to the ethical frameworks, there are four guiding principles. Respect for autonomy, self-determination. You can debate whether or not a 17-year-old, even a 21-year-old, my kids are 21, 18, and 15. My 21-year-old does not have self-determination. I'm still working on it. But there's a personal rule of self for those who have self-autonomy. That is free from both controlling interferences by others and from personal limitations that prevent meaningful choice. And that's secretly taking notes, but I think these are all the questions that I would love for us to explore in the Q&A. How does poor mental wellness and toxic stress be fuddled, the ability for agency and autonomy? And what is our responsibility as healthcare providers, nurses, doctors, any interaction with the health system? What is our responsibility? Benefits, actions that are done to benefit others. I would say that we're all challenged to provide the best possible care for every patient who walks in the door. Do we achieve that? Knowing what I've shared with you thus far. Non-malfeasance. We have an obligation not to harm others. And this may be the controversial one. Do we further harm if we only treat and street victims of intentional violence? This one I can have a lot of debate about, not myself, but with whoever disagrees, because to do it, not to act is not to do. And then justice. We have an obligation to provide others what they are owed or deserve and to impose no unfair burdens. And in this age, I have so much concerns about income inequality, healthcare disparities, discrimination, racism, white privilege. This gets really touchy in a pluralistic society to have dialogue about, because it gets at the issue of values, which is really hard to legislate and really hard to adjudicate. This is my only science-y slide. This is a science-y room, but everyone doesn't come, I know former FBI guy, this may not be the science that you're used to. This is what we call a Kaplan-Meier curve. And it's used to look at survival over time. So survival is on the y-axis up-down, x-axis across, and years is this charge, is what the parameter is on this axis. But this is not a chemotherapy or radiation therapy intervention trial. This is an observational study done by one of my colleagues from the program. Who looked at universal Maryland shock trauma data over a decade, and the two curves here, top curve, the solid line, are the people who have been the victim of violence once and only once. And the bottom dotted curve is people who have been the victim of violence two or more times. And the striking thing about this separation of curves, by the way, you want to be on the top line if you had an option. You don't want to be in either line. And we'll get to that in a second. But if you're gonna be in either one of these lines, you want to be on the top curve. But the interesting thing is that the people who died on the bottom curve, even though they're victims of the second or third or fourth or fifth, or more violent episode of trauma, didn't all die related to that trauma. In fact, across the country, and we have a very recent study example of this, where 527 people, one day, 15 minutes, were injured by gunfire. That's where 59 of those people died. That's a case fatality rate of just over 10%, which is actually not uncommon, because unless you really intend to kill someone and shoot them point blank in the heart, correct me? Or in the head, people actually do survive. But we also don't think about what's left behind, what the impact of that survival is, what that life experience is afterwards. So the question here is, is there an opportunity to intervene in the lives of people after they've been injured, as will become the University of Chicago Medicine, and change the arc, so they go from the bottom curve to the top curve. But also part of this conversation that we are gonna have is what's the role of never being shot in the first place? Primary prevention. Because at the end of the day, the best trauma center is the one that's like a firehouse. You're glad it's there, provides this degree of safety for bad things when bad things happen, but you never need to use it. That would be the ideal trauma center. This is a study I did a couple of years ago that looked at this other issue of recovery, and the thing that's striking about recovery is that you can survive the hospitalization, and in some ways we often think about trauma as one of the purest forms of health care delivery. No matter how you get injured, no matter the contacts you get to the hospital, you're gonna bleed the same, you're gonna get the same operation, you're gonna get the same outcome. But that's not really true because anyone who's ever suffered anything traumatic, recovery doesn't end because you get discharged from the hospital, because the important role of rehabilitation. And really from the person's perspective, the most important form of recovery is return of function, especially return of function around loving, living, playing, praying, doing all the things that you could do before. And oftentimes, other part of this that we don't address is what's the emotional, psychological, social impact of that traumatic event. That's the thing, that's the real, real hard work that we've mastered anatomically exposures to trauma. We've figured out that doing a 12-hour operation in someone who is hypothermic, quagmopathic, that means they're the blood students, thin, they're too cold, doing a long operation in that person almost invariably needs a death. And we've learned ways, approaches, techniques to address that problem. And we can weather a lot of people through some really bad stuff. But this stuff, healing the mind, the spirit after the trauma, we don't know how to do this. At least we don't know how to do it well. And hospital-based violence recovery programs, and this is a bit of a long definition, but it's an operational one. It's a multidisciplinary approach to offering support, ongoing case management, advocacy for victims of violence in their close contacts, note the close contacts because violence affects everybody around them, not just everyone around them. But during the hospitalization and beyond, it's the beyond part that we often fall down. We don't continue the accompaniment of that patient on their recovery. And those efforts can include things like, before discharge, are you safe? Can we help you find a safe place to be? Vocational training, mental health counseling, and social support. Those are what one would think of the fuzzy things, but in some ways, the things that matter the most because these are the scars that are invisible that continue to linger in the lives of people when victims of trauma. And the city of Las Vegas is gonna be traumatized, and the secondary trauma to every healthcare worker in that context is gonna be lasting for decades to come. This was just a quick slide to let you know that University of California, San Francisco has a wraparound set of services called UCSF wraparound. And they basically looked at over time in the city of Chicago, which has a county hospital system where all trauma patients go to San Francisco General, and basically found that the investment in these programs, not only save lives in terms of preventing recidivism, but also saves money. And the facility recovery across systems requires breaking down traditional silos. So this is a complex slide, but there's a role of violence interruption, programs like C-SPIRE and Teamwork Anglewood, addressing educational issues, criminal justice, issues that are foundational like housing, legal community, job training, advocacy, substance abuse, and use, all of those things are important components, but the University of Chicago Medicine or any health system can't take all those on. That's an important role of partnerships, breaking down silos, in many ways, being a convener of set of services that meets people where they are and helps them on their continued journey to recovery. And finally, my challenge to all in this room and beyond is that our proximity is our call to action. Within 10 miles of us, at this proportionate amount of intentional violence and gun violence happens every day. And part of this, I alluded to when I made the comment about the 18, 19, and 21-year-old who were killed in that car. We often hear narratives about gang bangers, about bad people. There's a moral failing component that they're isolated. I heard something very somewhat disturbing where apparently on the NPR there was a story yesterday about the Las Vegas shooting and the psychologist was being interviewed at NPR. And the host was really trying to get the interview, or the psychologist to answer a question. So horrific. 527 shootings, horrific. Not people dead, all the time, 50 minutes, horrific. But he brought up a 764 in Chicago last year. And why wasn't that equally horrific? And the response was that is background noise. Background noise. It's an NPR. Because they come across isolated events, two here, two here, one here, one here, one on Thursday, one on Friday, five on a Saturday, compared to the bolus that is national. Again, I'm not mitigating the impact. I just said this is gonna have lasting effects in the city of Las Vegas. 764 last year, 530 so far this year. And overwhelmingly, the focus is on punishment and locking people up and in track. And I hope I don't come across wrong. Crime is a problem for everyone. And crime should be punished. You'll learn that as a golden rule. That's how our judicial system is set up. And I hope that you can provide some questions, comments. However, that leads to a framework where this, that we witnessing for 30 plus years is intractable, unsolvable, and just the way it is. And as long as it's not in my backyard or my kids, it's not my problem. So what if it's actually a learned behavior? You know, I tell you about my nine-year-old in my six-year-old. They've had adverse childhood exposure to trauma. The biggest trauma was that my ex-wife and I divorced, and that was pretty traumatic for them. But they've lived pretty idyllic lives, otherwise, photographer, panelist here from the maroon is classmates with my middle son. She's actually housemates with my middle son. I need to talk to her in order to get to him, by the way. Because he doesn't talk to me anymore. He's so busy in college, she says. Is he in college? But it's also norms, right? What's normal? If I had normalized that, just hit your brother when he offends the. What happens with the next time when he gets teased about Velcro or whatever? Is it contagious? Now, there's a lot of study, one of the more compelling ones, to me besides the work of Kira Vales, Gary Slotkin, and others, is a study that came out this year on January 1st of this year in JAMA, Internal Medicine. I'd looked in the city of Chicago at co-offenders. Co-offenders are people who get arrested for the same crime on the same day at the same time. And they look over time what happened to those people. And it's like my grandmother now passed, used to say to me, you're known by your friends. The power of your social contacts is powerful. And so if a co-offender was shot, that was one of the highest predictors of their co-offender being shot as well. And if it's contagious, if it's contagious, I'm making the argument it is, then it's possible that there could be elements of disease control. And disease control, to me, looks this way.  I got to do those things to improve my longevity after a heart attack. Currently, what do we do after a violent episode where someone is a victim of violence? I'm not going down the path right now of someone who is a perpetrator of violence, but a victim of violence.  No risk factor has been addressed. And if we take that framework, then perhaps we may have a solvable problem. And the burden of the conversation really pushes us around this issue of breaking down our traditional silos, because it's really the intersection. Your daughter is asleep. I was going to say SAS. SAS, I'm going to use a word called intersectionability. It's the intersectionability of all of these aspects that actually can lead to a sustainable solution. SAS, for those who don't know, is SH blank T, academic say. But it's really impactful, because it's about the ability of these different sectors, built environment, social, cultural context, economic and educational environment, and how those things together, working in synchronously, leads to the outcome of violence. And they become opportunities of intervention. And that's the big idea that we have before us. And we often talk today, because we've advanced our knowledge so much in the biomedical model around DNA, RNA, messenger RNA, DNA splicing, cloning. All of that basic science has transformed us with an ability to now talk about and sometimes do precision medicine. One in eight women in this room, epistemologically, will develop breast cancer. None of you who develop breast cancer will be treated the same. Because of your individual genetic markers and phenotype, we have figured out the right mix of interventions to prolong your life. We don't do that with violence. We don't do it with an intentional follow. Treat everyone exactly the same, no matter how they got there, and no matter what their needs may be. And this is a part that I think is one of the more underdeveloped sciences, which has to do with how our environment and our experiences shape us. That's a neurocognitive impact of violence. And adverse childhood exposure to trauma and structural violence, like the impact of segregation or racism, discrimination has upon us over the course of our life cycle. And this is really unknown territory in terms of how do you measure it, how do you impact it. And a question that I think many people would love to know, how do people experience bad things in their life, horrific things in their life, and become resilient? They don't break, but it becomes a source of strength. How does that happen? What happens in the brains of those people? How do those experiences mesh? What's different about the phenotype, the genotype? There are epigenetics that makes that experience really, really bad, painful, but propels them forward, but doesn't hamper them. So in our discussion, these are things that I'm going to have Dr. Siegler come forward. And he's going to actually moderate. These are things that I like to think about. Because it turns out, I love complexity. That's why I'm here. Everything that we're trying to do in New York's Drug and Medicine with respect to this travel program and the impact in community is complex. But violence is complex too. But it's really only through shared working together that we're going to make an impact. And that's really hard work. If we agree that violence is a complex disease and we know that our community is at increased risk for death, what is our responsibilities to mitigate these factors and when does it end? How far do we accompany people on their journey and then let them go? What is a bundle of services needed to make a real impact? And how do you measure that impact? And that last comment I made about resilience, bad things happen to lots of people. But it doesn't break everyone. And some people are really informed by those bad things. And at least for me, I've been really blessed by failure. I've learned the most by failure. I've grown the most through failure. But how does that actually happen? That does happen in some and not in others. So I have always been pushed by words because words are powerful, which is why I've spent so much time starting off with definitions and also used my words carefully. Because when you use certain words, they can transform the action. I think the opportunity that we all have in this room is to inform some of the great words about the King Jr. The arc of the moral universe is long, but it bends toward justice. That's it? Five minutes over. Thanks for your talk. What will happen to your patients from the trauma center when they are discharged? So we're right in the midst currently of doing two things. I said I put up three fingers, so three things. The first is to identify assets in the community that are doing this work. So what's this work? This work looks like on vocational training, mental health services, advocacy.  They're doing good work on the street corners and the blocks in their neighborhoods in a trusting way that people in the community value. We're trying to asset map those and sort out who are our natural partners and where can we, when we can, lift up their work. That's one. The second is culture. Some of this talk, some of the things that I've been doing in terms of meeting, greeting, people where they are, is identify where we are as an institution, as an academic medical center and start addressing some of the culture that we need to meet people where they are and that we would help them to be, which is actually hard work. And then advance our ability to help them on their journey to recovery. And then the third is actually more about people. We've got to develop the right model for case management, mental health services, community-based services that at times are non-traditional, because not everyone wants necessarily, quote unquote, go and see Frasier. Frasier was a shrink, right? I can't remember.  But the mental wellness piece is real. So when someone tells you, every time I'm back in that corner, I freeze. Patients tell me, after traumatic, particularly gunshots, every time I hear the backfire in a car, I drop to the ground. I can't control it. And even on top of that, how people relate to others changes. Reverend Harris, who speaks next, or in a couple of weeks? Yeah, a few weeks. So he is a Bronzewell pastor who has an NGO focused on the communities in Bronzewell. They did a survey in partnership with the School of Social Service Administration. And with that survey of 4th to 8th graders, 30% of the kids had subclinical or clinical depression. I mean, what do you do with that? Because it's not like you can learn well if you're depressed. And the challenge is, what's the source of that depression? And it's clearly currently an unmet need. So there are lots of things going on in our communities that are all around us that are relatively unmet needs, that we can't meet all of those needs. But we can be advocates. We can be conveners. We can be connectors. And I think that's the opportunity that we have. Does it make that thoroughly answer your question? And it's also in development. I got nine months, so bear with me. There's a question right there that may have been first with the mic, but yes, that's so bad. So I'll just make this one quick, because I'm sure I'll have a lot to ask and say as long as we're here. But this is about ethics. And your question was, what is our responsibility? So my question is, in this context, what is the first person plural we're talking about? Who are we talking about? Who is, what is our? Who's our? Who's we? Whose responsibility are we talking about? So there are two ways to ask that question. I'm going to say the thing I learned in Texas is all y'alls. And I'm being facetious, right? This is really an all of us problem.  And the problem is, the reality is we don't. And the challenges, because back to the ethical framework, should we? And actually, that's a dialogue that I think I would like to hear multiple voices up. Because I actually think that I do have a responsibility beyond myself and beyond my three children. But does everyone feel that same way? And we have a national debate going on about this very thing. You can look at health care, you can look at security, you can look at a lot of things. Clearly, we have a difference of opinion about that question. So I'm going to push a little bit. You're pushing? Yes. So you're talking about how we feel and what we believe, right? Yes, values. So what about we? Does we include the institution? Because the institution doesn't feel. It doesn't care. It's not a human being. It's an institution. Is that part of the we? Is that the main we? I think the main we is people. It's all the less in the room. I think institutions are at some level uncaring, because they're institutions. But at the same level, we can influence institutions in the context of policies, procedures, values. Those things are being shaped every day. And I think we're in the midst of evolution. I'm actually going to have my senior colleague speak to that question a little bit, if you don't mind. I agree with you, that institutions speak through the people and personnel who are within them, as well as by virtue of the programs, they develop encourage and support. And you and I have spoken already about the many years that have gone by between the time that the University of Chicago had a trauma center 29 years ago, and the fact that we are creating a new one to begin in May of 2018, I think begins to speak to an institutional level of responsibility and commitment, and the fact that you're the leader of this new program can only indicate that the institution's perspectives are clearly moving in the right direction. Yes, with the mic. You moderate. I apologize. I'm showing the surgeon in me. I'm taking lead. I'm just an intro. Please. Thank you. You have a next. I've been holding it. That was a really good presentation. Thank you very much for it. I'm very glad to see you taking such a broad view. I was somewhat active in the trauma center movement over the last five, six, seven years. And I hope there's other people here from that movement. I don't know if they were contacted about this series. If not, I hope they were. Anyway, my question really builds on those first two, which were the broad questions I was going to ask. So let me get more specific on that. Do you have any specific plans yet for what the university itself and the trauma center itself will do in regards to wraparound services, recovery services, post-acute services? I know that there are a lot of community organizations that will be involved, but I don't know what the university itself is going to do. Oh, I'm sorry. I'm looking for a mic, and I already have one. It shows my cold as tick goes to my head. So we already have a balanced recovery program manager hired and here for six months. And like me, who's been here for nine, one of the things that's a strength and a weakness is I'm an outsider. I say that fondly, but I don't have any baggage. I just showed up. I'm a chief implementer in charge. I have no hard feelings, bad feelings, ill feelings. I'm just here as a humble servant to be the best servant leader I can be. With respect to that, there's a lot to learn about Chicago. It's a lot to learn about the University of Chicago. There's a lot to learn about the University of Chicago Medicine. There's a lot to learn about institutions. There's a lot to learn about the South Side. I read a lot, but no matter how much I read, it gets more complicated. One of the things that I was tasked with early is to read every single story about the reason I was here. I'm saying that actually what I'm saying, two things happened within the past 24 hours that's part of the massive plan. One is there was a internal town hall community-wide within the community of the University of Chicago Medicine to start a culturating University of Chicago Medicine. And this is just part of many, many such things around what trauma means here. But part of that was also this conceptual framework about violence recovery and not just focusing on physiological restoration for people after they're being victims of trauma. So that's a frame shift. That's an important frame shift. But the other part of that is learning who all of the actors and actresses are throughout the South Side. Because one of the things that I have sensed since being here as an operational word is a word silos. And breaking down silos is going to be foundational to make a lasting and sustainable impact. Because one of the things that has to happen is that bubble hair, bubble hair, doing similar work or complementary work would be better as a bigger bubble. And especially since so much of this intersectional, some small NGOs, big NGOs, would be really good at vocational opportunities. Some may be really good at mental health services. Some may be really good around advocacy. Some may be really good about legal stuff. How can we actually get that all together and get that individualized, tailored program for an individual just right to help them on their recovery? The larger issues around prevention, around stressful violence in our society, around segregation, those are big, long, historical, national issues that aren't going to be fixed by the university. But we could all be part of the solution. I hope that begins to answer your question. There'll be greater clarity by May 1. But I got time. I know I feel like running out because the baby is coming and it's going to birth. But I got to, I really, really, really know that the only real, sustainable solution to this complex problem is partnerships with the community. Us doing stuff that the community ain't going to work with, likely will work, co-definitely will work. I guess relevant to that question, one of the things that struck me when I moved to Chicago is that relative to other academic medical centers I've interacted with, it seems like, and this could have been an incorrect perception, that UChicago has relatively sparse engagement in and just a physical presence in Woodlawn and Englewood. You don't see outpatient special clinics there. You don't see a ton of primary care there that's part of the UChicago network. And that limits our ability to provide people with care after they're discharged from the drama center. Do you see that changing during your time here? I certainly hope so. You can give me a better historical framework. I'm even touch-based with Jason Heeler, chief operating officer. We are looking at exploring partnerships with St. Bernard's Hospital in Englewood. There is a, in some ways, a philosophical shift or a strategic shift that there is much more outward reaching. So I think, again, not being here, but just looking at the history. For a while, we were a relatively insular medical center. We're here. We sat here. People came to us. And I think some of the things happening in Enlil's and Enlil Park is starting to do this. What you're proposing is getting closer to where I was around the neighborhoods. And I think that's a strategic shift. I don't know if, Mr. Keeley, you want to comment? Microphone here? I think that we've been talking about required resources. Our first move off of the Hyde Park campus was to a place like Enlil Park and South Loop to generate revenues to be able to support programs like trauma, which is not going to be something that makes the organization money. So we have to have strategic programs to support that, to reinvest in important community benefit programs. As Selwyn mentioned, we have, over the last probably year, year and a half, had a tremendous amount of outreach to the other health care providers in and around the vicinity. St. Bernard's being probably one of the most prominent, knowing that this is going to take more than just University of Chicago to be able to support it, and it's going to require the resources of the local health care community, but also the community at large. And I agree with Selwyn. I think, as you talked to Brenda Bowell and others, there's a lot of community work being done, but it is being done in silos. And it's going to be critically important that there's a convener, likely could be us, to convene those resources and ensure that we as a community are solving this problem. When I say community, it's the city of Chicago. It's the state of Illinois. It's ensuring that there are resources to fund a problem that is big. Question here. Mike. Mike Masal, Developmental Pediatrics. I'm so glad you talked about silos. And I work at 61st and Ellis in the Woodlawn Early Intervention Outreach Program, which has been a tradition of the section of developmental and behavioral pediatrics for over two decades. And I was recently struck, because there's a tendency to say, this doesn't apply to very young children. And what you said about silos reminded me of it. I was seeing a young boy who was 2 and 1 half. The mother was concerned that he had speech delay. And he was more intense in his tantrums. And I just, matter of fact, said, is there anybody he reminds you of? And she said, he reminds me of my younger brother. And all of a sudden, she started crying. And I said, well, tell me about your younger brother. And she said, oh, he had ADHD, struggled with reading. He didn't do so well in school. He was expelled numerous times. He started doing more things on the street. He started getting involved with the gang. My older brother tried to steer him right. But the gang said my older brother was evil. And so when I was 12, the mother of this child that I'm seeing, she's now 25, the younger brother shot the older brother in the house at the request of a gang. And this mother said to me, I am worried that my son is just going to be like my older brother, who's changed because of all of this, who realized he did wrong. And the reason I emphasize this story is what I can't say to the mom about the younger brother is there are no behavioral health services on the South Side for preschool children. Our child psychiatry and child psychology services do not have enough human power. There are many kids like this. The city of Chicago does not have school counselors or behavior health, importantly for adolescent and pre-adolescent depression. There are no social workers in many Chicago public schools. The structural problem is protean. And we have to put this on the table and break down the silos. Thank you for all of this. And I echo that. And I'll share that this is one of those arenas where our voices as advocates for that relatively voiceless 25-year-old mother is one of the things that we can do, and we must do. There's a question here, but we'll get the question in the back, please. Hi, I'm sorry. I'm coming down with the code. I must have what you had. No, I got mine in Italy, unless you were in Italy. I'm a first year graduate student at the School of Social Services Administration. And what we're learning primarily in our core curriculum is our role as people, even as social workers, to address the concerns that are happening within our communities. What can we do to alleviate the issues that poor people or even people that are dealing with trauma? What can we do to alleviate those problems? And I wanted to address the trauma center. I guess from what you've mentioned, the trauma center would do tremendous work in addressing some of the issues in the community. And I'm wondering, in particular, how do you see the trauma center working in tandem with the community? And in addition to that, what sort of examples can you give of a patient coming into the center who has had a gunshot wound? How do you address the services that they receive, what types of services will they receive, and how can they go back into the community being contributing members of society? So that's kind of a follow-up question to the woman in orange shirt. I guess one way I can answer the question is framing it this way. Personas give you a linear narrative of what our compassionate, evidence-based, ethically bounded, socially conscious trauma center will do, as we put all the pieces together. Person gets shot 61st and what was the address of 61st and Woodlawn, all right? So our service area, they're 10 minutes out. High functioning, this is maturing trauma center. Not only will we know that person is coming, but our outreach program, violence prevention program, will either know almost in a real time or shortly thereafter that that person was injured. There will be a dispatch in conjunction. Again, police are doing their thing and there's ideally better coordination than relationships with policing doing their thing. But the violence disruption piece is around preventing retaliatory violence or that person who may be injured. You gave me the chess example, but there are thousands of people who are injured and their immediate response after being the victim is I become now our perpetrator. So that's one issue. But that person is shot. We, that's Dr. Prakash is on call. The person loses their vital signs. She opens her chest, rushes them to the operating room. Within 20 minutes, they have a blood pressure again. They go through a long hospitalization, but they survive. During their hospitalization, as they recover, physically, we start addressing their mental health needs. Healing her people, psychologists, psychiatrists who have dealt with what they need, cognitive behavioral therapists, peer support, interfaces in their life with their needs. And if they are not involved in the criminal justice system, because that obviously goes on a different path, they're going to get to a point where they need rehabilitation. But in addition to that rehabilitation, they'll get a tailored plan to address the needs in partnership with the community around what are the set of unique things, services, programs that we could plug that person into to help them on their journey to holistic recovery. The opportunity there is tremendous because it does two things, ideally. Prevents recidivism. Prevents transformation of that victim to perpetrator. Saves lives, saves money in the holistic society perspective, and potentially it's a better Chicago. The other opportunity there is one of the things that we don't often talk about, which is wasted human capital. When someone is a victim of violence and they don't fully recover holistically, what do we lose as a society? And the next question I'm going to ask is what if we prevented them from getting shot in the first darn place? What could that person's life cycle be? No, I'm going to. Before I thank Dr. Rogers, I just want to remind the audience that next week we'll be hearing from the Commissioner of Public Health of the City of Chicago, Dr. Julie Morita. And some of the numbers and statistics that Dr. Rogers showed us indicates the deep level of concern in the city and nationally for the level of violence here. And so Dr. Morita will come and I've asked her to talk about what the city's efforts are in regard to working to reduce violence. I don't know what to say to Dr. Rogers, except to welcome him to the University of Chicago, to tell him how excited and delighted we are to have him as a colleague and leader of the new University of Chicago Trauma Center, and to recognize that his view of trauma surgery as an end stage in a process that needs interventions at earlier stages is very powerful, and works then both at the beginning in the preventive way, but also in the rehabilitative and restorative way beyond just the techniques of surgery. So it's a great pleasure to thank you and to welcome you.


three two one hello and welcome back to the crop box my name is Brenton today we're in episode 77 of the paragon of a walk-through continuing through aqua not aquila valencia if you haven't checked out last episode ago do that and if you haven't checked out any of the previous episodes go and check out that the link is in the description to the playlist down below today we are starting by listening for court gossip getting that juicy gossip yeah so last episode we met came for the first time I believe from memory I think it was and we defeated commander typhoon see that lady there dame moscarino is hopelessly tiresome but she's a mountain of gossip let's ask her okay um here we go not the zics of a secret and a ruined bit rover what else could in rage her father so indeed we shall see captain I know how we can see her let's go to villa nobody may see young desdemona her father he has forbidden it who are you anyway so via the angeli at your service I am a tutor of classical literature do provangio insists his daughter's education must continue and what need has a tutor of all these other people circus performers basical passages show him piramus and this right oh night with you so black oh night whichever art when day is not but what's the high no this be do I see my love though art my love I've seen that very well desdemona is within enter Wow that was different and we didn't even have to okay that was interesting um let's continue that was really weird but hopefully I think we level up after talking to her we should hopefully and who are you yay level 67 the resistance heaven I'm a certain that I know nothing about those horrible traitors how could you even think that I daughter of an esteemed don't play koi with me caliostro thinks you know quite a bit caliostro you must be seeking me in a circle wait are you the pirate they want captain's deed spoke so highly of you are this is an honor I will help you but I fear I must ask your help my true love my sweet boss anio is in prison he stands accused of being a resistant spy but he is innocent I am the spy not he he must not die for my deeds if he should perish for my actions I will die in anguish these letters prove his innocence but the risado the legate in charge of a son your case or refused to consider them now father would not let me leave my home please take these letters to the whole of justice you must convince risado where I could not okay I'll be back when I am at the halls of justice just about to enter the halls of justice when it loads thank you for loading you're so long I don't know why here we go there is legatrizado let us see how stubbornly it's Bassanio ah yes the accused traitor no he cannot be released he is everything trying he's trying to begin let me see in eight weeks you have no evidence oh dear I'm afraid the discovery phase indeed some weeks ago no new evidence is admissible I'm sorry good day so what now another jail break be silent a jail break in the shadow of the palace have you lost all reason no you must be subtle we shall solve this the valencian we found no help with the top so we start at the bottom I need a clerk you want to introduce a new evidence I fear your cause is hopeless legatrizado is far too old-fashioned to I think I may have a way risado is old-fashioned he loves the classics bring him a gift from aquila a statue carved of aquiland gray marble offer it to him and he'll give you anything you want the skyway is full of smugglers trying to dodge the tariffs on aquiland goods perhaps you could get a statue from one of them it is indeed worth a try many thanks captain shall we return to the ship okay um yeah I'll get these I'll be back in a little bit okay I'm back smugglers have no statues traveling well the way is longer but if you have a ship you could always go to aquila yourself now perhaps my help was worthwhile to you indeed and it deserves to be rewarded here take a humble token of our thanks oh how son is coming home you get that everybody yes we are going to aquila I'm pretty sure Kane heard you too well done okay so basically we found out that the smugglers didn't actually have any statues which is unfortunate and yeah now we need to go to aquila so I'll be back when we're in aquila okay I'm back yeah back and aquila once again again again it's not very cool actually it's quite cool I quite like aquila but yes Hall critis once again hello look who's here long time no apprehend my friend as I keep saying to all sobiotes we've got to stop meeting like this you need a marble statue well you've certainly come to the right place they're practically laying around in the streets here in aquila oh it's going to be a gift then you need something special there's a sculptor here in town pigmalion he's the best there is talk to him okay let's head over to pigmalion and see what he wants us to do with this problem that we're having bloody people bloody smugglers not having the right stuff he's over here oh kid okay you know he must be over this way I thought he was over there oh well maybe I'm wrong he's here hello going da da da da going da da da da who let you in welcome welcome to my humble studio so you need a statue of a unicorn interesting a challenge no doubt and one worthy of my talents I'll carve it out of smoky gray marble the effect will be quite striking and then oh wait I'm afraid I cannot do this work for you but I fear I have entirely too many imperial commissions to finish and less I'm working on another project something special you might call it a labor of love help me with that and I'll make room in my schedule it requires the finest marble whitest driven snow it can be found in one place quarry cave but Ophidians have driven the stone cutters out I'll also need my special tools that confounded cyclopes sold them from my outdoor studio in Ilios bring me white marble in my tools for my special project and I'll make sure your statue is ready by the time you get his voice reminds me of captain gun all the way back in Skull Island he has sort of the same like it's the same sort of like tone and I think it might be the same voice actor but yeah I'll be back when I'm in Ilios defeating Cyclops is cycle please whatever it's called okay we are in that battle with the Cyclops seas we've already defeated one I started a bit late because I completely forgot I wasn't recording so yeah but yeah we are going we're rocking our full our full musketeer sit up okay that's pretty cool of watch nice attack not nice okay and you're stopping right there okay let's try and get these two out with this one yeah sure sure why not you know might as well done okay okay he did he did and one left hopefully Chantel can defeat yeah hopefully yes Chantel is a god there we go hopefully we get both things we needed this battle but we may not do we we got one so yeah I'll be back when I've got the other okay I am back okay that was kind of scary didn't want to get pulled into that battle um let's go and collect the marble which is for some reason than the cave all the way up here because that makes complete sense right yep definitely okay let's head into this not suspicious looking cave why did I not get it oh yeah that's right team up wasn't really added to the new stuff like it is now but it wasn't before that's a bug that's a bug got a lot of finding the bugs the bug the bug okay let's get these guys defeated um what level are you level a hundred billion level 65 okay let's do that look it's marble oh no it's rubble don't worry then we can do let's do that we're gonna move down there and we're gonna destroy hopefully that's good okay really you would just walk through all of them wouldn't you okay yikes this is gonna be bad already sensing this is going to be bad calm down calm the fly what was that what was that what the flip what the hell what the hell what the I'm on a hundred and twenty nine health and it's only the first like just finished the first round what the flip is that that is not fair that is BS that is so not fair die you better die if you don't die I'll be angry double check on to it yes thank you so it can do a whole bunch of damage and one hurt but yet I can't kill it with three people hitting it like what the flip how was that fear it's not really this is complete BS this game is unfair this game is rigged this game is rigged this game is rigged this game is rigged this game is rigged dodge thank you this game is rigged this game is rigged this game is rigged okay hopefully one of them is dead not okay that's unlikely it's not even fair okay this is BS blup really what the flip that's not even fair I'm dead now okay then that's fine just correct you know just pretty every single that you do why don't you you would wouldn't you that was weird that attack animation didn't even show oh okay okay cool cool you know what you're so cool yeah just pretty every head and kill you know that's fine that's perfectly fine you know it's perfectly fine look at this for the flippin to house this fear oh wait it isn't haha gotta love this game at least over indeed please kill this one please kill it why did you not kill it right damn it okay the fucks sakes blade still want to shantel kill shantel okay that is this game is terrible I hate this game why do I even play this game why do I even play this game this game is the world wow he blocked okay that's cool you know what you know what you're so amazing like yeah yeah you know you can just continue to do that obviously I don't care so this is so unfair so unfair really you would block wouldn't you please stop stop being good like this isn't fear this isn't fear you're not meant to be good stop critting and killing things oh look an epic it what a surprise oh look he has less health more health than me what a surprise oh look Louis can't burst fire what a surprise oh look we are going to die what a surprise is that 157 health what a surprise please kill Louis please nope okay see look at this this is slightly retarded I hate this game this is complete bullshit this is complete bullshit complete bullshit complete bullshit complete bullshit complete bullshit I quit


The Navy's energy programs are on display for the 2013 Sea Air Space Exposition through April 10th at the Gaylord National Resort and Convention Center in National Harbor, Maryland. At the Expo, the CNO spoke about issues of importance and challenges that lie ahead in the fleet. Well, the Sea Air Space event is an absolutely wonderful opportunity for industry and the military, our sailors, soldiers, airmen, Marines, everybody, Coast Guardsmen, to get together and talk about issues of importance. It's about talking about our challenges, our opportunities, and I think most importantly, where we can find solutions. Sea Air Space is the largest maritime event in the nation and is organized by the Navy League to discuss energy issues and resolutions in the fleet. From the Defense Media Activity, I'm Petty Officer Amara Timberlake.