On the first Monday in October, three men came calling for David Ross at his office, located in the University of Maryland’s Medical Center campus in downtown Baltimore. All three men had survived gunshot wounds, and their visits to Ross, a licensed social worker at the hospital’s Violence Intervention Program, could mean that they were looking for socks or hats, necessary items for the coming winter. But on that day, an unseasonably warm one, the men didn’t knock on Ross’s door looking for clothes.

One man, a 27-year-old, had lost his job and worried that, even with the moratorium on evictions put in place during the COVID-19 outbreak, he would lose his home. Ross assuaged those fears. Another man in his 20s asked Ross to put some money on his Charm Card, Baltimore’s electronic transportation pass. And a third man needed help with the Internet. “With him being older,” Ross said of the 62-year-old, “it is a little bit more difficult for him to navigate.” He also wanted to bend Ross’s ear for a few minutes. The man lives alone, so these visits double as social calls.

Mondays at the Violence Intervention Program are generally busy. The weekend often brings a fresh round of shootings to Baltimore, and leaves the hospital’s Shock Trauma Center flush with new victims for Ross to counsel. The cases pile up: three to five gunshot patients are usually waiting — and so are old clients who come back weeks, months, and sometimes years after they have been discharged from the hospital. They come looking for simple, tangible things — a toothbrush or a new pair of socks — but stay for long, informal therapy sessions. “They will come to get some toiletries and they will talk about a dilemma they are having,” Ross said.

Before that day was over, Ross received a text from yet another patient in his program. The two hadn’t spoken in months, but in minutes they were on the phone.

The patient, a 26-year-old man, was reaching out because he was back on the corners selling drugs to survive. “It’s not something he wants to do, he doesn’t want to be part of that life,” Ross said. “But it’s what he goes back to when everything else fails.” It’s a cycle Ross has observed since the man arrived at Shock Trauma almost a decade ago, soon after being shot.

The last time Ross talked with the patient was at the end of 2019, during the holiday season. Every year, Ross, who is a licensed social worker, and 13 staffers at the Violence Intervention Program assemble gift bags for shooting survivors and their families. “I would see him at least once a year, because we would get Christmas gifts for him and his children,” Ross said. The gift didn’t come with strings attached. It was a way to tell him that Ross and those at the program cared. And it was the way they kept in contact, even if those encounters were sporadic.

Baltimore has recorded more than 1,500 homicides since 2015, and even more people have survived being shot, stabbed, or beaten violently. In 2018, Maryland lawmakers promised to spend $4 million per year across the state on violence intervention programs. Shock Trauma received a portion of that money, along with grant funding. But the support from the state has been inconsistent. In the three budget cycles since approving financial support for violence intervention, the state has fully funded those efforts once. The pandemic has put a gaping hole in state and local budgets, leaving many to worry that the officials won’t meet their commitments to supporting violence intervention programs.

The Violence Intervention Program is based on the idea that wrapping social and emotional services around victims of violence can keep them from being victims again. The program is carrots without sticks. Ross won’t toss a client out for struggling with addiction, or resorting to violence on the streets, or getting arrested. The offerings made by the program are designed to build trust. The men — and it’s mostly men — who come through the doors know they can reach out when they are in need. Ross estimates that he speaks with as many as 500 victims each year. “There have been moments when a few clients have said ‘I see a therapist, but I like coming here,’” Ross said.

Ronald Nix. Shan Wallace for The Trace

The office is filled with snacks that the clients can eat or take with them. The regulars will come back almost daily to grab a snack one day, a toothbrush or toothpaste the next, maybe a hat the day after. Ross says they often want more, they just don’t want to come out and ask for it immediately.

“A lot of times they use [a toothbrush, toilet paper or a hat] as an excuse to stop by,”’ said Erin Walton, program manager for the Violence Intervention Program. “But what they are really coming by for is the therapeutic aspects of the program.”

From the outside, it would be easy to assume these small items are bait, a way to entice victims of gun violence to seek help. But Walton says the program has not and will not “leverage clients.”

“Even if they don’t participate in the program, I would still offer clothes or other items to them, Ross added. “The clothing may be all they need from me. But I hope they remember this is a place they can come and talk to me.”

COVID-19 didn’t change much for those who come through the Violence Intervention Program. As Walton is quick to point out, many patients in the program are homeless, some are in and out of the above-ground labor market, and some live alone. The program’s group sessions were interrupted in the spring because Ross was unable to host large gatherings at the hospital, but those restrictions have been relaxed. Life on the margins is a constant scramble for basic needs.

In 2017, Ronald Nix, a Baltimore-area pastor, met Ross. Nix worked in the enforcement division of Maryland’s Child Support Services. He helped Ross with a few clients whose child support cases were keeping them from landing jobs. During his time with Ross, Nix saw how acute the need for hygiene products was among the men and woman. He approached his family with an idea. “Instead of doing Christmas and exchanging gifts with each other,” Nix thought, “why not be a blessing for others?”

Nix told his family to start collecting items to stuff inside backpacks. His sister often circulates a list of the items that are needed by text. The process can be piecemeal. A trip to the store for toothpaste means buying a few extra tubes for the backpacks, or a few extra toothbrushes. Twice a year, the family gathers at Nix’s home just outside of Baltimore to stuff the backpacks. Since 2017, the initiative has distributed 200 of what the family calls “mercy packs” to Ross’s patients. Nix makes sure to throw in a small Bible and gospel tract. He sees the work as a ministry, but not one that is looking for converts. Mostly, he wants to remind those who have been victimized by gun violence that they are not invisible: “I want them to see that someone cares about them. That they matter.”

On October 11, Lamont Clifton Randall became the 263rd homicide victim in Baltimore this year. Less than 48 hours later, a 19-year-old woman was shot in the chest and left in serious condition, according to police accounts. Less than 30 minutes after that shooting, police responded to shots being fired and would later connect the shooting to a man who walked into a city hospital with a gunshot wound.

This steady pattern of violence was one of the reasons why David Ross received the text message from his on-and-off-again client, the man hadn’t seen since the previous Christmas. The 26-year-old client who texted Ross has survived two shootings. The call was an attempt to avoid a third. “In the street he is facing physical harms,” Ross said, “and he wants out.”

Getting out is hard. Ross tried to convince the man to remove himself from the cycle of violence and drug dealing after the first shooting, but Ross says he wasn’t ready to make the transition. “In the way a so-called normal person has those fears of growing, my clients have those same fears,” Ross said. “In some ways a dangerous situation feels more comfortable than an unknown situation. You stick with the dangerous situation because you know it.”

Still, the man reached out to Ross. Not because of the toothpaste, or the Christmas gifts, the socks or the hats. But because he knew that someone was on his side.

“We want them to know we understand this is what you are going through, and we are here to support you,” Ross said. “I think it’s a recipe for continuing a meaningful relationship and that is going to have an impact on changing the way we are in our city and mitigating violence. At least that’s my hope.”