Donald D. Trunkey, MD, FACS, long considered one of the most influential trauma surgeons in the U.S., died May 1 in Post Falls, ID, after a protracted illness. Dr. Trunkey truly was a unique individual, in many ways a “free spirit” but grounded by lofty ideals and laudable principles.
Don was a large person and seemed larger than life. Don believed in leadership through service and he followed this tenet throughout his career and numerous leadership positions. He instilled confidence on first meeting and garnered the respect of his peers for his equanimity, moral code, and unwavering commitment to his ideals and doing what was right for trauma patients. His coy smile and warm, upbeat personality, along with his true love and appreciation for his fellow human, were always present and freely shared with old and new friends around the world. Don was a true friend and mentor for an entire generation of trauma surgeons.
Early influences
Dr. Trunkey was born June 23, 1937, in Oakesdale, WA. Growing up in farm country in eastern Washington State instilled in him the work ethic, persistence, and integrity needed to be the successful leader he eventually became. He graduated from Washington State University, Pullman, and earned his doctor of medicine degree from the University of Washington, Seattle, in 1963. Following medical training, he completed a rotating internship at the University of Oregon under the direction of J. Englebert Dunphy, MD, FACS, who inspired Dr. Trunkey to become a surgeon.
After his internship, Dr. Trunkey joined the U.S. Army and served in Bamberg, Germany, for two years. Upon his return to the U.S., Dr. Dunphy, who had moved to the University of California San Francisco (UCSF) as the chair of the department of surgery, recruited him to the UCSF resident training program. His residency rotations at the San Francisco General Hospital (SFGH) under the mentorship of F. William Blaisdell, MD, FACS, led to his interest in a career in trauma surgery.
After his residency, he spent a year at Parkland Memorial Hospital, Dallas, TX, involved in trauma research on cellular function in shock with G. Thomas Shires, MD, FACS, who would go on to be elected Chair of the Board of Regents of the American College of Surgeons (ACS) and ACS President; C. James Carrico, MD, FACS, who also went on to chair the Board of Regents and to serve as ACS President-Elect; and Peter C. Canizaro, MD, FACS, a renowned expert in trauma and shock.
Dr. Trunkey returned to SFGH in 1972 and was tapped to serve as chief of surgery in 1978. After serving in that position for eight years, he accepted the chair of surgery at Oregon Health & Science University, Portland, and was named the Mackenzie Professor and Chair, department of surgery, in 1986, a title he held for 15 years.
Advocate for trauma patients
Dr. Trunkey achieved national and international stature as a trauma surgeon as a result of his research, publications, and larger-than-life persona. However, Don had a chronic problem—he refused to accept the unacceptable. He was driven to improve the prevailing standard of care of the injured patient. And, to rectify the inadequacies and inefficiencies he found in trauma care, he became a change agent despite any existing resistance and potential personal repercussions. On his own strength of character and conviction, he led numerous paradigm shifts and improved the care of thousands of injured patients.
While at SFGH, he published a seminal study in 1979 comparing the disparity in preventable deaths from trauma in Southern California against the organized system of care provided at SFGH. His recognition of the need for consistent high-quality care in standard-driven trauma centers as regional resources for an overall systematic approach to trauma care led to today’s modern trauma centers and systems of care.
During his tenure on the ACS Committee on Trauma (COT), which he chaired from 1982 to 1986, Dr. Trunkey and a group of his contemporaries established the Advanced Trauma Life Support® (ATLS®) course, which has become the world-wide standard for the initial care of the injured patient.
In 1976, Dr. Trunkey led the COT’s efforts to publish Optimal Hospital Resources for the Care of the Seriously Injured, the first document aimed at defining and developing trauma centers and trauma systems. Later, he virtually single-handedly created the Trauma Center Verification process within the COT, a process that has been and continues to be used to confirm trauma center level of function and improve care and outcomes from trauma throughout the U.S.
Don and a group of international colleagues then created the Definitive Surgery for Trauma Care course, which focuses on operative care training following the initial resuscitation defined by ATLS. This course has been provided to thousands of surgeons around the world and is adaptable to low-resource settings.
Demonstrating a deep commitment to our wounded warriors and military medicine throughout his career, Dr. Trunkey was activated to serve in Desert Storm as Commander of the U.S. Army Hospital in Riyadh, Saudi Arabia. After his experiences in Operation Desert Storm and Desert Shield, he wrote a commentary in the March 1993 edition of Archives of Surgery, “Lessons Learned,” that called out the weaknesses in the military surgical readiness and urged a major restructuring of training and maintenance of competence in military medicine. His proposals are now encoded in federal legislation as an expectation for our wounded warriors. For these and so many other advances in trauma care, he has become known to many in the surgical community as the “father of modern trauma care systems.”
An Icon in Surgery
In appreciation for his outstanding leadership, the College honored him with the ACS Distinguished Service Award in 2005 and in 2018 as an “Icon in Surgery.”
Among other recognitions from the College, Dr. Trunkey presented the ACS Scudder Oration on Trauma in 1989, and in 1995 received the National Safety Council Surgeons’ Award for Distinguished Service to Safety.
He was recognized for his lifelong career of advancing the care of the injured by his election to the presidency of the American Surgical Association, the Society of University Surgeons, and the American Association for the Surgery of Trauma, as well as a director of the American Board of Surgery.
Don was a great friend to me and to numerous other colleagues, a trusted confidant, and a lifelong mentor. He was always available, always willing to provide insight and advice, and to support my career and that of so many other beneficiaries of his willing guidance. A great personal honor was being given the Jane and Donald D. Trunkey Chair in Trauma at the University of Washington as chief of surgery at Harborview Medical Center, Seattle. An honor and a challenge for me is to always work and strive to make Harborview the highest quality trauma center possible, one worthy of his gift and his ideals.
At home, Don was recognizable as the one with a parrot habitually on his shoulder. But above all, Don’s highest priority was family. He was a dedicated father and husband for nearly 61 years to his lifelong love, Jane. Jane was the omnipresent support and sanity throughout Don’s far-flung career. Our love and prayers reach out to Jane in this time of great loss—one shared by the thousands he touched in so many ways. His tireless devotion to his high ideals and drive for the improvement in care of the injured will live on in the multitude of survivors of severe injury who have benefited from his impact on their care.
