Exposed: horror of city's knife crimes

But his snapshots of Glasgow Royal Infirmary patients are probably the most accurate record of the epidemic of knife violence being meted out across the city.

In a seminar room off a corridor behind the main accident and emergency waiting room, Crawford turns on his projector in a matter-of-fact way.

What the long-serving accident and emergency consultant seeks to illustrate with the horrific pictures is the true extent of knife crime. He believes that two-thirds of knifing incidents are not reported to police, judging by the hospital’s own figures compared with the official statistics.

Crawford and his team see up to 1,100 victims every year, many of whom have no intention of making a complaint despite often being badly injured.

One picture shows a severely beaten man with a home-made spear protruding from his neck: the flattened and sharpened metal tube had become stuck in his spine.

In another, a bread knife is buried in a woman’s eye socket, beyond which it is lodged in her brain cavity.

The back of one seriously injured man’s head shows six massive gouges from a machete, while another victim has had his arm and shoulder slashed open to the bone by a single and presumably massive blade.

Another patient is missing a large slice from his forehead, cleanly removed by machete.

In yet another slide, an elderly man sits with part of his chin hanging off, his face dripping blood.

Other images, taken during recent life-saving surgery, show hearts sliced almost in two by knife blades. Some are in the process of being physically stitched together again.

In another, a man’s lungs, clearly blackened by cigarette smoke, are exposed to the air as doctors try to stabilise a wound which has pierced one of his lungs and his heart. He did not survive the attack, which may have been triggered by a petty argument.

"It’s pathetic, really," Crawford says. "Life is cheap in some parts of Glasgow."

He has grown used to seeing young men die in front of his eyes, but still laments the "complete waste of life" involved.

A typical attack in the city involves a knife being thrust upwards into the chest below the ribs by a right-handed assailant. From that entry area the blade can easily penetrate the heart, lungs, major blood vessels, or a combination of all three.

Some victims die when their punctured heart pumps so much blood into its own protective sac that the pressure inside squeezes the organ lifeless, a condition known as cardiac tamponade.

Others succumb to massive haemothorax, defined as blood loss inside the chest of 1.5 litres or more.

Accident and emergency doctors also deal with dozens of cases of pneumothorax, in which a lung is punctured and air escapes into the chest cavity.

They may have to operate within minutes on stab victims, opening the chest with a retractor and physically sewing organs back together again.

Some of the most dangerous injuries can appear as tiny puncture wounds on the outside of the body, while inside there is major bleeding and damage to organs.

Victims may attempt to walk to hospital because, in the absence of external bleeding, they are unaware how seriously hurt they are. They then collapse suddenly and can die almost on the spot.

Stabbings to limbs and the neck may also be fatal if a major artery is severed, causing catastrophic blood loss.

The GRI team is now perhaps the most experienced in Europe at dealing with major injury caused by stabbing.

Visiting doctors are shocked by what they see: the injuries are more like those inflicted in gang and ethnic violence in Africa or Jamaica.

One US medic, who asked how many stabbings there had been in the previous month, was surprised to be told only two. What his Glasgow colleague meant was that only two stabbings had happened inside the department: hundreds more had been treated there.

The problem for the police is that many victims will not say what has happened. They may fear reprisals, distrust the police, be part of a gang culture which does not want any official attention or view a minor injury as an occupational hazard.

Even when cases come to court, assailants whose victims are lucky enough to have lived may escape with light sentences if they can persuade a jury they did not mean to kill.

Given the danger of cutting an artery or some other vital structure when any sharp instrument is used as a weapon, Crawford describes that as "crap".

"As far as I’m concerned, anybody sticking a knife into someone’s body must know they may kill them," he says. "It is a lethal act."

He is also dismissive of a growing trend towards carrying a shortened knife, in the mistaken belief that its owner will thereby avoid a murder charge. "It simply isn’t true," he says.

But although the GRI could be dubbed "knife central", a place where the staff inform each other about unusually large numbers of cases by referring to a "stab fest", the situation is little better in other parts of the urban west.

Staff at Monklands hospital in Airdrie are also inured to it, particularly after Old Firm games.

Mike Simpson, a former GRI doctor now based there, reels off a list of "standard knife wounds" which come in from Airdrie and neighbouring Coatbridge after the pubs and clubs shut, invariably sustained in drunken assaults.

"There’s the single knife slash to the face, which can cause a bad scar. There are the multiple slash wounds done with a Stanley knife. There is also the stab to the buttocks, which is more of a punishment thing but can still be highly dangerous.

"Then there’s the stiletto to the chest or back, which is without doubt aimed at killing."

Last Hogmanay, a woman was rushed into his accident and emergency department with two stab wounds to the front of her chest. She had an emergency operation in the resuscitation room, but didn’t survive. The knife had penetrated her heart.

Staff nurse Martin Beattie says: "The worst wound I’ve seen was a guy who had been struck with a sword or machete right across the top of his head [Beattie makes a Samurai-esque vertical two-handed chopping movement]. There was a lot of blood because there’s a very rich supply up there. I can’t remember if he’d fractured his skull as well. But the last thing he would do was tell the police who had done it."

Then there was the man who leapt out of a car with another Samurai-style weapon and flew at a young passer-by. "To defend himself the lad put out his hands, which got turned into mince," 32-year-old Beattie recalls.