A Baltimore Trauma Center Shift for the Wall Street Journal

I shoot a pretty wide variety of subjects, mostly features or portraits.  I love to shoot features, and portraits pay the bills- but it’s rare I get commissioned to shoot anything in the hard news category let alone investigative journalism.  When one of my editors at the Wall Street Journal called me up to ask how I felt about documenting a shift at the R Adams Cowley Shock Trauma Center, I said I felt like I was born to do this shoot.  My mother has an unusual fascination with hospitals and medicine, so I grew up watching a lot of Rescue-911 and E.R. shows.  No, not scripted medical dramas- actual E.R. documentary shows where they leave little to the imagination.  Also, we would sometimes watch surgery programs during dinner.  I was all about this shoot.  When I learned about the story that prompted it, I was even more excited.  You see, homicide rates have gone down in America, but if you think that’s fine and dandy and the country is becoming a better place, you’d be pretty damn wrong.  Turns out stabbings and shootings are up.  Dramatically.  Reporter Gary Fields did what any good investigative journalist would do and he got to investigating.  Signs point to improved emergency medical practices saving more lives and skewing the numbers.  Gary and I made our way to this shock trauma center in inner city Baltimore on a Friday night in the fall to witness the role that these centers play in the violence game.  Please read the article and watch the video.  Understand what’s going on in America.ShockTrauma03The shift started off peacefully enough, but it was the calm before the storm.  This is a view of the hospital complex from the helipad.  ShockTrauma04Learn more about he TRU, or Trauma Resuscitation Unit here.ST4This is the board and it is the nerve center of the TRU in many ways.  When this phone rings, someone is hurt and likely dying.  This isn’t a normal ER.  They see the worst of the worst here- major traumas.  The EMS teams on the ground from all over Maryland will call this phone if they think an injury is severe enough.  The folks at the TRU make the decision whether or not to accept the patient (there are a limited number of bays and other resources like medical personnel) and when they do, they write down pertinent details on this board and then they wait…    Shock Trauma Shock TraumaWhile the story was about violence, the non-violence-related injuries were also relevant to the story.  Each case allows the doctors to improve how they practice emergency medicine.  We observed many very sad and disturbing cases, such as this middle aged woman who jumped off a one story building.  She came in as a Jane Doe and was one of the most critical patients from the entire shift.  It is so easy to hurt yourself so badly.  My heart ached when her family showed up later in the evening.  I kept asking myself why she would do a thing like jump off a building with such a caring family.  So many things you can’t tell about people just by looking at them…ShockTrauma08Her pelvis was severely damaged.Shock TraumaThis is Dr. Thomas M. Scalea, the Physician-in-Chief at the Shock Trauma Center.  ShockTrauma10This is the central bay for support staff and it is where the medical team gathers when they are not responding to a patient.  The individual patient bays are arrayed around this. ShockTrauma11I keep seeing the splayed arms of the severely hurt.  It seems to be something the human body just does.  I wonder if it’s related in any way to the fencing response.  ShockTrauma12Members of the medical team wait for a helicopter to come in.  Patients arrive by air from all over the state.  They tend to arrive by ambulance if injured within city limits.   ShockTrauma13 ShockTrauma14 ShockTrauma15 Shock Trauma ShockTrauma17 Shock TraumaMaking the rounds. ShockTrauma19The board with a description for a GSW, or gunshot wound. Shock TraumaThis was our first gunshot wound patient of the night. Shock Trauma Shock TraumaOne of the surprising things about the night is how much nudity I saw (and consequently had to work around) because when the medical team starts working on your traumatized body, they quickly cut off all your clothes.  There were so many desexualized breasts and penises- just body parts on frail frames.  I don’t see nude strangers very often, so it was jarring at first- more so than the blood.  As the night wore on the feeling wore off and I became inured to it.  ShockTrauma23 Shock Trauma ShockTrauma25This is Stephanie, cleaning up the bay after the night’s first gunshot victim.  He did not survive. Shock TraumaGunshot victim number two was shot a few times, most notably in the face. ShockTrauma27This young man did survive. Shock TraumaBad car accident.  These were the cases that gave me chills.  These people were so broken and from doing something we all do so casually every day. ShockTrauma29This man was stabbed. Shock TraumaHe also survived. Shock TraumaThe police came to interview him and take pictures for evidence.  Shock Trauma ShockTrauma33 Shock TraumaYou don’t get through at shift at the TRU without a little help. Shock TraumaDr. Scalea is indeed the boss.2012_12_08_cmyk_NA_04 2012_12_08_cmyk_NA_04Thank you to Matt Craig at the Wall Street Journal as well as the University of Maryland Medical Center for allowing such broad access.  While I had to be very, very careful to not shoot patients’ faces for privacy purposes, our handlers for the evening were good about letting me roam about freely.  Also thank you to Gary Fields for keeping me company during this long night and for writing this important story.

 

26 thoughts

  1. Good question. First, we had unusually good access thanks to the permission from and cooperation of the hospital. I’m guessing they saw this story as both a potential positive story on their shock trauma center, and an important social issue story that affects us all. I’ve shot in hospitals before, and I respect HIPPA and make serious efforts to obscure identities. We also had a PR handler with us the entire time who wasn’t hovering, but was vigilant about making sure we complied with HIPPA. Late night for her, poor thing.

  2. This was fascinating to me. I live in Baltimore, drive past Shock Trauma every night, and have been there once for a friend who was hit by a car. Thank you for allowing me to peak inside the inner workings of such a great place.

  3. Melissa,
    I work at the University of Vermont College of Medicine and do this kind of work with our level one trauma center all the time. I thought you did a wonderful job showing the emotion and commitment of those working this trauma center. Really nice job.

  4. This is the greatest hospital around. They saved my daughter life last year. You won’t find more caring and dedicated people around. They will always hold a special place in my heart.

  5. Thank you for sharing. The doctors and nurses of Shock Trauma are all angels. I have seen this first hand. Unless you are a patient or the family of a patient , you do not realize just what these people do.

  6. Fantastic series of a harsh reality, thank you. Shock Trauma paved the way in trauma care and is one of the best. The staff truly are angels.

    As a side note, since you wrote that your mom has a fascination with real life hospital dramas, check out the Virginian Pilot’s series about a combat hospital in Kandahar, Afghanistan in 2011.

  7. I used to work at Shock Trauma, and it truly is unlike any other hospital in the world. I have since become a traveler and moved on but I will never forget my home and miss it very much! Wonderful(and accurate) depiction.

  8. My daughter was in UMMC, in August of 2012 and only had a 25% chance of living, although she was not in shock trauma., she is alive today because of that hospital, and she was 21 wks pregnant, both are doing fine, BEST HOSPITAL. Around

  9. Thank you all so much for sharing your comments and stories. Shock Trauma at UMMC is a truly remarkable place. They saved the life of a friend of mine who was in a horrific motorcycle accident outside of Baltimore and they perform miracles of modern medical science every single day. I don’t think this came across in the original blog post, but it was an honor and a privilege for me to watch the medical team in action.

  10. I’m proud to say I’m a Shock Trauma groupie. I was given a tour once for business and the experience motivated me to fulfill my dream to become a nurse despite a successful career behind me. I achieved my RN at age 50 and spent a shift in the TRU with an experienced TRU RN. It remains one of the most incredible experiences of my life. I witnessed the first gunshot death of a young man, stabbings, the woman with no face after a motorcycle crash, car crash victims – I kept a list that night. These were the real nurses! I admire them tremendously. I also realized that, at age 50, I wasn’t physically up to the challenge of the TRU. Maybe in my next life – I’ll start when I’m younger and become a flight nurse. Dr. Cowley changed everything about trauma care and Dr. Scalea carries on with the same commitment. Thank you all. Hopefully, I will only visit with my feet on the floor!!

  11. My daughter was a patient there and I’m a open heart nurse it was the most amazing place runs like clockwork so proud we have this they saved her life she is currently enrolled at university of md hospital and will graduate as an RN this dec I can never thank dr scalea enough thank u for all you and your TEAM does I know we will never forget u

  12. What an awesome tribute. My son was a patient at Shock Trauma for 64 days in 1996. Today he is alive and well thanks to God, all the prayers and for all the “angels” at Shock Trauma. The staff, without a doubt, provides the ultimate in trauma care! So much of this story brings back lots of memories from that tragic time in our lives. I am so thankful that Dr. Cowley saw a vision all those years ago to bring this outstanding medical facility to Maryland. Thank you all for everything you do every shift you work!!!!!

  13. I am currently a medical student who rotates through STC. It is truly an amazing experience. (See a couple of my buddies in these pics. Great piece!)

  14. The Shock Trauma Hospital has long been a part of my life as my daughter Meghan has worked there for years. What an outstanding group of medical professionals. We should all applaud them and all the work they do so selflessly. God bless them all!

  15. I work both MD EMS and at UMMC/STC….unless you have worked here/been a pt here, you will never understand the true dedication of this staff…R. Adams Cauley Shock Trauma Center is a 1-of-a-kind hospital that is dedicated to only Trauma patients…they do it right and they do it best! Shock Trauma is where our military go for training before deploying overseas…if you ever get the chance to tour it, you wont be disappointed. Thank you for the recognition, these guys rarely get the recognition publicly that they deserve. Stay Safe all!

  16. I was in an MVA in December 2005 and was transported via MSP helicopter to Baltimore Shock Trauma with a head injury. It was an experience that changed my life. After recovering, I became an EMT and then graduated in January 2011 with my RN. Thank you to everyone in the TRU for what you do and inspiring me to pursue nursing.

  17. My Daughter is a Shock Trauma Nurse with TRU. So good to get an inside view of her work life. Very impressive unit and outstanding professionals. Thanks for the great coverage.

  18. i have been flown in there twice once in 1983 for burns on 42 percent of my body and again in 2000 for a car tire explosion which broke my right arm 22 times and my face in 5 different places and dr eglesader saved my arm and the whole trauma team are wonderful people thank you all very much

  19. Thank you for giving us the opportunity to see inside STC. I was a patient there 5 years ago, brought in by Trooper 1, after being run over by a dump truck.
    I was unconcious in the TRU, so I don’t remember it, but I do remember and am well aware that I am here because of the caring and dedicated people at STC.

  20. What a great way for me to see into the world my daughter enters each day. When she announced to me she was going to be a nurse one of the prouder days of my life was the day she graduated as one. The opportunity she has to work and learn from some of the most talented group of medical professionalsd in the world is just what any father would want for his kid. The incredible medical expertise and angelic care shown to whomever enters, regardless of the reason, only serves the community of Baltimore well, with pride and distiction. Thank you all at RACST for what you do…

  21. This is an amazing story/pictures. IT shows people what nurses/doctors/emts/firefighters go through on a daily basis.
    I am a firefighter/training to be certed in EMT, and this story is now saved to my computer as a “hey, people need you, never give up.” reminder.
    Thank You. God Bless.

  22. I use to live in Baltimore and k ow 3 people that are alive today because of shock trauma. Back as far as 1984 for the first friend. The men and women that work there are very special people. I wish we had something even close in Ft Myers FL but I don’t think our trauma center comes even close!

  23. I, too, was a patient at Shock Trauma. I spent only a week there despite 11 broken ribs, 2 broken vertebrae, punctured lung, lacerated liver, broken collar bone, torn ligament in the shoulder and a torn rotator cuff!!! If was not even one of the worst but got the best treatment!!! The didn’t just care for me, they cared for me! Thanks for all you do!

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