To the Editor.—I would like to respond to the invited editorial comment by Trunkey1 in the March 1991 issue of the Archives on the article by Esposito et al2: "Why Surgeons Prefer Not to Care for Trauma Patients." I am a surgeon who prefers not to care for trauma patients and would like to explain the rationale behind my decision. I am board certified and a graduate of a 6-year medical school-affiliated surgical residency that included rotations in an inner-city trauma hospital. I practice general and vascular surgery in a community where the hospital is one of the major employers. The hospital has a well-equipped, combined intensive care unit and coronary care unit of 12 beds and a large, monitored, step-down unit. Twenty-four–hour computed tomographic scanning and laboratory services are daily realities. I can provide competent diagnostic and operative surgical care to patients suffering major trauma.