Book Review: Hurt’s So Good
I have this thing about doctors: I expect them to know medicine and not much else. I sometimes assume all that doctor stuff they learn consumes their neurons at the expense of other capabilities they might have had.
A foolish premise, I know, but that’s why I was surprised at the breadth and polish of Hurt: The Inspiring, Untold Story of Trauma Care by pediatric surgeon Catherine Musemeche. Boy, can she write! So much for my theory of medicine monopolizing gray matter.
Brains are a big part of Hurt, and I don’t mean just the author’s. Not only does Musemeche devote a quarter of her book to the mechanisms and physical consequences of grisly head trauma, she also offers cyclical reminders of the social and psychological aspects of disabling injuries, and emphasizes civilization’s responsibilities to rehabilitate and re-integrate trauma survivors.
Hurt isn’t simply another life-and-death-on-the-streets compendium; it will entice you with the macabre, then take you back to school. The lesson? It’s never too early to make good patient-care decisions.
I’m a big fan of books with parallel story lines. They’re harder to compose, but when written well, they sustain the sort of suspense that makes you want to read one more chapter before going to bed. Hurt is like that. Musemeche mixes narratives of barely-survivable trauma with historical perspective: the World War I soldier whose mandible and surrounding tissue was blown away when he peeked out of his foxhole in France; “Texas tower” shooter Charles Whitman’s first victim, whose colon, stomach, hip and eight-month-old fetus were torn apart by a single bullet; ABC newsman Bob Woodruff’s long recovery after the left side of his skull was pulverized by a 155-milimeter shell on an Iraqi roadside. In each case, we get not only the presenting problem, but how it was handled with whatever care was customary at the time.
Nineteenth and early-20th-century limitations in medical expertise versus 21st-century advancements is a significant part of Hurt’s value to trauma buffs. Want to know what happened to Civil War combatants hit by .58-caliber minie balls? Amputation of a shredded limb was often the best-case scenario. How about the author’s own experience with two victims of a 1976 car-vs.-train accident in Orange, Texas? Both patients died because neither trauma centers nor EMS, as we know it today, had been invented yet.
Contrast those cases with the story of Katie Holland, a 17-year-old equestrian whose right leg and pelvis were torn apart during a 2007 tractor mishap. Thanks to timely on-scene care and definitive treatment at an elite trauma center, Holland is riding horses again. Musemeche takes us through the little decisions that made big differences in Katie’s recovery, and encourages each of us who plays a role in patient care to help grow a trauma system that is still less than 50 years old.
Hurt’s structure is logical, with sections on transporting trauma cases, treating trauma, and the recovery of its victims. My favorite part is Chapter 10, “The Save,” that details how physicians have handled some of the most gruesome facial trauma since plastic surgery was developed by Dr. Harold Gillies 100 years ago. Fan’s of TV’s turn-of-the-century hospital drama, The Knick, should recognize references to early tissue-harvesting techniques.
Hurt’s not perfect—the subtitle sounds cheesy, and illustrations would be nice—but the writing is first-rate, and the stories should engage both medical professionals and amateurs who are fascinated by the process of putting the appallingly injured back together.
Even better, Hurt is as educational as it is intriguing. Whether you favor reading for recreation or study, you’re going to appreciate this book.