I shoot a pretty wide variety of subjects, mostly features or portraits. I love to shoot features, and portraits pay the bills- but it’s rare I get commissioned to shoot anything in the hard news category let alone investigative journalism. When one of my editors at the Wall Street Journal called me up to ask how I felt about documenting a shift at the R Adams Cowley Shock Trauma Center, I said I felt like I was born to do this shoot. My mother has an unusual fascination with hospitals and medicine, so I grew up watching a lot of Rescue-911 and E.R. shows. No, not scripted medical dramas- actual E.R. documentary shows where they leave little to the imagination. Also, we would sometimes watch surgery programs during dinner. I was all about this shoot. When I learned about the story that prompted it, I was even more excited. You see, homicide rates have gone down in America, but if you think that’s fine and dandy and the country is becoming a better place, you’d be pretty damn wrong. Turns out stabbings and shootings are up. Dramatically. Reporter Gary Fields did what any good investigative journalist would do and he got to investigating. Signs point to improved emergency medical practices saving more lives and skewing the numbers. Gary and I made our way to this shock trauma center in inner city Baltimore on a Friday night in the fall to witness the role that these centers play in the violence game. Please read the article and watch the video. Understand what’s going on in America.The shift started off peacefully enough, but it was the calm before the storm. This is a view of the hospital complex from the helipad. Learn more about he TRU, or Trauma Resuscitation Unit here.This is the board and it is the nerve center of the TRU in many ways. When this phone rings, someone is hurt and likely dying. This isn’t a normal ER. They see the worst of the worst here- major traumas. The EMS teams on the ground from all over Maryland will call this phone if they think an injury is severe enough. The folks at the TRU make the decision whether or not to accept the patient (there are a limited number of bays and other resources like medical personnel) and when they do, they write down pertinent details on this board and then they wait… While the story was about violence, the non-violence-related injuries were also relevant to the story. Each case allows the doctors to improve how they practice emergency medicine. We observed many very sad and disturbing cases, such as this middle aged woman who jumped off a one story building. She came in as a Jane Doe and was one of the most critical patients from the entire shift. It is so easy to hurt yourself so badly. My heart ached when her family showed up later in the evening. I kept asking myself why she would do a thing like jump off a building with such a caring family. So many things you can’t tell about people just by looking at them…Her pelvis was severely damaged.This is Dr. Thomas M. Scalea, the Physician-in-Chief at the Shock Trauma Center. This is the central bay for support staff and it is where the medical team gathers when they are not responding to a patient. The individual patient bays are arrayed around this. I keep seeing the splayed arms of the severely hurt. It seems to be something the human body just does. I wonder if it’s related in any way to the fencing response. Members of the medical team wait for a helicopter to come in. Patients arrive by air from all over the state. They tend to arrive by ambulance if injured within city limits. Making the rounds. The board with a description for a GSW, or gunshot wound. This was our first gunshot wound patient of the night. One of the surprising things about the night is how much nudity I saw (and consequently had to work around) because when the medical team starts working on your traumatized body, they quickly cut off all your clothes. There were so many desexualized breasts and penises- just body parts on frail frames. I don’t see nude strangers very often, so it was jarring at first- more so than the blood. As the night wore on the feeling wore off and I became inured to it. This is Stephanie, cleaning up the bay after the night’s first gunshot victim. He did not survive. Gunshot victim number two was shot a few times, most notably in the face. This young man did survive. Bad car accident. These were the cases that gave me chills. These people were so broken and from doing something we all do so casually every day. This man was stabbed. He also survived. The police came to interview him and take pictures for evidence. You don’t get through at shift at the TRU without a little help. Dr. Scalea is indeed the boss. Thank you to Matt Craig at the Wall Street Journal as well as the University of Maryland Medical Center for allowing such broad access. While I had to be very, very careful to not shoot patients’ faces for privacy purposes, our handlers for the evening were good about letting me roam about freely. Also thank you to Gary Fields for keeping me company during this long night and for writing this important story.