NEW ORLEANS -- Each year the number of severely injured people brought to the area's only Level I Trauma Center rises. Nearly 2,100 people, from the 11-parish region it serves, needed immediate life-saving attention last year.
More than half of the injured have penetrating wounds. That's a higher percentage than any other trauma center in the U.S.
In this exclusive report, our camera got unprecedented access to see the trauma team in action.
Andres "Chico" Gonzalez, a young New Orleans officer shot in the line of duty after Hurricane Katrina, survives. Chad Jones, a former LSU football player headed to the NFL severely injured in a car wreck, runs again. Michael Boyington, a St. John Parish deputy receives life threatening injuries while protecting citizens.
They're survivors with something in common.
"Emotions cannot get involved because if emotions get involved, your judgment gets involved, and if your judgment gets involved, you don't think clear," said Tulane Trauma Surgeon Dr. Norman McSwain, who is Director of the Spirit of Charity Trauma Center.
It's all in a day's work for this highly specialized, highly trained team of medical professionals. Inside the Emergency Department at the LSU Interim Hospital -- better known as University Hospital -- LSU and Tulane doctors treat seizures, heart attacks, drug and alcohol illness, breathing problems, babies about to be lost through premature birth, and with the lack of out patient services, the reappearance of mentally ill patients over and over and over.
At the same time, these faculty doctors are teaching young residents how to do this on their own one day.
"That's the beautiful thing. That's why we're doing what we do. We like the adrenaline. We like the multi-tasking," said Dr. Luis Camero, an LSUHSC Emergency Medicine Physician.
"How you feeling today?" says a priest as he makes the sign of the cross over an elderly patient's bed.
But what many may not know is that there is a hospital within a hospital here -- The Spirit of Charity, a Level I Trauma Center where in minutes, when everyone's phone gives the alert, the renowned 'Room 4' will become full with a perfectly placed medical team.
Each professional knows which spot, which job, and what lines to say, like a perfectly blocked Broadway play. They are ready to save the most critical patient clinging to life from gun shots, car crashes, falls, stabbings, industrial injuries, child abuse and more.
On a night in early March, another inner city shootout happens. EMS arrives like guardian angels taking people out of the danger zone, keeping them alive, transporting them in minutes. Then the choreography of men and women, with decades of schooling and hands-on training, begins.
"We have one wound to the left medial thigh. There's shrapnel coming out of that one too. We've got two plus upper extremity on the right. He has another wound to the left lateral thigh. OK, we got one to the left lateral thigh with obvious femur deformity," yells out Dr. Bruce Hurley as the doctors examining a moaning patient.
There are two Room 4 activations. The first: a young man with gunshot wounds staggers in on his own.
Then, EMS brings another from the same scene. The team attends to both beds. Everything is documented. Names made up of Greek letters and numbers are assigned to the wounded. The trauma surgeon stands quietly at the foot of the bed, assessing every diagnosis.
In the doorway, the surgical team and the anesthesia team await a quiet signal from the trauma surgeon. Either of these men may need what the military calls 'immediate damage control surgery' to save their lives.
"The most critical component is airway number one and bleeding number two," said Dr. McSwain
"Give yourself a hug baby. Give yourself a hug. We got to do our job. OK, we gonna roll to left, no roll to right because the left leg is the one that's broken. OK Bud, we're going to get you pain medication," says Dr. Bruce Hurley, as the patient moans in pain.
"Another 100 going in. Another 100 of Fentanyl to the right," calls out two other members of the trauma team as they administer the pain killer medicine via IV.
Fentanyl, 100 times more potent than morphine goes in, while one of the bullets comes out. It is placed in a plastic cup.
"Our response time is 10 minutes for all the trauma team to get in here in this room around the patient," Dr. McSwain explains.
What makes a Level I Trauma Center different from a hospital emergency department is 24 hours a day, 7 days a week, every person, every medication, every tool, and the O.R. space it takes to cheat death, are always instantly available.
Decisions are made at lightning speed, so the on-call surgeon lives in the hospital. Several O.R's are outfitted. CT scan is ready to aid the doctors in precision. The blood bank on site never closes, stocked with O-negative blood, the only type everyone can use.
During that Room 4 activation, the blue Igloo ice chest appears. It's part of the team. Orthopedic and neurosurgeons are available quickly too. Recent state budget cuts put this staff at a critically low level.
Now with a change in who will run things, staff numbers are going up.
"If you have a Level I Trauma Center, there's good supportive data to show that there's a higher survival rate from trauma because you've got a dedicated group of people to take care of the patient," said Dr. McSwain.
Dr. McSwain is one of the several Spirit of Charity trauma surgeons. He has traveled the world teaching a program he designed called Pre Hospital Trauma Life Support.
On this night, neither man faces imminent death. But those who do, would go on special express elevators to surgery only to stop the bleeding. Then to a special recovery room with a high ratio of nurses. From there, it's to the trauma ICU where on this day an officer is visited as he recovers. Within a day or two, most patients go back into surgery to fix the bones, the organs, damaged by trauma.
"Many times we do get gunshots that are completely from head to toe. I mean, they are just riddled with bullets. So, I mean, there's a lot of things happening at one time," said Dan Kiff, an LSUHSC nurse and Trauma Program Manager about just how injured patients can be.
That golden hour to save a life starts with an EMS team specially trained in trauma.
"We're a busy system, so and our paramedics go on a lot of calls. So they see a lot of critical patients, a lot of trauma patients," said The Director of EMS for the city of New Orleans, Dr. Jeffrey Elder, an Emergency Medicine Physician at LSUHSC.
On this night, as X-ray looks at where the bullets are, a team member gets Room 4 ready for the next trauma. Police try to get answers. A patient worries about what the gun fight may have been about.
"Hey, hey, hey, hey, I can't get my money out of my pants, Bud," yells out one of the trauma patients as he is being wheeled to another room.
Nurses have locked a wad of cash in the hospital safe.
Dr. McSwain remembers years ago, putting the intestines of one of tonight's patients back together from previous bullet holes.
He says his profession is filled with adrenaline junkies. He's seen horrific frontline trauma. He knows he can't save every trauma patient, but the feeling of giving a mother her child back is rewarding.
"Frequently patients come up say, 'You don't remember me, but I remember you.' And it's heartfelt. You feel it. It's good, " said Dr. McSwain with tears in his eyes and his hand over his heart.
When asked if those former patients give him a hug, he quietly says, "Yeah."
The Trauma Center and the city also have community programs to help prevent trauma.
Cease Fire aims to stop retaliation violence. Sudden Impact's goal is to prevent drunk driving. And the child safety seat program helps parents understand that proper use of child seats can save lives.
For more on these programs, call 504-903-3181.