Street Violence Stirs a Doctor’s Fury and Compassion

The night was a monster, baring its fangs, howling in sirens and the sound of mothers weeping as it spit out a mangled 8-year-old named Valerie onto Dr. Juan Asensio’s operating table.

She had been shot in the spleen, pancreas, diaphragm and left kidney while shielding a 1-year-old boy against gunfire that exploded outside her East Los Angeles home. Gang violence had ripped into its latest innocent victim.

Asensio, chief of trauma surgery at County-USC Medical Center, surveyed the damage and wielded his surgical knife in ways he knew would change Valerie’s life permanently--if she lived. He cut out her spleen, two-thirds of her pancreas and the left kidney, all obliterated beyond saving.

On an 8-year-old, the surgery guaranteed a frail immune system and a host of health problems. The girl lived, but “even if she gets a sore throat,” Asensio said, “she could die.”

He was furious. A world-renowned trauma surgeon, Asensio hates to lose. That is why he fights to tame the beast of urban violence that last year delivered 2,045 gunshot and knife wound victims to his overcrowded hospital.

Instead of just treating casualties, Asensio tries to prevent them.

Clutching surgical slide photos of Valerie--plus those of an unborn baby he had tried saving before realizing a bullet had pierced its brain--the burly doctor marched recently from his hospital to the nearby county Juvenile Detention Center.

Through a county jail program called Excel, Asensio has made the same journey every few months for several years.

“You explain this!” the doctor shouted to about 100 teenage inmates recently packed inside a detention center assembly hall. His Cuban American accent cracked as he pointed to graphic images of the dead baby’s head. The male and female prisoners looked on in handcuffed silence.

Showing a score of gruesome slides in quick succession, Asensio--as comfortable with street slang as he is with medical jargon--hopes to scare young violent offenders straight by “putting a face on trauma” during his hourlong lectures.

He also urges the predominantly Latino and black prisoners to take command of their own destinies.

“Everybody thinks that just because you’re poor and a minority, you’re automatically a bad person,” he told the inmates. “You’re not. You need to prove that to them.”

His efforts are a climb up Mt. Everest, Asensio believes, because of the indifference toward violence perpetuated by Hollywood, video games and the media. In poor communities, a lack of positive role models makes matters worse, he said.

But with random violence dominating the headlines and about $2.3 billion spent annually on gunshot wounds in the country, somebody has to do something, Asensio figures.

“You think this is funny?” he asked a few orange-jumpsuit-clad teens who snickered at his enthusiasm, then answered him with icy stares.

Clicking to a detailed close-up of Valerie’s open torso, Asensio bellowed: “Laugh at this . . . !”

Some male inmates responded with a chorus of “ewws,” while the young women gasped and shrieked.

“This is reality,” Asensio said. “You laugh, it shows you have no heart.”

Later, he added: “We need to show these kids that when you say, ‘I’m gonna blow your head off,’ this is what happens.

“This is not Hollywood,” he said. “There are real consequences.”

Asensio, 46, is a master of those consequences. During 24 years of surgery, he has become a darling of the medical school lecture circuit from Brazil to Switzerland.

“Everybody knows the name Asensio all over the world,” said Dr. Demetrios Demetrieades, a county hospital colleague. “He is one of the foremost experts in trauma surgery.

“And yet nobody thinks to do the kind of community work he does,” Demetrieades said. “We surgeons typically fix our patients’ injuries and send them home. We don’t have the time or resources to follow up and investigate the roots of the problems we deal with, to ask: ‘Why was that kid shot?’ ”

Asensio, who often takes his medical students to his jailhouse lectures, makes time for such questions.

Initially, he’ll attribute his passion to his childhood amid gangs and violence in Chicago.

“I am you!” he told his skeptical inmate audience. “I was poor. I cut up some people. I did some bad things. But look where I am now.”

Only later, however, will Asensio admit that it is not his success that drives him to act as a role model to the youths in bad neighborhoods. It is his tragedy.

His baby brother, Alfredo, was gunned down as a teenager in Chicago after falling in with a dangerous crowd. Asensio was a young resident at the University of Chicago hospital when his brother died.

The county coroner, a friend, broke the news to him in tears. Asensio identified the body and helped the coroner reconstruct his brother’s bullet-riddled face.

Even more agonizing was dragging his parents in to view their dead son. Operating on his next patient--who bore an eerie resemblance to Alfredo--twisted Asensio’s heart with new intensity.

“I never want anyone to go through that,” the doctor said.

Throughout his career, in Chicago, Philadelphia and Los Angeles, Asensio has since been like a pit bull in the face of young gangbangers, barking warnings about their fates.

Something in the awkward intimacy of having one’s hands cradling organs inside their bodies affords Asensio the power to get through to many of his patients, he said.

They all think they’re tough guys, but when they come into the hospital “they’re crying for their mommies,” he said. “It takes more guts to stay away from violence.”

Jose Garcia, one of Asensio’s many young male patients, said he appreciates the doctor’s efforts.

Laid out in the hospital with several gunshot injuries after a fight in Monterey Park, the 23-year-old said the doctor is admired by the patients in the trauma ward.

“Doctor, I heard you’re from the streets too,” he said. “You’re one of us.”

Some county detention center inmates express similar sentiments.

“You can’t do nothing but show him love for what he’s doing,” said Desi B., 17, who attended one of Asensio’s slide shows. “You feel like someone still cares. You understand life ain’t no joke.”

Lonely and facing 25 years to life for armed robbery, Desi B. recently tried to kill himself by drinking a bottle of Windex.

“I cry every night,” he said. “Every single night.”

Sylvia S., 20, who faces a life sentence for her role in a gang-related murder, said the doctor’s slides hit her hard.

“How could they fire a bullet at a baby?” she asked, adding that she had seen such tragedies occur in her South-Central Los Angeles neighborhood.

After each lecture, Asensio prays alone for the young inmates inside a nearby chapel.

“I feel so impotent when I go in there,” Asensio said of the detention center, his face briefly crumbling into tears inside the dimly lit chapel. Then he straightened himself up and walked back to work.

‘This is not Hollywood. There are real consequences.’