Crime and Punishment : Justice: A brutal beating during a robbery almost killed prominent surgeon Larry McCarthy. But he recovered to face the accused in court, where he wants ‘justice to be done.’

As a surgeon, Larry McCarthy has seen the carnage of the city flow through emergency rooms--gaping gunshot wounds and the awful traumas of freeway accidents.

In Vietnam, he treated terrible war wounds as a company medic. And the North County plastic surgeon has ministered to his share of the needy--performing free operations for Mexico’s downtrodden and disfigured.

Then suddenly, the doctor so skilled at treating the victims of perverse chance and violence found himself thrust into an emergency room with the roles reversed.

This time, he was the victim.

Using a heavy metal pipe to crush his skull, two youths--one freshly escaped from jail--allegedly attacked McCarthy one night last December as he returned a handful of mystery thrillers to the Carlsbad public library.

The 50-year-old Massachusetts native with the salt-and-pepper hair was robbed of his identification and his credit cards. Then he was left to die, authorities say, writhing in the darkened parking lot as his ambushers rushed off to a short-lived Los Angeles spending spree.

But on Thursday the doctor turned the table on one of his accused assailants.

Gazing intently across a Vista courtroom, McCarthy stared face-to-face at an 18-year-old homeless youth charged in the attack. Henry Grajales, on trial for attempted first-degree murder, gulped twice as McCarthy identified him to Superior Court Judge Franklin J. Mitchell Jr. and a hushed jury.

McCarthy has attended court appearances for both youths. The other is a 17-year-old juvenile. For McCarthy, it’s a simple way to even the score, to let two criminals know that he is still alive and doing well.

If the jury sees it his way, he’s going to watch them go to jail.

“I beat the bastards,” McCarthy said during an interview in his Oceanside office before Grajales’s trial started Thursday. “It was close. They almost killed me. But the bottom line is that I’m still alive.”

That he is extremely lucky is disputed by no one. Not detectives, who call the attack a “violent, vicious” crime. Not prosecutors, nor even the doctor himself--a self-described fitness fanatic, scuba diver and martial arts expert.

“He should be dead,” said Greg Walden, the deputy district attorney prosecuting the case. “They hit him three times, crushing his skull.” Authorities say McCarthy lost 25% of the blood in his body as he lay in the parking lot.

He spent two days in a coma at Scripps Memorial Hospital in La Jolla and spent weeks recuperating. “They swung just as hard as they could,” Walden said, “like swinging a baseball bat.

Herb Weston, the attorney defending Grajales, doesn’t dispute that his client wielded the pipe.

“But this kid did not intend to kill anybody,” he said before the trial. “Look, what you’ve got is a couple of kids--neither of whom is a real genius--and they pull a robbery as a way to get some spending money.”

Weston told jurors Thursday that his client was molested as a child and suffers from emotional problems, including post-traumatic stress syndrome, that prevent him from reasoning clearly.

Shortly before the attack, Grajales walked away from a youth detention facility in Campo and was thinking about joining the French Foreign Legion. “His life,” Weston said in an interview, “has been nothing but a tragic existence.”

Jurors were provided with a letter, rife with misspellings and grammatical errors, that Grajales sent to the physician while awaiting trial. It was a letter Walden had promised would “make your blood run cold.”

“I’m writting you this letter to show that I’m not a monster . . .,” Grajales wrote. “That night I hit you, something came over me, Like I was the devils stepchild.”

In the six-page, hand-written letter, Grajales admits that he struck the doctor numerous times with the pipe to render him unconscious.

“After hitting you some more, tring to knock you out, you did go out. I started thinking to myself. Who is this man superman? That’s when I started looking at the grown and knotest that I was standing in your blood. All I could see was blood.”

The attack occurred Dec. 26 as McCarthy walked out of the main branch of the public library near downtown Carlsbad.

The doctor testified in a flat Boston accent that he had passed the pair on his way toward the library. One wore an olive-colored trench coat and the other a white ski jacket, he said. Back outside moments later, he passed the youths again and noticed one was looking at him intently.

“The way he looked at me, I thought I knew him from someplace,” McCarthy said, looking at Grajales, who was dressed in a crisp blue suit and leather espadrilles with no socks. “He could have been one of my patients, or the family of a patient. I was trying to recognize who he was.”

McCarthy said that as they passed the youth wearing the trench coat whirled and struck him with a metal pipe. The surgeon heard a “swishing, swooshing sound” and recalled waking up moments later to feel his pockets being searched.

Prosecutors claim the youths were trying to open the trunk of McCarthy’s late-model car and planned to dispose of the body at another location. But the headlights of an approaching vehicle scared them off.

The two were arrested the next day in Los Angeles after using McCarthy’s credit cards to purchase bus tickets, spend the night at a hotel and purchase clothes at a K mart store.

“They signed my name all over Los Angeles,” McCarthy said in the interview. “Right down to the M.D. at the end.”

Reeling from his injuries after the attack, McCarthy was able to drive to his nearby Carlsbad home and called 911. Carlsbad Police Officer Patrick Preston described the doctor’s condition shortly after the attack.

“His hair was matted with blood. It was streaming in his face. His shoulders, chest and back were covered with blood,” he told the court. “The cut, it was huge. The skin was parted and you could see his skull.”

McCarthy spent nearly a week in the hospital, having suffered three skull fractures. In his brief testimony, he described his relief when he awakened from a coma.

“I put my hands up because I wanted to see that they worked,” he said. “They’re my life.”

Colleagues say the attack has changed McCarthy.

“Larry’s definitely more cautious than he was,” said Cyril Kellet, a fellow plastic surgeon who shared a practice with McCarthy. “He’s a karate expert and I think he always figured that nothing like this could ever happen because of his physical abilities.

“Now that he’s become a victim--even though they blindsided him--he’s not at all as confident that he can take care of himself. He realizes his vulnerability. It’s been a real eye-opener.”

The attack was an ironic twist for a surgeon who has spent much of his professional career helping to correct the physical deformities of the young and old.

For 14 years, he has participated in a Mercy Hospital outreach team that has traveled throughout Mexico to perform free-of-charge operations on patients with cleft lips and palates.

He has seen children without noses or ears and performed surgery on an old man who had never known life without having to hide his disfigured face. He has repaired battered hands and repaired the ravages of skin cancer.

And he has felt humbling satisfaction when a poor mother and father broke into tears as they thanked him for the surgery that corrected their child’s terrible deformity.

“What we do in those operations is give these kids a chance to be on equal footing with everyone else,” he said. “What they go on to do with their lives is totally up to them. They could be good or turn out bad.

“But you help to make them socially acceptable. You save them the ridicule.”

His empathy stops short when he talks of the youths charged in his attack.

“They’re sociopaths,” he said. “I go to these court hearings because I want to confront them. I want justice to be done. And when it is, I want to be there.”

McCarthy hasn’t let his brush with violence stop him from helping others. In February, just three months after the attack, he flew to Mexico for a series of operations to repair cleft palates.

Next month, he’ll be on hand when 60 disadvantaged patients arrive from Mexico to have their deformities corrected at Mercy Hospital in San Diego.

Now, Larry McCarthy says he knows what it’s like to be a victim.

“I’m a wiser man now,” he said. “Now when I read those stories in the newspaper about people being shot and stabbed, I can empathize with them. I know how their families suffer. Now, I look over my shoulder.

“Because I’ve been the victim. And it can change your life.”