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Why Surgeons Prefer Not to Care for Patients With Trauma-Reply

DONALD TRUNKEY, MD
Arch Surg. 1992;127(1):119. doi:10.1001/archsurg.1992.01420010140026.
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In Reply.—In Virgil's Aeneid, aged Priam throws a telum imbelle sine ictu, which literally means "a feeble weapon without a thrust." This is like an argument that falls short of the mark or misses it altogether. Clark states that I am guilty of the old "town and gown" problem and that I have shown "the usual egotism and arrogance." In my reply to Sloane, I stated that there is no scientific evidence to support this ("that good trauma surgery could not be done in community hospitals"). I further replied that the American College of Surgeons' Committee on Trauma has steadfastly insisted that community hospitals be integrated into any regional trauma system. Clark's argument is a feeble thrust and relies on name-calling.

In the preface to the 1986 document, Hospital and Prehospital Resources for Optimal Care of the Injured Patient,1 I wrote, "A major goal of the American College

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