It is the ripple effect of gun violence, and it is happening in our own community.
"It used to be where 'did anybody get shot today?'" said Curtis Pope, an environmental service worker at University Hospitals Cleveland Medical Center. "Now it seems like you come in and ask how many."
Pope's job is to clean and sanitize University Hospitals' level one trauma room after each patient. That includes cleaning up the blood that is left behind, on the floor and on the walls.
"The gun violence, all of the violence, it's really sad to me," said Pope. "It's disheartening."
"It's not uncommon to see two, three, four gun shots come in in a night," said Dan Sherman, a UH paramedic.
News 5 spent three nights embedded in the UH Cleveland Medical Center's emergency department, which includes two level one trauma rooms. Three gun shot victims arrived in less than 24 hours.
"Not only is it physically taxing, it's emotionally taxing as well," said Dr. Keith Clancy, medical director of trauma for UH at the time. He left the hospital in October to work in another trauma center. "When I think it takes the emotional toll is when I take them [the patient] out of the operating room and then go to the family. And in the family, you see a mother, a father or a spouse or children. In them, you see the hopes and dreams they had for that patient."
With each passing day, doctors, nurses and medics at UH work tirelessly to save gunshot victim after gunshot victim. The support staff experience the aftermath and stress of it all in some of the most personal ways.
"What gives you the drive to come back everyday?" asked News 5 Reporter Kristin Volk. "Just being strong, taking care of these patients, being very strong," responded Gayle Crowell, an environmental service worker who also cleans and sanitizes the trauma rooms.
"It seems like everyone just wants to grab a gun," said Pope. "You just want to try and reach and talk to them [the gun shot victims]. There's a better way. There are better ways of solving problems."
Retaliatory violence is always a concern in the emergency department, especially when multiple gun shot victims arrive or visitors show up to see patients. Often, it's unknown whether they know each other or how.
"At any particular point, we don't know who's coming through that door with a gun," said Brian Dziak, a registered nurse.
Armed security guards stand by watching carefully for rival gang members.
"We have to be really really careful," said Clancy.
"This whole situation, this hospital, it makes you think about your life, makes you think about everything around you," said Crowell.
"It's not a job for just anybody," said Catherine Uhlenhake, a registered nurse.
It is so much more than just a job for so many people who work in the trauma room.
"Working down here in the ER has changed me to a point," added Uhlenhake. "It makes you a little bit rougher around the edges."
It is a life-changing experience. The darkest moments creep up only after the carnage is gone when there is time to reflect.
"I've become a little more humble," said Pope. "I've seen a lot. I don't know how long I'll be able to do this. I think I can handle it for a while. At least I'll try."
The UH medical team saved all three gunshot victims who came in during our time in the emergency department. There is grief counseling available to all employees.