ST. LOUIS — The doctor laid it out to the teens in exacting detail.

First they cut off the clothes to find the bullet holes. Then comes the tubes in the chest, arms and mouth. The lucky ones make it to surgery. For those who die, there's the room where parents go to see the body. And the Quiet Room.

"It's when we put people in a room and we tell them that you're dead," said Douglas Schuerer, trauma director at Barnes-Jewish Hospital. "Every one of them is upset when a family member dies. Even though you think that they won't (be)."

The eight boys, all part of the St. Louis Family Court's six-year-old "Gun Court" juvenile probation program, skulked in the emergency room hallway behind the doctor. Most were 15 and 16. But one was 13 and baby-faced — a "hard talker," said juvenile officer Rhonda Norris. "We keep telling him someday someone is going to have him deliver on it."

They were in the ER because they faced charges of weapons possession, armed robbery and involuntary manslaughter. The Gun Court — which couples intense probation with tours of an ER, morgue and funeral home — aims to remind the teens that they could someday end up here.

But the words seemed to fall short with this group. There were few questions and no shocked faces.

During a slide presentation, they learned that the ER handled 43 teen gunshot victims in 2007. Seven had died within 48 hours.

One youth sleepily laid his head on a conference table.

"You guys have the power to choose your direction," Schuerer told them.

Catherine Horejes, a field supervisor with the court, was optimistic.

"With the kids," she said, "you just really try to plant the seeds."

TEENS, GUNS, FEAR

No one can quantify how many guns are in the hands of teens in St. Louis' poor urban neighborhoods. But if you're a juvenile and you want a gun, you can get one, researchers say.

A study of 338 high-risk St. Louis youths last year by criminologists at the University of Missouri-St. Louis said that guns were pervasive and that teens were likely to arm themselves out of fear. More than half said they handled a gun at some point.

Lois Pierce, director of the School of Social Work at UMSL, said that most kids in poor areas lived in constant fear and that getting a gun was sometimes a natural fight-or-flight response. This is significant for boys because without therapy, they may respond to trauma with aggression.

"It gets to the point where they say, 'I'm tired of being bullied,'" Pierce said.

An UMSL study of city schoolchildren co-authored by Pierce last year said the district's typical 10-year-old had post-traumatic stress disorder.

Twelve percent of the children interviewed had witnessed a homicide in their neighborhood, she said.

"Even the good kids feel like they have to carry guns because otherwise, they're not safe in the community," Pierce said.

But the problem is most pressing with gangs. Kabir Muhammad, an anti-gang consultant, said kids without role models were being recruited by age 10.

"If you have a 12-year-old telling you to your face that he doesn't care about living," Muhammad said, "that says something about his home environment and his school environment."

Norris estimates two-thirds of the youths in Gun Court are in gangs. When they go off probation, they can face a dreadful choice: Rejoin their gang or become its enemy.

Norris said she once kept visiting one of her youths to fool his gang into thinking he was still on his one-year probation.

"That gave Mom time to move him out of the area," she said.

TAKING A STAND

The outpatient room of the Rehabilitation Hospital of St. Louis was the final stop for Gun Court on the day the eight boys were on the program.

Rehab liaison Rene Schreier passed around catheters. A person becomes incontinent if a bullet pierces the spinal cord, she said.

As if on cue, Terrence Clark wheeled himself into the room.

"Here," the newcomer said, pulling up his pants leg to expose a plastic bag. "This is where I keep mine."

Quadriplegic Brandon Morris, a hulking man in a motorized wheelchair, came in minutes later. In a separate shooting incident 11 years ago, Morris, 33, was struck in the spine an inch above where Clark was hit, leaving Morris unable to breathe on his own.

Both were hit in north St. Louis by stray bullets. Both were in places they shouldn't have been. And both had a message.

"You take the path you're taking, you will end up sitting here," Morris said, his ventilator whirring.

Still, the teens were mostly silent.

So the men continued: pressure sores, impotence, doing time in prison in a wheelchair. There was the teen who battled his way out of a wheelchair and into a walker, but then rejoined his gang. He was attacked at a barbershop.

"He was on a walker. He couldn't run," said Morris.

The words hit the mark.

"He was over there living by me," a teen responded.

Soon others talked. One said he had already been shot. Most had relatives who'd been killed.

Norris reminded the group that another youth should have been in the room with them. And the teens nodded quietly. The previous weekend, the teen broke his curfew, she explained.

"He went somewhere where he shouldn't," she said. Now he had a gunshot wound that had pierced his liver.

But not everyone was buying into the talk. One boy even bragged about the people he knew who had been shot.

"You one of the little dudes that like guns and how they feel, aren't you?" Clark said.

Morris said, "You better change them ways."

He and Clark, who've gone to school, married and left the streets, said they were glad to be alive, even in a wheelchair.

"I'd rather be dead," said one of the teens.

Clark didn't flinch.

"You'd rather have this," said Clark, nodding downward to his crippled body, "than be dead."

There were no declarations to change, no outward shows of emotion. But as the teens gathered to leave, without prompting, they lined up single-file before the two men in their wheelchairs.

One by one, they bent and shook the men's hands.