Next Generation is a Brigham Clinical & Research News (CRN) column penned by students, residents, fellows and postdocs. If you are a Brigham trainee interested in contributing a column, email firstname.lastname@example.org. This month’s column is written by Juan Herrera-Escobar, MD, a trauma research fellow in the Center for Surgery and Public Health.
I was born and raised in a city with one of the highest murder rates in the world: Cali, Colombia. The year I was born, homicides were the first cause of death for all ages in Cali, even surpassing cardiovascular disease. From a young age, I knew I wanted to become a doctor so that I could help tackle problems such as organized crime and gang violence. During my medical training in Colombia, I took care of patients who were injured by landmines, grenades and high-velocity guns. One patient with multiple gunshot wounds grabbed my hand while we were transferring him to the operating room saying, “I am too young to die doctor, do not let me die.” Sadly, that patient, who seemed to be about my age, ended up passing away. When leaving the operating room, a phrase the attending surgeon said got stuck in my head: “Parents should not bury their children.”
Usually we see the blood after it has been shed. We see it through the safety of our televisions or mobile devices. But, in 2015, I found myself in the middle of the hustle to save the lives of 20 soldiers who had been wounded by a guerrilla group —FARC(Revolutionary Armed Forces of Colombia). Itwas the kind of chaos I could have only imagined existed in movies, but for the first time I was living it. Young men were being wheeled into an emergency room that had been silent just moments ago. Exposure to such devastating cases where life is over in just a few minutes and will never be the same for those who survive influenced my decision to pursue a career in trauma surgery. However, I realized that I needed to get out of the operating room; I wanted to do things differently and “fish with a net rather than with a line,” as we say in Colombia. For me, that meant pursuing a career at the intersection of research, policy and public health. After completing my mandatory social service year as a doctor in Colombia, Adil Haider, MD, MPH, former director of the Center for Surgery and Public Health (CSPH) at the Brigham, recruited me to become the first Panamerican trauma research fellow. It was very easy to accept his offer since training in the mecca of medical research, in the place where Joseph Murray and Sir. Francis Moore developed their career, was a dream that I always had.
‘A True Passion to Change the World’
With the belief that the benefit of surgery is not limited to the operating room, I came to the CSPH in 2015 to enhance my research skills under the mentorship of Dr. Haider. At CSPH, I have gained a more comprehensive understanding of how trauma systems work. It has also served as a platform for me to develop my research, leadership and communication skills.
Brigham has given me the resources and guidance to carry out large-scale investigations that have the potential to improve patient outcomes and inform health care policy. Working in such a diverse environment has enriched me personally and academically. The Brigham has introduced me to multiple mentors who have inspired me through their teachings and research. Dr. Haider, my first mentor at the Brigham, taught me about the importance of finding my passion, developing the expertise in the field I am interested in and finding a caravan of teammates for my journey. Two other mentors of mine, Ali Salim, MD, chief of the Division of Trauma, Burn and Surgical Critical Care, and Deepika Nehra, MD, also of Trauma, Burn and Surgical Critical Care, have taught me great lessons about professionalism and research integrity. They have also guided me in the development of my career to reach my goals. It has been amazing meeting so many leaders and others who have a true passion to change the world for the better. It has motivated me to continue my work to make a difference for trauma victims.
One of the projects I’ve been working on at the CSPH during the last three years is the Functional Outcomes and Recovery after Trauma Emergencies (FORTE) study, which aims to build a long-term, patient-centered outcomes registry of patients who have experienced traumatic injury. The FORTE study team comprises numerous faculty, students and staff from several institutions. Members are collecting data for the study, including information on health-related quality of life and post-traumatic stress disorder, through thousands of telephone interviews with patients from the Brigham, Boston Medical Center and Massachusetts General Hospital. Coordinating this multi-institutional study from its inception has strengthened my research, management and analytical skills, and also deepened my understanding of the gaps in current trauma registries, which is critical for my future career plans. The simple premise, “If you can’t measure it, you can’t improve it,” has motivated me to learn more about using data to improve patient outcomes and quality of care. I look forward to returning to my home country soon to work on the implementation of trauma registries and strengthen the trauma system.
I have always been inspired by the quote: “If you want to get different results, do things differently.” I look forward to becoming one of the leaders Colombia needs to break the cycle of violence, trauma-related deaths, improve quality of care and effectively obtain different results.