Saving Antonio: Can a renowned hospital keep a boy from being shot again?

Antonio Cheadle trained his eyes on the floor, tufts of dark hair falling to the linoleum, lightly as snow, as the barber traced an electric razor along the curve of his head.

The eighth grader - whom friends and family call TO - appeared in the barbershop mirror in flashes as the chair swiveled. His New Balance sneakers and camouflage hoodie. The brace on his right hand, so stiff with scar tissue that he couldn't comb his hair. The scar, a dimple of pink, to the left of his jaw.

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Bullets had spiraled into Antonio's 103-pound body, one after another, as dusk fell outside his mom's apartment in Southeast D.C. It was four days before Halloween in a city beset by gunfire killing and injuring kids.

One bullet struck the side of Antonio's face, splintering the then-13-year-old's jaw and seven teeth. Others grazed his left hand, fracturing the delicate bones, knuckles and tendons of three fingers, and sliced through his right upper arm, severing the nerve that connected to his wrist. Another - the most serious - struck just below his chest, arcing through his diaphragm, stomach, spleen and liver.

It missed Antonio's heart by two millimeters.

It had been 96 days since his last class at John Hayden Johnson Middle School, 78 days since his fourth surgery at Children's National Hospital, and 45 days since his 14th birthday. Now it was late January, and Antonio was returning to school for the first time since the shooting.

He insisted he wasn't nervous, but Jawanna Hardy, the Children's National specialist helping Antonio navigate his recovery in a perilous world, knew better. Hardy had driven him to the barber shop, wedged in a Suitland, Md., strip mall, hoping a fresh haircut would give him confidence. Her job, part of new violence intervention efforts at one of the country's premier medical facilities for children, was to keep this teen from falling prey to bloodshed again.

The haircut complete, Antonio slid out of the barber chair and got back into the passenger seat of Hardy's Tesla.

"He do good," Hardy said to Antonio, scrutinizing his haircut as she backed out of the parking lot. "What else you need for school? You good? You got everything you need?"

Antonio, who'd had his jaw wired shut for nearly a month and still found it hard to speak, unlocked her cellphone and began playing "Reminiscing," a song by Jahh Fetty, over the car stereo. The rapper's most popular hits were "Caskets," "Victims," and "MURDER." Antonio twisted the volume knob all the way up. Hardy gave him a moment, steering toward the Washington Highlands neighborhood, where the boy was staying with his cousin and her two young children.

There'd been no arrests in Antonio's shooting, which appeared to be random, but no one really knew. The teen had never been in any trouble before. According to a police report, officers found him lying on the side of Jasper Road, conscious and breathing. No one else had been shot. More than 10 bullet casings were found at the scene.

His mother's place no longer felt safe, so Antonio had been sleeping at relatives' homes since his discharge from the hospital in mid-December.

Hardy turned down the volume, asking him about school again.

"You 'bout to get all this love and attention," she said.

"I don't like attention," Antonio replied, looking out the window.

- - -

'Not again'

When Antonio arrived at the ER in the back of an ambulance just after nightfall on Oct. 27, another child was already on the operating table at Children's with life-threatening gunshot wounds. A second pediatric surgeon was paged for help.

Mikael Petrosyan, who has worked at Children's for a decade, was on his way out to dinner with his wife when his pager beeped.

"Not again," the surgeon thought.

Children's had become an epicenter of the city's youth gun violence crisis - the place where kids with bullet wounds were rushed for treatment again and again. In 2022, 105 children were shot in the nation's capital, according to police data, 16 of them fatally.

There was the 15-year-old who had been shot while sitting on a porch near an elementary school, the 16-year-old who had been killed walking from his grandmother's house to a football game over Thanksgiving weekend, and the 14-year-old slain on the same street where he'd been injured in a shooting the month before.

"Violence is a chronic disease," said Katie Donnelly, a pediatric emergency medicine physician at Children's. "We know that, if you survive your first gunshot wound, you are far more likely to die of gun violence in the future."

That scenario had played out repeatedly in D.C. Last year, 19-year-old Corey Riggins Jr. had been shot three times in the years before his death. A 15-year-old named Chase Poole had been shot twice before gunfire at a Black cultural celebration called "Moechella" took his life.

Donnelly wanted to change that cycle with a violence intervention program that would continue to help kids even after they left Children's.

"I was tired of seeing kids die on my shifts," she said.

Antonio nearly became one of them.

Petrosyan (pronounced Pe-tro-sian) dropped his wife off at home and drove to the hospital, where he found Antonio in the trauma bay. Though his vital signs had remained remarkably stable, Petrosyan sent Antonio for a CT scan, which would offer the doctor a detailed glimpse of his injuries.

The surgeon, known to his young patients as "Dr. P.," had seen more children with gunshot wounds than he could count. In 2022 alone, he and his colleagues at Children's treated 49 children injured by gunfire. Three of them of them died in the trauma bay. Another four kids died after admission.

As a 48-year-old father of three young boys, each case he worked on haunted Petrosyan.

"If you have kids at home, it can be a scary thing," he said. "It could be my kids getting shot - a lot of times, these kids are innocent bystanders. That's why it's devastating."

Gun violence is now the leading cause of death for kids and teens in the United States. But for Black children like Antonio, that had been the case since 2006.

Petrosyan didn't know Antonio's name yet. Children often don't carry identification, meaning hospital staff didn't learn their names until panicked family members crowded into the emergency room waiting area. As a placeholder, the hospital gave kids state names, and so the 13-year-old was simply called 'Acute Mississippi.'

On the CT scan, Petrosyan saw what wasn't visible to the naked eye - a critical multi-organ injury. Antonio's abdomen bulged from internal bleeding. "He was dying," Petrosyan said later. The teen was given two-and-a-half liters of blood and plasma in the resuscitation bay, then rushed into the operating room.

At 9:20 p.m., Petrosyan - dressed in blue scrubs, goggles, a mask and a tightfitting cap - made the first incision. He staunched the bleeding in Antonio's liver and spleen and began suturing the holes in his stomach and diaphragm. During the procedure, the teen lost 300 milliliters of blood - or about 1 1/4 cups - requiring a second blood transfusion.

An hour and 20 minutes later, the surgery was complete. Antonio was transported to the intensive care unit, where specialists would begin to address the injuries to his face and hands.

Recovery would take months - if it was possible at all.

Children were never the same after a shooting, Petrosyan had found while working with six others on an academic paper about pediatric "recidivism" - or how likely a child was to be readmitted to the hospital following a major trauma.

Published in October 2019, the study was the first of its kind, finding that children with "penetrating injuries," like a gunshot wound, were more likely to return to the emergency room.

Many lived in neighborhoods where gunfire was common - and where retaliatory violence was common, too.

"Willingly or unwillingly," the study concluded, children can "fall into a vicious cycle of exposure to violence."

The nature of Antonio's injuries meant that he'd be considered a "tier 3" patient - the most serious, with a high likelihood of getting caught up in violence again. He would struggle to regain mobility where the bullets had ripped through his flesh. He'd have to relearn how to write his own name, to shoot a basketball, to grip the controller of the car racing video games that he loved.

He would have to fight to survive his childhood. But he wouldn't be doing it alone.

- - -

'A hurting feeling'

There were four more surgeries.

Doctors swaddled Antonio's arms in thick casts and braces and wired his jaw shut. They replaced the severed nerve in his upper right arm - which had caused his wrist to drop like a claw, rendering his dominant hand useless - by transferring muscles and tendons from elsewhere in his arm. They operated on each individual finger, reconstructing the joints with bone from his hip. For two months, Antonio was stuck in his hospital bed at Children's, first in the ICU on the third floor, then on the fifth floor's trauma unit.

Donnelly's violence intervention program was tailor-made for kids like him. She'd created it with $230,000 in grants from the city and federal government. By late April, 130 children were enrolled in the program, with a staff of three trying to address the factors in a child's life that might lead to a recurrence of violence.

Hardy, 35, who had been assigned to help Antonio, liked to sit in his hospital room, typing on her laptop. She'd been hired as a violence intervention specialist but was better known for running a local nonprofit - and corresponding Instagram account - called Guns Down Friday, meant to reduce violence in the community she'd grown up in.

Already soft-spoken and shy, Antonio didn't say much at first. His mouth was full of metal wiring. But Hardy thought he had a nice smile. She won him over with snacks from the cafeteria: Oreo milkshakes and, once he was able to eat solid food, hot chips. He told Hardy that his dad had died of covid in 2021, and his older brother - who, coincidentally, knew her 18-year-old daughter's boyfriend - was in a Job Corps program. They watched his friends' music videos on her cellphone. Antonio struggled with the touch screen on his own.

Hardy got to know his mother, Joanna Cheadle, 38, too.

Cheadle also carried bullets in her body. In 2017, she said, she and two friends had been struck during a drive-by shooting while walking home from the grocery store. Antonio had been 8 years old then, safely tucked in bed with his brother and a few cousins. Cheadle was only in the hospital overnight, she said, but her absence had scared Antonio - so did the lumpy scar tissue that formed around the bullets, which doctors weren't able to extract from her legs. She still walked with a limp, and on rainy days, her legs ached.

Cheadle had never imagined her boy would be shot someday, too.

"It's a hurting feeling to see your baby get shot," Cheadle said. "Your mind is blacked out when you get news like that. I just thank God that he gave Antonio another chance, that he's still on this earth. I realize how precious it is to have a second chance."

This was partly why Donnelly, 39, had started the violence intervention program at Children's, which is similar to those at hospitals in Milwaukee, Chicago, and Oakland, Calif. She was tired of kids assuming bullets were an inevitable part of their fate, of treating boys without fathers - only to find out that they were also victims of gun violence - and of teenage pallbearers.

"Having people that you trust around to support you - to ask, 'How are we going to recover from this? How are we going to make sure you still get to do the goals you had?' - makes a big difference," Donnelly said.

To treat gun violence like a chronic disease, her team would have to look at all the factors that led to shootings. Where did a child go after school let out? Was he even in school? Did he have food and safe housing? Was he caught up in neighborhood beefs that led to cycles of retaliatory violence? Could her team disrupt what was happening in a child's world that put him at risk?

The biggest question always loomed.

Could they save the next kid?

Donnelly - along with Hardy and another part-time social worker, Yvonne Doerre, 53 - worked out of a multipurpose room painted in periwinkle, just off the hospital's ambulance bay. When emergency vehicles arrived, the room's single window flashed blue and red.

Month after month, children continued to arrive at Children's with gunshot wounds. Hardy often sat in that multipurpose room, waiting to talk with them about what had happened, calling their parents and police detectives, and arranging rides to school and hospital appointments. If they failed to show up, she'd drive over to their apartment building and knock on the door herself.

She liked to ask kids what they wanted to be when they grew up. She thought it helped to have a dream - some goal or ambition bigger than themselves.

Antonio, she worried, never had an answer.

- - -

Hoops

The tiny orange basketball arced through the air, and for a moment, it looked like a sure swoosh. Then, it ricocheted off the toy basketball rim.

Antonio grimaced.

It was late March - nearly five months since the shooting - and the teen was still struggling to regain control of the fingers of his left hand. On this afternoon, he was working with Jessica Knapp, an occupational therapist at Children's. Knapp encouraged Antonio as he pulled back the lever a second time, catapulting the orange ball toward the net. This game was intended to help him gain mobility in his pinkie finger, which was still supported by a splint most of the time.

Again, Antonio missed.

Progress had been slow and halting. Earlier that afternoon, Knapp had massaged his hand to help break up the scar tissue. Then, she measured each finger as Antonio extended them, to see whether he was able to stretch out the digits farther than before. Success was measured in millimeters.

Antonio's right arm - which had recently been operated on, making it his fifth surgery - was still in a thick white cast. Antonio didn't like it and wished his doctor would saw the cast off. It was too big to shove through the sleeve of his T-shirt, so his arm rested awkwardly against his bare abdomen, like a bird's broken wing.

"This is looking really, really good," Knapp had said, jotting down a measurement. "How's school been going?"

"Good," said Antonio.

He was back at Johnson Middle three days a week. His English language arts teacher had been excited to see him return, and during lunch, he met with his credible messenger - the city-assigned mentor helping him navigate the complexities of eighth grade.

But school wasn't a haven from gun violence. The building in Southeast D.C. had been locked down repeatedly in 2023 because of gunfire in its neighborhood, Johnson's principal, Latisha Coleman, said at a recent D.C. Council budget hearing. In 2021, an eighth grader at Johnson was shot and killed steps from the school.

Antonio wasn't insulated from gun violence at home, either. His mother wanted to find new housing in a safer neighborhood so they could live together again, but it hadn't happened yet. In February, Antonio had returned to his cousin's apartment after school to find yellow police tape looped around the front entrance. Earlier that day, U.S. Marshalls had fatally shot a 22-year-old as he was taking out the trash. He was a friend of Antonio's cousin. Officers said they'd been trying to take him into custody for a parole violation when they saw a gun.

Upset, Antonio had missed the next day of classes.

Still, there was a lot for Antonio to look forward to. In June, he planned to attend the eighth grade prom with a girl he liked. Two days later, there was middle school graduation.

Administrators had promised he could graduate with his friends as long as he kept up his attendance. If not, he might have to go to summer school. The hospital had already paid the $207 for Johnson's premium graduation package, which covered Antonio's cap and gown, his prom ticket, the yearbook, a T-shirt, and the eighth grade class trip to Kings Dominion, an amusement and water park in Virginia.

Even better, Hardy had promised to buy him a pair of Gucci shoes to wear to the graduation ceremony - but only if he kept up his grades. She hadn't bought them yet, she said, because they gave Antonio an incentive to stay on track.

He smiles every time she brings up the shoes.

At the hospital, Knapp finished taking Antonio's finger measurements and jotted down more notes.

She had Antonio roll out a lump of bright pink Theraputty - she joked that it was 'adult Play-Doh' - and flatten it like a pancake. The movement was halting, but not too long ago, he hadn't been able to do this. Knapp helped him fold his fingers down, squeezing the putty into a lump. He opened his hand again. A ripple of pink scar tissue bloomed on his palm.

"What is your pain like right now?" she asked.

"Nothing," he said.

Next, he shoved circular blocks - orange, green, yellow - into the putty and practiced pinching a towel into a tight line. Finally, he moved onto his favorite game: basketball.

As the orange ball pinged off the rim again, Hardy looked up from her conversation with Antonio's mother.

"How does it feel to be improving, TO?" she asked.

"It's cool," he said.

"So nonchalant," she replied.

"A lot of people say that," Antonio said, smiling.

Again and again, he tried to shoot the basketball through the tiny hoop.

Then, with a click, it connected with the plastic backboard and fell through the hoop.

- - -

The Washington Post's Emily Davies contributed to this report.

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