Trauma doctors struggle to keep pace with surging violence in Baltimore

Inside Shock Trauma as Baltimore violence surges
Posted at 11:28 PM, May 04, 2017
and last updated 2018-12-13 11:21:56-05

They call it a sea of pink, but to those of us outside the trauma resuscitation unit at R. Adams Cowley Shock Trauma Center, it looks like a scrum; it sounds like chaos with voices competing with blaring machines over the steady rustling of sterile plastic gowns and the incessant hissing of oxygen.

But this cacophony of trauma is harmonized; composed under the firm direction of Physician-in-Chief, Doctor Tom Scalea as he runs point around a crowded bed side two rows deep, choreographing the fight to save a life.

"We're in here counter punching every day and every night just trying to keep our head above water."

Because at the nation's most renowned trauma center, its care model replicated world-wide is being tested...pushed by the limits of Baltimore's depravity.

Certainly the continuation from last year into this year has been pretty discouraging,” Scalea said, “It's all bad. It's all bad."

The doctor is not a sky is falling type but his numbers just keep rising.

Focusing on what Shock Trauma calls penetrating injuries, the staff is sounding an alarm because through the years 2012 to 2014 the trauma center admitted an average of just more than 600 patients either stabbed or shot.

The year of the riots bumped that number to nearly 800 and it stayed there through 2016, but the first three months of this year are shattering even those dire statistics.

Shock Trauma is on pace to see nearly 950 patients from violent injury, a staggering rate helping to just about double the percentage of patients admitted with gunshots and stabbings since 2014.

"When we tend not to see as much, we saw in spades this year. It gets kind of numbing. Another one, another one, another one, another dead kid.  A couple of nights ago two come in, together, dead. You get the opportunity to tell another mother her kid is not going home, ever...and you just go, how many times do you have to do that?...This sense of rowing up stream is very much a part of our world in the last months and couple of years."

Trauma surgeons and caretakers throughout the trauma center say they could feel the difference, especially in the last few months.

"I guess when you are here for long enough, you feel the pulse of the city, you feel the pulse of the trauma center. The pulse feels quicker. It just feels different,” said Chief of Trauma Doctor Deborah Stein, “That same lull that we would normally have when it is cold and when it is rainy…it just, it just doesn't exist this year and last year it existed a little bit less and a little bit less a year before and every year it seems to be getting worse."

Doctors Stein and Scalea say they are seeing the bloodshed of a true epidemic, not a spike.

They feel something has fundamentally changed in the streets of Baltimore.

The victims are sometimes as multiple as the gunshot wounds they suffer, a carnage they know is a much longer journey then from the TRU to the operating room.


"It is certainly scary for us. Looking at what is happening to people, looking at not just the deaths but the unbelievable long term morbidity of these injuries, and that is assuming we can save them, there are a lot of these kids we can’t yeah, I think we should be very worried."

Worry is not something you normally see on the faces of this staff.

They have seen just about everything except now, at the recent pace at which they are seeing it.

Since the calendar flipped to 2017, Baltimore is bleeding out at a record pace and with spring just getting here, these doctors warn Shock Trauma's busy season is approaching.

As they brace to keep up with the wounds, the top doc hopes city leaders can begin to address the symptoms.

"When I sit down and think about it I go, wow. And if I thought that we had charted a course that was going to bring us to where we wanted to be…if I though we were going there and said this is how we are gonna get there, a clear trajectory to get us there that would be great but I'm not seeing that,” Scalea lamented, “It's not a great sign. Will it get better? Maybe, I dunno. It would be great if it did."