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Lifelines: On the night shift

Medicine@Yale, 2012 - March

For Yale trauma surgeon, saving patients’ lives is an everyday occurrence

Since the days of her childhood in Larchmont, N.Y., Kimberly A. Davis, M.D., has had a penchant for taking things apart, finding out what’s wrong with them, and putting them back together. It’s one of several reasons, Davis says, that she chose to become a trauma surgeon: “I wanted to be able to intervene in the acute episode of a patient’s illness and get them back to their normal level of functioning.”

Now, Davis spends her days—and often her nights—helping to repair patients’ bodies, and their lives, following traumatic injury. As professor of surgery and chief of the Section of Trauma, Surgical Critical Care, and Surgical Emergencies at the School of Medicine, Davis sees patients during their initial care in the emergency department (ED) at Yale-New Haven Hospital (YNHH), where she is trauma medical director.

In the ED, patients are resuscitated, given fluids, and sometimes ventilated; their injuries are assessed; and physicians determine what sorts of surgical interventions, if any, they require. “Most of what we see is blunt trauma,” Davis says, meaning injuries caused by car or motorcycle accidents, falls, and, less commonly, gunshot and stab wounds.

The work is intense, but methodical. “Trauma surgery requires that you address things in specific order,” Davis says. “You stop the bleeding first. You [then] stop any contamination occurring from holes in the gastrointestinal tract. And depending on whether the patient is stable, you either surgically address all of the patient’s needs at that time or you get them up to the intensive care unit, and you come back to fight another day.”

Davis first came to Yale in the 1980s as an undergraduate, majoring in molecular biophysics and biochemistry. But after college, a two-year stint as a research assistant in virology at the Rockefeller University helped her realize she wanted to pursue a medical degree. “While I found the basic science research very interesting, I decided that I missed the human contact,” she says.

Davis earned her M.D. at Albany Medical College, then completed a residency in general surgery at Brown University’s Rhode Island Hospital and a fellowship in trauma and surgical care at the University of Tennessee Medical Center. In 2006, she returned to Yale from Loyola University Medical Center in Chicago, with an appointment as associate professor of surgery. She was promoted to professor in 2011.

Because the need for rapid care is paramount and the stakes are so high, trauma physicians face unique personal demands. “When you finish caring for a sick patient, you’re absolutely exhausted. You’ve had this huge rush of adrenaline, then you crash.” It’s a field, Davis says, in which physicians need to be emotionally resilient. “We often have to tell family members that their loved ones have died. To see a family fall apart, and realize the magnitude of what they’re going through, is difficult to do over and over again without being compartmentalized.”

If urgent care on the wards has taught her to compartmentalize, it’s a skill Davis has put to good use. Her tenure as section chief has seen the recruitment of eight new surgeons, a continued focus on education and mentorship, and a deepened commitment to clinical research. Under her watch, YNHH became the first Level-I Trauma Center in Connecticut for pediatric patients, a designation bestowed by the American College of Surgeons on centers that offer the highest level of surgical care. And as if she weren’t busy enough, in her spare time Davis is working toward an executive Leadership in Healthcare M.B.A. at Yale School of Management, and will graduate this spring.

How has she managed? “I juggled,” she says, “and I have a group of very supportive partners.”