CHICAGO — Christine Goggins was just about to check in with the family of a gunshot victim, a new case that had been handed off from the previous shift, when the high-pitched beep of her pager sounded in her office at the University of Chicago’s medical campus.
A middle-age man who had been assaulted and suffered severe head trauma was five minutes out from the hospital.
Goggins, 30, headed across three buildings, nearly a city block, to the emergency department at the U. of C. Medical Center. She found the man in too much pain to talk. The medical team was getting him stabilized and starting IVs, and Goggins would have wait to see if he was able to talk later in the day.
So she found a spot at the administration station to make a call and returned her attention to the morning’s gunshot victim.
Goggins used her cellphone to check and see if the family needed anything, after reaching a relative. The victim, a young adult woman, was headed to surgery. Things were going OK, the family member assured Goggins.
It was just 15 minutes into Goggins’ shift on a recent afternoon, and she’d already seen two emergency victims. She was sitting in a coffee shop near her office, still wearing her UChicago face mask, looking at a sheet of paper on what the day would bring.
After dealing with what the prior shift had handed her, she was ready to tackle her own cases.
“Oh,” she said when she got to the bottom of the list. “I have all gunshot wounds. I didn’t even realize that.”
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There are many ways to measure and consider Chicago’s deadly 2020.
There are the 175 children age 16 and under who have been shot. There are the weekends when as many as 60 to 70 people have been hit by gunfire. And there was the single mass shooting on the South Side that left 15 wounded.
But another way to understand the toll of the violence is to spend time following Goggins, one of nine violence recovery specialists at University of Chicago Medicine, who, like a doctor or nurse, responds immediately to trauma patients and their families.
Goggins’ care is different, if also complicated and necessary. While the medical team tends to the physical wounds, Goggins offers immediate emotional support in traumatic moments, and she also tries to answer a question that some say isn’t asked nearly enough in Chicago: What other treatment and help do victims of violence need?
Goggins’ first job is, as she describes it, is to “hold space,” for people in those first minutes after they’ve been shot or stabbed or beaten. Some don’t or can’t talk. But if they do, Goggins is there to listen about whatever they want to share, which is often the shock of what it feels like to be targeted for violence or, often, death.
Later, Goggins shifts to the second part of her mission. It is what she calls “finding justice” for her patients by trying to make sure they and their loved ones have what they need to feel safe, whether it is housing, mental health counseling, a job or even something as simple as food.
“Justice looks like having someone advocate for them and having someone really give them the resources they need to be a survivor,” she said. “It gives them their control back, and I think when you seek justice that is what you really want. It is not ‘an eye for an eye’. It is, ‘I want somebody to care that this happened to me. I want some resources. I want to feel safe.’”
This work was only more challenging during the exceptionally bloody summer in Chicago, where living with high rates of gun violence in the Black community was complicated by a deadly pandemic, not to mention a national, ongoing, overdue reckoning on racism.
To Goggins, it has made the work more urgent.
“We are seeing all that is happening in the world in our patients,” she said.
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Thirteen years ago, it was Goggins who found herself in a hospital waiting room, feeling helpless.
Goggins, then a Gwendolyn Brooks high school student, had just turned 17 in May 2007 when she got phone call from a grade school friend. He asked her if she was sitting down, and then delivered the devastating news.
Their classmate and friend, Blair Holt — the boy with the big curls and bright smile she met when she was 9 or 10 and he was helping behind the counter at his grandparents’ store in her Roseland neighborhood, the boy she went to a skating rink with, the boy she hung out with at the River Oaks Center mall — had been shot.
Goggins raced to Advocate Christ Medical Center in Oak Lawn with her parents, where she waited for good news that never came. Blair, a Julian High School student, died from the gunshot wounds he suffered that day after a 16-year-old opened fire on a crowded CTA bus in Roseland, aiming at someone else.
Four others were wounded in the brazen shooting, which was captured on a bus security camera and shocked the city. Witnesses reported that Blair, 16, had jumped in front of a friend when the shots rang out.
“At the time I just felt like my entire childhood was shattered,” Goggins said. “How could this happen to a young high school student, getting shot on a bus? It ‘grows you up’ in way there is no bracing for — my friend being gone and knowing he would never come back. I needed to do something with these feelings.”
Within a month, Goggins was volunteering with organizations that were campaigning for safer gun laws, reaching out to statewide organizations with a determination that stood out to adults who were pushing for change.
“I remember a teenager getting in touch with us because her friend had been shot and killed,” said Nina Vinik, who formerly headed the Illinois Campaign to End Gun Violence and is now the director of the Joyce Foundation’s gun violence prevention and justice reform program. “And she was so motivated and outraged and moved by that experience to want to take some action. I remember very much that Christine was just a real example of that kind of outrage and passion kind of all coming together.”
Goggins also joined anti-violence campaigns and foundations on behalf of Blair, supporting the work of his parents, a Chicago Fire Department captain and a Chicago police gang crimes officer, and eventually switched her career goal from emergency room physician to counseling and social work. She is currently enrolled in the master’s program the University of Chicago’s School of Social Service Administration.
Ron Holt, who retired from the Chicago Police Department two years ago as the commander of the community policing unit, said Goggins became a source of support to him and his family after they lost Blair, and that she has remained involved, making suggestions on how to keep the foundation relevant.
“I think that Christine feels like l feel,” said Holt. “We wish we would have been there for Blair when he was shot on the bus. To see Blair doubled over, on the floor of that bus in the fetal position, we wish we could have been there to prevent it. But we were not there. (That) image became part of Christine’s calling.”
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By about 2 p.m. on a recent day, Goggins was sitting at a table in the lobby of the hospital, eyeing the list of the seven gunshot patients she would be monitoring that day.
“I look at this daily,” she said, glancing down at the paper. “I pull up this list and go down, one by one. … During summer, this is typical.”
Due to rules instituted during the coronavirus crisis, the Chicago Tribune was not permitted to follow Goggins during her time with victims, but met with her at the medical campus during her shift to discuss her work.
The Violence Recovery Program opened in 2018 to serve adult and pediatric trauma patients and their families at University of Chicago Medicine. The hospital had added a Level 1 adult trauma center that same year.
The recovery program is part of an emerging field of hospital-based violence intervention programs that emphasize the urgent need to treat not only physical wounds of violence but also the emotional and mental trauma and social upheaval, such as loss of a job, that victims suffer.
The work is driven by research showing there are strong indicators that a person who suffers a violent injury is at risk to be hurt again. So what Goggins and the other specialists are trying to identify is what has put a patient at risk for injury in the first place and help them address it.
“The more we think about the act of violence as a health issue, the more we start to think about the factors, all of the factors, that are at the root of interpersonal violence,” said Mark Ohrtman, manager of the Violence Recovery Program and Goggins’ supervisor. “The housing, the food, the behavioral health. Acute stress and substance use. … If these things are addressed, there is good literature saying re-injury risk goes down.”
To that end, the specialists, in addition to being on call three to five days a week to respond to the emergency department, carry a caseload of patients who are still recovering at the hospital or back home.
They become a critical way to hopefully find support and help in a city, where years of disinvestment and drained resources from Black neighborhoods has left many behind even as deadly violence has taken hold.
There are immediate concerns to address, including whether the patient feels they are at risk of being targeted again. Housing is a huge requirement, both the need to immediately relocate people for safety or find a stable long-term living situation. People want help finding jobs too. Goggins provides links to services that can meet their needs, going as far as helping them fill out the necessary paperwork.
Mental health referrals are a key part of the work. Some need help signing up for food stamps, and there is a state victim-assistance program they can enroll in for financial help.
Glancing at her caseload on a recent day, Goggins ran through to-do list:
She had to follow up with a nonprofit that specializes in reentry for a patient who was shot shortly after getting out of prison. She also needed to come up with a ‘discharge plan’ for him, in case it is not safe for him to return home. In that case, she might also need to contact the state parole office on his behalf.
Another patient, a younger man, had said he didn’t feel safe, so Goggins planned to contact one of the city’s street outreach teams to get him some help. And although he had not indicated he wanted counseling, Goggins planned to continue that conversation, especially because he has children.
And for another patient, who was still in the early, painful stages of recovery, Goggins would continue to check in on his mother, who has been at the hospital regularly.
“Right now, I am just being an emotional support to her,” she said.
As fulfilling as her work is, Goggins gets frustrated too. She can fill out paperwork and get clients on waiting lists, but she can’t make more shelter beds or create more jobs.
That is the work of policymakers. And as she listens to the debate in the city over the seemingly endless violence, she wonders if those in power really understand the problem, how a “culture” of violence has taken hold in this void of opportunity and hope.
“If you don’t understand the ‘why,’ we are never going to get to a real solution,” she said. “The key to any type of change, reform, is understanding that culture. We have to get to those people, what leads them to committing violence?”
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About an hour before her shift ended that day, Goggins’ pager beeped again.
She was on her way to the emergency department to check on the man with the head injury, who had arrived at the start of her shift, when the notification came in — a young adult male with a gunshot wound was about 12 minutes away.
Goggins shifted gears again, continuing over to the emergency department to find the arriving victim’s family. She joined them at his bedside to provide comfort and assistance before he headed into surgery.
For the rest of her shift, she remained with them, talking first about whether they felt he could be targeted again.
Goggins then spent some time explaining the state victim-assistance program, and how they might be able to get some support for medical or mental health costs. She could help with the paperwork.
They had chatted for about an hour, over Oreos and pretzels, before Goggins told them her shift was ending.
She was going home for the day. Goggins would be handing off her active case to a colleague coming on after her.
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