During the peak of the pandemic three years ago, when hospital beds were filled with COVID-19 patients, Cleveland’s emergency room physicians could barely catch their breath.
Though coronavirus admissions have long plateaued, frontline ER workers still can’t rest. They are too busy triaging young patients pierced with bullets.
Workers at MetroHealth Medical Center and University Hospitals –Level 1 centers that deal with critically ill or injured–feel the brunt of treating the city’s youth for gunshot wounds.
“We used to see one gunshot wound a night,” Dr. Jeff Claridge, a trauma surgeon at MetroHealth. “Now, they often come in pairs.”
Claridge said the hospital and its workers are seeing multiple gunshot victims a night, though it’s too early to tell if there’s been an uptick in wounded patients entering the emergency room this year compared to last.
What is known is that many gun-violence victims who need life-saving surgery have been largely Black males in their teens through their late 20s, Claridge said. On occasion, his team operates on toddlers and elderly people suffering from gunshot wounds.
“I think the sad part is that, you know, it’s getting closer and closer to everybody’s home,” Claridge said.
In July, nine people were injured in a mass shooting on West 6th Street in Cleveland’s Warehouse District. Victims of the incident were transported to MetroHealth.
As if that weren’t enough, hours later, a group of youth rushed through the emergency room doors of the hospital, knocking down metal detectors before scrambling out the door as security guards approached. It is unclear whether the group was connected to the mass shooting.
This busy and tense evening forced MetroHealth System CEO Airica Steed to reiterate her commitment to keeping staff and patients safe. She is also doubling down on the need to work with other hospitals and community groups to reduce the city’s violence problem.
“This includes expansion of our violence prevention and trauma recovery resources, increasing investment in behavioral health and drug treatment programs, and working more closely with community members to ensure our social and medical services meet the actual needs they are facing on a daily basis,” Steed said in an email to Signal Cleveland.
Claridge also told Signal Cleveland that there should be more recognition of the surgeons and nurses who care for the trauma patients every night. He said his team works diligently, and often nonstop, providing the best outcomes to patients entering the ER.
“I work with heroes every day,” he said. “ We don’t have time to actually deal with what it means to lose someone. We immediately have to go to the room next door to take care of the next patient. And we do that everyday.”
He added that prioritizing the mental health needs of ER staff, collaborating with other hospitals on best practices, and collecting more data on gun-trauma patients will help healthcare workers.
Emergency room visits declined, but healthcare workers still feel fatigue
Claridge said the increase in gunshot patients in the emergency room comes at a time when hospitals are already struggling to retain nurses and other care staff.
“My surgical team gets pretty burnt out, and I can see it on them,” Claridge said. “You know, day in and day out. Long shifts, hard work and minimal recovery.”
Cleveland has seen a significant increase in homicides and gun violence in recent years. It appeared to have peaked in 2020, when homicide rates increased by 42% over the previous year, according to data collected by the Cleveland Department of Public Health.
The most recent data, however, suggests that the homicide rate has remained steady in the last two years, but, between 2021 and 2022, there was a 34% decrease in visits to hospitals for treatment of gunshot wounds, according to data collected by the Cleveland Department of Public Health.
There is an underlying trend that worries hospital officials, as firearms were involved in more than 80% of all homicides from 2017-2019. In 2022, firearms contributed to 84% of homicide deaths in the city.
The last five years have also shown that gun violence was consistently higher in the months of June, July and August. There were 40 or more gunshot-wound emergency department visits in each of these months compared to the average of 32 per month for the entire year, according to the data reported by the health department.
Gun-violence victims were also more likely to be Cleveland residents who are Black, male, between the ages of 18 and 29 and who lived in ZIP Codes 44102 and 44105. There were 34 homicides per 100,000 residents among Cleveland residents in 2022, comparable to the previous year, according to data from the health department.
‘Enough is enough’
Dr. Edward M. Barksdale Jr., Surgeon-in-Chief at University Hospitals Rainbow Babies & Children’s Hospital, said the pediatric trauma center sees an average of 70 gunshot wounds a year. However, the number and severity of injuries are both on the uptick.
“We’re seeing patients that are younger and more severe, and that is telling us so much about the epidemic or the pandemic that we are existing in,” Barksdale said.
Barksdale said he is exhausted from reading the news headlines and recalling the list of young patients his team has operated on in the last few weeks: A four-year-old shot a few weeks ago by his 15-year-old brother who had several parts of his stomach removed. A three-year-old who shot his seven-year-old sister in the head. A 13-year-old was shot and killed a few weeks ago. The 20-year-old-basketball player, whose mother is a high school principal, was shot and killed.
“It’s just story after story after story,” Barksdale said. “We’re at a point that I would say enough is enough.”