Dr. Mike Reihart did his residency at Albert Einstein Medical Center in the Logan section of Philadelphia, a city where doctors see some 30 percent of all shooting victims in Pennsylvania.

Compared to that, Lancaster is a picnic.

But Reihart, attending emergency physician at Lancaster General Hospital, said Lancaster is less of a picnic these days, particularly on weekends. "Some nights are starting to feel a little like Philly," he said.

Statistically, the two cities can't compare. There have been 30 shootings in Lancaster in the past eight months. In Philadelphia, gunfire has claimed more than 135 lives in less than six months.

But emergency physicians at Lancaster General say the frequency with which they see gunshot victims has definitely increased. The director of the emergency department, William Adams, told the Philadelphia Inquirer last week that over the past 10 years, the hospital had seen "about a fourfold increase" in the number of gunshot victims it treats. "Where we used to see one or two a month, now we see one or two a week," said Adams.

Reihart, who sees many of those patients, said the increase is disconcerting. But it's nothing he and other medical staff at LGH can't handle.

In fact, he said, gunshots are actually easier to treat than blunt trauma, the type sustained in car accidents. Penetrating trauma, like gunshot wounds, "are a little easier; you know there's a hole here, and a hole there," he said. Blunt trauma, by contrast, often involves broken bones and significant internal injuries.

If someone is shot in the abdomen, said Reihart, they go immediately into surgery. "The science of gunshot wounds is changing," he said. "There are so many gunshot wounds in big cities" physicians in places like Los Angeles have figured out how to triage patients without surgery.

But there's a foreboding to treating gunshot victims that doesn't exist with other patients. "When we have gunshot wounds come in, everyone's anxiety level rises," he said. "A car accident is random; but these are intentional acts of violence," and when the shooter is still on the loose, medical personnel occasionally think about their own safety.

That's not really an issue, he hastened to add, as hospital security is tight. But fear, he said, is inevitably a factor.

Still, Reihart, who also serves as medical director of the city police Special Emergency Response Team, knows Lancaster is small potatoes compared to the hospital where he used to work. The trauma room manager there told state legislators last week that Albert Einstein Medical Center employees "fear being shot as we walk from our cars. .... We fear that somebody will come into our trauma bay to finish off a patient we're trying to save."

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Gil Smart is associate editor of the Sunday News. E-mail him at gsmart@lnpnews.com, or phone 291-8817.
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