As a medical resident taking care of children and adults in Baltimore, I see the downstream effect of traumatic experiences during childhood on my patients every day: heart disease, diabetes, unwanted pregnancy, addiction, depression (“More than 40 percent of Maryland children experience traumatic events," Oct. 19). An extraordinary accumulation of research over the past 20 years has taught the medical profession that early childhood trauma is common and associated with numerous chronic diseases as well as premature death. Science now tells us that early adverse experiences change the chemicals in our brains and become embedded in our DNA.
But medicine is just beginning to learn how to use this research to improve patients’ lives — and we cannot do it alone. Addressing childhood trauma requires going further upstream, before my patients ever land in my office. My patients need positive parenting classes and widespread violence prevention programs in their city. They need quality counseling services to fall back on when bad things happen. They need a city that is trauma-informed in every institution and every public space so that they can feel welcome and safe.
Baltimore’s health commissioner, Dr. Leana Wen, and many other city leaders are working hard to build this infrastructure — and to mobilize a network of services across disciplines to prevent the long-term consequences of childhood trauma. In the clinic, I will continue to try to meet my patients where they are, treating their medical problems in the context of the trauma they have faced. But more than any medication I can prescribe, it is our upstream efforts that will ultimately help my patients avoid suffering, nurture resiliency, and begin to heal.
Dr. Cooper Lloyd, Baltimore
The writer is a resident in internal medicine and pediatrics at the Johns Hopkins Hospital.
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