A man was killed outside my house the other night.

I was exhausted and it was late and I sank into an inky sleep nearly immediately. A mere ten minutes later, three (or was it four? Memory is such a fickle thing) sharp bursts invaded my dreams.

“Damn fireworks,” I thought and turned over, relishing again the softness of my bed.

The nagging at my brain started mid-turn. “Not fireworks,” it countered. “Gunshots?”

Surely not–not on our quiet little street. The mid-spring violence that has erupted recently is all many blocks east. We’re safe. We’re removed.

And yet something in my subconscious knew that this was no summer sparkle show. I looked out the window. Kids running up the street, a crowd at the house across from ours. Nothing unusual.

Or was there? As I cast my eyes up and down the block, trying to make sense of things, the bedroom door burst open. “Someone just got shot,” BH shouted, confirming my fears.

I argued with him-I couldn’t see anyone from my vantage point. He answered tersely and we ran up to the deck where he pointed at the slumped figure not a hundred feet from our front door.

“I have to . . .” I said as he interrupted me, already able to tell what I was going to say. “No way in hell you are going out there until police are there.”

I stared at him a moment and then flew down the two flights of stairs towards the front door. By the time I reached the front door blue lights were flickering through the front windows and I dashed outside.

The police officer exiting his car held up a hand and yelled “Stop!” but I brushed on by, shouting as I went, “I’m a doctor and someone needs to check that man.”

A few strides, even for my short little legs and I was at his side. He was hunched over, curled in a fetal position but instead of lying on his side he was on his knees, his face slumped over his legs. I touched his shoulder. “Sir, are you alright?” No answer.

I looked up at the cop. “Where are your gloves?” He stared back blankly. “Your gloves, in your first aid kit? Where are they?” I shouted and wished for the safety of all the thousands of green latex security blankets that surround me when I’m on the job. He pawed through the trunk, emerging with the metal box.

After hastily pulling on a pair of ill-fitting gloves, I turned the man over. No pulse. No breathing. I didn’t see any obvious injury but blood was pooling down his chest, spilling onto the sidewalk. “Help me move him,” I demanded to the cop, trying to position the 200 hundred plus pounds onto a flatter surface.

As if by instinct (and maybe it is instinct by now), I placed my hands on his chest, just below the sternum. I laced my fingers and began the steady up and down rhythm, trying to pump whatever was left in his heart through the rest of his body. I chastised myself for not carrying a rescue mask, aware that deoxygenated blood is not as useful but mentally deciding something was better than nothing.

Two small holes caught my eye-his right neck was violated, directly over where so many vital structures live-the jugular, the carotid, the airway. I knew then that my efforts were futile and yet I couldn’t stop. In the hospital there is so much I can do–I can intubate, I can start a line, I can put in a chest tube. I can order drugs and shocks and i-stat chemistries. But in the street I had nothing. Just him and me and a pair of gloves.

The paramedics arrived shortly-five minutes since I started? Who knew? Who was counting? Without drugs to time and monitors to watch, time moves differently. I hastily spilled out what I knew. “Shot at least twice in the right neck. Pulseless and apneic when I got here. Compressions only for about five minutes. Still no pulse.”

“Yeah, we can call this one,” the paramedic said. And that was that.

I drifted back towards home, feeling awkward in my ragged university T-shirt and ratty shorts. I pulled off those gloves, noticing a smear of blood on my arm. I walked to the kitchen. I scrubbed and scrubbed.

A cop came a few minutes later. And then another. Then the paramedic, checking to make sure I was okay. It’d been a busy night. This was not their first shooting of the shift, nor the first fatality. “Shit, we still got five more hours,” he said, glancing at his watch. A detective followed. He wanted all the details.

At one point he went up to the deck with us, staring down at the scene like disembodied spirits. It seemed like a scene from a movie-stark colors and grainy contrasts. The man’s yellow shirt, a pool of bright blood, all surrounded by dark shadows and shapes.

Death no longer fazes me. I’m scared sometimes, thinking about how compartmentalized my emotions have become in the past three years. I no longer cry at the tough codes. Ghosts rarely haunt my dreams.

But this was not work. This was my home. It’s where I go to forget the bodies, the tragedies. Blood and guts do not belong there, unless I’m recounting an exciting procedure or interesting case.

I realize again how naive I am. How violence is a way of life for so many in this world–not just those in the Sudan and Iraq and Kenya and all of the other places I can easily put aside after reading the latest update in Newsweek. It is here. It is in my city. In my neighborhood. On my street. Murder, perhaps the most dehumanizing force that exists, is not far.

And yet it is.  BH and I have a variety of protections-our race, our income, our education, our addiction to substances legally obtained.  I am not so naive to think that I can change the violence that surrounds me.  The issues which contribute to shootings such as this one are myriad and deeper than a 1,000 word blog post.  So for now I will just be thankful.  Thankful that I’m okay.  That BH is okay.   That our neighbors are okay.  And from there-who knows?