It used to end with a bloody nose or maybe a bruise. Not anymore.

While male-on-male violence in downtown Iowa City is nothing new, police have seen an alarming trend of seemingly random assaults and say the severity of the attacks is increasing. The incidents paint a grisly scene, with men reporting being victims of what police have called “roving packs” of numerous men punching and kicking a victim before leaving him unconscious on the ground.

“We are seeing more and more unprovoked, unsolicited attacks,” Iowa City Police Chief Sam Hargadine said.

Derick Schroeder was bleeding profusely as he tried to explain what had happened to police. He had tried to walk out of 3rd Base Sports Bar, 111 E. College St., during the early hours of April 10 but a crowd had formed inside the doors. Two men in front of him suddenly turned around and punched him numerous times in the face, the 21-year-old said.

“They just kept swinging away,” the Monona, Iowa, native said. “I didn’t know what was going on until I walked away.”

Schroeder said he sat down inside the bar and a 3rd Base employee called Iowa City police. An ambulance took him to UI Hospitals and Clinics, where he received six stitches to close the cut over his left eyebrow. He also sustained numerous bruises to his face. He had never seen the two men before, he said, and nothing precipitated the event.

Schroeder might be one of the lucky ones.

The series of attacks is sending men to the hospital for serious or even life-threatening injuries that take time to recover from.

Olivia Bailey, a UI clinical assistant professor of emergency medicine, said she’s seen many assault and fighting-related injuries, including concussions, broken bones, facial fractures, and internal bleeding in the brain.

She usually sees several men injured in attacks or fights each night on the weekends, she said.

He remembers seeing a person who appeared upset sitting on the front porch of a house near the intersection of Governor Street and Iowa Avenue, and Sims yelled to the house for help.

Immediately after that, a group of six or seven men came outside, Sims said, yelling at him, surrounding him, and finally attacking him. He doesn’t remember anything after the first punch, but Iowa City police Sgt. Troy Kelsay said a witness reported a group of men kicked the alleged victim on the ground.

The next thing the 6-1, 250-pound Iowa City native remembers is walking down Iowa Avenue bleeding, where police found him and called an ambulance.

Sims suffered a concussion and cut, bruised lips. Doctors initially thought his nose was broken but later discovered it was only badly traumatized. More frightening for Sims, he said, was the doctor’s fear his neck might be broken. Luckily, that, too, was only traumatized. Sims suffered a bruised jaw and couldn’t eat hard food for a month; he lived on soup, ice cream, and applesauce.

“I didn’t throw a punch,” Sims said. “I really don’t understand why they did it.” The perpetrators remain at large.

Alcohol-fueled violence is a common occurrence on any college campus. But officials in the two other regent university towns say unprovoked attacks have not been a major issue.

“Not to say unprovoked attacks don’t happen, but generally, the huge majority [of incidents] have two willing participants,” said Cedar Falls police Capt. Craig Berte.

Fights have not only become the norm in Iowa City, they have become normalized to the point where many don’t realize it’s a problem, authorities said.

“[Fights] are accepted as part of going out and drinking, like it’s OK,” Kelsay said. “And it shouldn’t be.”

Despite much speculation, Iowa City police Sgt. Mike Brotherton said, there is no evidence to indicate the recent change in violence is a result of gang activity.

Officials agree the bar culture in downtown Iowa City seems to encourage fights. When thousands of people fill the streets around the bars’ closings, increased friction and lowered inhibitions from alcohol consumption make assaults — spurred by both real or imagined wrongs — more likely, police officials say.

“The atmosphere downtown at bar close is, ‘Let’s hoot and holler and cheer and be spectators to this,’ ” Kelsay said, and crowds often push combatants back together when they appear to be done fighting.

Iowa City, Ames, and Cedar Falls officials agreed that alcohol is the root cause of many of the problems, and Bailey said alcohol often plays a contributing role in attacks that send men to the emergency room.

But Mike Porter, the owner of the Summit, One-Eyed Jakes, and Vito’s, said he’s seen a decrease over the last decade in the number of fights in his bars.

Kevin Ozeroff admits “words were exchanged” with three men he and a friend met near the intersection of Market and Gilbert Streets when walking to a party in October 2008. The Iowa City native, now stationed on an Air Force base in Omaha, doesn’t remember who started the verbal altercation. But he remembers turning his back to the men and walking away.

The 6-foot, 225-pound West High graduate said he was knocked down from behind. One of his attackers stood over him, punching him in the eye repeatedly, Ozeroff said. He walked to Mercy Hospital with his friend, where he found out he had a fractured nose along with a badly bruised eye.

“I’ve had to be reminded of it every day,” he said. “The black eye took months to go away. I can still see it sometimes. It was scary, because my vision was blurred in that eye for a couple months.”

Violence against men started to grab the public’s attention when UI senior Brian LaGro was attacked in May 2008 in front of the L&M Mighty Shop, 504 E. Burlington St., and had to be rushed into surgery with life-threatening injuries. In September 2008, UI law student Cody Kiroff was brutally assaulted at the intersection of College and Clinton Streets, only one block from where he said one of his friends was assaulted last week.

Six months after his attack, he still suffers from double vision, making law school difficult, he said.

“I had never encountered something even remotely close to the violence that happened to me, so naturally I didn’t foresee it as a problem,” he said. “I was wrong.”

Kelsay said investigators have few leads in the case of a UI junior who preferred his name not be used. The Rockford, Ill., native said he was walking home around 1 a.m. Feb. 15 when three men approached him from behind in the alley south of the 500 block of East Jefferson Street. They punched him in the head, and the next thing he remembers is waking up in his room.

“It was totally unprovoked, totally out of the blue,” he said. “It was like a joy beating.” The mechanical engineering major had a concussion, bruises on his face, and had to have two stitches inside his lip.

All of the men interviewed agreed they didn’t think about protecting themselves from assaults or know the extent of the problem of male-on-male violence until it happened to them.

“It’s changed my life,” Ozeroff said. “I’m definitely more aware; I’m always watching my back. I never really felt threatened by that sort of thing in my own town before.”

Kelsay said that while violence in Iowa City has long been a problem, it is not something that should be normalized.

“While these have become expected, it shouldn’t be some spectator event,” he said. “This isn’t something that should be acceptable. But, for many, it is.”