View from the Trauma Center: Why Gun Violence Persists

“Everybody that I know got a family member dead or locked up,” says Slim, one of the young Black men featured in Life After the Gunshot, a digital storytelling project coproduced by Joseph Richardson, a professor of African-American Studies and Anthropology at the University of Maryland.

A multimedia experiment, Life After the Gunshot gives voice to those who have experienced gun violence firsthand. It tells harrowing stories of pain, suffering and, sometimes, redemption. It is an unusual project for an academic, but not for Richardson.

Joseph Richardson

Trained as a criminologist, Richardson has spent the bulk of his career doing qualitative research, with a focus on Black male survivors of violence. Much of his energy in recent years has been devoted to work at trauma centers that care for gunshot and stabbing victims from Washington, D.C., and surrounding Maryland counties.

His research helped to inform the creation of the Capital Region Violence Intervention Program, a hospital-based program that provides trauma-informed care and psychological services to survivors of violent injury in an effort to prevent further violence and victimization.

In July 2021, Harry Frank Guggenheim Foundation Distinguished Fellow of Practice Greg Berman talked to Richardson about his work as a scholar-activist, his take on the recent rise in shootings in American cities, and the relationship between structural violence and interpersonal violence.

The following transcript has been edited for length and clarity.

 GREG BERMAN:  Can you rewind for me and tell me why you joined academia—and why you chose gun violence as an area of focus?

JOSEPH RICHARDSON: Man, this could be a long conversation, but I’ll try to give you the Cliff Notes. Born and raised in a Philly, working-class neighborhood. I grew up in the crack era—I was an adolescent and saw the kind of devastation that it had on the city. My neighborhood was not immune to it. Even though it was a decent low- to working-class neighborhood, at least four guys that I grew up with died from gun violence.

I can remember the first person I knew who got shot. I didn’t see it, but I saw the aftermath of it. I saw the way that he psychologically changed after he was shot. That always was disturbing to me. He was very well respected and then all of a sudden after he was shot, he became a zombie. He was doing a lot of drugs. He was eventually shot and killed on my block.

That was the beginning of my interest in gun violence. After graduating from the University of Virginia, I started graduate school at Rutgers. I started as a master’s student. I had no interest in pursuing a doctorate. I didn’t have enough money to complete the master’s program. My dean just placed me in the doctoral program as a way of finding money for me. I didn’t know anyone who had a PhD. I didn’t know anyone who was a professor. But that started me down the road.

BERMAN:  What was your dissertation about?

 RICHARDSON: My dissertation adviser, Mercer Sullivan, had written a book, Getting Paid: Youth Crime and Work in the Inner City. At the same time, he was also starting a project at the Vera Institute of Justice. He called me and said that he was leading an ethnographic research project on the social context of adolescent violence in New York City. It was a perfect match for me. He asked me if I was interested in helping him conduct his study, because there were three sites. One was Black, one Latino, and the other predominantly white. I said yes. I ended up at a school in Harlem, following 25 kids for three years. That was the time, in the late 1990s, that the Bloods and Crips were emerging in Harlem.

I had 25 kids—ten were girls, 15 were boys. Some were in gangs. Some were basketball players. Some were incredibly talented academically. I learned a hell of a lot about parenting. It started out as a study on the context of violence, but it became a study about social capital and how the utilization of it by kids either leads to violence, or desistance, or resistance.

After I wrote my dissertation and published a number of articles, I had a postdoc at the University of Chicago and then I started [my research] at the University of Maryland. The first study I conducted there was on kids who were adjudicated in adult court and detained in a D.C. jail. These were all kids who were 15, 16 years old, and they were serious violent youth offenders. I was working with kids who were arrested for murder, carjacking, attempted murder, robbery, et cetera. I did that for a year. It was really a study asking, “Why are we placing kids in adult jail?”

BERMAN:  How did you get from there to the work you have done in hospitals?

RICHARDSON:  I was watching CNN one night. There was a segment on Soledad O’Brien’s Black in America on a trauma surgeon in Baltimore whose name is Dr. Carnell Cooper. The segment was on how he would operate on young men in Baltimore for gunshot wounds, and then he would see them a month later for similar gun-related injuries. He decided to create a hospital violence-intervention program. It was fascinating to me, so I cold-called him. When he answered I said, “I saw you on Black in America, and I was just wondering if I could meet with you?” He invited me up to his office. I remember that day, because the Discovery Channel was there. He was always on television. From that point on, he became my mentor.

I started learning the ropes of how hospital violence-intervention programs work. In the meantime, Dr. Cooper became the chief medical officer of Prince George’s Hospital Center [in Maryland]. They’d get 745 victims of violent injury a year. Something like 40 percent of those are people from Washington D.C., because the hospital is close to the D.C. border. I asked him, “Dr. Cooper, do you think it would be okay if I use this trauma center as my lab to understand gun violence?” He said, “Sure.”

So I picked 25 young, Black men that were shot or stabbed and had come into that trauma center. I followed the lives of these guys for two years. I wanted that study to inform the development of a new hospital violence-intervention program. Dr. Cooper, who had already created one, was my counselor, giving me advice on how to go about developing one. He basically gave me full rein to develop it in the way that I saw fit. Ultimately, in 2017, I was one of the cofounders of a program at Prince George’s Hospital Center called the Capital Region Violence Intervention Program. I served as the codirector for two years.

BERMAN:  What are some of the key lessons that you learned in implementing the program?

RICHARDSON: A key moment for me was when I met one of the young guys that was in my study, Che Bullock, who was stabbed 13 times. He and I developed a really close relationship. I could see that he really wanted to get out of the streets. When I started the violence intervention program in 2017, he was the first person I hired. I told him, “Listen, you’re going to be the guy that approaches all of the patients that have been violently injured bedside because you have the lived experience of the guys that are lying in that bed.” He accepted the challenge.

When we first started, people were asking, “Why did Dr. Richardson hire this guy? Why do you have this guy that’s been injured on staff? Why is he going into the rooms?” Eventually, they saw how successful my program was, and he became the model for violence intervention specialists. Every single program in Maryland hired one.

BERMAN:  One of the clear themes that come through your work is an effort to put forward the voices of young Black men. Why is that important to you?

RICHARDSON: I give them credit for their resilience. They’re constantly teaching me, and everyone else that hears their story, not just about the realities of violence in their neighborhoods, but also about the humanity that they have. I’m a researcher that does qualitative work. I want to amplify their voices. I really believe in community-based, participatory research. I was doing that before I knew that there was actually a name for it.

Che is a good example. He goes from being stabbed 13 times in the street, to guest lecturing in my class, to becoming a violence intervention specialist for my program. Then we applied for a grant, and he becomes a co-investigator with me on the Life After the Gunshot project. That is the way that I choose to approach these issues—by having the people who are most impacted be involved in the work. They have the solutions to what we should do to address gun violence. Too often, we ignore their voices. In theory, we say that they should be involved, but we never really engage them in practice.

BERMAN:  One of the things that comes along with trying to elevate the voices of other people, in my experience, is that they are not just mouthpieces for our ideas. Sometimes they say things that we disagree with.

RICHARDSON: Che and I have debates all the time, just the way I would engage in debates in the academic world. There have been plenty of times that I have had a blind spot that he, or another one of my young men, has checked me on.

I’ll give you an example. When I was conducting my research with the young men that had been injured, I would bring them to my campus for the interviews. They would always ask me why the violence intervention program wasn’t on my campus. Initially, I kind of blew it off. I didn’t understand why they would want the program there. When I met Che, he came up to my office, like, three times a week. I knew, at a certain level, he probably was trying to get away from his neighborhood and that a campus space was really peaceful. He brought it up to me. “Doc, why do you have a program at the hospital, because the program is kind of re-traumatizing me because I was just stabbed and operated on there and almost died.”

I tried to explain this to the hospital administrators several times. I said, “We can start everything at the bedside, but the services can be provided off-site.” They weren’t interested in that model at all. I think it is because it is very sexy to have trauma surgeons involved at the hospital. People can buy into it. It’s got automatic credibility.

I mention this story because it gets back to your point about why it’s so important for those who are directly impacted to speak.

BRMAN:  I have seen you refer to yourself as a “scholar-activist.” I’m wondering whether you could spell out for me what that means and how you see that role.

RICHARDSON: I don’t really like the term “activist.” I would call myself a scholar that engages in applied research. I would say that all scientists should be engaged in applied research. Why do the work if it’s not going to be translated into something? Translating a study into a hospital violence-intervention program is scholarly activism to me. Translating my research into a documentary that is accessible to the public—that’s scholarly activism to me. Engaging in policy discussions with elected officials, that’s what I really mean by scholarly activism.

Scholarship should be informing policy or informing programming or changing the narrative with the public. To me, that’s scholarly activism. Scholarly activism doesn’t necessarily mean I need to get out in front of a Black Lives Matter protest. I don’t really see myself in that lane. I think there are multiple lanes that people can assume.

BERMAN:  You write frequently about the idea of structural violence. Can you talk for a second about what you see as the relationship between structural violence and the kinds of interpersonal violence that result in trauma center visits?

RICHARDSON: You can’t have a discussion about interpersonal violence without providing the context of structural violence first. Until recently, there was a long period of time when we were not discussing the ways that the structure has been violent. We need to move beyond the traditional framework. To use the title of Geoffrey Canada’s book, we need to move beyond Fist, Stick, Knife, Gun to see how systems have perpetrated harm against specific populations.

 For example, high concentrations of poverty, food deserts, environmental racism, entire communities under some form of criminal justice supervision—all of these things are forms of structural violence which ultimately lead to a shorter life expectancy.

In Washington, D.C., you have east of the river and then there’s the rest of the city. As you move further into the northwest section of the city, it gets whiter and more affluent. If you go to Woodley Park, which is in the northwest section of the city, the life expectancy is 89.4 years. If you take a 15-minute drive east of the river, the life expectancy is 68.4 years. In just 15 minutes, you lose 21 years of your life in the same city. That’s insane. People need to understand that. That’s just not in D.C. That’s global.

BERMAN:  Do you think there’s ever a tension between identifying these structural forces and the need to communicate to the men that you’re working with that they have the agency to change their fate?

RICHARDSON: It’s interesting that I’m making the argument about structural forces, but if you were to ask the young men I work with why someone did not make it, they would place the responsibility in the hands of the person. For them, it would come down to accountability and personal responsibility. They would place the blame solely on the person and say, “That’s the decision they made. They didn’t have to make that decision, and they’re responsible for it. ”

BERMAN:  I think that’s an example of what I was trying to get at before when I said that sometimes when we listen to the voices of the impacted, they say things that don’t conform with our ideology.

RICHARDSON: Exactly. My ideology is that the structure is responsible, to a certain extent. But I think it’s important to represent that the young men are holding themselves accountable for their actions. It’s complex. Because sometimes they’re actually discussing structural violence—they’re just not using the term. In the Life After the Gunshot film, one of the guys says, “Look at where I live. It’s fucked-up around here.” There’s a term for that. It’s called structural violence. That’s why I say it’s a little bit more complex because they can hold themselves personally accountable, but also they’re saying that the structures are problematic.

BERMAN:  In addition to writing about the people that are directly impacted by violence, you also have shined a spotlight on the caregivers that support them. For example, you’ve written about the use of exile as a parenting strategy. What do you mean by that?

RICHARDSON: I don’t think it’s necessarily a new strategy in the Black community. We’ve seen for generations across the African diaspora, but particularly in this country, parents kind of sending their kids away.

Let’s take two parents and they live in Harlem. Both of their kids are at that age where they are starting to get into trouble. Well, if you took the same family and they were white, and they were middle class, and their kids were involved in delinquency, there would be a ton of resources for that family. They might send their kids to camp. They might send their kids to counseling. They might find another school district to send their kids to—or a private school. But for many Black parents, the only alternative is, “I need to move my kid out of this situation.”

For Black parents in New York City with some social capital, they might be able to tap into, for example, the Fresh Air Fund, where they can send their kid to live in Connecticut for a summer and they get to see a world outside of their block. But if you don’t have that level of savvy in terms of social capital, they might send the kid to live with a brother in Texas.

Then there are other parents, who don’t have any of those resources, that are using the juvenile justice system to save their kids. They are saying, “I just want my kid locked up. At least I know where they are. They probably will have a higher survival rate if I go to the court and just tell the court, ‘Can you take my kid?’ I don’t want my kid to die in the street.”

Why do parents have to do that? Why do people of color, particularly poor people of color, have to go to extremes to save their kids? It gets back to the issue of structural violence.

BERMAN:  Do you have a theory about why shootings are up over the past year? 

RICHARDSON: I think there are multiple reasons. Let’s take Baltimore for example. Violence has been spiking in Baltimore since 2015. In my opinion, the fact that Baltimore has had over 300 homicides since 2015 is directly correlated to Freddie Gray. The Baltimore police department may have been ahead of the rest of the nation in terms of police not responding to incidents of violence in the way that they may have in the past. I know cops who have told me this.

 A few months ago, I had a long discussion with a cop who lives on my block in Philadelphia. I asked him why gun violence was increasing in Philly. His take, as an officer on the beat, was, “Look, I’m not jumping out of my car, I’m not doing any more pat-downs on the corner, if I know someone’s going to throw a camera in my face.”  He told me that he used to tell kids out on the street, “Listen, you got 30 minutes to get off the corner. If I come back in 30 minutes and you’re out here, whatever consequences happen, you know what it is.” Now he’s like, “I don’t even tell the kid that. I just let him stay out there.”

That’s one perspective. I’m not saying that’s the only perspective, but I’m giving you a perspective that I’ve heard both in Philadelphia and in Baltimore. One of my really close friends, who does hospital violence-intervention work, was telling me this story in Baltimore. He said that he saw two guys fighting. Clearly, it could’ve turned into a shooting. My friend goes around the corner and tells two cops sitting in their squad car. He says, “There are two guys around the corner that are fighting.” And the cops looked at him like, “So?” He couldn’t believe it.

BERMAN:  In recent months I’ve talked to a number of academics who are deeply skeptical that the police should play any role in responding to the uptick in shootings.

 RICHARDSON: [Those academics] are not on the ground. There’s a 30,000-foot perspective about that, and then there’s the perspective of the people at ground level. I tend to lean more towards what the people who are experiencing the impact of the police pulling back are saying.

To be sure, there are other narratives that are going on in the street. One of my guys said to me, “There are no drugs out here.” During COVID, it became harder to get drugs. The drug market was drying up in the city, which has an impact on people that were surviving by selling drugs. That’s squeezing more people out of the game. I’m giving you another perspective because that’s a perspective that I’ve heard from the ground. I don’t think anyone’s talking about that.

I also think COVID has driven more people onto social media. You have a lot of beefs that are playing out on social media now. We can go back and forth on social media, and if I see you outside it becomes very real. And now it is totally legitimate for me to wear a mask and gloves in broad daylight.

BERMAN:  You’ve written in the past about the relative lack of funding for gun violence research. As you look to a future where maybe there will be more money for gun violence research, what questions should we be asking that we don’t know the answers to?

RICHARDSON: I would definitely say the question you just asked, because it’s all really just speculation. I don’t think we’ve asked the hard questions about gun violence and COVID.

BERMAN:  Last question. I couldn’t help noticing that in various papers you have written, you have cited lyrics from Mobb Deep and Biggie Smalls. How has hip-hop informed your scholarship, if at all?

 RICHARDSON: In so many ways. I’m a child of hip-hop so it’s important for me to always represent hip-hop culture in the work that I do. Like a lot of people who were raised in that era, hip-hop was a huge part of my identity. It helped me frame a lot of my thoughts about the world. From NWA saying “Fuck tha Police,” to Public Enemy saying “Fight the Power,” to Brand Nubian talking about the Five Percenters—all of those things were sources of knowledge to me. They were secondary teachers for me, whether good or bad. It’s important to me to pay homage to that in my work.

Greg Berman

Greg Berman, Distinguished Fellow of Practice at The Harry Frank Guggenheim Foundation, previously served as the executive director of the Center for Court Innovation for 18 years. His most recent book is Start Here: A Road Map to Reducing Mass Incarceration (The New Press).

This article is the latest installment of the “At The Crossroads” series of  conversations with thought leaders examining the roots of gun violence, co-published with the Harry Frank Guggenheim Foundation. Views expressed are the participants’ own and not necessarily those of the Foundation. The previous article in the series, an interview with Jeremy Travis, can be accessed here.  Click here to see the entire series to date.