Month: June 2019

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

Opens large image

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.