Louisville Medicine Volume 66, Issue 3 | Page 13

VIOLENCE Gao Xingjian, Moon and Wind/Lune et Vent, 2016 THE ROLE OF PHYSICAL MEDICINE and Rehabilitation in Treating Victims of Violent Crime Sarah Wagers, MD A s a physiatrist, my main goal for patients is to return them to their optimal function—phys- ically, cognitively, emotionally and socially. At Frazier Rehab Institute, we see many victims of violent crime. These patients face many additional challenges to their recovery process. We see victims of gunshots, stabbings, assaults, and even assault with a motor vehicle. We see children who have been physically abused as well. All of these patients are treated by a team of medical profession- als that includes the physician, nurse practitioners, nurses, aides, secretaries, physical therapists, occupational therapists, speech therapists, social workers/case managers, psychologists and pulmo- nary therapists. Many of the patients come in under an alias due to the fear that the perpetrator of the crime is still in the community. While the patients are undergoing rehab, they have to deal with the added pressures of being a part of the criminal process as well. Our physical therapists work to get the patients back to their optimal mobility. For spinal cord or traumatic brain injury patients, this may mean from a wheel chair level if needed. Our occupational therapists work to optimize the activities of daily living including eating, bathing, dressing and toileting. Patients with spinal cord injuries face special challenges for a neurogenic bowel and blad- der. Unfortunately, a large number of our patients have sustained gunshot wounds to the spine. Another frequent area for gunshot wounds is to the abdomen. These patients frequently end up with a colostomy. Our speech therapists try to optimize both cognition and swallowing, especially the patients with head and neck injuries (continued on page 12) AUGUST 2018 11