Breaking the Cycle

As I write this in mid-May, Baltimore City has seen 103 people die on its streets, the vast majority male, Black and the victim of gun violence. By the time you read this, the death toll will almost certainly rise by at least a dozen more. Of course, Baltimore is not alone. In Philadelphia, 155 people have been killed so far this year; in Chicago, the homicide rate is just shy of 200.

Ideas vary for how to stem this carnage in our urban centers. In Maryland, Governor Wes Moore recently signed into law a sweeping set of measures aimed at tightening existing gun laws, including raising the age for qualifying for a handgun permit from 18 to 21. Other leaders are putting their weight behind stopping the flow of illegal handguns. And then there are those arguing for tougher sentencing for repeat violent offenders.

Against this backdrop, the Break the Cycle program at The Johns Hopkins Hospital offers one way forward that I think everyone can get behind. As you’ll read in Patrick Smith’s "Journey to Recovery," violence intervention specialists at Johns Hopkins are connecting with injured patients very early in their recovery, when they are most traumatized — then staying connected in the months to come.

By building trust and offering resources and support for a new future, the Break the Cycle team is interrupting the loop of violence in a lasting way, one person — and one neighborhood — at a time.

Letter to the editor:

Partners in Care

I write as a retired physician, having practiced health care with children and adults, in private and public clinics, from 1965 to 2015. I am responding to your article about “Personomics” published in the Winter issue of Hopkins Medicine(“Finding Meaning Through ‘Personomics,’”). I also read and essentially agreed with an article by Dr. Roy Ziegelstein, published in the Journal of Personalized Medicine in December 2017 [in which he coined the term personomics].

I want to add a story from my first day in medical school, when a professor welcomed the members of our class. He provided us with a quote from Dr. Francis W. Peabody, stated in a lecture in 1925: “The art of the care of the patient is in caring for the patient.” That “motto” provided the basis of my practice for those 50 years. One result for me: I did not consider myself as a “provider,” but rather as a practitioner.

I expected that my patients knew many things about themselves and their health challenges; I brought my knowledge base and experience to the relationship. We were partners. 

I realize that health care has become much more complex, as found in precision medicine and the usage of electronic medical records. Nonetheless, that quote remains true.

Thomas C. Washburn, M.D. (Harvard)

Johns Hopkins (fellow and faculty member, genetics, 1964–70)

Fernandina Beach, FL 

The Tipping Point

I have always learned from Hopkins Medicine magazine but this last issue on recent advances in positron emission tomography (“PET Projects,” Winter 2023) is by far the best issue yet. The content on PET and the future of PET will change medicine worldwide. 

The article explained in wonderful detail the landmark discovery of the high metabolic uptake of sugar in 90% of cancers. FDG [which combines PET isotope fluorine-18 and a sugar analog to create fluorodeoxyglucose] has convinced many doctors and patients that so many cancers, such as breast cancer and bladder cancer, need the fuel or substrate of sugar to survive. 

The article on the “toxic trade-off” of immunotherapy [“Toxic Trade-Offs”] shed light on what many people don’t understand as they only see the positive side of immunotherapy that many of us doctors explain, while minimizing the side effects.

We medical doctors and researchers are only a part of the truth. Medicine requires people like you, who can select and edit the best way to present technical information to make it understandable in common language to get the point across — and reach the tipping point. As my late mentor Dr. Donald Coffey said to me, “You need the work of all those other groups and professionals and journalists to ‘make it tip.’”

George Yu ’81