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Feature

Where Did We Go Wrong?
A Pediatric Perspective

By Sara E. Horstmann, MD, Chair, Child Health Committee

     It has happened again; this time, in our own Queen City.

 Mass shootings are the new norm and, although I am not surprised by what

happened, I am called to action because of it. That action is not just about guns.

W here did we go wrong? For me, as a pediatrician,                            Our sense of connectedness is one of the strongest resilience
                     the tragic loss of life is heartbreaking. Also         factors we have. Building personal connections is free, and it is
                     heartbreaking is to think that the shooter, barely     something we all can do. From the stranger on the street to your
                     more than a child, came through our collective         family, EVERY single interaction matters. The more we can build
doors. Pediatricians see children at least 24 times from birth to age       connections, the more likely we are to prevent tragedies like the
18. How did we not see this tragedy in the making? How can we               shooting at UNCC. The more we can listen to others — to get their
prevent it from happening again?                                            perspectives and understand their stories — the healthier we will be.

  When we ask these important questions, the answer becomes                   How do we go right from here? We focus on educating everyone on
clear. Pediatricians no longer can focus only on physical growth            ACES and toxic stress. We support programs, policies and practices
and development. We need to focus on assessing for trauma, social           that focus on the prevention of ACES and the promotion of resilience.
determinants and mental health concerns just as much as we focus            We support connectivity with one another. We ask the difficult
on hearing, vision and diet. We need to ask about adverse childhood         questions and know what to do when people answer them. We take
experiences (ACES) and toxic stress, because we know these                  responsibility for our community, each and every one of us. Together,
experiences affect the way the brain is formed and develops. These          we can prevent this from happening again.
experiences directly impact health and, in this horrific case, the health
of our community.                                                             I am ready to make this happen for Charlotte. Are you?

  A person’s brain begins to form mere weeks after conception,
and isn’t completely formed until the mid-20’s. Early brain growth
is critical to successful brain functioning as an adult. When young
brains are exposed to adversity, it takes its toll. These negative effects
can be ameliorated through resilience-building at both an individual
and community level. There is myriad evidence-based programs that
can be put into practice that address these risk factors and prevent
horrible outcomes, such as the death of the two students at UNCC.

  We, as a community, no longer can afford to ignore the toll
that early adversity plays in the way our brains develop. We need
to identify these difficult issues and tackle them. We need to
acknowledge that ACES are universal, work to eradicate them and
support people through these experiences as best we can. When we
don’t ask, we miss an opportunity to intervene and heal.

  I don’t know the shooter or his family. We each make our own
decisions in life. But those decisions are shaped and molded by our
experiences in society. We, as a society, need to accept responsibility
for the actions of all people. If we could have stepped in earlier and
recognized what this person needed before he made the decision to
take innocent lives, we would not be in this place.

  The Charlotte Resilience Project is trying to help. We are trying to
educate EVERYONE on the health effects of ACES and toxic stress,
as well as teach people ways to prevent them and build resilience.

6 | July/August 2019 • Mecklenburg Medicine
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