Trauma Story

I never expected to be touched so deeply by trauma patients and their families.
John Rogers

Over the years I saw and cared for many injured people from babies to grandparents, both in my career as a trauma surgeon and as an emergency physician.

I remember:

the 3 small boys whose throats were slashed by their father because he was mad at their mother

the young woman who had been beaten with a crow bar and then run over by her jealous boyfriend, she broke both arms both thighs and her pelvis

the 16 year old girl who was in a bad car wreck and came in on two ambulances – she was in one and her leg from the mid thigh down was in the other

the young mother who was shot 9 times by her husband in front of their small children

the man who tried to cut his own head off with a chain saw

the 7 year old girl who was shot while trick or treating and blew apart the blood vessels leading to her liver

the two nurses who were identical twins and were shot in the head by the jealous husband of one of them

the man who opened a package bomb at Christmas and blew his hands off

the electrical worker who severely burned both arms to the point they were both amputated above the elbow

the baby burned badly when his mother stuck him in a tub of hot water to teach him a

and I remember all of the heartbreaking talks with families which became too common and increasingly difficult for me to do

What I learned from all of this was that life can end or change dramatically in a matter of minutes and we should not take anything for granted. Sometimes we forget how lucky we are. I also learned that good trauma care was the only chance most of these people had to survive or to limit the disabilities they will suffer. Part of the success is getting those badly injured to an appropriate facility as soon as possible and the skill and training of the paramedics, nurses and physicians caring for them.

Sometimes it is not possible or safe to transport them directly to a trauma center as they are too badly injured and need to be stabilized first at the nearest hospital. Thus small hospitals are an important part of the system as are the large trauma centers and their personnel needs as much if not more training as their counterparts in more urban centers. Also not every trauma patient needs to go to the trauma center. To do so would overwhelm the trauma center with patients that very well could have been taken care of elsewhere. By flooding the trauma center with those patients take resources and beds away from patients that truly needed to go there. Thus a well functioning trauma system is valuable in directing patients to the most appropriate facility.

What you may not know is that Georgia has no organized trauma system. People are transported haphazardly without much rhyme or reason. There is no system, there is no organization and some people are taken to inappropriate places and others are brought to the trauma center when it was not necessary. The Georgia Chapter has been working diligently on establishing a trauma system in Georgia. We have also recently completed work on a Emergency Procedures Course through an ACEP Chapter Grant. This course is designed specifically for physicians and mid-level providers in smaller and rural facilities.

By the way, of the patients I told you about at the beginning of this story. All of them survived but one, the 7 year old trick or treater. I was her surgeon and she died on the operating table, still with part of her costume on and despite the efforts of everyone in the operating room that night. I will not forget the weeping from the OR nurses. Nor will I forget the absolute look of devastation on her mother’s face when I had the task of telling her that her little girl had died. It is the duty of the most senior surgeon to have these conversations and it is a duty I do not miss.

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