'Cradle to Grave' helps at-risk youth understand gritty reality of gun violence

Temple University Hospital wants to slow the rate of Philadelphia street killings by helping teenagers understand the gritty reality of gun violence.

Its “Cradle to Grave” program immerses at-risk youth in the last 15 minutes of the life of a 16-year-old boy named Lamont Adams. In 2004, he was shot 14 times near his home in North Philadelphia – not from the hospital.

His bullet-riddled body arrived at the hospital’s emergency department, where trauma unit head Amy Goldberg, M.D., fought to save his life.

Goldberg lost the fight, but after treating so many gun injuries and watching so many victims die, she decided to make a change. Together with Scott Charles, she created Cradle to Grave in 2006. The violence-prevention program brings small groups of teens to the hospital to show them what getting shot is really like.

Goldberg says it sends the message that gun violence is not the glamorous business sometimes depicted in television shows, videos and rap music.  “We want to educate these young kids that gunshot wounds and injuries can kill,” she says. “What they see on television or hear with hip-hop music is that you get shot and your fine. That’s not real.”

The program has a unique way of dispelling the students’ misconceptions about gunshot injuries. “By framing the issue around an actual person, we want them to gain an appreciation for what is really at stake,” says Charles, the program’s director and outreach coordinator.

The two-hour program begins when a group of about 20 or so kids and a teacher or counselor arrive at the hospital. Charles greets them in the parking lot and talks about Lamont’s story. Then he walks them into the trauma bay where surgical residents guide the students step-by-step through all the procedures done to try to save his life. One student acts as Lamont, and Charles attaches 24 circular red stickers on the student’s clothing to represent Lamont’s wounds from the bullets that entered and exited his body.

After that, Goldberg describes the surgeries she performed to try to save the patient. She tells the students how doctors inserted a tube into his groin to replace the blood he was losing and then opened his chest in the hope of restarting his heart, which had bullet holes in it. Goldberg holds up a stainless steel rib-spreader.

There is time for reflection. Students are asked “who would die for you?” and “how much is your life worth?”

The participants watch an hour-long presentation that shows graphic pictures and a video of more gunshot victims.

The students finally listen to audio accounts of family members of gunshot victims. It ends with an audio interview with Lamont’s grandmother.

Since its inception, Cradle to Grave has tried to help more than 11,000 young people realize that the cost of violence is simply too high to pay. The program is open to all schools in the city, but about two-thirds of the participants are referred by officials from the juvenile justice system.

“In Philadelphia, about 70% of the gun victims are African-Americans, 92% of them are males and half who get shot are under the age of 25,” Charles notes. “Young, black and male. The groups we bring into the program pretty much reflect that.”

In a 2010 paper published in the medical journal Injury, Goldberg cited data showing that students’ inclination toward violence decreased after participating in Cradle to Grave. “By no means do we feel our program is a panacea for reducing gun violence anywhere,” she says. “But we feel it is productive, it is an education, it is prevention, and we as a hospital are doing something.”

For an inner-city hospital like Temple, addressing gun violence is a public health imperative, Goldberg says.

“Gun violence is an issue in our community and we need to deal with it just as we need to deal with issues like diabetes, hypertension or poor access to healthy foods,” she says.

Read more AHA News stories on how hospitals are addressing violence in their communities:

How one hospital is applying public health interventions in effort to curb gun violence

Keeping teens from being repeat victims of gunshot, knife wounds

And learn more about the AHA’s “Hospitals Against Violence” resources to support hospitals’ efforts to help end violence in their communities.