Simulating gun trauma with a 'postcard of violence'

“How many of you know somebody who’s been shot?”

More than half of the nearly 30 students standing in the lobby of Temple University Hospital raised their hands into the air — a snapshot of what gun violence has done to their Philadelphia community.

Over the next two hours, the students were forced to look inside themselves and think deeply about a series of questions.

Who would miss me if I were inside that body bag?

How much money is my life worth?

Would I give up my life for anybody else?

The students were at Temple on Friday for one of the hospital’s weekly Cradle to Grave simulations. Cradle to Grave — a program started in 2006 by two Penn graduates — has taken thousands of inner-city Philadelphia youth on a journey over the years to teach them about the real impact of gun violence.

As legislators continue to debate the issue of gun control on Capitol Hill, Cradle to Grave Director Scott Charles believes the program is among the few that “truly knows what’s happening in the battlegrounds of our communities.”

“Just because time and distance go from Sandy Hook doesn’t mean that shootings are happening any less often here in Philadelphia,” said Amy Goldberg, Temple’s chief of trauma and surgical critical care. “What happened there is absolutely tragic, but what’s happening here every day is also tragic.”

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For two colleagues who are so close today, Charles and Goldberg couldn’t have lived more different childhoods.

Charles grew up in a violence-ridden section of Sacramento, where things like guns and drugs were a near-constant presence for him. For a young man who barely made it out of high school, it took Charles years before he found his way to Penn — earning an undergraduate degree in psychology from the University in 2000 and a master’s in 2010.

Goldberg, on the other hand, describes herself as a “white Jewish girl from the suburbs.” She came to Penn after growing up in Broomall, Pa., receiving a degree in psychology in 1983.

The way that the two interact with students during a Cradle to Grave program is a direct result of their childhood experiences, they say.

“I knew when we started this that it couldn’t be me standing up there and doing most of the talking,” Goldberg said. “I couldn’t come from the suburbs and be the one telling these kids about gun violence — it had to be Scott.”

In total, the two have worked with about 7,000 teenagers since the program began. While Cradle to Grave is open to all, it often targets youth who were referred by the juvenile justice system.

The Cradle to Grave model is unlike any other gun violence education program in the country.

Like it has for years, Friday’s Cradle to Grave simulation began by taking the students — from Philadelphia’s Feltonville School of Arts and Sciences and Olney Charter High School — through the real-life story of Lamont Adams.

Lamont, originally from North Philadelphia, was 16 when he died at Temple after being shot repeatedly over a gambling dispute.

During each simulation, Charles picks one student to play the role of Lamont.

On Friday, he instructed Carlos, a 14-year-old from Feltonville, to lie on a stretcher in the hospital’s trauma bay. As he’s done countless times in the past, Charles placed 24 small, red stickers on Carlos’ body — each representing one of the bullets that pierced Lamont’s skin.

“We’re trying to put a dent in gun violence in this neighborhood,” Goldberg said. “We’re trying to show that just because you grow up here doesn’t mean that you have to experience gun violence. These kids don’t need to be the victims.”

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It was after the trauma bay simulation, and the students were sitting in a dark presentation room, listening to Charles give a talk about gun violence in the city.

“This is a postcard of violence in Philadelphia,” he said, showing an image of a neighborhood vigil for a young gunshot victim, the streets lined with candles and teddy bears.

As Charles advanced the slide, the room let out a sudden, collective gasp.

On the screen in front of them was a gruesome image of a man whose jaw had been mangled by a shotgun — his face in an entirely unrecognizable, bloodied state.

“There aren’t any pretty pictures I have to show you of gunshot injuries,” Charles told the students, many of whom were clearly shaken by the image in front of them. “This is a gunshot injury.”

Each year, Charles went on to say, Temple encounters an average of 500 gunshot wound victims — about half of whom are younger than 25. Although around 80 percent of those victims live, the sheer volume makes the hospital among the busiest in the country.

Over the years, Cradle to Grave has gotten its share of national attention — often attracting media coverage after high-profile shootings like Sandy Hook.

Charles and Goldberg, though, remain doubtful over whether the nation’s leaders have recognized how large of a public health crisis gun violence is.

“If this were a real public health crisis, then maybe something would actually be done about it,” said Goldberg, a sense of frustration and anger clear in her voice.

Goldberg sees Cradle to Grave as having a responsibility to serve as a “professor” for inner-city youth.

“The people educating our youth about gun violence are the media and entertainment industries,” she said. “Those people are the professors, and they’re doing a pretty terrible job of teaching.”

Despite the fact that some have labeled Cradle to Grave’s methods as controversial, Charles said he has never had a parent complain to him about the program’s graphic nature. In fact, he added, he’s often had to turn down parents who want their children as young as 10 or 11 years old to participate.

Although Charles and Goldberg are the first to admit that it is still too soon to gauge the success of Cradle to Grave, some of the early returns are encouraging.

Charles said that, since 2006, only a few of the gunshot victims Temple has treated have previously gone through the program themselves. In a 2010 paper in the journal “Injury,” Goldberg also cited data backing up claims that the simulation has curbed gun violence tendencies among participants.

Moving forward, the two are hopeful that other hospitals — including the Hospital of the University of Pennsylvania — will consider adopting the model.

“We’ve all grown up around guns, and today was a wake-up call for a lot of us,” Brittany Mendez, a tenth-grader at Olney, said of her Cradle to Grave experience on Friday. “We need this in our lives, now more than ever.”

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