A young man dies of gunshot wounds, and enraged friends and relatives react by shooting up the hospital. A medical student leaving another hospital at the end of her shift is shot to death by a robber. Doctors working late take to sleeping in their workplace rather than risk being mugged.
In crime-ridden Venezuela, even hospitals are no longer safe.
No one was injured in the Aug. 20 shooting rampage at the Domingo Luciani Hospital in Caracas, but Eduardo Vargas, a 39-year-old nurse, recalled pulling children from their sickbeds as bullets broke windows and lodged in hospital beds.
"We took shelter in a closet and we threw ourselves to the ground," he said.
The shooters were arrested, but the next day public anxiety was heightened when the 24-year-old student was killed just outside a hospital in Valencia, Venezuela's third biggest city. Eduardo Morillo, an anesthesiologist explaining why he and others now sleep in their hospital, said there had been other incidents, but "this is the drop that made the glass spill over."
And the very next day a man barged into the hospital brandishing a gun and searching for a man about to be operated on for gunshot wounds, but gave up and left after doctors hurried the patient into hiding on his gurney.
Last year, Venezuela's homicide rate was more than double that of Mexico, which is engulfed in drug-related violence, and the third highest in the region after Honduras and El Salvador. The Venezuelan Violence Observatory, a nongovernmental organization that tracks violent crime, says there were about 17,600 homicides last year, compared with a 2009 estimate of 15,241 in the U.S., which is over 10 times more populous than Venezuela.
The government puts the murder rate at 48 per 100,000 people, up from 19 per 100,000 in 1998, the year Hugo Chavez was elected president. In polls, Venezuelans consistently rate criminal violence as their biggest concern, but they tend to blame societal and bureaucratic failures, and so far it doesn't seem to be affecting Chavez's support ahead of next year's presidential election campaign.
Still, the International Crisis Group, an independent Brussels-based organization focused on conflict prevention, says crime and violence are out of control and can "seriously threaten Venezuela's medium- and long-term stability."
In a report issued last month it says the main reason is that the public doesn't trust authorities to enforce the law. Chavez's government "seems unable but in part also unwilling to safeguard military and law enforcement institutions against criminal influences and corruption, fight organized and common crime and protect the population."
It describes perpetrators and victims alike as "predominantly young, male, urban and poor."
The report says among various changes during Chavez's presidency, he has centralized power and the institutions of law and order have been weakened. "Corruption, impunity and inefficiency have been the obvious results," it said. "The effects of this institutional decline have been particularly manifest in the justice system and the security forces."
It notes that the justice minister himself said in 2009 that police were involved in 15 to 20 percent of crimes.
Carrying a firearm requires a permit, but the law is widely ignored.
Chavez and other government officials say they are making progress. Thousands of new police officers have joined a growing national force, and this year all weapons, even licensed ones, have been banned in buses, trains and public transit stations.
Chavez has noted repeatedly that the crime problem predates his presidency, and in a Sept. 2 speech said that his country isn't alone.
"There's a situation of insecurity and not only in Venezuela, not only in Caracas. Go to Mexico. Unfortunately it's a phenomenon in the United States, in Europe," He said.
Still, critics say Venezuela has a long way to go.
On most weekends, the Caracas morgue fills with dozens of victims _ robbery victims, young slum dwellers, occasionally children hit by stray bullets.
Last month, authorities said seven armed robbers stormed a ranch in central Carabobo state that was hosting a children's camp and seized cellphones, cash and other belongings.
Another gang recently slipped into a movie theater and demanded money and valuables.
The authorities report arrests in both cases, but overall, according to Roberto Briceno, director of the Venezuelan Violence Observatory, arrests are made in only 9 percent of homicides, and security at hospitals is worsening.
Caracas' Jose Maria Vargas Hospital shuts its emergency room at 7 p.m. Domingo Luciani, the hospital that suffered last month's shooting spree, has installed a vehicle checkpoint and metal detectors at its entrance.
Last month hundreds of doctors and nurses rallied to demand tighter security. One sign said: "We don't want bullets, we want to save lives."