I clearly remember the moment, my hand on the old brass doorknob of my apartment at Logan and Mozart, the telephone ringing through the dark wooden door.
"Don't answer it," I told myself.
It was Friday, my day off, since I worked Sundays, and I was heading to the gym.
"Just leave," I thought.
But being a reporter is a calling, like a priest. I sighed, went back inside, answered the phone. The City Desk, of course. The Tribune, they said, was running some big piece on trauma centers, starting Monday. Trauma centers were expensive to run, and closing down. I was to go to Christ Hospital, soon to be the only Level 1 trauma unit on the South Side, and spend 24 hours in their emergency room, then write a piece.
For Monday.
Okay, I said. Being a newspaper reporter is a calling, like a...
I got Christ's PR person on the phone.
"I'm going to have to talk to the board," she said.
"That's fine," I said. "But do it quickly. I'm heading to the hospital right now, meeting a photographer there. You can either let us in or have us arrested."
They let us in. A different era. The problem I faced was that very little happened for the first 20 hours I was there. I caught a few winks on a stainless steel table in an examining room, worried as I drifted off that I'd wake up being operated on.
To show how long this has been an issue, this article is more than 25 years old. Holy Cross, at 68th and California, which gets bypassed by the ambulances in my story, announced last week it is spending $40 million to upgrade to a Level 1 trauma center.
Everything changed at 1:35 p.m.
After hours of coffee, pizza, chat and routine treatment of cut
noses and sore throats, the call came into the Christ Hospital
emergency room Saturday afternoon: Two men with serious gunshot wounds
were on their way.
An operating room at Christ, soon to be the only hospital serving
the South Side with an advanced trauma unit, was readied for surgery.
Specialists whom another hospital might take hours to find were
immediately contacted and put on alert at Christ. Doctors, interns and
nurses gathered to map out plans.
"Why don't we make the chest wound the 99?" said Dr. Joe Mueller,
giving priority to a 33-year-old man who police told them by phone had
been shot just above the heart.
Other patients were wheeled away. Supplies were laid out:
intubation tubes, packs of syringes, gauze and gallons of medical
fluids.
Paramedics soon rushed in with the first victim. In agony, he
tried to jump off the gurney. A dozen doctors and nurses held him down.
Nurses slit off his pants while doctors began the "90-second-survey,"
rolling him on his side to check for other wounds.
The big man, with homemade tattoos, cursed the doctors, then
cried out in pain.
"Hold my hand, hold my hand," he said, and a nurse gripped his
fingers.
Paramedics who had wheeled in a very old man stood waiting for
attention. They were brushed aside by another group of paramedics with
the second gunshot victim, a 19-year-old.
The shooting victims had wounded each other on West 69th Street
over a dice game. Twenty-dollar bills still lay on a gurney.
The ambulances carrying the men had bypassed two other hospitals — Holy Cross and St. Bernard — because they are not part of Chicago's
shrinking trauma network. Instead they came to Christ Hospital, at 4440
W. 95th St. in Oak Lawn.
Even as the trauma team divided itself between the two gunshot
victims Saturday, nurse Cheri Aardema put down a phone and announced:
"We've got another one coming in. IV drug user with multiple stab
wounds. Used heroin two hours ago. Here in 10 minutes."
By 3 p.m., one resident described the emergency room as a "war
zone." A technician, arriving to make a scan of the victims' hearts,
took one look and left the room to pass out.
The key to understanding the difference between a trauma center
and a standard emergency room is one word: readiness.
Any hospital could have inserted tubes to drain the gunshot
victims' chests, taken X-rays or cut into their ankles in search of the
saphenous veins to hook up lines to pump liquid into their shocked
bodies.
But as a trauma hospital, Christ had to be prepared for whatever
happened. If an aneurysm suddenly burst in a brain, neurosurgeons were
ready. Cardiac surgeons were standing by in case bullets had damaged a
heart.
It follows that since trauma hospitals must be ready for almost
anything, usually their capacities are not needed to their fullest. In
fact, for three solid hours earlier that day, from 3 to 6 a.m., no
patients were treated in the unit.
Other "Code 99" trauma calls Saturday were false starts. A
"gunshot wound to the left chest" arrived at 12:40 a.m. The trauma team
assembled. The operating staff readied.
But the bullet had been deflected by a rib; the only time the
patient was in real danger was when he lit a cigarette while an oxygen
tube was taped under his nose. The trauma team bandaged him up,
replaced lost fluids and told him to put out the cigarette.
One hundred six people came into the emergency room Friday, the
day before. They were a varied group: an 18-month-old boy who drank
bleach, a 93-year-old woman with a fever of 105, a man with a sore
throat, a drunk with a blood alcohol level of 0.436, several victims of
minor car accidents, a hurt wrestler, a fireman who inhaled smoke, four
people who breathed hydrochloric acid fumes at a factory, and dozens
more, none in danger of dying, none a trauma patient.
Despite the high cost of trauma care, Christ joined the trauma
network in 1986 "first, (because of) what it does for our educational
program," said Dr. Gary Merlotti, head of emergency services. "You
cannot run a surgical residency without trauma.
"It's important for prestige. If you want to become a community
hospital, that's well and good, but if you want to be more than that,
you need to provide trauma services. Also, the concept is consistent
with our philosophy and vision."
The network started out with 10 hospitals but will soon be down to
six when Michael Reese ends its participation next month. As hospitals
drop out of the network, the time it takes to get patients to the
remaining trauma centers grows longer, cutting into the "Golden Hour,"
or crucial period after an injury occurs when trauma care is most
effective.
"With all the trauma centers closing down," paramedics have to
struggle to keep people alive longer until they can receive trauma
care, said paramedic Jim Gleeson, who brought in one of the wounded men
from the dice game.
Merlotti said there are enough trauma centers in the network, as
long as they are evenly distributed. But since trauma centers cannot be
moved, he said, redistricting is needed, or new centers should be
opened. Whatever happens, Christ Hospital will stay in the network, he
said.
"If we leave the trauma system, it will collapse," he said.
As a trauma surgeon, Merlotti was called in when the two gunshot
victims arrived at Christ. After they were stabilized, he checked their
heart scans.
Suddenly, at 3:40 p.m. the room was quiet again. Merlotti gazed at
the pile of bloody material left by the gunshot victims, who had been
moved upstairs.
Musing on the huge financial losses that have forced hospitals to
drop out of the trauma network, he estimated that the bill for the
gunshot treatment could be $2,000 for each patient, though he doubted
that the hospital would ever get the money.
Many trauma patients are uninsured and cannot pay for the
expensive care, adding to the financial burden carried by a trauma
center.
"We could charge them $20 and have difficulty collecting,"
Merlotti said.
—Originally published in the Sun-Times, Jan. 15, 1990