At Temple University Hospital, Scott Charles, trauma outreach coordinator, left, and Dr. Amy Goldberg, chief of trauma and surgical care, held students’ attention.
PHILADELPHIA — In a darkened classroom, 15 eighth graders gasped as a photograph appeared on the screen in front of them. It showed a dead man whose jaw had been destroyed by a shotgun blast, leaving the lower half of his face a shapeless, bloody mess.
Students listed people who would miss them if they were killed.
Next came a picture of the bullet-perforated legs of someone who had been shot with an AK-47 assault rifle, and then one of the bloated abdomen of a gunshot victim with internal injuries so grievous that the patient had to be fitted with a colostomy bag to replace intestines that can no longer function normally.
These are among about 500 gunshot victims who are treated each year at Temple University Hospital, an institution in the heart of impoverished, crime-ridden North Philadelphia. While President Obama and Congressional leaders debate legislation intended to prevent mass killings like the elementary school shooting in Newtown, Conn., the hospital is trying to slow the rate of street killings by helping teenagers understand the realities of gun violence.
The hospital program includes listening to tapes of victims’ families.
The unusual program, called Cradle to Grave, brings in youths from across Philadelphia in the hope that an unflinching look at the effects that guns have in their community will deter young people from reaching for a gun to settle personal scores, and will help them recognize that gun violence is not the glamorous business sometimes depicted in television shows and rap music.
The program is open to all schools in the city, but about two-thirds of the participants were referred by officials from the juvenile justice system. Children younger than 13 are not normally admitted. So far, about 7,000 teenagers have participated since it began in 2006, and despite the graphic content, no parent has ever complained, said Scott P. Charles, the hospital’s trauma outreach coordinator.
A demonstration of gunshot wounds.
“In seven and a half years, I have never had a parent say, ‘I can’t believe what you just showed my child,’ ” Mr. Charles said.
On a recent day the eighth graders, students from nearby Kenderton School, gathered around Mr. Charles at the start of a two-hour visit. Most said they knew someone who had been shot.
“Our goal here isn’t to scare you straight,” Mr. Charles told them. “We’re just trying to give you an education.”
The program also teaches morgue terminology.
According to police statistics, 331 people were killed in the city in 2012, equaling the highest total since 2008, and the fourth consecutive year of increase. Eighty-six percent of them were killed by firearms, the police say.
Still, the number of killings in the city of about 1.5 million residents has dropped from a high of 406 in 2006, when national news media started calling the city Killadelphia.
In a 2010 paper published in the medical journal Injury, Dr. Amy J. Goldberg, the hospital’s chief of trauma and surgical critical care, and others cited data showing that students’ inclination toward violence decreased after participating in the Cradle to Grave program, especially among those classified as having an “aggressive response to shame.”
“These results suggest that hospitals offer a unique opportunity to address the public health crisis posed by inner-city firearm violence,” the study said.
Students listed people who would miss them if they were killed.
The program starts with a visit to the hospital’s trauma bay, the first stop for gunshot victims — half of them under 25 — who are brought to the hospital from North Philadelphia’s streets at an average rate of more than one a day.
As the 13- and 14-year-olds gathered around a gurney on a recent visit, Mr. Charles told the story of Lamont Adams, 16, who died at the hospital after being shot 14 times by another boy who believed Lamont had snitched about a street dice game that was broken up by police officers.
Lamont arrived in the trauma bay with 24 gunshot wounds, 10 more than the 14 rounds that had been emptied into him, because some of the shots had also exited his body, in some cases leaving indentations in the sidewalk, Mr. Charles told the students.
In case his verbal description was not sufficiently vivid, Mr. Charles asked Justin Robinson, 13, to play the part of Lamont. The boy lay down on an empty body bag. Mr. Charles attached 24 circular red stickers to Justin’s clothing to represent the wounds in Lamont’s body.
Mr. Charles told the students that the wounds he finds most moving were those in the boy’s hands. “He holds up his hands and begs the boy to stop shooting,” Mr. Charles said. “He had not prepared himself for how terrible this would be.”
The narrative was then taken up by Dr. Goldberg, who told the children that by the time Lamont arrived in the trauma bay, he was not breathing, so surgeons — without the use of anesthetics — quickly inserted a breathing tube into his windpipe.
Neither did he have a pulse but that did not stop the doctors from inserting a tube into his groin to replace the blood he was losing, and then to open his chest in the hope of restarting his heart — which turned out to have three or four holes in it, Dr. Goldberg said. She held up a stainless steel rib-spreader.
As the details of Lamont’s story unfolded, one girl struggled to keep her composure. Another hid her face in her friend’s shoulder. Lamont died about 15 minutes after arriving at the hospital, underscoring that prevention of gun violence is a lot better than trying to cure its effects, Dr. Goldberg concluded.
“Who do you think has the best chance of saving your life?” she asked the students. “You do.”
Despite the grisly images, most of the students said afterward that people should still be allowed to own guns for self-defense, although not assault weapons. Mahogany Johnson, 14, said she is in favor of a street ban on semiautomatic weapons like AK-47 assault rifles, which she said should be used “only in the woods.” Jabriel Steward, 14, said, “Everybody should be allowed to have one gun for protection, for self-defense.”
But Feliciana Asada, 14, said more students should be given the opportunity to participate in Cradle to Grave. “Programs like this need to be installed in schools,” she said.
*Courtesy of the New York Times