Shooting and Stabbings Increased in Past Five Years

Feb 23, 2008 3:00 AM David Smith.  The San Francisco Examiner

 Cindy Chew/The Examiner

San Francisco General Hospital trauma surgeon Rochelle Dicker, left and Wraparound Project case managers help those at risk of repeat violence.

San Francisco (Map, News) - The number of victims with gunshot or stab wounds admitted to San Francisco General Hospital has climbed over the last five years, with more than 440 patients either shot or knifed in 2007.

 The percentage of patients who die as a result of the wounds, called "penetrating injuries", has dropped slightly, with trauma surgeons, doctors and nurses saving 79 percent of shooting victims last year, compared with 76 percent in 2003.

 "Unfortunately,, the sad part of having so much experience is you get really adept at what you do," said Rochelle Dicker, a trauma surgeon at the hospital. 

 "[And] we're getting a lot of experience," she said.

 The death rate for stabbing victims has remained fairly low and consistent during that same time period, at about 2 percent.

 Since 2003, the number of gunshot victims brought to The City's public hospital has doubled, from 110 to 234 patients in 2007, according to the hospital's trauma registry.

 San Francisco police spokesman Sgt. Steve Mannina said police attribute the growing number of gunshot victims to the growing number of disputes being settled with weapons instead of fists.

 "It seems more common for people to push it to the next level," Mannina said.  "Now people are arming themselves and they're using these weapons to settle disputes."

 Last year, 50 of the gunshot victims and five of the stabbing victims did not survive.

 "The vast majority of victims who make it to [San Francisco] General are saved," said Nathan Ballard, Mayor Gavin Newsom's spokesman.

 Due to the high percentage of victims who were repeat patients - roughly 35 percent - the hospital launched a program two years ago that connects case managers with patients who are then linked with community programs and social services, Dicker said.  The Wraparound Project has contributed to the number of repeat patients dropping to 5 percent, she said.

 Along with the number of stabbings and shootings, the number of homicides in 2007 reached a decade-high record.

 In speeches, Newsom has called the high number of homicides the most frustrating aspect of his job.

 Last year there was a decrease in violent crimes - aggravated assault, homicides, rape and robbery - reported over the previous year, according to police data.  Last year's total, however, is 8 percent higher from the 6,160 violent crimes in The City counted in 2005.

 "We are pleased that our violence-prevention and law enforcement efforts have led to a decrease in crime overall, but we won't be satisfied until we bring the homicide rate down," Ballard said.

 Victims come from a community "war zone"

 When a trauma victim bursts through the doors at San Francisco General Hospital, doctors and nurses swarm to the patient, not unlike what is portrayed in television and movie emergency room scenes, said Dr. Rochelle Dicker, a trauma surgeon at the center.

 Patients with gunshot or stabbing wounds generally come from lower economic backgrounds, Dicker said, have lower education levels, are unemployed and may have a substance-abuse problem.  Their communities, she said, are often a 'war zone.'

 However, when patients enter The City's public hospital, they are often in a docile state and very respectful of the staff, although some victims turn inward and exhibit symptoms of post-traumatic stress disorder, she said.

 "Sometimes fear manifests itself as anger," said Dicker, who has been at the trauma center for eight years.  "For the vast majority there's a thankfulness that they got there alive."

 Dicker also noted a "huge disparity" in how trauma patients fall along racial lines, saying that while The City's black population has dropped to below 10 percent, blacks make up 60 percent of gunshot victims in The City.  Hispanics make up the second-largest group.

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