Ken Burns’ documentary on Vietnam is hard to watch!

Ken Burns’ documentary on Vietnam is hard to watch!  It reminds me of a time when the daily news was hard to watch—it was a time when in Medical School, it was difficult to embrace the value of life, when so much was destroyed each day and played out on the TV screens on the 6 o’clock news.  We would have to look away—because the truth of it was overwhelming—it was mired in bureaucratic maneuverings and lies. Perhaps it was then, or maybe a few years earlier when my father retired in protest over the lack of courage and commitment by those in charge of the University where he was chairman of his department., that I hung the meaning of life on my wall.

“Go now into the world in peace and know how much an old world needs your youth and gladness. Recognize that there are words of truth and healing that will never be spoken unless you speak them, and deeds of compassion and courage that we never be done unless you do them. —Never mistake success for victory or failure for defeat”…and it goes on…

I can no longer offer up my youth as a means to truth and healing, but I can offer up gladness and determination. Gladness that we have been able to create a system of care for children, youth and families in this County that protects them, encourages them to succeed and advocates that they too find gladness. My determination is that regardless of changes within the bureaucracy, that this focus, this goal will be a core element of what drives us and that we will not participate or support any person in power who vetoes attempts to normalize and legitimize care for all people regardless of social-economic status, ethnicity, religion, sexual orientation, age or immigration status. There will be no walls here to keep people out. We want our doors to be wider and more inviting in order to accept everyone in need.

So I spent some time weeping today as I watched another episode of “Vietnam” and realized that so many of those who spoke out against the injustice and the cowardice of leadership at that time were vilified and dismissed as criminals. As everyone of you know, I have never run and hid from the hard stuff…and listening to a grown man recollect about his leadership role on the ground in Vietnam—determined that his path had allowed him to hide from going to Vietnam—he cancelled his Rhodes Scholarship to volunteer for duty. He was unwilling to run and hide when he might be able to lead in such a way that not only could he preserve the lives of his fellow soldiers but he would work to protect their morality and goodness. This is courage—-doing what is right in the face of fear or danger.

There is an apprehension across Los Angeles today as we face the fact that leadership of health in Los Angeles is going to change. That the person who came to my office his second day in Los Angeles and promised to help me achieve more and better for the highest risk families, youth and children is going to New York City.  Is it possible that the children, youth and families that we serve will yet again slip to the bottom of the priority list—or do we have enough courage to “say the words and do the deeds.” I hope that our County leadership will listen and that they have the courage to insist on excellence and commitment to the children, families and youth of this County.….and equally so to those who charged with protecting and healing.

– Astrid Heppenstall Heger.


Violence: A political or a personal issue?

There were no smart phones, not even a television allowed in our dining room as a child growing up. Dinner was a time to discuss history, literature, ideas, news, and listen carefully to the wisdom of our parents. Politics were rarely the topic since my parents stood at opposite poles on this debate. One evening my father brought a news article to the table and asked us to discuss both the story and it’s morality. It was a story that later became a rallying cry around the value of women and interpersonal violence. It wasn’t until years later that understood the immense gravity of the violent death of Kitty Genovese on the crowded streets of New York city; surrounded by the hundreds of households who heard her screams, but closed their windows.

Although the idea of violence frightened me as we listened to this story, I knew it was far away in an urban environment that seemed foreign and like a parallel universe compared to the neighborhood my family lived in. I told myself that it would never happen here because we would have been the people who would have called. Would have helped. This of course, was the same excuse given by most who witnessed the violence; the situation didn’t seem to involve them and they did not want to get involved in a domestic situation.

This weekend placed a new meaning on observed, fatal violence, that can occur openly in the streets of our cities without serious comment or action by those charged with our protection and the application of morality and fairness in the lives of every single human being; regardless of gender, race, religion or orientation.

Perhaps it was “cheap grace” or moral indifference that led to the loss of Kitty’s life. These being the notion that it takes too much to make this violence a personal matter. The notion that yes something unjust is occurring, but it isn’t my responsibility, someone will do it, I do not need to get involved. Silence is compliance.

Although we too may be tempted to look away and trust that others will take care of things, we must learn from our mistakes. Whether it is in Chicago, New York or Charlottesville, we need to step up. This violence is not going away because we wish it away; it is not going away because we believe that some moral bureaucratic process is going to step up. It is up to each and every one of us to take action.

What I write is not political— it is personal. We are responsible for stopping this violence—violence against any group. It is our responsibility to stop this. We are all created equal. If we yet again look away and say nothing we are responsible for what is to come. It is in the doing nothing that true evil resides.

What Elie Wiesel Taught Me About Moral Indifference

This past Saturday, we lost one of our better angels. 

For years I have pulled from the wisdom of Elie Wiesel when speaking about the children and families who are brought into my clinic every day. While an accurate witness to the atrocities of the Holocaust, his life’s message transcended this horrific event and was put forth to teach and challenge everyone with courage and conscience to avoid moral indifference.

Wiesel knew all to well the dangers of moral indifference; this concept that we can know that something is terribly wrong yet we say or do nothing—or the idea of cheap grace, in which we count on someone else to take care of these problems. He makes a great case that the suffering of others is always our business as well as our problem to solve, and challenges us to prevent the unjust treatment or the abandonment of those who are without power or position. 

“Indifference is not the beginning; it is the end. Therefore, indifference is always the friend of the enemy, for it benefits the oppressor – never his victim, whose pain is magnified when he or she feels forgotten.” -Elie Wiesel

From where I sit there are thousands of victims of abuse and neglect who are abandoned each year by those charged with their safety and welfare. I am particularly concerned about the children, broken by parents or guardians, who have turned to us to find hope and a sense of the future. When we become indifferent to their plight and turn our backs on our collective responsibility, we all but assure that these children grow into adolescence and adulthood knowing absolutely that we do not care about them. This is why my staff and I make it our mission to never allow any child within our reach to ever fall through the cracks of society; to always ensure that those suffering never become invisible.

Four years ago, VIP made history when we opened up a center so that DCFS could provide the basic care and support that every newly detained child should expect, including medical and mental health services, fresh clean clothes, warm meals, a real bed to sleep in, and loving caretakers to make sure they felt safe. This unique program was created to provide children with a place where they knew for certain that they were not invisible or forgotten. Sadly, the space for the older children became a dumping ground for the most difficult cases that DCFS have all but given up hope on, many of whom have been cycling in and out of foster care for years and are now invisible to the system. When DCFS lost control and the LA Times wrote a story, the state came in and now everything is closed.

Now these children are becoming invisible once again. Is someone paying attention to their health, their future, their sadness?  Are they getting the care that they so desperately need? Are we preventing the creation of more and more youth who clearly are becoming this city’s future homeless?

In Los Angeles, VIP is in a unique position to stand up and be heard, changing the direction for these children. And yet there is a sense that we should not stand up because it is unpopular and might create problems for those who are charged with the responsibility of keeping these children safe. This is my dilemma; I can be morally indifferent and trust that those in power will provide the necessary change to protect these children, or I can step up and do the hard thing and speak words that cannot be spoken by those who are without power or advocates.

Elie Wiesel was always charging us to never ignore our better angels and to always speak up and take action when we witness the suffering of others. This compassion, he taught us, starts with a single human being caring for another. With so many foster teens in crisis in Los Angeles, what better time than now for us to step up and change their present course, giving hope to those who need it most?  

I will always try to answer his call to avoid moral indifference. Together we can honor his memory and continue his legacy so that future generations can build upon a foundation of compassion and common humanity.


“Hope is like peace. It is not a gift from God. It is a gift only we can give one another.”
~Elie Wiesel

I have been in a fog since Sunday when I heard about the mass shooting in Orlando. For all the evil I have seen in my career, I continue to be shocked at the depths people will go to inflict pain on others. Each time I hear of another shooting, I make a conscious effort not to become desensitized or assume this is the “new normal”. Each victim deserves our utmost and sincere feeling of loss and grief. But what do we do after we mourn?

Forget that the victims were targeted because of their sexuality. Forget that the shooter had been investigated by the FBI for ties to terrorism overseas. Forget even that this was the largest mass shooting in our country’s history, a history that seems to be racking up exponentially more and more gun deaths as time passes.  What I choose to focus on is my response as a spectator to these senseless killings. I’m not a legislator, though I can influence them with my vote and voice. I am not a gun owner, though I can advocate for responsible and sensible gun safety laws. Our greatest force for change is our ability to show compassion for those individuals we see in crisis BEFORE tragedy strikes. Every day I see children brought into the clinic that have experienced abuse, neglect, or exposure to violence both physical and toxic language or beliefs. I have seen what happens to these children if left alone; they will end up in prison, on the streets or become abusers themselves. That is why I started the Violence Intervention Program over three decades ago. I didn’t want one child in crisis to ever slip through the cracks and have their trauma evolve them into perpetrators of abuse and violence. This is the foundational principle to which I have dedicated my life and career and what I ask from my staff, supporters, and friends. The gunman in Orlando, like the shooters in countless other mass killings, wasn’t born with hate. It manifested over time and was left to fester by spectators too afraid to step in and give it the attention it needed to heal.

I believe we need more sensible gun laws, but there will be time for those discussions. Right now, we should mourn both the victims we lost and the part of our humanity that is lost with each shooting that could have been prevented, either though policy changes or individual acts of intervening compassion.  We should remind ourselves that compassion is our greatest weapon of prevention against these kinds of atrocities. When we teach our children to love and accept others and when we take the time to recognize others who need help and ensure they receive it, we are protecting the collective by strengthening and uplifting the individual.

Take a moment to start a discussion with friends and family about compassion, becoming the change you wish to see in the world so that others will follow. I will continue to provide love and hope to the children and adults I see in crisis; join me in providing that same active and intervening compassion to those you see in dire need of help. Together, we can begin to pull back this encroaching tide of violence and set a new path and example for a younger generation.

Love always,


Our What vs. Our Why

This past week has been especially tough. As I write this, we currently have two patients in the Pediatric ICU who may never completely recover from their abuse.  It has brought me cause to consider both the “what” and the “why” in my life. Both children have received the best of care (i.e. the “what” in my life), and now because of the “why” in my life, we are helping these children and their families to have the best future possible, despite the trauma they have suffered.  My “what” has always been centered around medicine and the ability to recognize trauma, illness, neglect.  The “why,” or the force behind coming to work every day is never accepting mediocrity or, for that matter, never taking “no” for the final answer when it comes to building a safety-net of caring for the children and families that we see every day.

While in the ICU, I noticed a family gathered at the bedside of an 18-year-old boy; family members coming and going, tears being shed and many questions being asked about this boy’s future. A product of the foster care system and abandoned by his family at an early age, this young pre-med student is now a quadriplegic after a tragic automobile accident. His family resources are minimal, but his sister has reunited with him and is by his side daily; his foster mom comes to visit frequently, and his biological father is driving from Modesto every weekend to reconnect with this is only son. Despite the fact that he is not my patient, he is one of the many children who have passed through our clinic’s doors over the past 30 years.  For this 18-year-old, the “why” of VIP is me asking him “How can I help you?” and ensuring that his family has the support they need as they begin to move forward. We now have an expert clinician going to see this young man every day and we are providing Dad with transportation assistance and food support so that he can continue to see his son in the hospital.

The emotional weight our clinicians endure caring for the children, women, and families impacted by violence, can be overwhelming. The “why” has continued to push me forward. The “why” in my life is based on making every interaction and intervention personal; it is asking families how we can help you, and then finding a way to answer and provide a solution. The “why” is the passion for change; change here at VIP and our Children’s Medical Village at the LAC+USC Medical Center, and change in the lives of families who have so little but need so much.

For VIP, the “what” of our work remains possible because of your commitment to why VIP exists, why it grows, and ultimately to the goal of creating a stronger system of care where children, women and families are able to achieve health, safety and security.


The World is an “Unfenced Pool:” Common Sense Rules for Protecting Your Child (Part 4)

1. Young children must be in the direct line of vision of an attentive caretaker at all times. 

This is particularly true of unprotected front yards, driveways, apartment common areas, malls, school yards, stores, amusement parks and at the movies

Over twenty years ago, two year old Amy Sue Seitz was watching cartoons in the front room of her babysitter’s house. She dozed off, and when she woke up she wandered out into the front yard to play. It was not uncommon for her to entertain herself in the front yard, so when the babysitter heard the front door open and close she assumed it was Amy going outside to play. A few minutes later she had disappeared. This was a child friendly neighborhood where young families up and down the street allowed their young children the freedom of front yards and neighborhood.

Unfortunately, six weeks earlier and 120 miles away in Atascadero, a repeat child molester was released on parole from the hospital for the criminally insane. He had been declared cured by the psychiatric staff of the hospital. As you can well imagine, child molesters look pretty good when incarcerated away from children.  He quickly made his way to Los Angeles where he launched a series of sexual assaults against children and adolescents that would result in his being arrested and tried for multiple offenses before he was ever arrested for the rape and murder of Amy Sue.

Two days before he kidnapped Amy Sue, he had tried to grab another little girl in Ventura. But her mother interrupted him and it was her description that finally let to his arrest. But Mr. Frank was not deterred by almost getting caught and returned next day when he spotted the little blond-haired child playing in her front yard. He slowed, and then pulled over the curb… “Hi, sweetheart would you like to see the puppies in the back of my van.” They found her raped and tortured body in a Topanga Canyon cul-de-sac three days later.

Being a parent of a pre-schooler means being on high alert at all times! Whether you are home with him alone, with other children on a play date or in public settings! Small children find their way into big trouble quickly when left to their own curiosity and innocence. It is always hard to be omnipresent, but as parents this becomes our role.   In the next section we will discuss abuse at the hands of those we know or trust.

The World is an “Unfenced Pool:” Common Sense Rules for Protecting Your Child (Part 3)

Driving to work this morning, I was stuck in traffic on the 2 Freeway and I looked up to the overpass and watched as two kindergarten-aged children walked across the pedestrian bridge alone. I took the next off-ramp and circled back until I could see that they were not alone.

It is a hot day in July. You visit your sister’s house. The children are anxious to get in the swimming pool. You help the children into their swimsuits and then you and your sister retire to the kitchen to talk and share a cup of coffee. Hardly!

Our minds have been trained to think of swimming pools or any unprotected water as a potential threat. We automatically shift into protection mode when young children approach water. One adult for every two children in the pool! We understand the importance of that rule and wonder who was not paying attention when a child drowns at a birthday party or in the neighbor’s back yard.

We need to create a similar alert watchfulness for young children when they are outside of our homes. This heightened attentiveness does not mean that we alarm our children, become tense, nervous and lash out at the child; rather, we become so practiced in our protective behavior mode, that we can shift into this gear without creating any anxiety in our children. We remain relaxed and natural but with a new set of instincts that change our level of alertness when we are in circumstances where our children might be in danger.

Thankfully, most of our children’s activities are contained within schools, playgrounds, and homes. But it is on the edges of these safety zones that danger can lurk.  It is the child that strays away from the group, becomes the straggler at the park or when walking to school that is quickly identified as a potential victim by the practiced predator.  Most children under the age of five or six are unable to understand danger, whether it is drowning in the neighbor’s pool or being snatched by a stranger or molested at school. They need to have adequate supervision and simple, concise rules of behavior and communication in order to keep them safe.

The vulnerability of the young child requires that we as adults stay alert and pay attention. There are thousands of stories of adults intervening in the nick of time to protect a child from danger. This can be from accidents, assaults by strangers, and even from abuse by their own families or caretakers. We have a collective responsibility to protect every child from abuse and violence.

In order to begin changing our mindset, let’s look at some simple, but effective, rules that will protect your child.

Rules: Part One

  1. When outside the home, young children must be in the direct line of vision of an attentive caretaker at all times.
  2. Parents must directly participate in the child’s activities whether they are at home or playing with friends.
  3. Create a place in your backyard or common areas where children are safe to play under your watchful eye.
  4. Attend play dates at other homes, particularly when there are more than 2 or 3 children invited.
  5. In public areas: parks, amusement centers, restaurants with child play areas, malls or while shopping never take your eyes and/or your hands off your child.
  6. Never let a child go to the public restroom alone.
  7. Teach your child to identify strangers.
  8. Do not expect your child to be able to fight off an assailant, run, say no or disable his car anymore than they will automatically learn to swim if they fall in the deep end of the pool.

Summary: We all want to say yes to our children when they ask to go outside and play. So say yes, pick up a chair and move to the yard, the driveway or the garage. Your child will know you care; the stranger (or neighbor) will know you are watching.

The World is an “Unfenced Pool:” Common Sense Rules for Protecting Your Child (Part 2)

Having your child abducted is every parent’s worst nightmare! Of the 466,949 children that went missing last year, 32,687 were kidnapped by a family member, 9,338 were kidnapped by non-family member, and about 100 were abducted by strangers (Federal Bureau of Investigation 2015, NISMART 2003).

These numbers alone should give us pause, at the same time remembering that a more insidious form of abduction is child sexual abuse that steals the child’s self esteem and truncates their childhood. In our clinic, that evaluates both child sexual abuse as well as child sexual assault, only 15% of all children are assaulted by strangers. The vast majority of perpetrators are known to the child and many are part of the extended or nuclear family.

Young children (0-10) are the most vulnerable for abuse and/abduction. We begin this series with some simple ideas on protecting your young child from strangers but we will also focus attention on learning to protect your child from individuals who your child sees everyday but who may also present a real danger. Understanding how children are abused, what signs and symptoms are warning signs for parents that should remind them that their child is at risk. Parents are the critical foundation in protection through communication and through understanding how children disclose abuse or frightening events. Teaching your child to stay safe and make good decisions must begin by sharing knowledge and communicating with your child at an early age. Families can establish habits of protection and behavior that will extend through the dangerous “tween” years (9-12) into high school and college.

These ‘tween’ years have become increasing dangerous particularly for our girls. With more girls going through puberty at younger ages, we are faced with the challenge of having young children in woman’s bodies without the maturity to make safe choices. In addition, we consider them to be “just kids” and delay providing them with the information they need to stay safe. These young women are a particularly tempting target for all sexual predators; the stranger; the acquaintance as well as the family member or friend. Much of the child pornography that I am asked to review for the FBI and local law enforcement involves children between the ages of 9 and 12. Add to the fact that we are constantly bombarded with the media, children of all ages are increasingly vulnerable and available to predators through social media. Understanding the real risk of web-based searching for children as potential sexual victims, is critical in building a system of protection within the home.

Adolescents and college students have an amazing capacity to see themselves as “bullet-proof.” We need to give our adolescents and beyond, enough common sense to keep them safe when they are exposed to a world that does not value their innocence or their lives.

The goal of this series is not to alarm parents or create an atmosphere of danger lurking behind every bush or to change a carefree happy childhood into one of fear and dread. Quite the contrary, the goal is to help parents develop simple rules; apply them in a matter-of-fact “we love you” attitude that builds an open atmosphere of sharing and communication in every home. The end result will be that children will be safer while families are drawn closer and closer to each other. The best tribute to those children who are victims of abuse and assault, is for us build a living memorial through strong, loving and safe homes and communities.

The World is an “Unfenced Pool:” Common Sense Rules for Protecting Your Child

Jessica climbed into the back seat of her mother’s SUV and burst into tears. “I am so sorry, mommy, I didn’t mean to do it!” How it was that five year old Jessica immediately disclosed the most horrendous and disgusting sexual abuse at the hands of her maternal uncle? A few hours later, I congratulated her on her being not only beautiful and smart but also courageous. Why was she different from most of the children that we evaluate in our child abuse and sexual assault center? The answer lies in the information and communication that was shared with her from the time she was old enough to understand “private parts”, “good and bad touching” and secrets. Her family had a tradition of communication, listening to their children, all the way to the end of their sentences, and providing an environment where there were no forbidden topics or secrets.

At the other end of town, seven-year-old Jacob was walking home from school with a group of his classmates. A black van pulled up to the curb and the man behind the wheel waved to him to come closer to the car. “I’ll give you five dollars to help me find my dog!” Jacob backed away from the curb and ran to the corner grocery, where the manager called the police. Jacob had been prepared by his parents to identify strangers, to stay away from cars asking directions and to never accept money or gifts of any kind from someone, even someone well known to them, without permission.

As the Director of one of the largest child abuse and sexual assault centers in the United States, I am a witness to the successes and the failures in the lives of the most vulnerable—our children. In addition to listening to the Jessica’s in my practice, the darkest hours are spent in the cold, foul basement of the coroner’s office, providing expertise in the deaths of children. For these few our inability to protect them is 100%. I am grateful that these are the exceptions. Most children are not kidnapped, raped and murdered. However, when I walk the 100 yards back from the coroner’ office to my clinic I feel overwhelmed by the abuse that may not kill the body, but steals the soul.

As a mother of three boys, I celebrate the safety and joy of their childhoods. I felt within myself the potential to become the ultimate overprotective “boogie-man” of a mother. Watching them like a hawk! Never allowing them to leave my side or sight! Suspicious of everyone! I vowed that the darkness of my career would not spill over into their childhood filling it with the constant fear of impending doom and death. Gratefully, most of our children spend their lives surrounded and protected by parents who love them and guard them with a ferocity that is awe inspiring.

However, this has been a frightening year of child abduction, sexual assault and murder. This series of chapters was written to help parents create new habits that will change how we create a protective environment for children. The goal is to acknowledge that each child is vulnerable every day, but develop skills to protect them without creating a childhood that is defined by a climate of fear and over-protection.

The idea of the “pool” is that we build fences and have laws that protect children from being around water unprotected. We do not want our children to be afraid of water, but we want them to be safe…thus the title of this series of articles.

What children need to know to stay safe once they leave home:

  1. Rules for communication:
    • No secrets
    • Good and bad secrets
    • Inappropriate touching
  2. Ask questions – and listen to the answers!
  3. Walk/drive your child to school.
  4. Keep safety rules simple
    • Stranger-danger seems simple, but still needs to be reviewed.
    • Children should never leave school with someone who is not the designated driver or caretaker.
  5. Children cannot “Say no, Run, and Tell” – by then it is too late.
  6. Teach your child to listen to his or her feelings and to immediately leave any place that makes them feel uncomfortable.
  7. Teach them that even trusted adults can do scary things and that no one can ask them to keep a secret from their parents.
  8. Teach them to understand appropriate behavior between adults and children and that only parents and doctors should ever need to see their private parts.