The scent hung in the air, something that he had always noticed at the Brooklyn hospital. Lately the smell of blood has been more prevalent, a sign that the gun violence that has gripped the city perhaps has its tightest hold on the communities surrounding his hospital.
“It has a little bit of a metallic smell. And it kind of just lingers with you,” said Alexander, 36, who added that on particularly violent days he can’t stop smelling blood, even after he’s gone home and showered. “You know it when you smell it.”
Brookdale, a level one trauma center, has been a lifeline for shooting victims from East New York and Brownsville — neighborhoods that have been the most ripped apart by gun violence in the city. And after struggling to help their community survive the Covid-19 outbreak, Alexander and the rest of the staff now find themselves dealing with another crisis.
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‘Broad daylight, people are getting shot’
Brookdale saw nearly 100 more gunshot victims in June, July and August of this year compared to the same period last year, according to data from the hospital.
There were 149 gunshot victims treated at Brookdale during those three months — 38 in June, 66 in July, and 45 in August. Last year there were 55 gunshot victims — 12 in June, 25 in July, and 18 in August.
And while shooting numbers continue to rise to levels not seen in New York City in years, staff at the hospital struggle to save victims, a task that has not only become more frequent but more problematic. It’s a strong indicator that the violence isn’t stopping.
“What we’ve noticed recently over the last couple of months is that 9 a.m, 10 a.m., 11 a.m., broad daylight, people are getting shot. People are getting murdered,” Alexander said. “You’re sometimes like, ‘Wow, it’s 10 o’clock in the morning. I got up at 5 a.m. to go to work. What time did this person get up to shoot somebody at 10 o’clock? People used to think in the daytime you have some safety.”
And it’s not just safety during the day that’s in peril, Alexander says. He’s seeing more and more come in with multiple gunshot wounds, which ultimately makes it harder to save a life.
In July, 81% of the patients who were shot were in critical condition and needed level one trauma care, according to the hospital.
“Normally you’ll get someone who was shot twice. Three times maybe. But we’re talking about twenty, thirty times. One person,” Alexander said. “So we know as physicians that our ability to save that person at that point is almost non-existent. There’s just too much damage in too many places to be able to control anything.”
New York City’s summer explosion of gun violence
Gun violence has tightened its grip on the city as Covid-19 started to get under control. As of Aug. 27 there were 974 shooting incidents across New York City, which is almost twice that of the year prior, which had 527. There were also 1,174 shooting victims while last year there were 602, according to NYPD statistics.
East New York and Brownsville are two neighborhoods that have led the city in shootings. Year to date as of late August there have been 66 shooting incidents in Brownsville, compared to 25 the year before. Shooting victims are also higher, with 77 compared to 43 the year before. In East New York there were 84 victims compared to 50 the previous year. And 65 incidents compared to 41 last year.
And while shootings have skyrocketed in the city, gun arrests are still not yet at last year’s pace, though they are climbing back up.
As of Aug. 23 there were 2,062 gun arrests, down from 2,221 from last year.
“Since June 1, the city has just exploded in gun violence,” said NYPD Chief Michael LiPetri, chief of crime control strategies.
“We have large groups of people committing quality of life offenses, whether it be gambling street dice, whether it be drinking, that then, unfortunately, turns into violence after the fact. Mainly gang members, committing firearm related violence,” said LiPetri, who added that narcotics related shootings are also another driver of the violence.
“There are many many factors and we can’t just be focused on one of them,” said LiPetri, who said the number of those released from jail was closer to 2,000.
‘Regular people’ are victims
LiPetri has been outspoken about how crime statistics are about the victims, not about numbers. Dr. Alexander also sees the people beyond the statistics.
“When you say gun violence the majority of people are thinking, oh, a TV gangster or something along those lines,” said Alexander. “No. Regular folk. Regular people, 30s, 20s, teenagers, preteens, people less than 10 years old. Those are the people that we see. And the impact of that is profound to say the least.”
Dr. Patricia O’Neill, the trauma medical director at Brookdale, said she recently had three gunshot wound victims that she treated. One was shot 10 times. The other had bullets rip into his neck and out through his face. The other serious injury was a teen who was shot only once and had a single bullet that tore through his chest but somehow sat neatly between his heart, aorta and esophagus.
“He was 19 years old and he still had braces,” O’Neill said of the victim of the “magic bullet.”
“It just sort of made me think he was so young.”
But not to be ignored was the vicious cycle of violence spurred by a lack of cooperation and vengeance, she said.
“On these particular shootings people are unwilling to cooperate because they want to go out and take care of it themselves,” Clark said. “One incident happens, you have an uncooperative victim so there’s no arrest. That means the person that did that shooting is not being held accountable. But what you’re also seeing is that the victim now is taking matters into their own hands, getting their own people involved and retaliating, and then you have another victim.”
‘A real deal miracle’
There are some victims Dr. Alexander will never forget.
There was the woman shot in the back of the head one time and the bullet was lodged in the middle of her brain. Not only was she alive, she was conscious.
“Arms and legs moving. Talking, communicating, blinking their eyes and with you. That is a real deal miracle,” Alexander said.
Then there was the overnight shift on New Year’s Eve 2019, where he had to break the news to the man’s family that he did not survive the shooting. He was told afterward by a detective that his patient was the first homicide of the new year. What he remembers most is choking back tears while the family wailed.
“I told them I’m sorry for their loss,” Alexander said. “Unfortunately that probably does sound routine and mundane and repetitive to people listening to this on the outside, but it’s probably some of the most sincere words that we share as physicians.”
And last month a young man was shot in the stomach, but he had enough wherewithal to brag about his injuries on Instagram.
“You see that from time to time,” Alexander said. “They want to Instagram Live or go on Facebook and say, ‘Hey I got shot. I’m a gangster.’ No, you almost died. And your mother would have been mortified.”
From Covid-19 patients to gunshot victims
And while gunshot victims continue to cycle in and out, Alexander tries to make sure he and the rest of the staff, already brutally taxed after dealing with Covid-19 patients, still have enough left in the tank for their patients.
The mere mention of Brookdale Hospital during the height of the Covid-19 outbreak was enough to make Alexander roll his eyes and shoot his head back in disbelief and exasperation. The ICU at Brookdale was overflowing with sick and scared Covid-19 patients only a few months ago: Indeed, East New York and Brownsville were two of hardest hit areas in the city, according to city data.
Patient beds lined the hospital’s hallways and refrigerated trucks, designed to be emergency morgue space, were overflowing with victims who could not be saved.
Alexander said he slept four to six hours a night and didn’t take a day off from February 20 until April 17.
“Although it was emotionally traumatizing and mentally anguishing it was something that was very different than the public health emergency of gun violence,” the doctor said.
“I don’t walk into work thinking, ‘Oh, I’m going to have thirty people shot today.’ I don’t walk into work thinking that,” Alexander said. “I walk into work thinking I’m going to help people and help those that I need to take care of. I don’t know how traumatic that may be for me. Emotionally, mentally, physically, depending on what comes through that door.”