RN Kuwaza Imara makes notes on a trauma patient's records. Highland is required by law to keep detailed paperwork for every patient admitted to the Trauma Center.

Trauma coordinator Patti O'Connor, a registered nurse, with a trauma patient.

A 16-year-old gunshot victim and Castlemont HIgh School student recovers.The small balloon is a gift from the boy's grandmother.

Over the last four years, Highland lost $80 million. Alameda County was set to close Highland down, but last April county officials voted to keep the hospital's doors open. The decision came after heavy lobbying by private hospitals, which would have had to absorb the patient load Highland treats.

When young children are shot, they are usually treated at Oakland's Children's Hospital, but Highland does treat gunshot victims in their teens. Sometimes when young gunshot victims are treated at Highland they are more interested in the bullet than with their injuries.

"A lot of kids think it's a badge of courage to get shot. They want to know if [the doctors] found the bullet," Benton said. "From our standpoint, the bullet is inconsequential. We're far more concerned with the damage that's been done than with a little piece of metal."

If Highland's young patients knew that their insides looked like Swiss cheese, they'd be less concerned about bullets too, Benton said.

Patti O'Connor, a registered nurse who came to Highland nine years ago, said one of the first gunshot victims she cared for at the hospital was a teenage boy. His injuries had resulted in a temporary disconnection of his digestive tract. His waste was accumulating in a plastic bag strapped to his hospital bed.

"I was very concerned. I said, 'My God, when can we get this kid connected?'" remembers O'Connor, who as trauma coordinator is responsible for seeing that Highland comply with State, County and Medical Board regulations in its treatment of trauma patients.

She said the young man seemed more interested in the fact that he would have a scar -- a badge of honor.

A 16-year-old gunshot victim, a junior at Castlemont High School, was admitted to Highland with a gunshot wound to the left leg a few nights after Juan. He said he was walking to his aunt's house when a car full of people drove up behind him. He said he heard someone say, "Get the gun out of the [car] window," and then he heard a shot and felt a pain in his leg. He ran the rest of the way to his aunt's house and asked her to call an ambulance.

Recuperating in the hospital, the 16-year-old said he has a lot of time to think about what happened to him.

"I'm just happy to be alive," he said. Neither he nor any of his friends had ever been shot.

"It happened," he said. "I can't be scared about it."

Dr. Benton gave him a pamphlet about the anti-youth violence group Teens On Target. The group, which is active at Castlemont High, trains students to educate their peers about the costs and consequences of violence.

The 16-year-old said he had heard about the group and about its co-coordinator Sherman Spears, who was paralyzed from the waist down when a bullet injured his spine 4 years ago.

"Maybe I'll check that out," he said. "Maybe."

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