As the Honorable Francis X. Kelly Distinguished Professor of Trauma Surgery and Director of the Program in Trauma at the University of Maryland School of Medicine (UMSOM) and physician-in-chief of the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center (UMMC), Thomas M. Scalea, MD, FACS, MCCM, has pioneered advances to trauma care for patients in the United States and around the world.
He has cared for tens of thousands of Marylanders critically injured in motor vehicle collisions, falls and violent attacks, traveled to China and Haiti to render assistance to earthquake victims, helped train thousands of U.S. Air Force personnel, and worked alongside military physicians in war-torn Afghanistan. He has steered Maryland’s highest-level trauma center through two years of the COVID-19 pandemic.
On Jan. 4, Scalea marked his 25th anniversary as the leader of the Shock Trauma Center at the University of Maryland Medical Center and the Program in Trauma at the University of Maryland School of Medicine. Shock Trauma delivers more trauma care than any other institution in the United States, treating 7,000 patients a year with a 96 percent survival rate. Scalea has carried on the legacy of Shock Trauma’s founder, R Adams Cowley, who championed the concept of the “golden hour” that has defined modern trauma care. The Program in Trauma at UMSOM is the only multidisciplinary dedicated physician group practice that cares for injury in the United States. The goals of the program go well beyond that of patient care, with education and research at the cornerstone of its mission. The goal is to save lives, advance science, and educate all types of health care professionals from many disciplines.
“When I look at what we have been able to accomplish over the past 25 years, I can truly say that we changed the face of injury care in the world,” said Scalea, who is also system chief of critical care services for the 12-hospital University of Maryland Medical System (UMMS). “I am very proud that we have been at the tip of the spear for many advances, with a lot of innovation coming through our long partnership with the U.S. military — all for the benefit of patients.”
Scalea said Shock Trauma is recognized internationally for the use of endovascular care for trauma — using catheter therapies instead of open surgical procedures or in combination with open surgery. It has also pioneered innovative therapies for severe traumatic brain injury and created a novel way to organize critical care through its Critical Care Resuscitation Unit and the Maryland Critical Care Network, which is comprised of adult intensive care units at UMMS hospitals throughout Maryland.
“The concepts were reimagined and became very important during the COVID-19 pandemic, serving as a model for the state of Maryland to ensure that critically ill patients received the right care at the right time at the right place,” he said.
As part of the Program in Trauma, Scalea has played an instrumental role in the leadership of the Shock Trauma and Anesthesiology Research (STAR) Center, a world-class, multidisciplinary research and educational center focusing on critical care and organ support, resuscitation, surgical outcomes, patient safety, and injury prevention.
Originally established by Congress as the Charles “McC.” Mathias Jr. National Study Center for Trauma and Emergency Medical Systems, the STAR Center was designated as an organized research center at UMSOM in 2007. It is the first research center in the nation dedicated exclusively to the study of trauma, its complications and prevention.
Scalea came to Maryland from New York City, where he served as chief of critical care and trauma and founding chairman of the Department of Emergency Medicine at Kings County Hospital/SUNY Brooklyn. “I planned to live and die in New York City and didn’t really plan to move to Baltimore,” he recalled. “But when I got the opportunity, I hesitated zero seconds and said, ‘Yes.’ Because it’s Shock Trauma. It’s as good as it gets. When you do what I do, this is the best job in the country, maybe the world.”
Shock Trauma — Maryland’s only primary adult trauma resource center (PARC), which is at the heart of Maryland’s unique Emergency Medical Services (EMS) System — has grown tremendously under Scalea’s leadership. He has been instrumental in creating or developing many key programs and units, including:
- C-STARS (Center for the Sustainment of Trauma and Readiness Skills) program to train U.S. Air Force personnel
- Trauma Resuscitation Unit, a specialized unit to quickly evaluate patients and begin lifesaving treatment, and the Critical Care Resuscitation Unit (CCRU), the only unit in the country designated for rapid evaluation and treatment of critically ill patients transferred from another institution
- Violence Prevention Program to help victims of violence avoid becoming victims again
- Shock Trauma Go Team, a physician-led team that travels to the scene to treat severely injured patients
- Lung Rescue Unit, launched in 2015, one of the busiest units in the U.S. to provide prolonged cardiac and respiratory support with ECMO (extracorporeal membrane oxygenation)
- STAR organized research center, which opened in 2009, for the prevention and treatment of trauma
- Shock Trauma Surgical Critical Care Fellowship, which is the largest and one of the most prestigious programs to train physician leaders in trauma and critical care medicine of its kind
- Critical Care and Trauma Simulation Center, a state-of-the-art simulation lab for training medical staff, located in the new Shock Trauma Critical Care Tower, which was built in 2013
“Although Dr. Scalea is widely known and regarded, both nationally and internationally, for his incredible expertise as a trauma surgeon and physician-scientist who has made enormous contributions to trauma research, those who have worked with him or trained under him will tell that you that Dr. Scalea is an equally gifted leader and mentor,” said E. Albert Reece, MD, PHD, MBA, vice president of medical affairs, University of Maryland, Baltimore and the John Z. and Akiko Bowers Distinguished Professor and dean of UMSOM. “He is carrying the torch of Dr. Cowley’s original mission to provide cutting-edge care to ensure the survival of the critically ill and injured.”
Bert W. O’Malley, MD, professor of otorhinolaryngology-head and neck surgery at UMSOM and president and CEO of UMMC, added: “Tom Scalea is the heart and soul of Shock Trauma. Our trauma center is regarded as the premier trauma hospital in the world in large part because of his hard work, dedication, and commitment to serving the most critically injured and critically ill patients in Maryland and beyond. He and his team always bring their ‘A’ game and have saved thousands of lives over the last 25 years, developing new procedures and techniques that have been adopted by other trauma specialists. He is a dedicated, selfless public servant.”
O’Malley noted that Shock Trauma has been at the forefront of UMMC’s response to the COVID-19 pandemic, caring for the sickest patients, many of whom required treatment with ECMO.
Theodore R. Delbridge, MD, MPH, executive director of the Maryland Institute of Emergency Medical Services Systems (MIEMSS), said, “For the past 25 years, Dr. Tom Scalea hasn’t just led the R Adams Cowley Shock Trauma Center, he has devoted himself to the care of injured people throughout Maryland. The value of his expertise and commitment to Maryland’s statewide emergency medical services system and its abilities to treat trauma patients is immeasurable.”
Said former patient Allie Gold Cunningham, who suffered a serious brain injury and nearly died from multisystem organ failure after falling off a golf cart in 2005, “Dr. Scalea saved my life. I know that if I were under the care of another physician and team, I would not have survived. He took care of both me and my family extremely well, and we will be forever grateful.” She called Scalea “a wonderful physician and person.”
“Sitting down with a mom and telling her that her kid is not coming home is just demoralizing at the highest level. The older I get, the more it weighs on me,” Scalea said. He added, “Everybody who works here feels those losses in a very personal and very profound way. But we just keep answering the bell.”
Answering the bell has taken the now-70-year-old trauma surgeon to other parts of the world. After the 2008 earthquake in Sichuan, he headed the only non-Chinese team invited by the Chinese government to provide medical care to victims. He personally led Shock Trauma’s efforts to help the victims of the 2010 earthquake in Haiti. He traveled to Afghanistan in October 2011 to witness the “Wounded Warrior” care program in the field, during transport, and in military hospitals. Shock Trauma provides pre-deployment medical training for U.S. Air Force physicians, nurses, and medical technicians as part of the C-STARS program.
Scalea is a prolific researcher, authoring or co-authoring more than 600 studies, including a 2017 study published in the Annals of Surgery that found a blood-cleaning device could be put to new use to help patients with acute liver failure. He also oversaw Shock Trauma’s participation in a groundbreaking 2015 transfusion study that aimed to save lives from major blood loss.
“It’s very exciting to create solutions for patients not helped by standard therapies — to innovate on the fly,” Scalea said. “My team and I put our heads together and say, ‘Let’s try this,’” whether it be an operative technique, a procedure in the intensive care unit, or a philosophic approach. I love that process. I have been practicing medicine for 40 years, and that’s still an incredibly energizing experience.”
He observed that trauma care has changed dramatically over the years, with a much shorter evaluation process, staging of surgeries over the course of several days, earlier blood and plasma transfusions, and more advanced imaging. There have also been innovations in critical care, including the use of ventilators and ECMO, which oxygenates a patient’s blood outside of the body.
“Every year we are better at doing this than we were the year before,” Scalea said. “We are a lot smarter now than we were 25 years ago.”
He has also lectured to physicians, medical students, and professional organizations all over the world. In 2007, he pondered, “Would Lincoln have survived if he was shot today?” at UMSOM’s annual historical clinicopathological conference and concluded that modern medicine likely would have saved the former U.S. president.
Scalea is a member of a host of trauma organizations and served as president of the American Association for the Surgery of Trauma and the Western Trauma Association and executive director of the Pan American Trauma Society. He is a member of the American Trauma Society and the American College of Surgeons Committee on Trauma. He was featured in two TV programs about Shock Trauma, “The Critical Hour: Shock Trauma” in 2004 and “Shock Trauma: Edge of Life” in 2015.
He credits his mother, Anne Scalea, with instilling in him a deep-seated desire to serve. “When I was a kid, my mama said to me 10,000 times, ‘You do for others before you do for yourself.’ It was the motto in my house. It’s how I have lived my life,” he said.
Scalea, who still performs about 600 surgeries a year, said he loves his job and has no plans to retire. “It’s who I am, it’s what I do, it’s the only life I know,” he said. “It’s what I will do until I can’t do it anymore.”
“I’m always on call. I’m always at the ready,” he said. “If the phone rings and somebody needs help, the answer is, ‘I’m on my way.’”