As a nurse held a 4-inch needle and explained that it sometimes is inserted in the groin of IV drug users, Monica, 18, stood by, nervously clutching her hands and shifting her weight from one foot to the other.
Continuing her explanation, the nurse held up a chest tube and said it is inserted between the ribs to get to the lungs. Of course, she added, these procedures are done while the patient is wide awake.
Sometimes that's a necessary part of treatment at the Maryland Shock Trauma Center.
All too often, the nurses see patients involved in alcohol- or drug-related accidents, either as perpetrators or as victims. Yesterday, several Baltimore County high school students toured the center, at the University of Maryland medical complex in Baltimore, as part of the county's Adolescent Trauma Prevention Program.
The students were first-time drug or alcohol offenders who had been arrested or expelled from school for possession or use of drugs and alcohol. The program consists of a five-session course on the effects and dangers of drugs and alcohol. More than 1,100 students have completed the course since it began in 1985.
At the Shock Trauma Center, the students see patients who are paralyzed, in comas or otherwise severely injured. Students often faint during the tour, said nurse Debbie Yohn.
That didn't happen yesterday, but the students listened attentively as Cheryl Hammer described the treatment patients receive when they are admitted. Ms. Hammer, a nurse at the trauma center for 10 years, said that up to 90 percent of the patients are admitted because of drug- and alcohol-related accidents.
"Think before you drink, drug, and drive," she warned the students. "Think before you drink and drug. It's bad news.
"I know you all get into arguments with your parents. I know you think they don't care about you, but when I go out there to tell some parents their child is dead, I've never heard a parent say: 'Whew! what a relief! I'm glad he's gone!' They all cry," she said.
Throughout the tour, the students were somber and quiet; it's not always easy to admit the effect of visiting the Shock Trauma Center. Monica, who had wrung her hands while Ms. Hammer described trauma procedures, was nonchalant when she spoke.
"To be frank, I came here because I had to," she said. "I would have never done it for the hell of it. It was interesting, and it got me out of two classes."
Because she took the tour, Monica said, she was exempted from two of the five sessions required to complete the program. A recent high school graduate, Monica was caught buying alcohol for some friends and using a fake ID. She said she does not know if the program has changed her attitude about drinking.
Whether or not students admit the program's success, statistics show it is very effective. One year after completing the program, less than 4 percent of the students are involved in the corrections system again, said Mike Gimbel, of the county's Office of Substance Abuse.
Mr. Gimbel said students are shocked sober. Physicians say they just don't want the students to wind up as Shock Trauma patients.
"Our goal isn't to scare the kids -- it's to educate them," said Ms. Yohn. "It's tough to stand at a bedside and tell somebody they've killed their best friend. We don't want that to happen."