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Know a surgeon? Pass this onA number of years ago, I was sitting in the waiting room at my internist's office awaiting my annual physical. Sifting through the stack of magazines, I came across the most recent copy of the Journal of the American Medical Association. Leafing through it, I found an article on access to trauma care in the U.S. What I read stunned me. What I saw in an accompanying chart scared me. In short, the article told of large holes in the U.S. trauma system. The chart showed how the so-called "golden hour," in which trauma centers nationwide hope to give the injured hospital care within an hour of a mishap, was virtually non-existent in large parts of rural America, particularly in western Kansas, western Oklahoma and the northern Texas Panhandle. However, within those spaces was an area in the Nebraska Panhandle that stood out like an oasis in a desert. There was apparently a Level II trauma center in Scottsbluff. I wanted to find out why. Thankfully, my internist let me take the JAMA home. I've devoured the contents. Last year, our editorial staff decided to develop a rural health and safety special emphasis issue. I cried out for dibs to tell the story of this amazing hospital, its hero surgeon, and the committed staff and volunteers surrounding it all. You can read it on the front page of this week's edition of the Journal. The main question I had of the people in Scottsbluff was: "Why are you guys, and not other places, committed to trauma care?" The answer kept coming back: Dr. Lloyd Westerbuhr. Dr. Westerbuhr, it seems, had the vision to make Level II trauma care a reality in his part of the world. He brought together doctors, nurses, and rural first responders in a commitment to advanced care for the injured. Dr. Westerbuhr got the local hospital foundation to stop thinking internally and start thinking outwardly--raising funds for a state-of-the-art communications system linking all phases of trauma care to more than 30 rural hospitals and clinics. He convinced hospital administrators to add more specialty doctors, particularly neurosurgeons, and to bring in an advanced life support helicopter to the area. Finally, he brought all interests together for training in how to use that new communications system and how to communicate with each other. Along the way, they learned new skills together about caring for injured people. They also learned about themselves and how to trust each other when lives are at stake. As Dr. Westerbuhr put it: "It was a huge commitment, but it created a lot of enthusiasm once it got going." Over 12 years ago, Regional West Medical Center was given Level II trauma center status by the American College of Surgeons. It's part of a four-hospital statewide trauma network in Nebraska, giving 74 percent of the state's population--one of the top numbers west of the Mississippi--access to "golden hour" care. Even in the most remote areas of the Sandhills of that state, what once was a wait as much as five hours long, to a top trauma center, has been cut in half in most cases. That's a substantial difference. It's a difference we can make ourselves, too, in those places where top-flight trauma care is scarce. That's why it's important to show this article to your surgeon, if he or she is in one of those areas of Kansas, Oklahoma and Texas where the "golden hour" seems non-existent. Get them thinking about this issue. Our neck of the woods needs more hero surgeons like Lloyd Westerbuhr who will advocate for their patients that just because they live in a rural area, it doesn't mean they should be denied quick care. It also needs more people like Regional West's administrator, Jim McHugh; it's nurse coordinator, Shermaine Sterkel; the head of the local ambulance service, Randy Meininger; as well as the good people at the hospital foundation, rural facilities and first responders to share in that vision. Still, it looks like it's going to take what it took in Scottsbluff: The vision of a surgeon who saw too many friends get hurt and take turns for the worse because of inadequate trauma care to bring it all together. It's been said that surgeons are like life-saving gods or warrior poets to their patients on the operating table. Now's the time for them to say "enough" to unreasonable deaths and be the lead advocates for better trauma care in rural America. Docs, I'll be right behind you. Larry Dreiling can be reached by phone at 785-628-1117 or by e-mail at ldreiling@aol.com. 9/15/08 Date: 9/10/08
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