Medicine: Trauma Care on the Critical List

Of all the rules of thumb that govern emergency medicine, one of the most basic is to get the patient to the nearest hospital -- and fast. More and more, however, that precept, designed to save lives, has gone awry. In medical centers and hospitals across the country, disorganized, underfunded and understaffed emergency services are on the critical list. In Chicago not long ago, a fire-department rescue team rushed a 19-year-old gunshot victim to a nearby hospital emergency room unfamiliar with such cases. Within hours the patient, who had been alert and in satisfactory condition, began to fail. The hospital staff,...