Trauma II

For some, those who go into trauma surgery, there is an air of excitement when running down to the trauma bay. Anything can come through the door; there can be multiple injuries, some catastrophic; the interventions can be dramatic, even heroic. It is a challenge of triage, cool-headedness in the face of the unexpected. Many patients can come in at once. There is thrashing, body secretions, knives protruding, the stuff that makes horror moviegoers cringe. Yet in the end, patients who get into gun fights or jump off bridges or have tussles with industrial machinery may walk out of the hospital in a way that is immensely satisfying. That is the lure trauma has on some physicians.

I am not one of those people. I don't like the unknown, don't like the feeling of being unprepared. I don't like blood and vomit and who-knows-what. I am not a trauma guy. My stomach clenches when I see some injuries. I want to survey and catalog before jumping in and intervening. I don't like chaos. No trauma victim wants to be there. They want to jump off the bed, wrestle the lines and tubes out of them, and go home.

Nevertheless, clinical experience with trauma is important. The ability to assess a situation immediately, identify priorities, and accomplish them in the midst of a chaotic trauma bay is really important. From an anesthesia standpoint, quickly determining how to anesthetize, intubate, or support an unstable patient through multiple surgeries is invaluable. So even though I don't crave it, I try to get as much out of on-call trauma as I can.