Do you ever wonder why we keep doing it? I mean, really, why do we put in 60 hr a week and get paid for 40? Aren't we getting tired of dealing, year in and year out, with early morning rounds, lunch hour M&M, late afternoon conference calls, and weekend ATLS courses? How many more pre-review questionnaires can we slog through? Why do we continue to hassle with clueless state bureaucrats, obstinate physicians, uninformed legislators, and frustratingly naive hospital administrators? Why do we do it? It's been more than four decades since trauma was identified as the silent epidemic in America. Why do we continue to watch billions of research dollars flow to other health care problems while trauma limps along on scraps? Why? Why do we put up with it? Everyone knows we could make just as much money, with a fraction of the stress, feeding babies in the nursery or taking histories in the outpatient clinic. So why, why do we keep doing it? I'll tell you why. Melissa is why we do it.

Melissa is one of my oldest friends, my wife's best friend, since the fourth grade. She was the maid of honor at our wedding. We've raised our kids together, laughed, and cried together. We've shared more memories together than I can count. A few days after New Year, Melissa's car was hit broadside; her husband of 3 weeks was killed instantly. Melissa suffered a severe pelvic fracture, a pneumothorax, and a transected thoracic aorta. Her ISS (Injury Severity Score) was pushing 50. Unconscious, it took EMS more than 30 min to cut her out of the car. She was rushed to a Level I trauma center, where she underwent emergency surgery to repair her aorta.

Melissa spent weeks in the hospital and more than a month at an inpatient rehab center. Melissa came back to her hometown 4 months after the crash, where she continued to recover with the love and support of her family and friends. After many more months of outpatient therapy and several surgeries to correct blurred vision and a damaged trachea, she is thinking about her horses and is planning to move back to Arizona. She no longer uses a walker; she can speak clearly, and no longer has double vision. Last week we went out to eat. Next week we may go to a movie.

I've heard her parents say, "What a wonderful surgeon she had, he really saved her life," or "Thank God the squad got there quick, they saved her life." EMS routinely pulls nearly lifeless victims back from the edge of the abyss. Doctors and nurses perform amazingly complex, intricate lifesaving procedures with seemingly nonchalant ease. Rehab therapists work life and function back into limbs that 30 years ago would have been summarily amputated. Sure it's easy to point to any one of these or the many other links in the chain of trauma care and say, "Here, this is what saved her life." But it's not the links ... we all know that. It's the chain ... it's the chain that makes up the system that saves lives. As important as the individual links are, it's all about the chain. Because of the chain, Melissa will be going to a movie next week. Because of the chain, Melissa will be sharing another holiday with her family and friends. Because of the chain, Melissa will be going home to take care of her horses.

You don't know Melissa, but chances are you know someone just like her. There are hundreds, probably thousands, of Melissa's out there; every one of us has a Melissa, and I think that is why we do it. Melissa is why we do it.