"I didn't sleep a wink yesterday. I wonder how long I can hold on. Nevertheless, the first reason I cannot leave the trauma center is the patients. I cannot leave them behind. My colleagues and team members also cannot leave."
This is what Professor Heo Yoon-jeong (37) said during a meeting at the regional trauma center of Dankook University Medical Center in Cheonan, South Chungcheong Province, on Nov. 19. Professor Heo has been the youngest doctor at the trauma center for five years since he joined in March 2020 because no trauma surgeons have come in since then.
Professor Heo became a surgeon after training at Bundang Seoul National University Hospital from March 2016 to February 2020. To obtain certification as a trauma specialist, a surgeon, a thoracic surgeon, an orthopedic surgeon, or a neurosurgeon must choose trauma surgery as a sub-specialty and undergo additional training for two years.
There might have been a faster way that guaranteed a better future, but why did I choose to come to the trauma center, where others stay away? Contrary to expectations, Professor Heo said, "Choosing the path of trauma surgery is not due to a great sense of mission or sacrifice," and added, "I came here because I wanted to save patients." He expressed it as being "deeply in love with patients" in his book titled 'I Want to Save Again.'
Dankook University Medical Center opened the third regional trauma center in the country in November 2014. It is responsible for treating severe trauma patients resulting from traffic accidents or industrial disasters in the Chungcheong region. The Chungcheong Regional Trauma Center received an 'A grade' from the Ministry of Health and Welfare's evaluation of regional trauma centers for four consecutive years. Only four out of 17 regional trauma centers nationwide received an A grade.
Professor Heo noted, "Although there are hospitals like Ajou University Hospital where the regional trauma center system and working environment are well established, in most trauma centers it's the opposite," and added, "Dankook University Medical Center ranked second after Ajou University Hospital because, despite its small size, there is strong cohesiveness and commitment among the center's members."
During his training at Bundang Seoul National University Hospital, Professor Heo attended a lecture by Lee Kuk-jong, a professor at Ajou University Hospital who pioneered severe trauma centers in Korea (currently the director of the National Defense Medical Center). He asked the director of the surgery department at Bundang Seoul National University Hospital if he could visit a trauma center. Professor Heo said, "I was dispatched to Ajou University Hospital's trauma center for two months, and I became fascinated with trauma surgery after watching the medical staff there."
He stated, "People often think that someone who does work that others avoid has a tremendous sense of sacrifice or feels pity for them, but I learned early on that in such fields, it's easier for me to stand out," adding, "If you put in just a little effort, you can become the best in that field, and I chose it because I thought there would be opportunities."
The environment in which he grew up also played a role. Professor Heo said, "Many of my relatives, including my father, husband, and cousins, are doctors, and they are all in what are called vital specialties, which are essential medical fields that people tend to avoid," adding, "I can continue this work because I have family members who understand and support the irregular daily life of trauma surgery."
Professor Heo mentioned that the life of a trauma surgeon is not easy day after day, but he is able to endure it because he draws strength from his patients. In particular, although many people said it was difficult for everyone, a patient who ultimately stood up gave him strength.
One patient was in a complete state of paralysis from the neck down after an accident on the highway while driving a truck. Contrary to expectations, after a long rehabilitation, he returned to his family. Professor Heo said, "He was a patient with a daughter about the same age as my daughter," adding, "The moment I heard that he was able to produce urine after a long time on dialysis when he couldn't generate his own urine was the happiest moment for me."
The patients whom Professor Heo loved were mostly those who got injured while doing difficult and hazardous work. There were times when he wondered if there were people in the world doing such dangerous jobs. Professor Heo said, "They come after having major accidents, risking their lives without proper protection while doing incredibly hazardous tasks," adding, "The trauma center is the last refuge for the marginalized and vulnerable patients who cannot comply with the law."
The conflict in the medical community triggered by the expansion of medical school enrollment last year shook the trauma centers. Most trauma centers across the country operate under extremely tight staffing conditions, so if even one person is absent, the system collapses. Professor Heo said, "Especially, the emergency patient transfer system has completely collapsed." He added that there are patients who should originally go to Hospital A but suddenly lose their destination as a result of doctors leaving Hospital A. Emergency patients who lose their destination and paramedics find themselves searching for emergency rooms, resulting in incidents where they plead or push into trauma centers that are supposed to see only severely ill patients.
The shortage of personnel in the essential medical field has worsened as many medical students have given up becoming residents due to the conflicts in the medical community. Trauma centers initially do not have residents. Instead, they have been affected by the departure of residents from other departments due to the conflicts.
Professor Heo stated, "To save severely injured patients with no part of their bodies unhurt, all departments of the hospital must join in," adding, "Even if the trauma center holds on to the patient's lifeline, if there are not enough personnel in orthopedics, surgeries cannot be performed in time, leading to delays in treatment and the development of serious complications."
He stated, "Society should not only compel doctors to have a strong sense of mission but also provide adequate compensation and institutional safeguards commensurate with the labor intensity and risks to encourage doctors to pursue essential medical fields." Professor Heo noted that "one of the reasons medical students and residents avoid essential medical fields is the risk of lawsuits," adding, "It doesn't make sense to hold those who have a long way to go to become specialists legally responsible and liable for civil damages."