Rogers helped found the trauma center in 2018 on Chicago's South Side, which had lacked a local adult trauma center since 1991. For nearly 30 years, people injured on the South Side had to endure long ambulance rides to access care elsewhere in the city, and lives were lost as a result.
Live Science spoke to Rogers about his work, new book and vision for how Americans should tackle this epidemic.
Dr. Selwyn Rogers Jr.: I'll start off by saying, I'm pathologically optimistic. Otherwise I couldn't do what I do as a trauma surgeon, where I see some of the worst things.
There are all of these moments of human connection. If we just look for them, they're all around us. That brings me hope every time.
SR: I trained in Boston at the time of the crack epidemic in the early 1990s, and Boston, like many cities in the United States, had a fair bit of penetrating trauma. (We separate trauma into "blunt" and "penetrating": "blunt" meaning events where there's no penetration of the skin by a missile or a projectile, and "penetrating" where there is some projectile that violates the skin and causes internal damage.)
That brought me to Vanderbilt and Meharry Medical College in Nashville, which is where I took my first job. I earned a Master's in Public Health at Vanderbilt School of Medicine, and as part of that experience, I had to do a practicum that involved real-life work trying to understand healthcare outcome differences across a two-mile difference in space: I was at Vanderbilt, a traditional academic medical center, and Meharry Medical College's county hospital, Nashville General Hospital.
Resources
Directory of Crime Victim ServicesTrauma Survivors NetworkNational Child Traumatic Stress NetworkSurvivors EmpoweredThe Rebels Project
SR: When I was in training early on, as well as when I was a junior faculty, it was really striking to me that there were some patients who would come back again and again after traumatic injury. Thinking about how we treat other conditions that are not trauma — for example, heart disease — if I had a heart attack, blockage of my coronary blood vessels supplying my heart, I would today get a stent and get antithrombotic, antiplatelet therapy to reopen my heart. But if at the same time it was discovered that I had high cholesterol, I was overweight, I had a sedentary lifestyle, I smoked, those risk factors would also be addressed as part of my holistic recovery.
But we don't look at all the other factors that put you at risk in the first place. And because we often don't do that, when people leave the hospital, the four walls of the emergency department or the trauma center, their risk factors haven't changed. Why would we think that they're not going to be re-injured again? So bringing that framing has been a very fundamental part of my both professional journey and my academic journey.
SR: In many ways, I've been preparing my entire career to be in Chicago. My current role combines both my technical interest in helping people using my skills and training as a surgeon, but also the social drivers of health and healthcare disparities.
I've been here nine years now, and I love the city of Chicago. I love what I do; I love the patients I take care of; I love the community. I can't imagine doing anything else.
SR: The distinction is that the emergency room, emergency ward, emergency department is a place. It's a place where people who are the most severely ill go to seek care. Now, in our healthcare system, people also seek care in the emergency department because they don't know where else to go. They may not have a primary care doctor, they may not have health insurance, so the ED becomes a place where they go.
Trauma centers offer a comprehensive system of care that can't necessarily be delivered by an emergency room alone. (Image credit: Douglas Sacha via Getty Images)For traumatically injured patients, time is critical and minutes mean life or loss of function. Let's say you fell off your bicycle and you lacerated, or cut, your brachial artery, the artery that supplies your arm. If you don't go to a trauma center within a short period of time — minutes, maybe an hour max — you will likely die from that relatively straightforward injury.
In 1991, when there was no adult trauma center on the South Side, people who were injured on the South Side of Chicago would go to other adult trauma centers throughout the city. Chicago, as you know, is a pretty big city. You can drive for an hour and still be in Chicago. It's hard for me to calculate the number of lives lost [because of the time it took to reach a trauma center].
You can debate whether or not that may be true, but it's hard to debate the reality that time matters if you're shot and actively bleeding to death. Because Damien Turner led a youth group called Fearless Leading by the Youth, in his honor, that organization mobilized around a simple slogan: Trauma center now.
NL: What do you think people often get wrong about gun violence in Chicago?
With this framing that Chicago has all this violence, this is all a Democratic city problem — urban blight became synonymous with Chicago, which is far from the truth. One of the things that made me write the book is to dispel those myths. But also to bring the stories to change the narrative that this problem of gun violence in America is not unsolvable, it's not intractable.
NL: What would it mean to bring a public health lens?
That's what I would call secondary prevention. Something has already happened; how can we lower the risk? It's no different than someone who has an opiate addiction, and we make sure that they have access to naloxone so that they don't overdose and die. That's a public health risk mitigation strategy. Having a team of credible, trusted messengers to help transition that person from injured to recovered is something that every hospital should invest in.
I think that there is an important opportunity for surgeons in particular, plus emergency medicine, physicians, nurses, and other healthcare providers, to bring voice to the voiceless. Oftentimes, people who are injured who come into our emergency departments, they don't have the agency that a physician or nurse or other healthcare provider has. How can we bring their voice to the forefront, often realizing that people who are the closest to the problem can often be the source of some of those solutions?
NL: What do secondary prevention programs look like for the patients?
That's the first thing, to create that trusted relationship. The next thing that happens is you're getting out of the hospital. What's your life look like afterwards? If you were on the margin and living paycheck to paycheck, and now you're not working, now you can't pay your rent. Where's the next meal gonna come from?
We could approach gun violence not as a criminal problem, but as a public health one.
There are also a number of more established secondary prevention efforts. Oftentimes, street outreach organizations like Institute for Nonviolence Chicago have credibility to interrupt those cycles of violence. And there are others, like Cure Violence, that take people with lived experience, who are justice-involved, have spent time in prison or jail, and want to do something positive.
With that framing, you take folks who have been injured, shot themselves or [who have] shot others, and you wrap around a set of services to take them from the illegal economy into the legal economy. That might involve trauma-informed care, cognitive behavioral therapy, and skills development. I think those are all things that have evolved very intentionally in the city of Chicago over the past decade.
Related storiesNL: We're currently seeing social support being weakened at the federal level. Do you see that as a place for cities to step up in new ways?
Holistically, no matter what's going on at the federal, state, municipal, local level, at the end of the day, it is about the human connection, right? It's about what we do for the person next to us. It's what we do for our neighbor. If your neighbor is sick and shut in, do we actually show up for our neighbor and say, "Hey, can I bring you a cup of soup?" How much does that really cost?
This interview has been condensed and edited lightly for clarity.
"Healing the Gun Violence Epidemic""Healing the Gun Violence Epidemic" shares the stories of gun violence victims that Dr. Selwyn Rogers Jr. has met through his work as a trauma surgeon, as well as the lessons he's taken from bearing witness to that multifaceted trauma. Rogers explores underlying factors driving gun violence and shares insights into which policies have failed and which solutions have succeeded not just in his home of Chicago, but across the United States.
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