LOS ANGELES -- When three bullets ripped into Jose Vasquez's back and leg during a gang shooting in Compton, paramedics rushed him to a sadly familiar place: the trauma unit at the Martin Luther King Jr./Drew Medical Center.
He was born at the hospital, and had gone back often over the years to be there when several of his friends died of gunshot wounds. And now, on a summer evening in 1995, he expected to join them.
"I thought I was dead," said Vasquez, 26, recalling his seven hours in the trauma center. He had blacked out at one point, noticing only the stiff brace around his neck and a white light above him. "Then I heard people coming in, and I knew I was alive."
Now the trauma center itself -- located in South Los Angeles, in the middle of one of the nation's bloodiest urban battlegrounds -- may become the neighborhood's latest casualty.
The county Board of Supervisors voted 3 to 1 last month to begin the process of closing it, with final approval expected next month.
County supervisors and health officials say the trauma center is draining money and manpower from the rest of trouble-plagued King/Drew and must be shut down.
King/Drew has been ordered to correct its problems quickly or face the loss of accreditation and $200 million in federal funding.
Neighbors and paramedics worry that closing the trauma center could create delays in treatment that could mean the difference between life and death.
"People are probably going to end up dying," paramedic Richard Sandeman said outside the inner-city hospital, a cluster of buildings where some entrances are guarded by metal detectors.
The trauma center is the second-busiest in Los Angeles County and handles more bullet wounds than any of the county's 12 others. Gunfire can be heard from its front doors.
The center's nurses recognize "regulars" who get shot frequently, and gang members have been known to dump bleeding friends at the doorstep without even speaking to a nurse.
King/Drew employees call it the "homeboy ambulance" network and say it accounts for more than 10 percent of the 2,000 patients treated annually at the trauma center.
"If you're my buddy, you got shot, I'm going to take you to the nearest hospital," said trauma nurse Kathleen Higgins.
With the closing, such drop-offs would either be treated in the emergency room -- which already handles 47,000 patients a year -- or taken to another trauma center. The nearest one, at St. Francis Medical Center in Lynwood, is less than 4 miles -- and a precious 3 or 4 minutes -- away.
"Some of these people, they're shot 18 times, 19 times, and blood is everywhere," Higgins said. "Had they gone somewhere else, mostly likely they would have died. And we do get a lot of patients that come in like that."
The trauma center is particularly well-situated for the work doctors do there.
Watts, the site of deadly race riots in 1965, is immediately to the north. Compton, long troubled by poverty and gang violence, is to the south and east. The two nearest parks are gang hangouts, and the area surrounding the hospital recorded 572 gang-related crimes during the first eight months of this year, more than any other section of Los Angeles. "I call this place the jungle," said an emergency room nurse assistant, Felix Doe.
Over the years, many US military doctors have trained at the King/Drew trauma center because they get to handle so many gunshot wounds.
Health officials say the problem is that patients who enter the hospital through the trauma center are mostly uninsured, and end up receiving follow-up surgery, pain treatment, and therapy -- all of which cost the hospital money.
What's more, doctors on call for trauma care are distracted from their other duties, said Thomas Garthwaite, director of the county Health Department. "We have to take some drastic action," he said.
The trauma center's doors could be shut as soon as December, following a state-mandated public hearing that supervisors referred to as a formality.