Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, October 11, 1995 TAG: 9510110028
SECTION: NATIONAL/INTERNATIONAL PAGE: A1 EDITION: METRO
SOURCE: LINDSEY TANNER
DATELINE: CHICAGO LENGTH: Medium
The aqua-green double doors burst open as paramedics hustle a gurney bearing a young gunshot victim into Cook County Hospital's trauma unit.
Shaking uncontrollably, his face obscured by an oxygen mask, the youth is ``shot all over the lower extremities,'' says a physician, one of a team of trauma doctors and nurses who quickly swarm him.
``Are you cold or nervous or both?'' a doctor asks as others hurriedly strip off the patient's clothes, cut off his bikini briefs and insert an IV line.
``Have you been here before?'' another doctor wonders.
``Oh yeah, you've been here before,'' a colleague says soberly, noting the thick vertical scar stretching from the young man's neck to his pelvis, and several old gunshot scars on his abdomen.
The new wounds have pierced his left thigh and buttocks, leaving little visible blood and small innocuous-looking holes in the skin.
``He has holes all over him,'' says attending surgeon Seth Krosner, shaking his head. ``He's 21. He can barely drink legally.''
Krosner is not reciting some scriptwriter's dialogue. This is another night of real life in one of the nation's busiest trauma units.
\ County General Hospital, the large, public Cook County hospital in the television sensation ``ER,'' is fictional, but trauma staffers at Cook County Hospital think of themselves as the real ``ER.''
An 80-year-old behemoth on the city's West Side, it's the only public hospital in a county of about 5 million people. It treats 40 percent of the county's trauma victims, and has a reputation for getting some of the worst trauma cases but giving some of the nation's best trauma care.
Most of the nearly 5,000 trauma patients treated each year are poor minorities, and about a third are gunshot victims.
``It's blood and guts in Trauma,'' a triage nurse says bluntly. Her job, conducted in the large lobby outside the unit, is to evaluate patients quickly before sending them through the green doors into the unit.
When those doors burst open, doctors and nurses know they're often about to witness a tragedy.
``I've seen only-children who were murdered on Mother's Day and you have to go and tell the mothers that,'' says Krosner, 33, a tall, muscular surgeon with a thatch of punkish thick brown hair, a goatee and wire-rimmed glasses.
His most memorable case during his three years at County involved a woman 8 1/2 months pregnant, shot in the head and wheeled in unconscious with faltering vital signs.
``In a case like that, everybody thinks you have two patients, but you don't,'' he explains. ``You have one patient - the mother. Without her, the baby won't survive. So you have to do everything you can to save the mother.''
``So we cut her open,'' he says matter-of-factly - a Caesarian section on a dying woman.
It was conducted with the slim hope her body could use the blood that had nourished the fetus. The baby survived; the mother didn't.
``You can't imagine the trauma of taking a baby who then goes on to cry out of the womb of someone who's dying,'' Krosner says. But, he adds, ``It's nice to salvage an innocent, clean start.''
\ ``It's exciting. You take people who are literally dying and stop that with your own hands - literally.''
That's how Krosner explains why he chose a speciality that to an outsider seems simultaneously abhorrent and fascinating, and dizzyingly fast-paced.
Doctors and nurses become a sea of indistinguishable arms as they insert intravenous lines, take blood pressure readings, draw blood, remove clothing and ask questions to gauge each patient's condition - all within five minutes of the patient's arrival.
The official reason for stripping all patients naked is to check for hidden wounds, but it's also done to check for weapons.
``We're very careful about stripping people down for their own protection - and for ours,'' Krosner says.
Guns and knives have been confiscated from patients - one reason that an armed hospital police officer stands stoically at a podium near the outer entrance to the unit. The badge on his chest gives his last name, Epps, but he does not want to identify himself further.
``You can get 40 gangbangers in here like that,'' he says, snapping his fingers. His job is to ``basically stand between them and where they want to go.''
Gang members frequently rush in after one of their own is shot by rivals, Epps says, ``looking to vent ... 'cause their homey just got shot.'' And, chillingly, visitors also can include members of the rival gang.
Krosner knows he's probably worked many times to save a victim who's just killed someone else.
Still, he says, ``You don't forget that they're human beings.''
by CNB