On any given evening when the doors of the Cook County Hospital Trauma Unit crash open, the duty surgeon can face anything from a pregnant woman shot in crossfire between rival street gangs to a thug with multiple stab-wounds.
Loud, busy and with lots of blood and yelling — that’s the gritty reality of the renowned Chicago Trauma Unit which inspired the acclaimed medical drama ER and which for many years was headed by Cork-born surgeon and gunshot wounds expert Dr John Barrett.
“Most of the poor people in the city live on the west and south sides, and trauma is endemic among that population,” explains Barrett.
“We’re one of six designated trauma units in the city but we do most of the gunshot wounds because of our location.”
The first of its kind to be established in the US, the unit sees about 5,000 seriously injured patients a year from the notorious south and west sides of Chicago.
The ER series is quite accurate, says Barrett who worked in the unit for nearly 30 years until his retirement in 2002, 20 of them as Director of the Trauma Service.
A native of Turner’s Cross, who graduated from UCC’s medical school in 1969, Barrett returns this week to his alma mater to be presented with one of the university’s prestigious alumni achievement awards. “I really enjoyed the series, I think it was a very realistic portrayal of what goes on in the trauma unit of Cook County Hospital — the show has a kind of gritty feel to it.
“The reality is very bloody, very loud, confused, people yelling and talking and that’s portrayed very well,” he says, adding that both the injuries and treatment procedures are medically correct.
Although he points out the character played by George Clooney, Dr Douglas ‘Doug’ Ross, is not a trauma surgeon, but actually a compilation of different medical specialists, he believes the show is well-researched.
“The only thing,” he quips, “is that their success rate seems extraordinary!”
The insight provided by ER into the workings of an emergency ward fascinates people, he believes:
“ The show makes people more interested in what goes on in an emergency ward— prior to this viewers didn’t hear the confusion and see the blood and get that mix of excitement and anxiety which goes on there.”
It’s that combination of excitement and anxiety which attracts the kind of personality, according to Dr John Barrett, which makes a good trauma surgeon. “We’re often adrenalin junkies. There’s a particular kind of person who goes for that work — they are people who are motivated to action.
“What happens in Trauma is the doors burst open and the paramedics come in with a young man on a trolley with multiple gunshot wounds.
“They say his blood pressure is dropping, that he’s dying and then they hand him over to you.
“You act on very little information; you know nothing about the patient except that he or she’s been shot and there’s no time for x-rays.
“It’s down to you, the patient and the nursing staff. You act based on your clinical findings. It’s about your hot little hands and your old stethoscope!”
Trauma surgeons, he says, tend to be “unbelievably confident and very decisive” personalities, though the work itself is very much a team effort:
“The nursing staff are crucial and are intimately involved. It’s like a very complicated dance that we do — can we stabilise the patient or do we need to operate immediately?
“It’s the immediacy of the decision. A patient will die if you don’t get inside their belly and control the bleeding and you have a maybe 20 or 30 minutes to do it.”
Not everyone would like the job, he acknowledges, adding that seeing the results of such violence can change your attitude to life if you’re not careful: “At the hospital we are in the middle of a sea of violence. The world appears to be an incredibly violent place. You perceive the world to be more brutal. It could give you a pretty jaundiced view of life.
“Many of those we see are ordinary poor people who get caught in the crossfire between the street gangs.”
The violence is non-stop, he says, recalling a young man who was rushed into the Trauma Unit with a gunshot wound to the abdomen.
While under examination Dr John Barrett spotted a faded surgical scar on his belly: “I recognised the incision as my work. I’d operated on him before for a gunshot wound, and he was still only in his early twenties.”
You have to retain your ability to see patients as people and not just as a succession of gunshot wounds, he emphasises: “You can lose your humanity if you go that way— that’s the dark side, if you begin to see the patient as just another gunshot wound. Of course they’re not, they’re all human and you have to treat them as human.”
Staff turnover at the unit is rapid — young doctors and nurses tend to work on the trauma unit for a few years before moving on because, he explains, they’ve acquired a set of valuable skills which they use to advance their careers.
His work at the unit has made him an active campaigner in the drive for gun control:.
“We want a federal law requiring everyone to have a background check before they get a gun.
“Even the NRA agrees with this but there’s a small wealthy group of people who stymie every effort at any kind of reasonable gun regulation in the USA.”
He also rails against the inequity in the US medical system. Even with Obamacare, he points out, although poor people now have access to medical care, they must pay something:
“American medical care is the best in the world if you can afford it but not everyone can access the highest tier of the system.
“There is a great disparity in the US between people who have and who have not. I was privileged to work with the poor because they are the people who need your skill the most. It was an honour to do the work. To me medicine is not a business, it’s a calling.”
Dr John Barrett will be among five distinguished UCC graduates to receive an Alumni Achievement Award from the university at a gala black-tie dinner in UCC this Friday, November 28th.
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