It's true, trauma is the dumping ground of the surgical specialties. They are the IM hospitalists of surgery.
If ortho can't come up with a legit reason to put someone on the med service (afib, well controlled dm, etc) 8 times out of 10, they'll be on trauma.
Ground level fall? Level I baby! Helo them in and mobilize the OR!
Chronic vegetable from a Subarachnoid hemorrhage that caused a patient to fall? That MUST be from the fall! Turn on the sirens!
Hell, I've had patients who have broke their arm from the kneeling position in the trauma bay!
Pregnant lady who witnessed a car crash now with a leg cramp? The medics crap their pants with that so that gets air evac'd with the rest of the criticals!
Nothing like rounding on patients who's main goal of recovering is to be able to "pop a cap in that !@#$# who shot me" or getting served with a lawsuit by an undocumented immigrant whom you saved the life of and stayed in the hospital for 3 months without paying a dime but goes home and has a wound infection.
And who doesn't like rounding early in the morning to that refreshing smell of sweat, blood, B.O., alcohol and regurgitated taco bell in each room? it's like a fresh breath of sunshine everytime!
And oh the mental masturbation that goes into writing my progress notes. I have to decide everyday about whether to write "A/P per ortho" or "A/P per neurosurg" or "A/P cont PT". Decisions, decisions....
The only saving grace of trauma is the great reimbursements for us. Most of the patients are on Medicaid or some other form of govt subsidy that as you all well know, is responsible for the vast surge on doctor's salaries in the past decade that made our morale so high.
But nothing warms your heart like the blank look in a patient's face when you ask "what kind of insurance do you have?" and they say "what insurance?" or "no habla ingles"
There is talk right now of accredited Trauma fellowships coming about in the next few years. My PD always talks about it and how he wants one at our institution. This will be different than the non accredited Trauma/CC fellowships that exist right now. I don't know how it would be different other than getting a CAQ in "Trauma." My only guess would be they get a dual CAQ in Trauma and a MSW (masters degree in social work) to make them a true trauma jockey 🙂
I can think of a few instances that would make a happy trauma surgeon
1) you got the hots for a trauma nurse
2) you are a female surgeon (or gay male surgeon) and really dig firemen in uniforms
3) you didn't have the step I score to get that coveted internal medicine residency/pulm fellowship but wanted to do a specialty where you round in the ICU all day and never operate. Actually, pulm fellowships are pretty competitive, right up there with the likes of endocrine and rheum fellowships!
