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.

Resurrection by Dr. Russell Strong

In 1977, I visited several trauma centres in the USA, with particular reference to management of blunt liver injuries and spent three weeks at the San Francisco General Hospital with Don Trunkey.  It was there that I witnessed a true resurrection. 

On Sunday afternoon 27th November 1977, I was seated in the Emergency Department when a call came through from the Ambulance Service regarding a teenage lad who had received gunshot wounds.  He was walking along a footpath with his girlfriend after attending church, when two young teenagers jumped from behind a bush, grabbed the girl’s handbag and shot her.  He went forward to resist the robbery whereupon he was shot in the lower abdomen and as he fell forward was shot again in the upper abdomen/chest. 

While being transported to the hospital, an intravenous infusion was commenced in his left arm.  An ECG of the patient in the ambulance was shown on a screen in the ED while travelling to the hospital (I had never witnessed this previously) and, as the Ambulance entered the hospital driveway, the ECG went flat, indicating cessation of heart beat. 

He was immediately transferred to an operating table in the ED, while simultaneously being intubated and ventilated and a catheter inserted into his femoral vein and Don opened the chest.  The heart was flaccid and not beating.  He began internal cardiac massage which, together with the rapid intravenous fluid infusion and oxygenation via the endotracheal tube, resulted in filling of the heart and restoration of heart beat and circulation.  There was a through and through bullet wound of the heart which Don repaired, together with splenectomy due to penetration of the spleen by the bullet.  I am a little hazy about the intra-abdominal wound by the first bullet, but believe it was damage to the left iliac vessels which were repaired.

Chatting to the patient and photographing him in bed several days later (photo) made the classification of a “resurrection” to be real.

Don and his wife Jane have been close friends with Judith and myself for over 40 years and we have spent many, many wonderful times together in different parts of the world, which has included our combined love of wines.  After some search, I have found a photograph of us together in formal dress (all the others seemed to have shown us with a wine glass in our hand) and one where Don shows his legs wearing a kilt.

I also enclose a photograph of Don in the Australian outback on one of our trips.  He is throwing a spear with a special device, generally called a spear thrower, which were often used by Aborigines to increase the distance they could be thrown, with an expert thrower (probably not Don) getting two to three times the distance he could throw without using one.  They have a peg at one end where the spear fits in and the thrower holds it by the other end to throw the spear.  The spear thrower instrument is called Woomera.  The town of Woomera in South Australia was the site where Australia was involved with the British in developing rockets and missiles, which seemed to be an appropriate name for the Indigenous weapon.

San Francisco Good Bye Roast – My Dad is a BIG DEAL

My Dad has really always been impressive to me.  Growing up, he seemed to always be a little stronger, faster, and smarter at everything than me (and most other people too).  He was an incredible athlete (I think he played 3 sports in high school and basket ball at WSU) and could beat me at everything, even ping pong which I played a lot as a kid.  I once saw him throw a grown man over his shoulder out of a raft into the river in a water fight with only one hand on his life jacket. He has close to a photographic memory.  He read about a book a week — usually history — and would remember most of it.  He knew many constellations and individual stars that I just couldn’t retain the same way.

But it took me awhile to realize that he was a really big deal in the world of medicine.  I noticed the respect that the other doctors, residents, and nurses had for him on the rare occasion when I visited at work.  He was occasionally in the news paper and in 1978 he stared in an episode of Lifeline.  That was amazing, but it was more about how he saved individual lives.  My Dad’s true superpower was changing policy to save people by the thousands.  He has a no-nonsense honesty and sincerity that either inspires or offends.  He challenged the status quo and stepped on a lot of toes. He was hard to please but sincere in his praise when he gave it.  I hope to have other doctors write more about his effect on policy as they know the details better than I do.

One of the biggest examples of when I realized what a big deal he is, was at the party in 1986 that the hospital threw for my dad when he moved to Oregon.  I heard many incredible stories that night about my dad.  The main roast was by the mayor or former mayor and he had the audience roaring.  I wish I had it all on video but I don’t.  Please share your stories below if you were there.

One story was about how he opened the burn unit while the hospital administrator was out of town.  He invited the Mayor and the media so that it would be awkward to close right away.  This part is captured in the newspaper article below.  I also heard stories about the Moscone-Milk shootings, my dad threatening to fire doctors that wouldn’t treat AIDS patients, a patient with an arrow in his backside, a mugging victim shot in the heart in the alley behind the hospital (he lived), and numerous other amazing medical feats.

To view the article: right click and save image to computer, then zoom in.  Apparently, the big paper in The tech city is not yet digitized.

Good bye roast from San Francisco