Temple University Hospital's trauma outreach coordinator Scott Charles wants to do everything for young gunshot victims. Keeping them from returning to the emergency room is a good start.
In Scott Charles' job there is a pivotal moment he calls the window of opportunity.
Light filters through the moment someone fires a gun and the bullet pushes through its victim's flesh, nerves and veins. It opens when the cops or emergency medical techs rush the gunshot victim to the emergency room of Charles' North Philadelphia hospital. It opens when the army of trauma surgeons--so good at their calling that military medics want to learn from them--crack a chest, spread a rib, clamp an artery and save a victim's life.
Trauma surgeons call escaping near death a good save.
But not Charles.
"We gotta quit being content with that," he says. "The only time it's a good save is if he walks out less likely to get shot or shoot someone. If you only patch him up, you haven't given him a second chance at life but a second chance at death."
Charles' job as Temple University Hospital's trauma outreach coordinator is part prevention, part intervention. But he's not a savior. He can't be when the city hemorrhages gunshot victims at the rate of five a day, and when utter hopelessness infects a victim's mind.
Charles knows, though sometimes it's bitter to accept, that even if doctors can save the 500 gunshot patients who'll be rushed to Temple University Hospital this year, he can't. He's just the guy with the pocket square, he says, and compared to what the trauma surgeons do, his job is easy. But it is perhaps the most critical.
"I'm not the first person to tell them their life is headed in the wrong direction," he says. "I'm just the one to tell them at the moment they're most willing to listen. I'm trying to get them to see it as a turning point, as a wake-up call. I tell them, 'I don't want this moment to define you.'"
In that window of opportunity Charles becomes an uncle, a brother, a friend. He's also a peddler. Unlike the trauma surgeons' work, his job is to offer a lifeline--a hard sell, even after a hail of bullets.
His job is harder still because the moment is so fleeting. He has to keep the window of opportunity open before pain turns to anger, before fear turns cold, while life still feels fragile, still worth living.
At Temple University Hospital for nearly two years, Charles describes his job as triage in a war zone. Last year Philadelphia mourned 406 murders--and this year, with an average of more than one murder a day, the city is on pace to exceed that number.
The murders, Charles says, are just a symptom of the epidemic. The disease rages inside the shootings, which are random, petty, multiple and many.
Last year the city suffered 2,004 shootings--about five for every murder. As of April 30, there were 563. And since 2001 some 10,000 people have been shot in Philadelphia.
The victims and perpetrators of the city's gun violence are overwhelmingly young, male and black. A 2006 University of Pennsylvania analysis found it more dangerous to be a young black man in Philadelphia than a soldier in Iraq.
Charles' focus is on gunshot patients between 15 and 24 years old, the majority of the city's victims. His hope is to enroll them in a pilot intervention program to keep them from getting shot again or shooting someone.
Sometimes his job is easy. Some gunshot patients desperately reach for the lifeline he's offering. Others tell him to go fuck himself.
"It would help if I had a job for them or something tangible to offer," he admits. "The only thing I can offer is life."
And hope where there was none. But again, it's a hard sell.
The prevention part of Charles' job starts with his Cradle to Grave program.