In a new memoir, the world-renowned trauma surgeon shares his incredible stories working on the front lines in American cities and war zones.
by JAMES S. KIM
It seemed written in the stars for Peter Rhee to become a surgeon. When he was 6 years old and living in Uganda with his family, he saw a local villager with a spear in his belly brought to his surgeon-father, then watched as the elder Rhee rode away on the bed of a truck with the victim next to him.
Though the younger Rhee would consider engineering as a career path at one point in his life, partly because he was a rebellious teenager who didn’t want to follow in his dad’s footsteps, this dramatic scene never left him, and he would later come to embrace medicine for himself.
“It just felt right,” he explains in his new memoir, Trauma Red: The Making of a Surgeon in War and in America’s Cities, published earlier this year. The book, co-written with journalist Gordon Dillow, is the result of years of family and colleagues prodding the world-renowned trauma surgeon—perhaps most recognizable for his role in saving the life of U.S. Rep. Gabrielle Giffords—to share his story. Today, the 53-year-old doesn’t hesitate to tell his own children and the rest of the world how fulfilling his career—which includes serving as a frontline Navy surgeon in Iraq and Afghanistan—has been. But he notes he wrote the book not for himself, but first and foremost, for his profession.
“[Nearly] everyone knows what a brain surgeon is and what a heart surgeon is in this country,” says Rhee, sitting outside a Santa Monica café in July. “Maybe 20,000 people know what a trauma surgeon is.
“Trauma is one area where … it could be a kid, it could be an old mother, it could be a police officer, someone in prison, a drug addict—it doesn’t matter. I just get to take care of you, and I get to deal with all of society,” he says. “It’s a gift.”
Trauma surgeons treat those with traumatic injuries, which include blunt trauma, vehicle accidents, falls and gunshots. America saw a team of them at work following the events of Jan. 8, 2011, when 19 people were shot in Tucson, Arizona. Congresswoman Giffords had been holding a public meeting with constituents when a gunman opened fire on the crowd. Ten victims were rushed to the University of Arizona’s Medical Center, including the congresswoman, who had been shot in the head.
As the chief of Trauma Critical Care and Emergency Surgery at the University Medical Center, Rhee’s job was to oversee the crisis. But he wasn’t even at the medical center when he received the call that Saturday, as he was taking a jog near his home. With a trauma program and his team ready at a moment’s notice, Rhee knew there was no need to worry. When he arrived at the medical center, he calmly slipped into his scrubs and got a situation report from his team.
“To an outsider it probably would have looked like chaos, but it wasn’t,” Rhee writes in his book. “Everything was working exactly as it was supposed to, exactly the way we had trained for and done so many times already. My job now was to make sure that it continued that way, to take charge, take command, to make the critical life-and death decisions that had to be made.
“It was as carefully choreographed as a ballet.”
Just like battlefield casualty situations in his military past, Rhee would go around and assess the patients—the triage stage, where he would assign the wounded to three categories. The most seriously injured who had a chance of living would be prioritized, followed by the less seriously injured. In other, more extreme settings, like when Rhee served as a combat surgeon in Iraq, he often had to make the tough decision about those who were deemed certain to die, to leave them be and declare them “expectant.”
“In my career I’ve had to make hundreds of decisions like that,” he writes in his memoir. “It’s something you train for and practice over and over, but in real life it’s not like the drills. You never get over it, and you never forget the faces. But there are times when deciding who lives and who dies is part of your job—and if you think too much about what you’re doing, you wouldn’t be able to do it.”
Among the faces he’s never forgotten is a 6-year-old girl, a victim of Los Angeles gang violence. As the director of the Navy Trauma Training Center (NTTC) at the L.A. County-USC Medical Center in 2002, Rhee saw a constant stream of trauma patients, including gunshot victims. In his memoir, he talks about how he and his team were unable to save the girl who had been shot. As he cleaned up in the restroom, he broke down in tears for the first time in his career. But then it was back to work.
“Fortunately, I was alone,” he writes. “No one had seen me break down. If the leader breaks down, the troops will lose confidence in him, and it may cause them to break down as well. We simply don’t have time for that.
“To be a trauma surgeon, you have to put some Kevlar around your heart. But the little kids are the chink in the Kevlar.”
Then there was “Rose Bowl Day” on Jan. 5, 2006, in Ramadi, Iraq, the worst mass-casualty situation he had ever experienced, before or since. A suicide bomber hit a recruiting center, killing 58 people. Charlie Med, the medical facility in Ramadi where Rhee was stationed, saw over 70 wounded that day, mostly Iraqi men; Rhee declared 11 of them expectant.
“I remember one of [the expectant] distinctly still,” he writes. “Unusually for an Iraqi, his eyes were sky blue, and the clarity in them was profound. … I saw a huge, gaping, bleeding hole on the left side of his head that had left brain matter exposed—a hopeless, mortal wound. When I looked back at his eyes, I could see that he understood.
“I’ve never forgotten that man’s face, and the way his eyes locked on mine. I probably never will.”
* * *
When Rhee came to the University of Arizona Medical Center to build its trauma program, the survival rate for people with gunshot wounds in the brain treated at the medical center was 10 percent, or at about the national average. By 2011, the survival rate had risen to 46 percent due to a new program of aggressive treatment, including emergency brain surgery.
Congresswoman Giffords was one of 13 patients who survived a gunshot wound to the head after being treated at the medical center. Rhee knew intimately her chances of survival when he was fielding questions from media at press conferences immediately following the Arizona shooting, and that’s why he was so unequivocal in his answers.
“I could tell from the reporter’s questions that they still weren’t quite buying it, that they still couldn’t believe that someone with a bullet through the brain could actually survive,” he writes.
“Finally I decided to be more emphatic. When a reporter asked me again about her chances of survival, I responded, ‘She has a 101 percent chance of surviving. She will not die.’”
The statement made headlines around the country, and Rhee caught some flak for sounding overconfident or even cocky. But the physician was just speaking from experience.
Such promising survival numbers are only possible, Rhee says, thanks to the amount of research that has gone into new medical technologies and practices, particularly in trauma. He is proud to call himself not only a surgeon, but an academic surgeon. When Rhee applied to a civilian surgery residency program at the University of California, Irvine, in 1988, he said he wanted to be a good general surgeon—which was the wrong answer, according to his interviewer.
“What we’re looking for … is someone who is going to further our field, who will improve our profession, who will do research and teach others,” said the chairman of the UCI Medical Center at the time. “There are a lot of community training programs that will make you a good general surgeon. If that’s all you want to be, you should look for a job elsewhere.”
That got gears turning in the then-27-year-old Rhee, who at the time was looking forward to a nice life of doing “routine surgeries and pulling in a big paycheck and going home to the wife and kids at the same time every evening.” Rhee blew the interview, but still successfully got into the residency program and would end up immersing himself in the labs at UC Irvine, helping with a number of projects on how traumatic injuries affect the human immune systems.
After completing his residency, Rhee began working as an attending trauma surgeon in Washington, D.C., and as an assistant professor of surgery at his alma mater, the Uniformed Services University of the Health Sciences in Bethesda, Maryland. That’s a full load for most people, but Rhee apparently didn’t think his plate was full enough: He obtained a five-year grant to open his own research laboratory.
It wasn’t the large, brightly lit, white-walled room most people envision, though. Rhee ended up with a small room in the basement of the university, and his equipment was all borrowed or bought secondhand. There was a lot of MacGyvering, too. It definitely wasn’t the most glamorous environment.
“It was a very difficult time in my life,” Rhee says. “You go underground for a while. You walk up to a building, but you just go underground. It was some horrendously tough hours.”
But research was, and continues to be the foundation of his storied career. Despite funding limitations and two other jobs, Rhee says he loved it.
“Everything and every day is about the research. It’s not [always] about patient care,” he explains. “It’s how we’re going to change the way we do things through research.”
Rhee says he’s fortunate that every research project he was involved with has led to significant changes in how medicine is practiced. Some of these sound like terms out of a sci-fi novel: a new hypertonic saline solution in treating blood loss; QuickClot, a hemostatic agent that stops bleeding in areas where a tourniquet won’t work; wireless vitalsigns monitoring (this came into play with Congresswoman Giffords); and even suspended animation.
“Suspended animation puts the question into your head—what’s dead?” Rhee says. “I now know that dead is a gray zone. It’s not just alive and dead. You can by all definitions be dead, but still recoverable.”
Rhee doesn’t spend much time in the lab anymore, and he’s done his share of touring overseas with the Navy, but that doesn’t mean he’s done with them. He’s now able to oversee his own labs, providing input, guidance and vision, as opposed to laboring away like he did in his younger days. Rhee also regularly continues to consult for and attend meetings with Navy medical researchers.
“After all my years as a trauma surgeon,” he writes, “sometimes I feel like I’m getting old. But the job never does.”
The surgeon travels around 30 to 40 times a year. In between his conferences and speaking engagements, he comes back to the University Medical Center for his patient calls. Last year, the South Korean government flew Rhee out to be a consultant in developing trauma centers in the country. After his interview with KoreAm in Los Angeles in July, Rhee was off to Colorado for a trauma symposium.
The married father of two says he can better appreciate his own father and how the latter never pressured his son to become a doctor. “My father was the sweetest, kindest man, trying to eke a living out for his family, shuffled around from job to job, whatever he could find,” Rhee says. “My father always said, ‘Be whatever you want to be,’ and that’s how I am with my children. They know that I’m going to be there for them all the time. They’re going to need the self-drive to push themselves. I’m not going to be the one who does that.”
The Rhee’s Christmas photo from 2011. From left to right: Rose, the horse; Rhee’s daughter, Anna; Rhee; Rhee’s son, Michael; Rhee’s wife, Emily; Levi, the horse; and in front, the dogs Kramer and Morgan. (Photo courtesy of Peter Rhee)
Rhee now also heads a training program in Tucson that runs a two-year fellowship for future trauma surgeons. It’s different from his research and surgery days, but the breakneck pace is still there. “I’ve been going at it my whole life,” he says, chuckling. “I wouldn’t know any different.”
The trauma field has come a long way, but Rhee says there are still many more exciting developments to expect in the medical field with the next generation of researchers and physicians.
Many Americans may still take trauma care for granted, but Rhee hopes that the events of January 2011, and his resulting prominence in the field will raise awareness for what it provides.
“Gabrielle Giffords is what propelled me into the limelight,” Rhee acknowledges. “[But] I don’t want to be defined by just me happening to be in Tucson when she was shot in the head. We’re very glad that she had a good outcome and that she was very lucky, and we were very fortunate that our hospital got a lot of credit, as if we had done something extraordinary.
“But we didn’t do something extraordinary. We did our job that day, we did our job the day before, and we did our job the day after. We do that kind of work all the time.”
This article was published in the October/November 2014 issue of KoreAm under the title “The Making of Peter Rhee” Subscribe today! To purchase a single issue copy of the magazine issue, click the “Buy Now” button below. (U.S. customers only. Expect delivery in 5-7 business days).