Just before 1 a.m. on a recent night in the city, an ambulance rushed a man to Temple University Hospital's trauma ward. As paramedics rolled him in through the sliding emergency room doors, he screams, "I've been shot... He shot me, man!"
Medics quickly let doctors and nurses know the man's vital signs and confirm the patient's diagnosis: "Single gunshot wound."
Trauma surgeons and nurses race to save the man's life. X-rays show the man may have internal injuries. He was rushed to surgery.
In Philadelphia, gun violence is disturbingly routine -- almost every day, several times a day, somebody gets shot.
Last year, more than 500 gunshot wound victims were brought to Temple University Hospital. Trauma surgeons have grown weary of the carnage.
Temple's chief trauma surgeon Dr. Amy Goldberg wants to do more than simply treat the wounds that roll in each night. She wants to stop the violence.
'Cradle to Grave'
"Seeing these young kids get shot and die, night after night after night, it made me realize that there is so much more that I felt we were obligated to do than just give our medical care," Goldberg said.
Goldberg has teamed up with Scott Charles, trauma outreach coordinator for the hospital, to create a program called "Cradle to the Grave." Together, they bring at-risk youth to the emergency room and demonstrate to them -- in graphic detail -- what getting shot is really all about.
Charles said that extreme violence has become routine for many of the young people in Philadelphia. "I think getting shot for a lot of young men in these neighborhoods becomes a rite of passage," he said. "This is part of being a teenager, growing up in this neighborhood, 'It's happened to friends I know and it's bound to happen to me.'"
A group of about 20 young people gathered outside the emergency room at Temple University Hospital on a recent afternoon. Most of them have been identified as at-risk kids, referred to the program by schools, county government or the courts system.
Charles began to tell them about Lamont Adams, a 16-year-old boy who came to the hospital with multiple gunshot wounds.
He was shot over a $100 dice game.
24 Bullet Holes
The kids who had smiles on their faces when they arrived were now somber. Most of them know a boy like Lamont.
Charles moved the group to a trauma room, where the most severely injured patients go. He asked one young man in the group to lay down on the gurney in the middle of the room. Charles said the young volunteer is about Lamont's size and build.
He then places tiny red stickers on the young man's body, each representing a gunshot wound. "Lamont would have had a bullet hole here… another bullet hole here," Charles said.
Some gasp, some cry. Charles was starting to get through.
Charles lifts up the palm of the young volunteer's hand and adds two final red dots. "He had 24 bullet holes. Out of 24 bullet holes, you know, these are the ones that bothered me the most. Why do you think that is?" Charles asked the group. "He was trying to defend himself," he continued.
The kids are shocked as Goldberg begins a graphic description of the effort to save Lamont's life. "Lamont wasn't breathing at all," Goldberg said. She picked up a large steel contraption from a surgical tray in the room. It looked better suited for a hardware store than a hospital.
Dying Young and Alone
"To gain access to his heart, we put in something like this. It's a rib spreader. And it spreads the ribs so we can gain access to his heart to see if it is beating or not," Goldberg explained. The metal crank of the device clanked. Goldberg continued, "When we looked into his chest and looked into the heart, we saw that his heart had a lot of holes in it… probably riddled with about four or five bullet holes."
Lamont Adams was pronounced dead after only 15 minutes. "In spite all of our efforts, we weren't able to bring him back and he died right here on this stretcher," Goldberg told the group.
"This is a 16-year-old boy that died in this room, by himself, surrounded by complete strangers," Charles added.
Seeing that he had the group's attention, Charles pressed the point. "You have the rest of your lives to make the decisions that will keep you from losing your lives around this bay. Don't put 15 minutes in the hands of our trauma surgeons and expect them to bring you back the life that you squandered."
Charles said he's hopeful that he is getting through to the kids. But he is a realist.
"I fear sometimes that we are past the point of no return," he said. "We've reached a critical mass of young people who believe that this city is just too dangerous to walk around in, unarmed."
The last step for these young people is the morgue. Gathered around a cold steel table, surrounded by freezers, the finality of it began to sink in. They left shell-shocked.
And the kids are getting the message. So far, none of the 600 people who have been part of this program have come back to the hospital as victims.