Donald Dean Trunkey JUNE 23, 1955 ~ MAY 1, 2019 (AGE 63) by English Funeral Chapel

Donald Dean Trunkey, M.D., 81

Donald Dean Trunkey passed away peacefully with his loved ones by his side on May 1, 2019, in Post Falls, Idaho. He was born on June 23, 1937, in Oakesdale, Wash., to John Douglas and Rebecca Nelson Trunkey. The family moved to St. John, Wash., where Don grew up and graduated from St. John High School in 1955 as valedictorian. He attended what was then Washington State College and received a degree in zoology, which made him the last person to have graduated from WSC before it officially became Washington State University. He was a member of Alpha Tau Omega.

Don and Jane Trunkey were married in Colfax, Wash., on Sept. 26, 1958. After graduation, Don went on to the University of Washington, where he received his doctorate of medicine degree. He did a rotating internship in Portland, Ore., at Oregon Health and Science University (OHSU).

Don later served within the U.S. Army with the 4th Armored Division 2nd Calvary, in Bamberg, Germany, in the dispensary for two years. While there, their son, Robert Derek was born in Nuremberg, Germany; followed four years later by their daughter, Kristina “Kristi” Jo, born in San Francisco, Calif.

Don had a stellar career as a trauma surgeon — first through his residency in San Francisco, then becoming chairman of surgery at San Francisco General Hospital. Also a professor emeritus of surgery at the Oregon Health Science University, Don was presented the WSU Alumni Association’s Alumni Achievement Award in recognition of his influential career and contributions to medical education, surgical methods and trauma care.

While in Portland, he also served as the head of the 50th General Hospital in Riyadh, Saudi Arabia within Desert Storm.

Don often volunteered in Landstuhl, Germany. While there, Col. Trunkey and Col. Daniel Cavanaugh flew Lieutenant General John. J. Yeosock to Germany for an operation. When they returned a few days later, Lt. General John J. Yeosock began the ground war. The order was given by Gen. Norman Schwarzkopf, Jr. Commander-in-Chief. Col. Trunkey was given a Bronze Star for his service.

Don is survived by his wife, Jane Mary Trunkey; son, R. Derek (Kristen Hammond) Trunkey and daughter, Kristi Trunkey. He is also survived by his sister, Sandie Trunkey and his grandchildren, Ethan, Nathan, Mason, Hayden, Hayley and Harrison. Don was preceded in death by his parents and his brothers, Jay, Gary, David Roger and K.B.

A memorial service for Don will be held at a later date.

In lieu of donations, please send to Trunkey Family Scholarship, S.J.E. School Foundation. PO Box 411, St. John, WA. 99171 or the St. John Heritage Museum, PO Box 315, St. John, WA 91711.

The family also asks for donations to be made in honor of Don to the College of Arts and Sciences Scholarship Fund or the College of Education Scholarship Fund at Washington State University, located at: https://foundation.wsu.edu/give/. Checks should be made payable to the Washington State University Foundation and mailed to the Washington State University Foundation at PO Box 641925, Pullman, WA 99164-1925. Please designate on the check ”in honor of Don Trunkey, College of Arts and Sciences Scholarship Fund” OR ”the College of Education Scholarship Fund.”

Dr. Donald D. Trunkey, FACS 1937-2019 from American Association for the Surgery of Trauma

It is with sadness that we report the passing of one of Trauma Surgery’s greatest icons, Dr. Donald D. Trunkey. Dr. Trunkey served as the Chair of the ACS Committee on Trauma from 1982-1986 and as President of the American Association for the Surgery of Trauma 1986-1987. In 1976, Dr. Trunkey led the COT’s efforts to publish the Optimal Hospital Resources for the Care of the Seriously Injured- the first document aimed at defining and developing trauma centers and trauma systems. Dr. Trunkey, MD, FACS was a pioneer in trauma system development, publishing seminal work on the impact of trauma systems development on preventable death. A critical moment in Dr. Trunkey’s career was when he published a paper in 1979 on death rates of trauma patients in the more rural Orange County, California compared to those in San Francisco County. It was one of the earliest, most persuasive pieces of evidence on the effectiveness of trauma centers. His message was unwavering: injured patients deserve the best trauma care available, and the best care includes an organized trauma system.

Dr. Trunkey grew up in rural Eastern Washington and was an alumni of the University of Washington Medical School. He did a rotating internship at the University of Oregon and then served in the US Army from 1964-1966. He completed his surgical training at UCSF and became a faulty member in 1972. He was Chief of the Burn Center at UCSF and had established a laboratory to study mechanisms of shock at the cellular level. In 1986, he was recruited back to Oregon Health Science University where he served as the Mackenzie Professor and Chair of the Department of Surgery from 1986 – 2001.

Five years into his term as Chair, Dr. Trunkey was activated from reserve status to active military to serve in the first Gulf War in 1991. He was stationed in Riyadh, Saudi Arabia during Operation Desert Storm and Desert Shield. He dealt with a number of operational and cultural obstacles that prompted him to publish a commentary in the March 1993 edition of Archives of Surgery called “Lessons Learned.” This document paved the way for how the U.S. Department of Defense trains its trauma personnel today.

In 2008, he received the King Faisal prize in medicine for his research improving trauma care. He has many other awards including Distinguished Service Award of the American College of Surgeons, Washington State University College of Science Distinguished Alumnus Award, Barry Goldwater Service Award, International Society of Surgery Prize, Honorary Membership of the British Association for Accident and Emergency Medicine and Honorary Fellowships of the Royal Colleges of Surgeons of England, Ireland, Edinburgh, Glasgow, South Africa and Brazil, Medal of the Royal College of Medicine of England and Honorary Professorship of the Royal College of Surgeons of Edinburgh. In 1989, he delivered the Scudder Oration on Trauma entitled, “What’s Wrong with Trauma Care?”. In 2018, he received the Icons in Surgery award from the American College of Surgeons.: https://www.youtube.com/watch?v=vVN0laPGF24&feature=youtu.be

Above all, Dr. Trunkey is remembered for his kindness, support, and mentorship to an entire generation of trauma surgeons. We offer his wife Jane and their 2 children and grandchildren our heartfelt condolences.

Dr. Donald D. Trunkey, Renowned Trauma Surgeon and Former Chief of Surgery at SFGH, Passes Away at 81 from UCSF

Donald Trunkey In The OR
Trunkey -Donald -10-January -2008

The Department of Surgery is deeply saddened to announce the passing of our friend and colleague, Dr. Donald D. Trunkey who died on Wednesday at the age of 81. Dr. Trunkey was an internationally renowned trauma surgeon and is considered the father of modern trauma systems. He served as Chief of Surgery at San Francisco General Hospital from 1978 until 1986. He was then appointed Professor and Chair of the Department of Surgery at the OHSU School of Medicine, a position he held until 2001. 

Following a first-year internship at the University of Oregon School of Medicine and a two-year stint in Germany as a general medical officer in the U.S. Army, Dr. Trunkey completed his general surgery training at UCSF in 1971. Dr. Trunkey returned to UCSF a year later after an NIH fellowship as a member of the faculty, pursuing a career in trauma surgery. He served as Chief of the Burn Center at San Francisco General and established a laboratory to study mechanisms of shock at the cellular level. Dr. Trunkey was a founding member of the Homeland Security Department as well as the National Foundation for Trauma Care. He served as Chair of The American College of Surgeons Committee on Trauma and helped establish the Advanced Trauma Life Support Course. His dedication is to the field is captured in Dr. Trunkey: An Advocate for Injured Patients, a Legend in Trauma Care. 

Dr. Trunkey was a towering figure on the Trauma Service at San Francisco General. His yeoman service, innovation and leadership at the General was memorialized by Dr. William Schechter, Professor Emeritus at UCSF, in The History of The Surgical Service at San Francisco General Hospital, “The Trunkey Years, 1978-1986”.  

Dr. Trunkey served in the first Gulf War in 1991, stationed in Riyadh, Saudi Arabia during Operation Desert Storm and Desert Shield. His commentary in the March 1993 edition of Archives of Surgery, “Lessons Learned,” served as a model for how U.S. Department of Defense trauma personnel are trained today.

Dr. Peggy Knudson, one of Dr. Trunkey’s protégés, currently Professor of Surgery at UCSF and Medical Director for the Military Health System (MHS) Strategic-ACS Partnership, recalled his outsized influence on her career: 

“Dr. Donald Trunkey was a father figure to me in my professional life. He encouraged me to dedicate my career to the care of the injured back in the day when trauma surgery as a discipline was still in its infancy. I had the great privilege of traveling and teaching with him across Australia and again in Germany where he worked tirelessly to assure the highest care possible for injured American troops. Trunkey as a figure was larger than life and the news of his passing has saddened the trauma community around the world.” 

Dr. Trunkey’s presence will be sorely missed. The Department’s heartfelt condolences go out to his family, friends, and colleagues. 

https://surgery.ucsf.edu/news–events/ucsf-news/81384/Dr.-Donald-D.-Trunkey–Renowned-Trauma-Surgeon-and-Former-Chief-of-Surgery-at-SFGH–Passes-Away-at-81

Don Trunkey 1937–2019 from Injury Journal

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Nothing lasts forever. However, for most of us, Don Trunkey was the innovator of modern trauma care and it’s hard to imagine a world which he is not part of. As Ralph Waldo Emerson stated it is not length of life, but depth of life that matters. Indeed, his talent, passion for improvement, and vision to look into the future were unique and his contributions to the evolution of trauma care have been priceless.

Donald D Trunkey FACS, was born in Eastern Washington and went to medical school at University of Washington. He served in the US Army in the mid 60 s in Germany and completed his surgical training in San Francisco. It was from San Francisco that his seminal “Two Counties” [1] paper was published where he convincingly showed that where a trauma system existed the mortality was substantially lower than where it did not. It was this paper, more than any other in the contemporary literature which led to the drive to systematise trauma care around the world.

Another of Don’s seminal papers was that on the trimodal pattern of death after injury which was published in Scientific American in 1983 [2]. In that paper he outlined that death after trauma was either immediate, usually as a result of catastrophic brain or torso injury, in hours as a result of uncontrollable haemorrhage, or in 2–3 weeks as a result on multiple organ dysfunction itself, a long term consequence of poor initial control of haemorrhage. While true in 1983, the trimodal pattern of death no longer exists because, through the efforts of Don and other trauma surgeons, effective early trauma care, particularly consequent on near-universal uptake of ATLS/EMST teaching, has resulted in effective early haemorrhage treatment.

Noteworthy, he was also a leading figure in highlighting the challenges of managing multiple injured patients with associated head injuries what he described as a ‘crisis’ in trauma care [3]. He suggested that ‘neurosurgery should step up to the plate and provide coverage for Level I and Level II trauma centres at a reasonable cost, and went as far as to state that ‘If neurosurgery cannot or does not want to provide coverage, they should let other surgeons provide coverage’ [3].

Professor Trunkey also was one of the first clinicians to express his concerns about the omissions of the USA public policy in relation to recreational use of drugs such as heroin, cocaine, methamphetamines, and marijuana and reported a direct link between alcohol or drug use and crime, corruption, violence, and health problems, calling for the need of formulating a workable public policy [4].

Professor Trunkey’s academic record lists 317 publications and 10,118 citations but his only publication in Injury occurred in 2000 and was a comparative study looking at trauma outcomes in Oregon Health Sciences University and Stoke-on-Trent [5]. This paper, co-authored by John Templeton and Peter Oakley amongst others showed that although raw mortalities were different, when casemix was considered there were no significant differences between the centres. This highlighted how important it was to carefully consider casemix in any comparison of trauma outcome.

Don’s early military career was bookended by a role in the First Gulf War 1990–1991 where he served as an advisor to the US Forces in Saudi Arabia. He dealt with a number of operational and cultural obstacles that prompted him to publish a commentary in the March 1993 edition of Archives of Surgery called “Lessons Learned” [6]. This document paved the way for how the U.S. Department of Defence trained its trauma personnel.

Don was a giant on the US trauma stage but also a frequent traveller who spread his knowledge and influence around the world. Apart from his Honorary FRACS and FRCS(Eng) he was also an honorary fellow of the surgical colleges of Ireland, Edinburgh, Glasgow, South Africa and Brazil.

Don was inspirational, enigmatic, friendly and forceful all at the same time. He influenced generations of young doctors, in surgery and in other disciplines, to improve trauma outcomes and contribute to the teaching and delivery of optimal trauma care. At conferences and courses he was an enthusiastic teacher and a challenging mentor. He conveyed the absolute necessity of taking action when time critical injuries were present and was never afraid to do so.

Donald D. Trunkey was a legend in every aspect of the word and the trauma community will be much poorer with his passing. His legacy however, of improved trauma systems, trauma care and trauma outcomes, is very much alive and society as a whole will be grateful for the career long contribution of this trauma giant.

https://www.nattrauma.org/don-trunkey-giant-in-trauma-remembered/
https://www.injuryjournal.com/article/S0020-1383(19)30303-1/fulltext?dgcid=raven_jbs_etoc_email

References

  1. West, J.G., Trunkey, D.D., and Lim, R.C. Systems of trauma care: a study of two counties. Arch Surg. 1979; 114: 455–460
  2. Trunkey, Donald D. Trauma. Sci Am. 1983; 249: 28–35
  3. Trunkey, D.D. The emerging crisis in trauma care: a history and definition of the problem. Clin Neurosurg. 2007; 54: 200–205
  4. Trunkey, D.D. and Bonnono, C. A rational approach to formulating public policy on substance abuse. J Trauma Inj Infect Crit Care. 2005; 59: S61–S66
  5. Templeton, J., Oakley, P.A., MacKenzie, G., Cook, A., Brand, D., Mullins, R.J. et al. A comparison of patient characteristics and survival in two trauma centres located in different countries. Injury. 2000;31: 493–501
  6. Trunkey, D. Lessons learned. Arch Surg. 1993; 128: 261–264

A Tribute to Donald D Trunkey by M. Margaret (Peggy) Knudson MD, FACS

To me and to many trauma surgeons around the world, the word “Trunkey” is synonymous  with the word “Trauma”. Most of us completing our residencies in surgery in the 1980s never considered trauma surgery as a career……it was just something you did when you were on call for the emergency room.

When I moved to California after finishing my chief year in surgery at the University of Michigan, my plan was to be a pediatric surgeon. But sometime during my first year of pediatric surgery fellowship at Stanford University, I realized that I didn’t actually like that field and was considering other areas of specialization.

Around that same time, the state of California was beginning to organize trauma systems by county, spurred on by the seminal work of Trunkey, West, and Lim demonstrating the high rate of preventable deaths after injury in areas of the state without trauma systems. (1) I decided to visit the Department of Surgery at the San Francisco General Hospital (SFGH) to scope things out and had the great privilege of meeting with Trunkey in person.

He told me that I belonged in the trauma world and when I asked him how he knew he replied: “I just noticed how your face lit up when you talked about trauma”! And so, I became a trauma surgeon, making frequent trips to San Francisco to learn from the masters at SFGH  while we set up the trauma system in the county of Santa Clara.

Even after Dr. Trunkey moved to the University of Oregon to assume the position of Chair of the Department, he continued to mentor me in both my clinical and my academic endeavors. In 1989, I was offered a position at SFGH under the leadership of Dr. Frank Lewis, only the second woman to be on their faculty after Dr. Muriel Steele. 

Shortly thereafter, Dr. Trunkey and  I, along with  Colonel Don Jenkins (US Air Force, ret.) traveled to Australia where we taught numerous trauma courses from Melbourne to Sydney. Of course, with Trunkey there was always fun mixed in with work. One day, we traveled to the Blue Mountains, the home of many fine Australian wineries.

We stopped at numerous tasting rooms and at every stop Dr. Trunkey would pull out his credit card and join their wine club so that he could have a continuous supply of Australian wine shipped to his home in Portland. But international travel can wreak havoc on your time zones and one morning during a teaching conference in Liverpool (AU) we were both in need of caffeine. We found ourselves in the kitchen of the hospital but no one was there. I decided to brew coffee and must have hit the start button too many times because not only did we fill the first carafe but also the entire floor with coffee! I was mortified of course, but Trunkey just looked at me and responded with his well-known laugh.  I don’t think the kitchen staff ever did figure out who spilled all that coffee!

In 2006, we initiated the Senior Visiting Surgeons Program that allowed non-military surgeons to work as volunteers at the Landstuhl Regional Medical Center (LRMC) in Germany. Landstuhl became the evacuation hospital for all wounded US troops from Afghanistan and Iraq.

Dr. Trunkey (Col, US Army, ret) was a frequent visitor to LRMC, mentoring young military surgeons in the ICU and operating room, caring for the injured, and assuring that LRMC would pass their inspection by the American College of Surgeons/Committee on Trauma Verification Review Committee (VRC)  (a committee he helped to found while he was the COT Chair) to become a level 1 trauma center. (2,3) (See also attached Photos)

I think my very favorite story about Dr. Trunkey occurred in Hawaii. We were both asked to speak at the Hawaiian Trauma Conference and at the conclusion were heading to a traditional Hawaiian luau. We invited Don to my cousin’s home in Oahu and offered to drive him to the party. When the doorbell rang my young twin daughters answered it and then ran to me saying: “Mom there is this really big man out there in a grass skirt”!. Yes, I said, that in a nutshell is Dr. Trunkey.

In many ways, Dr. Trunkey was my professional father. Even my own father (an engineer) knew his name and how important he was to me in my career and to the world of trauma. To me, Trunkey was larger than life and his death (like my own dad’s) leaves a void that will never be filled.

M. Margaret (Peggy) Knudson MD, FACS

Professor of Surgery, University of California San Francisco

Medical Director, Military Health System Strategic Partnership, American College of Surgeons

References

  1. West JG, Trunkey DD, Lim RC: Systems of Trauma Care: A Study of Two Counties. Arch Surg 1979;114:455-460.
  2. Moore EE, Knudson, MM, Schwab CW, Trunkey DD, Johannigman JA, Holcomb JB: Military-civilian collaboration in trauma care and the Senior Visiting Surgeon program. NEJM 2007, Dec 27;357:2723-7.
  3. Knudson MM, Mitchell FL, Johannigman JA: First trauma VRC site visit outside the US: Landstuhl Regional Medical Center (Germany). Bull Am Coll Surg 2007;92:16-19.

Legends for Figures

Figure 1: Dr. Trunkey helping to load an injured soldier onto the bus at Landstuhl for his trip to Ramstein Air Base and the beginning of his journey home.

Figure 2: The COT  Verification Review Committee at Landstuhl Germany. 

Changing hearts and minds by Robert C. Mackersie, M.D., FACS

My first encounter with Don Trunkey was as an impressionable 4th year medical student, doing an externship on the trauma service in the fall of 1977.  I had spent some time at SFGH previously doing computer programming for Frank Lewis and was beginning to understand that these trauma surgeons (Blaisdell, Trunkey, Lewis, Sheldon, et. al.) were not only impressively smart; could work wonders with their hands (and intellect), but seemingly had great fun at the same time. 

Trunkey epitomized it all – with a command of surgery (and medicine); a lightening-quick wit; and an ability to inspire.  And it didn’t stop there.  When I happened to identified a tune Dr. Trunkey was whistling one day on rounds (Rhapsody on a Theme of Paganini), he immediately replied:  “Yeah, and now tell me who Paganini was…”.   Gulp.  

However, I was hooked.  I was fortunate enough to be able to return to UCSF for residency during which Dr. Trunkey was the Chief of Surgery at SFGH.  Already an imposing figure, Trunkey became larger than life.  Striding around in his colored OR hat and white bucks for OR shoes, he was clearly in command of his realm.  Trunkey was a television star (Operation Lifeline, 1978); he was a bon-vivant (rushing back to the hospital OR one time in black tie), he was a wine-maker – I still have a bottle of Trunkey/Deveny/Upshaw Pinot Noir in my cellar – hopefully it doesn’t “taste like socks” (Trunkey’s opinion of one of his early vintages).  

Don Trunkey was internationally famous – in fact he travelled so much, the surgery residents laughingly posted a sign on his office door that read:  “TWA Visiting Professor of Surgery”.   His travel (and writings/lecturing) made him one of the most recognized figures in American surgery – and it wasn’t limited to purely medical settings.  Many years later, when I happened to be with a surgical group visiting Sydney, Australia, we dined at a place named Doyles on the Beach.  There the restaurant maitre’d was heard to remark:  “American surgeons ay?   Do you know a guy named Trunkey?” 

Trunkey wrote prolifically – on many topics including shock, sepsis, intestinal injury and resuscitation.  He used to remind us that crystalloid fluids were toxic and more than once I remember the senior residents being accused (by DDT) of “salt water drowning” by an overly aggressive crystalloid resuscitation of a patient in shock.  Of course we know recognize that Don was absolutely correct and that crystalloid solutions contributed to immune suppression, coagulopathy, and abdominal compartment syndrome among other things.   

His most notable efforts at changing hearts and minds were probably in the area of trauma center and trauma systems development.  With his charisma and energy, he made a superb spokesman.  Two of his most memorable articles were “Systems of trauma care.  A study of two counties” that he wrote with John West from Orange county in 1979, documenting the (staggeringly) high percentage of preventable deaths that could occur in the absence of an organized trauma center/system.  These concepts were further reinforced in a piece he wrote in Scientific American (1983) where he became one of the first to remind us that trauma accounted (and still accounts) for more productive years of life lost than heart disease and cancer combined.  

As a surgical educator, Dr. Trunkey was a blast to work with.  He was always the master of the ‘pimp’ question, yet held forth with such persistent good humor that one never minded being skewered.  He could be very direct – reserving use of the term “clean kill” for only the most egregious transgressions, but while appropriately critical of residents’ management, he was never, ever mean – a characteristic of his – unusual for the day, that I always admired.    He used to give an introductory lecture to 1st year medical students in the middle of which an agitated person would burst into the lecture hall exclaiming:  “Dr. Trunkey, Dr. Trunkey, there’s been a horrible accident – someone has been hit by a bus in front of the hospital!!”  Following this, the “victim” (a perfectly healthy, uninjured volunteer, in full moulage) would be brought to the front of the room and a number of students called up to help with the “resuscitation”.  It was wonderful theater and made for an experience that the students (and ‘assistants’) would never forget. 

He could be irreverent at times also – usually hilariously so.   One Saturday morning, during the old Morbidity and Mortality conference, our surgical Chairman, Dr. Paul Ebert (one of the most accomplished pediatric cardiac surgeons in the country) was in the midst of an unusually long-winded explanation of a complicated heart operation.  After going on for many minutes (to the increasing confusion and puzzlement of those listening), Trunkey finally blurted out:  “Oh hell, Paul, just give the kid a new set of gills & throw him back in the water”.  The place erupted in unconstrained laughter, (and even Dr. Ebert may have had a faint smile on his face).

I will remember Don Trunkey as one of the two individuals who most sparked my interested in surgery in general, and trauma surgery specifically.  He did the same for many of his residents and fellows who now occupy important positions in academic & community trauma across the country.   Trunkey was one of a kind – extraordinarily bright, articulate, committed, forceful, and charismatic, but with unwavering good humor and grace, and a clear devotion to and love of what he did.  They don’t make ‘em like this anymore.   Our community has lost one of our icons – a mentor, friend, and role model.  We will remember and honor him best by continuing to work towards the goals that he espoused and try to similarly spark the interest of the next generation of general/trauma surgeons who will carry forward the legacy.  

Respect and kindness for patients by Tammy Sloan-Minckler OHSU/MRH

I worked in Med Control/Medical Resource Hospital for OHSU Trauma. Your Father was my favorite Trauma Doc at the “U”.  Not only was I part of OHSU Trauma, my so was a four time kidney transplant patient and three time cancer survivor.  Including CNS lymphoma.  Dr. Trunkey always took time upon arriving in the ED before the arrival of his trauma patient, to stop in and ask about my son, Rory.  He always said he was available to help me with questions or concerns to help him reach the best person in the given field of need.   I adored him for his kindness to us. 

With each Trauma Activation, when Dr Trunkey led the team, I always knew this patient had the best chance and would be treated with the utmost respect, regardless of the patients outcome.  One of my earliest memories of Dr Trunkey, he and his residents arrived to the trauma bay for a gravely injured young man.  After he led the assessment and gave his initial opinion he allowed the team to work their amazing talents.  When the situation was hopeless for the patient, he would simply say “okay, thank you everyone, but stop now.” And a very respectful quiet would come over the ED.   You could see in him respect for every patient, every time.  So, sending my utmost respects to each and every family touched by Dr. Trunkey.  Forever a giant in the world of medicine, military, and humanity.”

My deepest condolences to your family.  This is a loss beyond measure.  I have lost both my parents and my son, Rory passed in 2012 from heart failure.   I understand where your hearts are now.  Please know how admired, respected, and appreciated Dr. Trunkey will always be. 

Beyond Friendship by Charles Schwab, MD

It has taken time to write about Don. When he started to decline mentally, it seemed incomprehensible that this great man would come to a disease that would strip away his mind. For it was his intellect that defined Don’s professional life and delivered the influence he had on the world. My father, decades ago, suffered the stages of dementia and Dad’s four-year decline was intensely painful. To know how Don’s remaining years might proceed crushed my heart.

It is difficult to put into words a description of Don Trunkey. For Don Trunkey was in a category all his own—a man of utmost integrity, a person who had all the gifts that could guide, advise and lead during the good times, and especially when paths had not been travelled and answers remained hidden.  Dr. Trunkey was the consummate professional: ethical behavior beyond reproach, altruistic to the core, constant intellectual development, committed to his convictions, with superb emotional intelligence and an inability to compromise his values. He was serious and strong, not arrogant, rather humble, and he constantly displayed a sense of enjoyment and fun about life and for the people he served and loved. He was “called” to the profession of medicine and sought to improve the health of others by perpetually elevating the care of the injured.  He was a visionary, counselor, leader, physician, surgeon, righteous citizen, patriot, confidante to many and the most impactful trauma surgeon of our time.

I don’t how, why or exactly when Don and I became good friends. Regardless, for some thirty years we were the best of friends. We rarely talked business even though we traveled together a great deal, vacationed with our wives and, if time sped on without talking,  with no regard for time zone or , continent,  a phone call  came about. Our Sun Fun group with Tommy Thompson, Lew Flint and Kim Maul kept the five couples together. Always a gathering in mid-winter, on a Caribbean island and a few rules: no business allowed, great music and entertainment, fabulous meals, and a little fine wine was a part of the glue. These gatherings were hilarious and an annual recharging of the energy cells of our bodies, minds and souls. Don and I were hikers and over thirty years we probably hiked thousands of miles. one on one.  Those times were precious. Margie and Jane were great friends and as a traveling foursome, our trips were adventurous and memorable.  We enjoyed each other’s company and our senses of humor and love of the comedy in life were lifelong bonds. Many, many tears were shared; most were from laughter, some from sorrows.  Friends for life.

I see today what I most admired about Don, both his gentleness and strength, easygoing joy and stubborn tenacity for issues he strongly believed.  He was a wonderful older brother, a navigator of my life and gently turned my compass a few degrees, and without my knowing the change in direction was taking place. He was beyond a friend and a precious gift in my life. Thank you, Don.

A Force for Good by Michael F. Rotondo MD

As the pearly gates swung open on May 1, 2019 and Donald Trunkey strode through, head held high, wry smile on his face – I am certain that St. Peter stood, offered a crisp salute and yielded his post. That’s because everywhere Donald Trunkey went, he was, by the sheer power of his personality and intellect, totally, completely and unequivocally in charge. His natural charisma, quick wit and his high-minded values made him beyond formidable. Everyone wanted to be around him.  Everyone wanted to be like him. Everyone wanted to be him. He was a force for good.

He was in a category all his own – a man of utmost integrity – I’ve met no other single human being more capable of leading a righteous cause, the right way, for the right reason. Not only did Donald Trunkey change the national consciousness regarding care of the injured patient – and in the process save the lives of thousands upon thousands, he brought generations of surgeons, nurses and medics along with him on the journey. I know because I was one of them. If you were to ask him why, he would have quickly served up a humorous quip and likely never answered the question.  But in the exchange, you would have garnered the answer – because it was the right thing to do. He was a force for good.

He had intensity without tenseness and a powerful mind without an ounce of arrogance or guile. When Donald Trunkey spoke, everyone listened.  An autodidact with far reaching intellectual curiosity across a broad range of topics, he had the unique capability of captivating those around him with his skills as a raconteur and the practicality of his approach.  After having met Donald Trunkey some years before while working with my mentor, Bill Schwab at the University of Pennsylvania, I vividly remember receiving an unexpected phone call from him in 1997. It’s hard to describe the feeling in those brief seconds between the moment my assistant informed me of the call and the moment I heard his voice. But I can still feel it now as I recount the story.  It was as if I knew something really important was about to happen. Dr. Trunkey told me that there was a hospital in eastern North Carolina looking for a new Chief of Trauma. He told me that they were sincerely committed to building the center and the surrounding trauma system. They needed leadership and he urged me to go and visit and consider it. He also made it clear that the people who lived there needed help and that the mortality rates were inordinately high for injured patients. With no expectation of ever actually going to such a place, I respectfully followed Dr. Trunkey’s recommendation, interviewed for the job and well, as you might expect, took the leap of faith that he proffered. I left Penn, went to East Carolina University and for the next 14 years, endeavored to follow in his footsteps and change the fate of injured patients in that corner of the world.  He was a force for good.

What can we do when these sorts of monolithic characters move on to otherworldliness?  How can we express all that they have meant to us? How do we explain to those around us how they have changed our lives and, in this case, saved countless lives?  To me, the answer is simple: live as he lived. Do right as he did right. Carry the mantle for those who cannot carry it themselves. And work as Donald Trunkey worked because he truly was – a force for good.  

A standard for the trauma surgeon by Dr Collicott

I first had the pleasure of meeting Don when we introduced ATLS® to the west coast in 1981.  I was a community surgeon interested in the task of improving the early care of the trauma patient.  Don, at that time was already an experienced trauma surgeon on his way to becoming an icon in trauma and American surgery.  He accepted the ATLS® approach with his full commitment without any undue criticism as many of his peers did initially.

My interactions with Don became quite frequent when he became chair of the American College of Surgeons Committee on Trauma (COT). We became well acquainted at the various meetings we attended together during his tenure as the COT chair. He never lost his enthusiasm for teaching all who participated in the care of the trauma patient.  We came to learn that our childhoods and values were very similar having been raised in rural America not being stymied by hard work to reach our goals.

The unselfish dedication and commitment of his professional career to the improvement in the care of the injured patient; his clairvoyant incorporation of the concepts of preventable death methods and evidence-based practice in support of trauma systems: his initial investigations of cellular response to injury; his élan as an educator, role model and friend to countless surgical trainees; his unpretentious personality;  and his exemplary compassion in the care of the injured patient will always remain as standard for the trauma surgeon.

I am proud to have known him for over 30 years.

                                           Paul “Skip” Collicott

Saving a brother by kindness and respect as well as a little surgery by Linda

It’s been more than 30 years since Dr. Trunkey saved my younger brother’s life.  James was barely 21 when a young man he’d never met before shot him in the neck over a foolish matter. Our local doctor in that small Oklahoma town packed him in an ambulance and sent him to Wichita, Kansas, 60 miles away. He thought the bullet could have hit an artery and that James would need an arteriogram.

He never got one. When James turned 21, My dad’s insurance no longer covered him. The surgeon told James the procedure was too expensive and that he’d send some medical students around to look at him. He’d be fine. He told James it was one of the few bullet wounds that could be taken care of with just a bandage.

A few months later, James, a mechanic, reached up to work on a car that on a lift above him. His arm went numb and he could barely move it. The doctor at the emergency room of the local hospital said it was extremely likely to be related to the gunshot wound. He told James he needed to go see the surgeon who’d seen him in Wichita. That doctor told James to come see him on Monday, three days later. James felt powerless. One doctor said it was outside his expertise and the “expert” said, “See you in three days.”

Three days later James’ arm was horribly swollen. Emergency surgery was performed to remove 11 blood clots from his arm and to repair an aneurysm the size of a hen’s egg on his brachial artery under the collar bone.

Why give all these details about James’ history?  To demonstrate the difference between a real doctor and, by my definition of a doctor, a fake. Real doctors can be busy, even gruff, but they respect you. They make sure you get the information you need to make decisions. They always, always try to save your life and THAT always comes first.

I asked James to come stay in San Francisco with me my husband, Lee Henry. He started a job but called soon after starting it to tell me something was wrong.  Lee told him to go to San Francisco General Hospital because he had a cousin working there and they accepted patients without insurance.

This is when Don Trunkey saved James’ life.  With another surgery on the damaged artery, yes, but there were several more of those in the following years. It was by treating him with kindness and respect. It was by giving James the information he needed no matter how depressing or negative it might be. James’ prognosis was very worrisome, but Dr. Trunkey was honest.  He was assigned to James by sheer luck, and James certainly got the best surgeon one could get. Dr. Trunkey successfully operated on James, but he also got down into the weeds about how James got into the predicament he was in. He asked James about seeing the initial angiogram because he saw that as standard treatment and found out there was none.

Some people may not like to hear about medical malpractice lawsuits. I’m sure many are frivolous. But James has suffered through seven major surgeries, including grafts taken from both legs to replace the latest failed repair on his artery. James moved back to Oklahoma and soon needed another repair operation. Dr. Trunkey graciously referred him to a doctor in Dallas he trusted. I know that Dr. Trunkey saw James as a young man who had been harmed by callous disregard. He saw him as a vulnerable young kid who needed care and simply did not get it. The results were years of surgeries and fear of the next one.

James did get a lawyer. He did sue the original doctor who told him an arteriogram was too expensive for a little gunshot wound. After many years he won, in part because of Dr. Trunkey’s testimony that an arteriogram is standard procedure on a case such as James’.  

James has gone on to live a full life. He has four children and grandchildren. He loves to fish, he still works as a mechanic, but he will not be able to have another artery repair. The artery is too fragile. He knows from his doctors what the eventuality is. But he’s at peace with that.

My whole family will always be grateful to Dr. Trunkey, a real doctor. I saw him several years after James left San Francisco at a fancy social affair and he asked me how James was doing. His face showed care and concern. That face that will stay in my memory as long as I live.

Fearless Mentor by Lenworth Jacobs MD, MPH, FACS

Don Trunkey was a trailblazing pioneer for patient care, trauma management and educating multiple levels of trainees in surgical management. I first had the pleasure of meeting Don in the mid 1970s when I was directing EMS for Boston and Boston City Hospital.

He came and site visited the Trauma Center and insisted on spending time observing the Emergency Medical System both in the prehospital phase as well as in the Trauma Center.
This was a particularly challenging time since paramedics and emergency prehospital care were in their infancy. He was so helpful both in concept and in detail as to how the system could be improved. He took the time to meet everyone and was particularly kind to me in those early days. He was particularly helpful in persuading the Commissioner of Health and Hospitals on the importance of physician led medical direction and medical control of the system.
The very next year he invited me to join the Committee on Trauma and paired me with Norman McSwain. His ability to include everyone both professionally and socially had an indelible effect on me. His straightforward no nonsense attitude coupled with an incredible sense of humor and the willingness to include young surgeons in the decision making process has stayed with me forever.
He was always open to ideas and encouraged younger people to present their ideas and concepts at the national level. As you can imagine this was intimidating for a young surgeon to be asked to present somewhat new and different ideas before the icons of trauma surgery. He would always give encouragement and constructive criticism which improved the concept and ultimately it’s implementation.
He taught me the importance of knowing every single detail of a new initiative or program.  Then being prepared to fearlessly defend it with the use of data and good humor. 
He championed so many positive concepts that have dramatically improved trauma care in the United States and in the world.

The ATLS program, trauma center verification, trauma system implementation, modernization of battlefield care, the inclusion of younger people on on numerous trauma committees which allowed them to learn the process and spend a lifetime in trauma care.
I think his ultimately legacy was that he always wanted to do the best thing for the patient and his willingness to be a fearless mentor for countless younger surgeons myself included. I will miss his leadership and friendship terribly. 
Lenworth Jacobs MD, MPH, FACS

Don Trunkey 1937-2019

Don Trunkey
1937 Born Oakesdale, Washington
1946 First Operation, Castration of pig
1955 Saint John HS
1958 Married Jane Henry
1959 Washing State College BS in Zoology, Also played basketball
1963 University of Washington MD
1964 Oregon Health Sciences University internship
1964 Drafted US Army, Nuernberg Germany
1966 University of California San Francisco, Residency
1971 Parkland Trauma Service, Trauma Fellowship
1972 University of California San Francisco, San Francisco General, Faculty
1978 University of California San Francisco, San Francisco, General Chief of Surgery
1985 Joined US Army Reserve
1986 Oregon Health Sciences University Chief of Surgery
1991 Desert Storm 50th General Hospital and After Action
2001 Oregon Health Sciences University Professor Emeritus
2006 Rotations to Landsthul Germany to relieve Army surgeons so they could visit home
2018 Moved to Idaho

Not commonly known about Don:
As a teenager Don shot squirrels for farmers and was paid 5 cents per tail. 22 ammo cost 2 cents so he became a good shot.
In High School he worked at a machine shop welding farm equipment and as a projectionist where he often fell asleep and had to be woken to change the reels.
He met my mom by repeatedly breaking his nose in HS sports which was set by Jane’s father. They also saw each other when St. John played Colfax in basketball and at barn dances.
He worked in mines in Montana during the summer in college to make money. He saw his first death on the first day of the job after a minor cave in.
He caught the biggest trout of his life fly fishing in New Zealand (about 24 inches).
He was an excellent cook.
His mom played college tennis and was 5’11”. Her family goes back to the Mayflower.
His 5th time great grandfather fought in the French artillery at Yorktown and deserted rather than go back to France.
He made his own wine with cousins and doctors and won a silver metal in the Oregon State Fair for Piot Noir (a competitive category)
He was in Tiananmen square the night before the 1989 incident talking to the protesters.
He also did historical research of surgery including Presidential assassinations and the Lewis and Clark Expedition

References
https://en.wikipedia.org/wiki/Donald_Trunkey
https://dontrunkey.com/
https://www.youtube.com/watch?v=vVN0laPGF24
https://kingfaisalprize.org/professor-donald-d-trunkey/
https://www.ohsu.edu/…/surgery/about/donald-trunkey-lecture…
http://archiveswest.orbiscascade.org/ark:/80444/xv64010
https://sfgh.surgery.ucsf.edu/…/234…/history%20of%20sfgh.pdf

50th General Hospital, by Dr. Tom Hutchinson, COL USA (Ret)

As the Commander of the 50th General hospital during Operation Desert Shield/Desert Storm (1991), I got to know Col. Don Trunkey pretty well.  He was our Chief of Professional Services and was always busy keeping the medical/surgical side of things on a straight and narrow path.  He presided over our M and M (Morbidity and Mortality) Conferences, and tolerated no nonsense in professional performance or behavior.  This was accomplished in the company of a splendid sense of humor.

When LTG Yeosock, our 3rd Army Commander, developed a gallbladder infection and needed surgery, I asked Don to manage the situation as I knew if I were to get involved, I would end up as a middleman which would create a problem-prone situation, not to mention adding unnecessary delays .  Don met with GEN Schwarzkopf (the Central Command Commander-and LTG Yeosock’s boss) to advise him how medical treatment for LTG Yeosock could be managed; and a decision was made to evacuate the general from the theater of operations and have him treated in Germany. Don and Col. Dan Cavanaugh, one of our General Surgeons, went to Germany with their patient, and performed the surgery.  A quick recovery and return to duty followed; setting the stage for the initiation of the Allied ground offensive.

As one of the nation’s leading trauma surgeons, Don was always an advocate for documenting wound management and preserving this data for analysis; so that any information that could be identified as ‘lessons learned’ would be on record.  He was particularly interested in seeing that this was done during Operation Desert Storm.

I remember sitting down with Don at Fort Lewis as we were being out-processed for discharge from active duty, and together working on a large stack of Officer Efficiency Reports which were due at that time.  Misery does love company.

Don was recognized by the AMEDD (Army Medical Department) for his distinguished career and his contribution to military medicine by induction into the Order of Military Merit.  Recognition he justly warranted.

After the first Gulf War, Don joined with us in the 50th General hospital Association.  In spite of the considerable distance between Seattle and Portland he and Jane were able to make several of our reunions, and enjoyed seeing old friends and visiting the Fort Lewis area.

Tom Hutchinson, MD,

COL, USA (RET)

Orthopedic Surgeon

A Surgeons’ Surgeon by Dr. David B. Hoyt

I first met Dr. Trunkey when he was on a T.V. show on Lifeline in 1978. I was a resident, I was thinking of going into trauma and seeing him being followed around the hospital at San Francisco General and actualize the job, talk about coordination of care to the patient, get after people that weren’t doing their job, and generally be a model of leadership created a distinction that I had not seen in my residency and modeled what I had been thinking about.

Dr. Trunkey was a surgeons’ surgeon. He was big – yet jovial, he was charismatic – yet kind, and he called it like he saw it. He championed things and pushed for things, even when they created controversy. Those of us following in his footsteps saw that as a model for how to implement a program that would challenge the very fabric of health care delivery. His leadership affected hospital-based systems, prehospital care, the American College of Surgeons, and essentially everything he touched. He was certainly no man’s fool but tolerated people whose heart was in the right place in working toward the ultimate goal.

My next encounter with Dr. Trunkey was again when I was a resident, I had decided to go into trauma and ATLS was being offered. We put on a course at the University of California which was led by Norm McSwain and Skip Collicott. Don Trunkey and Frank Lewis came out of the North at San Francisco General, both as leadership icons and participated in our course. Again, rather than as many trauma leaders at the time did, he did not dismiss ATLS but saw it as an opportunity for creating a common language. He threw himself into the course in all respects and we all had a great time getting to know him and following his leadership.

Above all I recall his emblematic commitment to the trauma patient and their care. He led this through his positive influence perhaps more than can be currently measured. He did it with a sense of fun, a sense of purpose, and a devotion to the intellect and history that made things the reason to proceed.  One seldom meets a person who when you mention their name gets the same reaction. For Dr. Turnkey it is immediate respect and a broad smile showing his friendly nature and his ‘never take yourself too seriously’ attitude. America trauma is different, as is trauma around the world because of his major contributions over forty years.

The Best of the Best by Dr. Susan Briggs

Don has been my close friend and mentor for 50 years. I first met Don as a nurse in the Mission Emergency Room, San Francisco General Hospital, while pursing my premedical studies. His commitment to patient care and advocacy for the underserved populations in the city was incredible. He is the reason I, and many others, found trauma surgery such a gratifying pathway in our surgical careers.

He has been a phenomenal mentor to scores of young surgeons throughout the world, both with his enthusiasm for and experience in trauma surgery. He has set the gold standard for excellence in trauma care- both the art and the science of trauma care. He is the ultimate educator, always willing to take time to share his expertise with all levels of medical providers, prehospital and hospital.

He has been a relentless patient advocate. He has never been afraid to confront the ethical challenges of delivering the highest quality of trauma care, such as “the issue of “preventable trauma deaths”. His publications on the many challenging areas of trauma surgery are held in high regard by surgeons worldwide.

Don is the “grandfather “of global surgery, taking his surgical expertise to vulnerable populations throughout the world, both through his role in the US Army Medical Corp and as a consultant to numerous international trauma communities. He loved to travel and share stories, both personal and professional, with his many international friends.

All of us will always cherish our times with Don, and the impact he has had on the trauma careers of so many of his friends and colleagues.

Briggs, Susan,M.D.

Learning from Dr. Trunkey by Dr Schreiber

I first met Dr. Trunkey as an intern at Madigan Army Medical Center in 1988.  Dr. Trunkey was doing his active duty training there and he was a Colonel in the US Army Reserve.  He spent a significant part of a day teaching in educational conferences and meeting with the residents.  As an iconic figure in trauma, I did not expect Dr. Trunkey to take the time to personally get to know each of the residents but this is exactly what he did.  I was immediately impressed with his breadth of knowledge and his ability to impart it. I still remember many of the topics we discussed that day and the words of wisdom he imparted

During the time Dr. Trunkey was at Madigan, I was assigned the first case of my career as an operating surgeon, a needle localized breast biopsy and I was shocked to find out that Dr. Trunkey, the famous trauma surgeon, was assigned as the attending.  So, essentially, right out of medical school, I was doing a case with 1 of the top 5 trauma surgeons in the country. But it was a breast biopsy, not a GSW to the heart but Dr. Trunkey was very patient with me and even with a breast biopsy, he was able to teach surgical concepts I carried with me for the rest of my career.  I considered the case to be a success because a trauma surgeon and a future trauma surgeon completed the case without massive bleeding!

That very brief exposure to Dr. Trunkey at the beginning of my career played a huge role in my decision to become a trauma surgeon in the future.  As the Chief of Trauma at OHSU, following in Dr. Trunkey’s footsteps, I feel honored to have learned from Dr. Trunkey and then later to have served as a colleague.

Martin A. Schreiber, MD FACS