Vol. 3 -- #4 "Family Violence: A Chronic Public Health Issue" Lecture to the Western Psychiatric Institute Pittsburgh, PA November 9, 1982 This is not the first lecture in which the subject of video games came up. I was interested that a statement made in one arena, i.e.: The Western Psychiatric Institute, might cause a minor revolution, but the same statement made in another i.e.: American Academy of Pediatrics can be taken in stride. The lecture I gave on family violence and public health before the American Academy of Pediatrics Meeting in New York City, on October 26, 1982 contained many of the same comments that were made in this lecture, and were taken in stride by that pediatric oriented audience. On the other hand, this same lecture given to a largely psychiatry-oriented audience and delivered in a psychiatric institution had quite the opposite effect. The specifics were in the question and answer session. I was asked if I thought that the video games led to violence, and my response was, "Yes. All you have to do is see a youngster playing a video game and watch his behavior as exhibited by body language or outright attacks on components of the game or the television screen to understand just how deep is the connection." The response of the press was extraordinary as though I had just said something that had never thought of or heard of before. By the next morning, the Department of Health and Human Services had two law suits on its desk from the manufacturers or the sellers of video games and the Secretary of Health and Human Services went to extraordinary lengths to be certain that my departure by plane to the World Health Assembly Meeting in Geneva took place in such a way that I avoided a cadre of the press that were lined up outside the ramp to my aircraft. I remained hidden at another gate until plane was loaded and then by prearrangement I was able to dash from the wrong gate to the right gate and through the press, without comment, to my seat on the plane. In addition to the chaotic behavior associated with this lecture, it is seminal to the extent that it tried to sell the idea that violence should no longer be owned by the Justice Department, but that public health interests should assume some responsibility as well. It was also seminal in that I announced one response to my Academy of Pediatrics lecture mentioned above, the Justice Department asked publicly for a definition of roles and wondered if a collaborative effort might not lead to primary prevention. That was the beginning of a cooperative role that I relished during the next six years as I worked with the Department of Justice on related issues, such as child pornography, spousal abuse, child abuse, and the difference between civil and criminal aspects of the legal system for the benefit of physicians who had to make court appearances. This is also the first time I called attention to the estimated 2,000,000 children who suffer physical or mental abuse each year and carry the scars of that experience throughout the rest of their lives. Also, this is the first time I mentioned elder abuse and gave a profile of the victim and the perpetrator. The intergenerational issues emerge and come together in this lecture and one can see the need to broaden our definitions of the nature of abuse. (Editor's note: Dr. Koop frequently amended his speeches en route to the venue where they would be presented. In the aforementioned speech before the American Academy of Pediatrics and this one, we have put his notes in italics so that the viewer gets some idea of what Dr. Koop thought of as being important to add to his presentation en route to so doing.) Battered child syndrome Behavioral research Child Abuse Conflict resolution Elder abuse Elder abuser profile Family violence Financial abuse High risk families Homicide Human aggression Intergenerational violence Medicalization of social problems Mimicry Motor vehicle fatalities Physical abuse Psychological abuse Sexual abuse Suicide Television & violence American Academy of Pediatrics American Medical Association Ashley Montague Centers for Disease Control Lenore Walker National Institute of Law Enforcement & Criminal Justice Rene Dubos