I was working nights in the ER at the Level 1 trauma center in Jackson, Mississippi. For a time Jackson, Mississippi, was, per capita, the most violent city in America. Places like Chicago and Detroit had larger body counts, to be sure. However, if shredded meat per unit population is your metric, Jackson eclipsed them all.

I never did a full shift in the ER without at least one gunshot wound. My personal record was seven. Once you got the holes plugged these unfortunate folks were surprisingly pleasant company, often even polite. The shooters weren’t typically psychopaths, not by a long shot. To an individual, they all just had poor impulse control.

The capacity to control one’s emotions is arguably the single greatest predictor of success in life. It isn’t money or race or social status. Most everybody I encountered shot up in the ER angered easily. Prisons are replete with such people.

Our hero was maybe eighteen or nineteen. For reasons that should soon become obvious, documenting his birthday was not our top priority. Our first inkling something was amiss was a frantic radio call from the ambulance. This young man had run afoul of some unlicensed pharmacist over turf, the exorbitant price of illicit pharmaceuticals, or the conflicted affections of some young lady. Eventually somebody slapped leather. He had been shot about fifteen minutes before reaching the ER.

It took five of us to hold him down. This guy was thoroughly jacked—think an anorexic Arnold Schwarzenegger circa 1984. He was also liberally festooned with gang tats. As they rolled him off the truck he was fighting like a Norse berserker—screaming, shouting, and cursing at all of us. All he wanted to do was to go home. He told us as much with great verve. How much of that was exogenous drugs, an innately fulminant personality, the intensity of the moment, or some toxic combination I shall leave to the philosophers.

We finally got him strapped to the bed and went to work. Once he realized he was not going anyplace he calmed down enough to speak. More to serve as a distraction than anything else, I innocently inquired who had done this to him. It didn’t matter at all. The perp was the cops’ problem, not ours. However, anyone in extremis benefits from a little redirection. They all wanted to share their stories. If I could get him focused on ratting out the guy who shot him he might not fight us so fiercely if we needed to start a central line. Panting from the exertion, he gasped sincerely, “It was Some Dude.”

The entire room erupted in marginally-restrained laughter. We weren’t trying to be cruel or make light of this poor guy’s sordid state. It was simply that his answer was so monotonously predictable. They all claimed some variation on this theme—“There I was, sitting on the front porch drinking iced tea and reading the Bible to my blind grandmother, when Some Dude jumped out from behind the bushes and busted a cap in my ass. It was dark and he was wearing a hoodie, so I couldn’t tell who it was, but he was packing a Glock nine…”

They all said that. If the local constabulary could just lock up Some Dude then Jackson would be instantly transformed into Mayberry. Mr. Dude was a bloodthirsty brigand indeed.

We got his clothes cut off easily enough. This guy was well and truly ripped. He had clearly logged some serious time with free weights. The external stigmata of his injury were deceptively benign.

There was a single black hole in his anterior chest roughly equidistant between the sternum and the right nipple. There was surprisingly little blood. There was also no corresponding exit wound.

Bullet holes are a special kind of black. They’re a bit like that inky dark spot between the stars on some warm spring evening bereft of overcast. Bullet holes seem to suck in both light and hope. This one was also sucking in a little air.

In my experience, thugs use whatever assortment of ammo they’re able to steal—sometimes it’s high-end, sometimes it’s crap. Cop bullets would reliably shred dudes. Thug rounds most typically just punched tidy little holes. However, just like real estate, the name of the game was location, location, location. This location was bad.

I’m expanding the timeline a bit. What happened here happened quickly. We were all working frenetically to keep this kid from dying. However, we were soon to be overcome by events.

I knew this guy for maybe ten minutes total. During that brief time he underwent the most remarkable transformation. When he rolled into the ER he was profane and venomous. He snarled at us, cursing and thrashing. He told us in no uncertain terms what he was going to do to us if we didn’t cut him loose and just let him go home. And then something creepy happened.

Gradually his demeanor thawed. He began begging us. He offered us money or drugs, anything we wanted, if only we would not let him die. This went on in the background for a few minutes, and then he ignored us altogether. That’s when he began to pray.

Maybe the guy grew up in church. Perhaps he had a Godly grandmother. At this point, our hero started praying like a nun at a Black Sabbath concert.

“Please, God, don’t let me die! Lord God Jesus, please don’t let me die! Oh, Jesus God, please don’t let me die!”

His voice got higher, and he struggled against his restraints. Then he arched his back and blew great gouts of blood out of his mouth and nose. It went all over the place. And then he died.

We worked on him for a while after that, but there was no fixing that much broken. We postulated that the round had likely perforated his pulmonary vasculature. These large-caliber vessels carry vast quantities of blood, particularly when you are properly tooled up. Most of your chest is empty space. Every second after he had been shot, he had been bleeding into his lungs.

A typical adult human carries around five liters of blood—two and one-half two-liter Coke bottles. Lose a liter of that in twenty minutes, and normal people are flirting with unconsciousness. Make that two liters, and it becomes life-threatening. There is surprisingly a lot of space in your lungs to park blood.

The support staff in such a world—the nurses, respiratory techs, and the like—are all of them maniacs. That’s the only reason anyone might voluntarily work in a place like that. They goaded the surgical residents for not cracking the guy’s chest right there in Trauma 1. However, the surgeons had all done this before. That’s not something sensible folk aspire to do.

I washed up and took a minute, actually about five. While we were dealing with our condemned thug, life went on in the ER. That meant sewing up lacerations, stabilizing broken bones, and valiantly battling the scourge of venereal disease one shameless John at a time. However, my heart wasn’t really in it. The rest of the night was a bit of a blur.

I had a half-hour drive to get home. I didn’t want my family to live in the kind of place where I worked. The parts of Jackson I traversed going home looked like Mogadishu. Some of the street walkers and drug dealers I saw in the ER likely plied their trades around my daily commute. By the time I got home the sun had come up. I pulled into my garage utterly spent.

My first stop was the laundry room. There I found Samantha, our golden retriever rescue. She was a simply magnificent dog—affectionate, loyal, and without a mean bone in her body. The fact that she was in the laundry room meant that she had been a distraction. My wife homeschooled our three kids. Whenever Samantha’s presence began adversely affecting the kids’ school work, she got banished. The same thing happened to me from time to time.

This time I needed her. I rubbed her ears and accepted her unqualified affection with gratitude. That’s the great thing about dogs. They love you when you’re tired, grouchy, and smell bad. Unlike humans, canine love does not come with preconditions. In this case, Samantha was showing an unnatural interest in my shoes. That’s when I realized it.

My sneakers were liberally doused in human blood. The vile stuff had also gotten into my socks. We typically gird up with goofy little booties and such, but this evening there had been no time. I shed all of it, scrubbed everything down in the sink, and put my shoes out in the garage to free Samantha from temptation. Now finally barefoot and suitable to reenter the land of the living, I stood beside the closed door and just listened.

On the other side of the door there was laughter and happiness not befouled by the world I had just abandoned. The kids didn’t always like school, and my wife was a serious teacher. However, there was so much love there. I felt vaguely like a man crossing a great desert who finally had water within his grasp. With that I pushed into the house.

The kids jumped up and ran over to grab my legs. My wife tolerated the interruption. I hugged each of them in series and then my bride. That was when she innocently queried, “How was your night?”

How do you answer that? I had just put my sneakers in the garage so the dog wouldn’t be drawn to the human blood that defiled them. My family did not need to be befouled by such as that. My wife never signed up for it. I just smiled and said fine. When you live long enough in an asylum, eventually it starts to feel like home.