Category: Trauma

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

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

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

My Dad

My father is Don Trunkey.  He was a renowned trauma surgeon and is finally retired to Idaho.  This web site will be about his life and achievements.

Basic Biography from OHSU:

Donald Dean Trunkey was born, raised, and educated in the state of Washington. He graduated with an M.D. from University of Washington in 1963 in the hope of becoming a General Practitioner. He interned under J. Englebert Dunphy at the University of Oregon Medical School, who became his mentor and turned his focus to surgery. When Trunkey was drafted into the Army, Dunphy went to San Francisco to begin one of the first trauma centers. He brought Trunkey in to join him after his service, and also got him a surgical Fellowship in Texas. On his return Trunkey rose to become chief of surgery for San Francisco General Hospital for 8 years. He then came back to Oregon to build a trauma system as Dept. Chairman over the next 15 years. An important interlude saw him as chief of surgery in an army hospital in Saudi Arabia during Desert Storm. After the chairmanship he returned to teaching and lecturing on a global scale as a Professor and Professor Emeritus.

His varied experiences influenced his thoughts and actions on trauma care. In the Army rampant alcoholism led him to institute A.A. programs. In San Francisco the drug wars of the ‘60s made him both an expert in gunshot wounds, and an advocate for controversial measures like gun control and drug legalization. Work with traffic accident victims led him to lobby for seat-belt and helmet laws. Likewise, exposure to the Texas Burn Unit not only led him to replicate one in San Francisco, but also to research fire-retardant clothing and self-extinguishing cigarettes. His wartime service likewise gave him an up-close look at the current state and problems of combat medicine.

Trunkey’s decades-long involvement with trauma and trauma systems led to new surgical protocols of both invasive and non-operative types; the authorship of hundreds of articles and book chapters; the delivery of innumerable lectures; and participation in over 30 professional organizations.