Shock Trauma’s Violence Intervention Specialists Help Break the Cycle and Change Lives After Violent Injury

It’s heard in the news cycle pretty often in Baltimore – the victim of a gunshot wound or stabbing is taken to Shock Trauma, where they survive their injuries.

However, it’s NOT often you hear about what happens to these survivors. How are they recovering from their injuries, mentally and emotionally? What are our teams doing to help them get access to resources to avoid violent injury again?

That’s where Leonard Spain and David Ross come in.  They’re both Violence Intervention Case Managers at the University of Maryland Shock Trauma Center.  Anytime someone suffers a violent injury and survives their injuries at Shock Trauma, they are seen by Spain and Ross.

Spain and Ross work to connect victims of violence with resources to get them on the path to success – including employment and schooling opportunities, mental health support, legal assistance and more.

Cut from the Same Cloth

Leonard Spain grew up in West Baltimore and, as a young man, was involved in the drug trade.

“The population that we serve – I was them. I sold drugs, I was a victim of gun violence and I spent time in prison,” Spain says.

That time in prison is what caused Spain to change his way of seeing things. When he arrived home, Spain realized the lack of resources available to help people like him get back on their feet.

He went to several career and job centers, attended job fairs and tried to do everything he could to stay out of trouble. After working a temp job for minimum wage for three years, Spain knew he wanted more for him and his daughter.

He enrolled at Sojourner Douglass College and received his Bachelor’s Degree in Human Services. He always knew he wanted to get into violence intervention and came to Shock Trauma after an internship with the Baltimore City Health Department.

When approaching patients at the beside, Spain focuses on building a relationship with patients as the first step of starting the case management process.

“I try to let them know I am just like them, just not out on the streets anymore,” Spain says. “Sometimes I gotta pull my shirt up and say ‘I got bullet holes just like you.’”

Poetry in Motion

Ross, also a Baltimore native, is a spoken word artist by trade.  He was discovered by the Shock Trauma team after performing at an anti-violence rally at Mondawmin Mall.

At first, Ross was a volunteer with the hospital with another friend.  By commission, he would come and talk with victims of violence and worked with the peer support group.  He then rose to his current position.

Now, when Ross learns of a new potential client, he will get background information on social media and online court records before meeting with them at the bedside.

“I’ll have that information in the back of my mind, but my next step is to speak and have a conversation with them and get their perspective,” Ross says.

Ross says he likes to ask the clients what they would like to gain from the situation and what they see as barriers.

“It’s not an easy thing to get them to trust you, and I understand that completely,” Ross says. “We’re usually asking them to change major aspects of their lives – and it definitely has to be broken down so we can work on one thing at a time.”

Usually, Ross starts with helping his clients get registered for health insurance so they can get their medication and get healthy. Next, they tackle employment. If it’s a criminal record holding the client back, they work to see if anything can be expunged. If it’s the lack of formal education, he works to get them in a GED class to receive a high school diploma at the least.

“I try to remove the obstacles to get them from point A to B,” Ross says. “Then, once we get them to point B, we see what other obstacles we can remove to get them to C.”

Spain and Ross both acknowledge that they are asking their clients to make massive life changes with not many resources, but overall, know it’s worth the trouble in the long run.

Spain is getting his Master’s in Conflict Resolution in University of Baltimore, and Ross is working towards his Master’s in Social Work at the University of Maryland, Baltimore.

Learn more about Shock Trauma Center’s for Injury Prevention and Policy.

A Gift of Thanks – 3 Years (and 43 Surgeries) Later

Grant (second from right) with part of the STC team and his parents

Three years ago, Grant Harrison was in a horrific motorcycle crash.  It was a bright sunny day on the Eastern Shore when a large deer struck the motorcycle Grant was riding.  He was airlifted to UMMC’s R Adams Cowley Shock Trauma Center with multiple life threating injuries.

The fact that he is alive today is nothing short of astonishing. Grant had a fractured skull, severe traumatic brain injury, bleeding of the brain and severe injuries to his limbs.

Grant spent 58 days on the Neurotrauma Critical Care Unit, and has had 43 surgeries on his road to recovery.

Grant is a now a walking, talking (and hilarious) miracle.

Exactly three years after the accident, June 6, 2017, Grant, along with his mother and father, wanted to give thanks to the nurses and doctors at Shock Trauma who showed them extraordinary compassion and care throughout this life-altering experience.

They brought the Shock Trauma team a framed thank you letter, along with photos documenting Grant’s journey to recovery.  The gift is now hung along the walls of the Neurotrauma Critical Care Unit, right outside the Patient Family Waiting Area.

The Harrison Family hopes that families pacing those halls (like they did many times 3 years ago), will read the testimony and find hope and encouragement.

Read a portion of the family’s letter below:

“The doctors and nurses here not only care for the patient, but for you, the family as well. They will always hold a special place in our hearts for their kindness and compassion. We encourage you to listen well to them, as they will educate and guide you through this unexpected journey. The Trauma Survivor’s Network, a resource offered through the hospital, was also most helpful to us.”

Grant with TRU Nurse Christopher Wentker

 

Remembering Dr. R Adams Cowley: A Revolutionary & Pioneer of Trauma Medicine


Dr. Cowley in the old CCRU

Dr. Cowley (center) instructing in the old CCRU

Dr. R Adams Cowley passed away 25 years ago today, but his contributions will live on forever in the form of thousands of lives saved.

R Adams Cowley, MD, a cardiothoracic surgeon, was the founder of United States’ first trauma center, University of Maryland R Adams Cowley Shock Trauma Center, and the Maryland EMS System. He revolutionized trauma medicine and is responsible for the development of the “Golden Hour” concept. As Dr. Cowley explained in an interview: “There is a golden hour between life and death. If you are critically injured you have less than 60 minutes to survive. You might not die right then; it may be three days or two weeks later — but something has happened in your body that is irreparable.”


Drs. Gens and Cowley

Dr. Cowley (left) with fellow trauma surgeon Dr. Gens in 1983

“R Adams Cowley was a pioneer, a man of immense vision and the father of American trauma care systems,” Dr. Thomas Scalea, Shock Trauma Physician-in-Chief, said. “At a time when we take organized trauma care for granted, it is important to remember that none of this would have happened without him and a few others who refused to take no for an answer. They fought the political and medical battles to demonstrate that organized trauma care saves lives. I am privileged to continue his legacy.”


Open Heart Surgery

A Baltimore Sun photo shows Dr. Cowley performing open-heart surgery on a 2-year-old boy

After many years of research and discussion, in 1958, the Army awarded Dr. Cowley a contract for $100,000 to study shock in people. He developed the first clinical shock trauma unit in the nation; the unit consisted of two beds (later four beds). By 1960, staff was trained and equipment was in place.

In 1968, Dr. Cowley negotiated to have patients brought in by military helicopter to get them to the shock trauma unit more quickly. After much discussion with the Maryland State Police, the first med-evac transport occurred in 1969 after the opening of the five-story, 32-bed Center for the Study of Trauma.

In 1970, Dr. Cowley expanded his dream, feeling that not a single patient should be denied the state-of-the-art treatment available at his trauma center in Baltimore. He envisioned a statewide system of care funded by the state of Maryland available to anyone who needed it.

Airport Drill

Dr. Cowley leads a drill at the airport

His dream became a reality with the intervention of former Governor Marvin Mandel. Governor Mandel became interested in Dr. Cowley’s program when a close friend was severely injured in a car crash. In 1973, the Governor issued an executive order establishing the Center for the Study of Trauma as the Maryland Institute for Emergency Medicine. The order simultaneously created the Division of Emergency Medical Services. Dr. Cowley was appointed as director.

Maryland had the first statewide EMS system, and it, like the Shock Trauma Center, has become a model worldwide. Countless lives have been saved due to Dr. Cowley’s vision.

r-adams-cowley-studentsWe thank you, Dr. Cowley, and will always remember your legacy.

400-victims-in-2-years

 

a-better-chance-of-living-than-ever-before-1970s

a-better-chance-of-living-than-ever-before-1970shospitals-special-trauma-unit-has-saved-lives-of-400-accident-victims-in-2-years-1971

Fighting Violence with Art; Art Against Violence 2016 Gallery Show

Gallery ShowMany thanks to all of the student artists who made the Art Against Violence 2016 Gallery Show a success!

The show featured nearly 50 works of art from local City School students across a range of mediums, including print, colored pencil, watercolor and a sculpture of found objects.

The following winners were announced:

Trinity K.
Peace and Justice 4 All
Renaissance Academy

Jenelda A.
Black Lives Matter!
Renaissance Academy

Bella S.
Nature or Nurture? From the Cradle to the Grave
Baltimore School for the Arts

Awards were presented by our panel of guest judges:

Dr. Carnell Cooper
Violence Intervention Program Founder

Dr. Jane Lipscomb
University of Maryland School of Nursing

Anisha Thomas
Special Assistant to the Deputy Commissioner, Baltimore City Health Department

Thanks again to all participants for bringing awareness to National Youth Violence Prevention Week.
Follow the conversation on social media: #nyvpweek16

Trinity

Jane Lipscomb and Jenelda

Bella

Gallery Show turnout

 

Lots of submissions!

Art Against Violence cake

Celebrating the 46th Anniversary of the First Maryland State Police Medevac Mission: March 19, 1970

By Sergeant Chad Gainey; Maryland State Police Aviation Unit, Flight Paramedic

As we mark Saturday’s 46th anniversary of the first medevac mission completed by the Maryland State Police, we reflect on a few of the accomplishments the MSP Aviation Command has achieved.

The Maryland State Police Aviation Division medical mission profile began in November 1960 with the acquisition of a Hiller UH12E helicopter. This aircraft was used primarily for police missions, however a medical “support” profile was soon established and thus began the idea of medical evacuation for the citizens of Maryland.

medevac 1Although systematic medical care was not provided on board, this aircraft transported medical patients such as heart attack victims and expectant mothers following severe snowstorms. Medical rescues were performed with the Hiller as early as 1966, but not under a complete system of enroute care.

medevac 2Within a few years, that concept would come to life. Dr. R Adams Cowley, perhaps best known for being the father of the “Golden Hour” concept in trauma medicine, collaborated with MSP Pilot Robert Y. Wolfe and other Maryland leaders to close the most significant gap in trauma care.

medevac 3On March 19, 1970 at 11:20 am, the first “Medevac” was completed under a complete system of enroute medical care. Originally called “Helicopter 108”, pilot Corporal Gary Moore and Trooper First Class Paul Benson responded to a traffic accident on the Baltimore Beltway (Interstate 695) and Falls Road and transported a patient to what was then known as the Center for the Study of Trauma, now known as the University of Maryland R Adams Cowley Shock Trauma Center, in a Turbine powered Bell Jet Ranger aircraft.

On that day, MSP formally expanded its role into the world of emergency medical services (EMS). That medevac mission marked the first time a civilian agency transported a critically injured trauma patient by helicopter; never before had this been done in a non-military setting.

Since that time, many changes have occurred to improve what today is called the Maryland State Police Aviation Command and the Maryland medevac system. MSP and Shock Trauma have earned a worldwide reputation as leaders in trauma care.

medevac 4The procurement of the AS365 Dauphin helicopters in the late 1980s provided additional enhancements for the fleet, such as increased speed, the added safety component of two engines, and additional space to accommodate two patients.

 

 

medevac 7

In 2013, the Maryland State Police began flying the latest and greatest technology in the form of the AugustaWestland AW139 helicopters. Additional safety measures were incorporated, along with the addition of a second pilot and a second medical provider to the standard flight crew.

More than 148,000 patients have been transported since that day in March 1970. The Maryland State Police Aviation Command, in conjunction with other medical partners around the State, and with the continuing support of our citizens, their government representatives, and other stakeholders, have made the Maryland Medevac system a success story for many patients and their families.medevac photo 6

Art Against Violence 2016 Gallery Show Now Accepting Submissions

Calling all Baltimore City School students!

The University of Maryland R Adams Cowley Shock Trauma Center’s Violence Prevention Program is now accepting submissions for the Art Against Violence 2016 Gallery Show.

Students may submit visual art of any medium through April 1st. The theme is Art Against Violence, but any artwork inspired by this theme is acceptable.

The Gallery Show coincides with National Youth Violence Prevention Week, which runs April 4-8th. This week has been celebrated since 2001, and aims to raise awareness of and help reduce youth violence in communities everywhere.

A panel of judges will attend and present special awards. Winners across other categories will be decided by popular vote.

The 2016 gallery show will be held April 6th from 4-8pm, with an award ceremony at 6:30pm.

Medical School Teaching Facility Atrium, 685 W. Baltimore St.

Members of the Violence Prevention Program are able to pick up artwork or give a brief presentation to interested students. Please contact Erin Walton at erinwalton@umm.edu or 410-328-6078 to schedule a pick-up or presentation.

Learn more about the show here: https://artagainstviolence2016.wordpress.com/

AAV

Previous Winner

A Day in the Life

Yesterday was an exceptionally exciting day at the Medical Center.

Shock Trauma patients welcomed two violinists to the wing. USNA Midshipmen 1st Class Michelle de Vente and Deborah Mullen played a selection of holiday music for patients. Patients even made requests and de Vente and Mullen happily obliged. Thanks for bringing the sounds of comfort and joy to our patients!

 

 

A Hero’s Story: CT Tech Delivers Neighbor’s Baby

By Sharon Boston, Media Relations Manager

Brad Jones noticed something unusual when he arrived home in Abingdon on the morning of Nov. 7 after an overnight shift as a computerized tomography (CT) tech at the R Adams Cowley Shock Trauma Center: His next-door neighbor, Matt Kulaga, was also pulling into his own driveway — not a typical thing at that hour when Matt would normally be at work.

Brad credits his training and experience at UMMC for helping him stay calm during the emergency that quickly unfolded.

“Is today the day?” Brad asked Matt, knowing that Matt’s wife, Emily, was expecting a baby at any time.

“I don’t know,” replied Matt. “Emily called me at work and said something is going on, so I am going to check on her.”

Brad said he’d wait by the car in case Matt and Emily needed anything. Soon Matt came back saying Emily could not get up. They both went back upstairs to find Emily on the bed ready to give birth.

“Emily, don’t push,” Brad told her.

“I can’t stop,” replied Emily.

Brad told Matt to call 911 and moved to the front of the bed to help Emily. The operators stayed on the line with Brad.

“Everyone was so calm, and the dispatchers talked me through the delivery. It was amazing,” says Brad, who has worked at UMMC for one year.

About seven minutes later, the Kulagas’ healthy daughter Aubree Mae was born. Paramedics arrived soon after.

Paramedics arrived soon after the baby was born

Paramedics arrived soon after the baby was born

Now, a month later, everyone is doing great. About a week after the birth, the Kulaga family and Brad met the dispatchers — one of whom was still in training — who helped them deliver the baby. They even got their picture in the local newspaper, and Fox 45 did a TV story on them.

At UMMC, Brad sees of hundreds patients in his job in radiology, but says he rarely has such a hands-on experience. He has an 18-year-old daughter of his own, but says she was born by C-section so he had never seen anyone give birth before.

So what does this hero neighbor think about his role in delivering his friends’ baby?

“The whole thing was just an awesome experience,” he said.

Here's Aubree Mae resting after her grand entrance

Aubree Mae resting after her grand entrance

Mr. Gower Lives On

By Marc Summerfield
UMMC Director of Pharmacy Services

Unlike the abundance of physicians and nurses depicted in film, the number of pharmacists in the movies — going back as far as you like — is few.  How many pharmacists in film can you name?

Unfortunately, fewer than a handful are notable.  The first was 1933.  W.C. Fields plays the pharmacist Mr. Dilweg in The Pharmacist.  The third was 1985:  James Garner plays a small-town druggist who romances Sally Field in Murphy’s Romance.  Arguably, the most famous film-pharmacist appears in the Christmas-season favorite, It’s a Wonderful Life, starring Donna Reed as Mary Hatch Bailey and Jimmy Stewart as George Bailey.  The great character actor H.B. Warner plays the BedfordFalls druggist, Mr. Gower.   

In It’s a Wonderful Life, Mr. Gower, depressed over the death of his son, loses his concentration and miss-fills a prescription.  A young George Bailey realizes Mr. Gower’s mistake and purposely fails to deliver the medication; thus, saving a patient.

In 2003, UMMC became the first hospital in the world to employ robots (TUGs®) to deliver medications from the satellite pharmacies to the patient care units.   The first TUG® was used to deliver medications from the pharmacies in the R Adams Cowley Shock Trauma Center to the Shock Trauma units.  The hospital now employs eight TUGs® to deliver medications to the Gudelsky patient care units, Weinberg patient care units, as well as in the Shock Trauma Center.

Consistent with the practice of naming inanimate objects, the pharmacy decided to name each TUG®.  The pharmacy named the first TUG® “Mr. Gower,” and he has been serving the hospital well for almost 10 years, 24/7.  In the photo above, he poses with two of his human colleagues, Marisol De León, RPh, PharmD, critical care pharmacy operations manager, and Sina Esnaashari, pharmacy application analyst.

Other TUGs® have been named “Clara” and “Florence,” as tributes to the great nurses, Clara Barton and Florence Nightingale. “Edgar” is a tribute to Poe, and “Tony” is in honor of a long-time UMMC pharmacist who died shortly before this TUG® was purchased.

So, when you are watching It’s a Wonderful Life this year for the ___th time (fill in the blank) and see Mr. Gower, remember that there is a lonesome, eponymous TUG® traveling the halls and serving the patients, same as all pharmacists and pharmacy technicians do, but in a different, modern, technology-based manner.

Super Staff Beats Super Storm — Every Time

The forecasts and predictions around Hurricane Sandy had much of the eastern third of the country braced for disaster. Baltimore saw heavy rains, wind and flooding. But the University of Maryland Medical Center didn’t skip a beat, thanks to the dedication of staff members who planned ahead or braved the elements to get to work. Their inspiration: hundreds of patients and colleagues were depending on them.

 We heard about staff taking extraordinary steps to be available for patients and to one another. If you have a story of your own, or you know of something that somebody else has done, drop us a line at communications@umm.edu.

 In the meantime, here are a few:

 From Karen E. Doyle, MBA, MS, RN, NEA-BC, vice president for nursing and operations at the R Adams Cowley Shock Trauma Center and for emergency nursing at UMMC:

“While I was making rounds yesterday [Oct. 29], I stopped and spoke to Darlene Currin, a housekeeping staff member in Shock Trauma working on 6 North.  I thanked her for being here, and told her that her work was really important.  She told me that she had just arrived (it was around 10:30 or 11:00 a.m.).  Darlene had walked all the way from East Baltimore to UMMC.  But, she knew she was needed and made the trek anyway.  Really unbelievable.  I was so inspired.”

 Currin (pictured above) said she doesn’t think she did anything that most of her colleagues wouldn’t do. “We all work here, we know it’s 24/7,” she said. On Monday morning, she was unable to get a taxi or sedan service (public transportation was shut down), so she decided to walk. It took her about 90 minutes.

 “I was soaked when I got here,” Currin said.

 From Monika Bauman, MS, RN, CEN, nurse manager for women’s and children’s ambulatory services:

“The hospital-based clinics officially closed on Tuesday due to the storm, but Ometriss Jeter, a scheduling and preauthorization coordinator who works in Pediatric Hematology and Oncology, reported for duty Tuesday morning at about 6 a.m.  She rounded in all of the outpatient registration areas offering her services and making sure they had adequate staffing for the day. Once she determined all was well, she reported to our clinic, even though it was closed, to be sure we were ready for operations as usual for tomorrow [Wednesday].”

 From Karen Cossentino, MS, RN, CCRN, senior clinical nurse II and charge nurse in the Cardiac Care Unit:

“I was in charge in the Cardiac Care Unit on Monday, Oct. 29, and it was an exceptionally busy day. So I would like to thank all the staff for working together. Two nurses deserve an extra thank you, but they asked that I not use their names. One of them had a vacation scheduled this week but offered to work for a nurse who is a new mother who would not have been able to get home after work on Monday to her 3-month-old baby.  Another nurse from Professional Development came to the unit and asked if we needed any help. I immediately took her up on her offer and she stayed most of the day and went from room to room and nurse to nurse and offered her assistance.”

From Rehana Qayyumi, MLS (ASCP), medical lab scientist, Microbiology Laboratory:

After making up my mind to stay [at work during the storm] on a very busy Monday, I did not have time to think about where I would stay after my shift. Then, our wonderful Microbiology Technical Specialist Donna Cashara, MLS(ASCP), asked me what I was  going to do.  I just told her, ‘Yes, I’m staying somewhere,’ while very busy with my assigned work.  Anyway, she personally walked two blocks away to the Marriott [as phone calls were not helpful] and reserved a room.  She was like an angel for me when I finally reached the room around 7 p.m. and took a shower and my medicines and bowed my head down for my unexpected landing in full luxury. Did I deserve it? Yes, I think all of us who decided to pay for comfortable accommodations to be ready for the next busy day deserved it.  We deserve all the best to provide the best services. TeamWORK works!”

Rehana Qayyumi and Donna Cashara

Rehana Qayyumi and Donna Cashara

Cashara said it was tough to get a room at an affordable rate that night at the downtown hotels, but the Marriott finally came through. She said many other seasoned lab staff know when storms are coming, they need to look out for each other. She and another staff person led a department-wide effort to make sure the hospital had enough lab staff and that those employees had either safe passage home or a place to sleep. The hospital provides dorm-like accommodations, but some staff prefer to split the cost of a nearby hotel room.

From Cassandra Bembry, MLS ASCP, outreach customer service supervisor for the Clinical Pathology Laboratory:

Jamillah Johnson, my front-end coordinator of the Clinical Pathology Laboratory (a.k.a. “Accessioning”) volunteered late Sunday night to pick up more than 80 percent of our day-shift staff for Monday who rely solely on public transportation.  She also took these employees home and picked up our evening shift crew.  Jamillah has consistently shown a great deal of care and concern for our staff that is unparalleled, in my opinion, and acts of this nature are routine for her.” 

 From J.V. Nable, MD, NREMT-P, clinical instructor and chief resident in the Department of  Emergency Medicine:

“The [physicians in the] UniversityofMaryland Emergency Medicine Residency met the challenges posed by Hurricane Sandy head-on. Despite the incredibly inclement weather, residents continued to provide vital services at emergency departments and other hospital units throughout the region, including: UMMC, the Shock Trauma Center, the Baltimore VA Medical Center, Mercy Medical Center, Bayview Medical Center, and Children’s National Medical Center in Washington, DC. Because some residents have lengthy commutes, those who live near the medical facilities invited them to their homes for dry and safe shelter during the storm. Many residents volunteered to rearrange their schedules, taking extra shifts to cover for those stranded by the storm. As part of the backbone of clinical services at UMMC, emergency medicine residents demonstrated unwavering dedication throughout this unprecedented event.”

From Shawn Hendricks, MSN, RN, nurse manager for 10 East (Acute Medicine Telemetry Unit) and 11 East (Medicine Telemetry Unit):
 
During Hurricane Sandy, the dedicated staff on 10 & 11 East showed up ready to work, with smiles and a determination to provide excellent care despite the weather outside. I gave personal thanks to patient care technicians Theresa Hicks and Danielle Brown for coming to assist with the patients on 11 East after completing their care on 10 East, until help arrived from Monique Thomas, a student nurse who had been off duty but came in to help. And, also, to Jocelyn Campbell, one of our unit secretaries, who came in even when she wasn’t scheduled, to help with secretarial duties and other tasks on 11 East. Finally, a big “Thank you” to all my staff who stayed late or came early to ensure the shifts were covered! These staff members showed loyalty, teamwork, and caring when it was needed the most!