stigma and barriers to care - Uniformed Services University of the ...

Day 1 Discussion 93
tools to address this in a good way. I would suggest that social networks are also
increasing tools for the bad guys to use stigma against us. I think we have seen some
Congressional use of this recently with the stigmatization of voting on National
Health Care. I think that was a stigmatization in action. I am sure that folks who
live in other countries or are sitting amongst us definitely know that. I see that as a
huge national security threat.
Let me take it on a different level. How do you de-medicalize stigma My experience
brings in musculoskeletal injuries and working with the Marine Corps. We
do not medicalize injuries. It is for the generals to figure out what the pain needs
to be. We were able to de-medicalize injuries in the Marine Corps by using athletic
trainers. Those of you that know what athletic trainers do, they do not take people
out of the game. They get them back into the game.
From a military, a continuity of operations, a national security or health security
standpoint, I wonder, how can we use the athletic trainer model to keep us in the
game Whether it is Haiti or wherever the next disaster or terrorist event might happen,
there are two very different bookends that are sort of vibrating around with me.
DR. HOBFOLL: To quote Pogo, from whom I learned everything I know, “We
have met the enemy and he is us.” We have to look at how as leaders we have not
changed training to make a difference. Really the things that we have talked about
have been well known for 30, 40 years. The real question is why are we stuck short
of implementation and change on these things
DR. LINK: I come here with this interest in stigma and I get to look at it through
different lenses and from different angles. One way is thinking about the military
culture and also about what is done after disasters or terrorist attacks. One of the
things I like about studying this area is that every time you take a different lens, you
learn something new. I will say a few of the things that I have learned in listening
to the rest of you.
A specific thing I would like somebody to talk about tomorrow, which would
have theoretical significance to me, is how stigma lines up with ranks in the military
I have a specific prediction about that from where I sit and I would like to see what
others think.
DR. WESSELY: What is your prediction
DR. LINK: My prediction in the military would be that the stigma would be
strongest higher up.
DR. ENGEL: Plus we have more money to go out and buy it ourselves somewhere
else.
DR. WESSELY: I am the Brit. If I had my time again I would be a historian
because historians know that most people have coped with adversity for long before
us and without us. There are only a few who do not. Even then I think we have to
recognize that at the moment either our products, or perhaps ourselves, still are not
that attractive to a large number of people. If only they would come and see us, we
can help them, though that really does not seem to be enough.
DR. ESTROFF: I am going to fall back on a couple of my favorite old sayings.
One is,“not everything that counts can be counted and not everything that we count
counts.” That is from Einstein. The other one is, I think, from Will Rogers. I am
paraphrasing here that, “It is not what we do not know that is the problem. It is
what we think we know that is not so that is the problem.”
Given that, I would like to return to this broader concern of what, if any, collateral
repair or damage the entry and openness about stigmatized conditions in