RICHMOND -- Sheriff's deputies thought they did the gunshot victim a favor, seating him in a patrol car while they called for an ambulance.
They apparently forgot where they were.
North Richmond remains one of Contra Costa County's poorest, most crime-ravaged neighborhoods, and one of the least trusting of police. Worried friends of the 20-year-old with the wounded ankle wanted to drive him to the hospital, perhaps uncertain if he would arrive otherwise.
"A crowd of about 50 people gathered around. They beat on the vehicle, threw things at the patrol car," including a metal scooter, Contra Costa sheriff's spokesman Jimmy Lee said after the incident last week. "From our standpoint, the way this whole thing unfolded was alarming."
Hoping to avoid a riot, the deputies let the victim go with his friends. But the crowd didn't realize that an ambulance idled nearby, waiting for a signal that it was safe to approach.
It's an old problem in West County's urban neighborhoods, where crushing poverty and generations-old mistrust of the authorities make for a gritty brand of self-reliance on the streets. Flatland residents often deliver themselves to the hospital when shot or otherwise suddenly hurt.
But too often it hurts more than it helps, paramedics say.
"We can do so much more for you if you let us do it our way. We can administer medications, we can begin advanced life support, we can do a lot more things than someone who may mean well, but is untrained," said Leslie Mueller, county director of operations for American Medical Response.
During a frenetic sequence of shootings in north and central Richmond last week, nine people were wounded by gunfire in 21 hours, including the 20-year-old at Shields-Reid Park in unincorporated North Richmond. None was fatally injured, but of those, four came to local hospitals by means other than ambulance.
So did 25-year-old Julio Gonzalez, who was pronounced dead at Kaiser Permanente Medical Center in Richmond after a shooting in North Richmond on Thursday night.
Moving a gunshot victim can complicate injuries, said paramedic Jim Maddox, who worked in Richmond during the late 1980s and early 1990s. He now serves as a field trainer for American Medical Response paramedics in Contra Costa County.
"The closest emergency room is not always the best emergency room for a particular injury," Maddox said. "And if they don't know you're coming, they won't be ready when you get there."
Gunshot wounds also can cause devastating internal injuries that are not always immediately apparent. A round nestled against a spine or artery can prove fatal or crippling if the victim moves the wrong way, and victims who feel relatively fine can die suddenly.
But flatland residents have a whole history book of reasons not to wait around for emergency medical help, community leaders say, particularly when accompanied by police. Some remember cases where gunshot victims died after police stopped a private car taking them to the hospital.
"These feelings go way back. It's the kind of thing that stirred the Black Panther movement. Let's just say that law enforcement has not been African-American friendly, historically speaking," said Fred Jackson, a longtime community activist in North Richmond. "But law enforcement has made great strides in that area."
Emotions run high after a shooting or car crash, and people often act with their hearts instead of their heads. In neighborhoods plagued by street violence, residents sometimes develop false confidence about traumatic injuries, refusing to go to the hospital for wounds to extremities, for example.
In other cases, it feels un-neighborly not to lend a hand.
"I remember my brother and I were riding up the street. When we hit the corner, we saw two dudes fighting in the middle of the street, and one stabs the other right in the back," said Garland Harper, a North Richmond peace activist. "We put him in the car, and we took off."
Harper drove up Rumrill Boulevard and flagged down a San Pablo cop, who called an ambulance. The victim lived.
"I remember I had one hand on the wheel, and with my other hand I was holding his back, putting pressure on it. My brother couldn't stand the sight of blood," Harper said.
These days, the greater Richmond area is guaranteed the fastest ambulance response time in Contra Costa County, according to the county's contract with American Medical Response, because the Richmond Fire Department does not employ cross-trained firefighter-paramedics on its engines.
To ensure that paramedics quickly arrive, ambulances working in or near the city must arrive to emergency calls within 10 minutes, according to contract, rather than the 11 minutes 45 seconds required in other parts of the county.
In Tuesday's shooting of the 20-year-old at Shields-Reid Park, dispatch records show the ambulance arrived in four minutes.
But police canceled it three minutes later, after the victim elected to ride a homegrown chariot to the hospital.
"I think that's kind of a sad irony," Jackson said. "I hate to see this happen. I think there does need to be some dialogue in the community. We have got to let the ambulance do its job."