When the doctors at Advocate Christ Medical Center in suburban Chicago hear that yet another shooting victim is on the way to the emergency room, they don't wait to find out their name.
The hospital — which sees its caseload rise and fall with the tide of crime on the city's bullet-riddled South Side — assigns each trauma patient an alias in alphabetical order.
Once an Alan Doe, Barbara Doe or Charles Doe is registered in the system, the staff can start ordering the tests and units of blood that may be needed to save their life.
"On a good night," Dr. James Doherty said with a touch of gallows humor, "you could maybe get through the whole alphabet."
The staff at Advocate Christ knows all too well that Chicago's headline-grabbing plague of violence — which appears to be on the downswing after hitting 500 homicides last year — is no laughing matter.
Last year, the well-regarded facility treated nearly 1,100 shooting and stabbing victims. The number of patients who are dead on arrival has quadrupled in three years. The number of trauma surgeons has jumped from three to seven in a decade – and they’re looking to add an eighth.
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In recent years, hospital workers say, they have seen more children caught in the crossfire and more bullet holes in the victims who are rushed to their campus.
"Instead of a patient with a gunshot wound to the abdomen, we have a gunshot wound to the abdomen and the head," said Doherty, who has led the trauma department since 2002.
"Instead of, you know, one or two gunshot wounds, they have 10 gunshot wounds. It just seems like the severity's much higher. Just a couple of days ago, we had someone with 28 gunshot wounds."
Dr. Ellen Omi, a trauma surgeon, has noticed the trend, too.
"We definitely see more people who are just covered in bullets," she said. "Twenty-eight? I would have to say that's close to the highest that I've seen but I think 32 was the highest. And it's really just chance as to what it hits or what it doesn't hit."
Omi finished her residency at the 695-bed hospital in 2005 and came back in 2010.
"It just seems like the number of patients has become overwhelming," she said. "It was busy then but it's nothing compared to what it is now."
From her vantage point, Omi has tracked another change: the bloodshed seems more "random" than it once did.
"Gang violence? There was some organization to it. It was us versus them or them versus us. And you could see the retaliation that went on," she said. "There's no rules anymore, it seems like, with the pattern of violence...it's just random five-year-olds getting shot. That really hits you hard.”
Chicago had more homicides than any city in the nation last year; its per-capita murder rate was more than triple the rate of New York City and more than double that of Los Angeles.
The murder of high-school student Hadiya Pendleton in January underscored the stubborn gang problem and focused attention on the issue of urban gun violence.
The Police Department says its anti-gang program, narcotics initiatives and emphasis on community policing are yielding results: shootings are down 24 percent and murders have fallen 26 percent over the same period last year.
At Advocate Christ, doctors say the number of shooting victims they see is down, but the ER remains incredibly busy – serving twice the number of patients as intended when it was built.
On a recent weekend night, seven trauma patients came in within two hours – including two shootings, a stabbing and an assault.
Fortunately, Advocate Christ has an admirable survival rate for trauma patients, which includes people hurt in car crashes and other accidents. Ninety-seven percent of those brought in alive will live.
"When you do something a lot, you get good at it," Doherty said.
Many of those who make it and are admitted to the hospital keep using their alias – another reminder to doctors of the threats that keep the suburban hospital so busy.
"A lot of patients tend to keep their Doe names as they move through the hospital system... Just because sometimes it's not safe for them to be known in the hospital," Omi said.
Once they save a life, the doctors hope never to see a patient again. To cut down on the number of repeat customers, the hospital has partnered with Cure Violence, allowing counselor Charles Mack to speak to victims and their friends and family.
“Unfortunately, while that hot steel is burning in their body, it gives me an opportunity to talk to them about life, about not being out on the street,” he said.
To Doherty’s mind, that’s preventive medicine.
“There's no doubt that when someone gets shot or injured and it's someone's fault, there are family members, there are friends who are gonna go out there and seek revenge,” he said.
“And if we can stop that process, prevent that from happening, that's less people we have to patch up.”
NBC News' Neal Carter and Ronnie Polidoro contributed to this story.
First published August 19 2013, 3:39 PM