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Surgeon Envisions Nationwide Trauma System

Cheryl Clark, for HealthLeaders Media, August 25, 2010

When trauma expert A. Brent Eastman MD, chairman of the American College of Surgeons Board of Regents, describes his inspiration to take up medicine, he often starts with a tale from his childhood in Evanston, in rural southwestern Wyoming.

He tells how in the early 1950s, his uncle Gilbert was basically the region's entire trauma system. Gilbert was not only the county coroner, he also owned the area's funeral home and taught first aid on the side.

"Whenever there were injuries on the roads or ranches, he and his mortuary helper could slip out the coffin rollers in his 1951 Cadillac combination hearse and ambulance, slip in a gurney, stick on the flashing red light, and be on their way," Eastman wrote in a recent issue of the Journal of the American College of Surgeons.  The article, part of the Scudder Oration on Trauma, is entitled "Wherever the Dart Lands: Toward the Ideal Trauma System."

Sometimes, a funeral had to be postponed for a medical emergency.  "It was a somewhat delicate maneuver to offload the casket and take off for the scene of the trauma, not to mention disconcerting to bystanders, when the hearse arrived.  No doubt some of them wondered about a conflict of interest; would they turn left to the mortuary, or right to the hospital."

Gilbert also organized the town's response to "The Great Train Wreck of 1951," when a train carrying surgeons from San Francisco to Chicago ran a red light covered by snow in Evanston, and hit the back of another train. Several of the surgeons were killed and several others wounded.

"As an 11-year-old boy I was taken by my father, a locomotive engineer running the great steam engines and my hero, to see this crash because the engineer was a next-door-neighbor and friend.  This was my first exposure to mass casualty and it awakened my interest in trauma," Eastman says.

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