Javier Antezana is one of the first people to approach a patient’s bedside when doctors rush a gunshot victim to the emergency room but he’s no surgeon. As a case manager for the San Francisco General Hospital’s violence-intervention program, his job is to think past the hospital stay, to the critical 24-48 hour window when the victim is most likely to retaliate.
“I tell them ‘You don’t have to prove yourself to your gang, to your community to anybody,'” says Antezana, a six-year veteran of the Wraparound Project. “‘You’ve already survived. You’ve awakened.'”
Antezana, 35, and the other case managers teach hospital patients how to reenter their community after the mental trauma of being shot, stabbed or in some way physically assaulted. They assess the victim’s background and provide him or her with customized therapy for up to six months. It’s an effort, they say, that works to reduce the number of repeat victims of violence in the ER.
“We do it by getting at the root causes.” says Dr. Rochelle Dicker, trauma surgeon and director of the Wraparound Project. Unemployment, substance abuse and lower incomes can all contribute to a higher risk for gun violence, she says.
Hospital-based violence prevention programs like the Wraparound Project are gaining ground nationwide. The initiative is part of a wider network of twenty other hospitals and organizations that conduct a similar type of bedside intervention.
Dr. Dicker’s inspiration to launch the program at SFGH came as a resident, she says, after she treated a teenage gunshot victim and saw him return with another bullet wound two weeks later.
“Are you really helping if you’re just sewing them up and sending them back out to the same risk factors?” she asked.
Since the program’s inception seven years ago, injury recidivism rate in the hospital has dropped from 16 to 5 percent.
Joe Drake, a musician and a mentor for incarcerated youth, is one of those success stories. The 23-year-old was introduced to Wraparound five years ago when he was stabbed and shot in the same day.
“I was involved in a fight in the neighborhood, got stabbed in my left arm and then two hours later, I was shot five times,” says Drake. The gunman shot Drake in the stomach, the head, the mid part of his thigh, his right buttocks, and one bullet ripped through his back and passed out of his chest, piercing his lung.
Soon after surgeons released him from the operating room, Drake says case managers Mike Texada and Javier Antezada visited his bed to comfort him and caution him against striking back against his attacker.
“After being shot, I felt inferior. I felt real scared that someone would find the weakness in my body,” says Drake, who soon after returning to his home, discovered the identity of the shooter. He says he called Wraparound when he felt the urge to seek revenge. “I was having a frustrating moment but they helped me pass it. Now, my vengeance is to teach the next young individual who needs to be guided in the streets.”
Drake now conducts a monthly seminar for young offenders at the Wraparound. He recounts his story, reveals his scars and pushes the kids to map out a future without violence.
According to police statistics, 125 people were shot in San Francisco in 2012, and at least 66 were killed. The rate is low compared to more violent cities like neighboring Oakland, but the numbers do represent an increase from last year, the police say.
Case manager Javier Antezeda says the Wraparound Project treats a majority of these victims but a lack of federal funding prevents the program from reaching all gun wound patients. He says he was able to escape urban violence and would like to help others do the same.
“I got into situations that got me into juvi hall,” says Antezeda. But, “I finally realized there had to be a different path for me.”