In the 10 days since one of the worst commuter rail accidents in California history, the region's trauma surgeons have reknit shattered limbs, repaired battered organs and returned dozens of patients to homes and families, where many will now face weeks or months of painful recuperation.
Twenty patients remain in the region's hospitals as a result of the Sept. 12 head-on collision between a Metrolink commuter train and a Union Pacific freight train in Chatsworth. Four were still in critical condition Sunday.
The most obvious injuries were the open fractures, where splintered bones in arms and legs had punched through skin, spilling tissue and blood. But the biggest threat to those who survived the initial impact was the hidden mayhem inflicted on lungs, hearts, brains, livers and other internal organs when the train came to a dead stop, slamming bodies into seat backs, tables, the steel sides of the train cars and one another.
"It would be like standing against a wall and having a car hit you at 40 mph," said Dr. Henry Gill Cryer, trauma director for the Ronald Reagan UCLA Medical Center, where several of the badly injured were treated.
In medical parlance, "trauma" has a precise definition: serious damage to the body from something external, like a gunshot wound or a car crash.
Other health crises, including heart attacks, pneumonia, appendicitis and injuries that are not life-threatening are treated in hospital emergency rooms. But for a hospital to be designated a trauma center, it must have, in addition to an emergency room, a team and equipment dedicated to treating severe injuries.
The new UCLA hospital, which was built to meet more stringent earthquake standards and opened in June, has the newest and most modern trauma center in Los Angeles County, at least until the replacement County-USC Medical Center opens in the fall. It has two rooftop heliports for receiving patients by helicopter and two resuscitation suites -- big, well-equipped rooms for treating the most seriously injured patients. X-ray machines, CT scanners and other imaging devices are in those rooms, rather than down the hall, to save crucial minutes in diagnosing internal injuries.
Of the 220 people on board the trains, 135 were injured, 86 of them seriously enough to be taken to hospitals, according to county officials. About 40 were in critical condition.
When eight of the critically injured arrived by helicopter at UCLA, Cryer's team was waiting.
