When he became trauma chief of the University of Arizona in 2007, Tucson had “hardly a trauma program at all,” Dr. Peter Rhee says in a memoir set to hit shelves in June.
A South Korea-born surgeon, Rhee came to Southern Arizona from the Los Angeles County and the University of Southern California Navy Trauma Training Center, where he prepared U.S. Navy doctors and medical personnel for the battlefield. He saw the Tucson job as a challenge.
“The program was in disarray, the funding was a major issue and almost all the staff had left — which to me looked like an opportunity,” Rhee recalls in “Trauma Red: The Making of a Surgeon in War and in America’s Cities.”
“I figured it couldn’t get any worse, that the program had only one way to go, and that was up.”
The book, written with reporter and war correspondent Gordon Dillow, is to be released by Scribner June 3.
The retired U.S. Navy captain writes about the “Trauma Red” that took him into the trauma room on a sunny Saturday morning of Jan. 8, 2011. That day, the local hospital treated then-Congresswoman Gabrielle Giffords and others who were shot when a gunman went on a rampage during a “Congress On Your Corner” event at a northwest side shopping center. Six people died in the tragedy.
Trauma patients who come through the door are not initially identified by their actual names. Each patient gets a trauma name that consists of a progressive two-letter code combined with a word chosen from an alphabetical list of randomly selected words. Giffords was listed under the pseudonym Baja LB.
Giffords staffer Ron Barber was Elk LB, and another injured staff member, Pam Simon, was Cactus LB. Simon had been shot in the chest and Rhee said the bullet “could have easily injured her heart and killed her.” The bullet that hit Barber missed his carotid artery by a few millimeters.
Rhee writes that Giffords kicked her left leg when she came in. He figured out that it was in frustration because she wanted to speak but could not. The speech center on the left side of the brain, called the Broca’s area, had been injured.
He writes about keeping Giffords in a medically induced coma to limit the electrical activity in the brain and help the damaged brain tissue to heal. To do that, he put her on a drip of propofol and fentanyl, which are both fast-acting drugs. In 2009, a Los Angeles coroner’s report attributed pop star Michael Jackson‘s death to a lethal dose of propofol.
The fentanyl and propofol are fast-acting both ways, so when doctors wanted to see how Giffords was doing they would stop the drip and she would wake up quickly. The first time he woke her up, Rhee asked Giffords to show him two fingers. She lifted up the first and second fingers on her left hand.
“That told me what I had already believed to be true: She was going to survive,” Rhee writes in the book. “I turned the drugs back on to give her a rest until the next day.”
The book describes some uniquely Southern Arizona traumas — a man impaled on a cholla cactus; rodeo riders whose fingers are torn almost completely off; and kids with horrifying injuries from low-speed ATV rollovers.
Rhee writes that building up the local trauma program wasn’t easy. The only top-level trauma center in Southern Arizona, the UA Medical Center handles about 5,000 patients per year whose injuries range from gunshot wounds and stabbings to car crashes and drownings. It wasn’t unusual for him to work 120-hour weeks.
“There were endless bureaucratic struggles over money and resources and methods and practices, constant battles to make the trauma program the best it could be,” he writes.
“The truth was, everything needed to be changed. I mean everything. And with so much to change, at first my style ruffled some feathers. … That first year was one of the hardest times of my life.”
He reserves some of his harshest criticisms for irresponsible use of firearms.
“The vast majority of Americans have never seen a gunshot wound, and they never will. It’s frustrating for me, because as a trauma surgeon I see the cost of gun violence almost every single day — not just in the bodies of the shooting victims but in the anguished faces of their family and friends,” he writes.
“The (Jan. 8) shooter had had a history of bizarre and disruptive behavior, the sort of guy that everyone knew had a mental problem, but in our free society there was nothing anybody could do about it. He had bought a gun at a Sportsman’s Warehouse, all very legally, and a month later he turned it on a crowd of innocent people. It was the same old story. Another nut with a gun in America.”
