Trauma Care Saves Teen's Life

Dr. Raymond Bynoe (center) discusses a patient's care with a staff member in the Emergency Department at Palmetto Health Richland.

The accident happened less than three miles from home.

Sixteen-year-old Shannon Johns was almost back to her family’s 144-acre farm in Wagener when she hit a curve going too fast. The teenager’s haste to get to home in time, rainy driving conditions, and slick roads made a dangerous combination. “I remember holding on tight to the steering wheel and praying to God,” she recalled as she lost control of the vehicle.

Unrestrained in her prized red Camaro, Shannon was ejected from the car, which flipped a number of times on the Aiken County highway. A passerby summoned 911, and the teenager was transported by helicopter to Palmetto Health Richland. When her parents arrived at the hospital, they found out that the news wasn’t good. Dr. Raymond Bynoe, a trauma surgeon and an associate professor of surgery, met with the family. “He told us that her condition was critical and that she had to go to the OR immediately,” her mother, Angie, said.

Shannon had suffered extensive internal abdominal injuries, thoracic injuries and a closed head traumatic brain injury from the accident. “She didn’t look like Shannon when we first saw her. She had started swelling, she had blood on her face and arms, and all kinds of medical stuff everywhere,” her mother recalled.

As surgeons addressed Shannon’s multiple injuries in the operating room, they needed to remove her spleen, which had ruptured. “There was so much fluid that we could not close her abdomen,” Dr. Bynoe said. Angie and her husband, Curt, remember that first long night when medical personnel struggled to restore Shannon’s dangerously low oxygen level. “Every few minutes Dr. Bynoe would update us on her condition. At midnight he came to us and said, ‘It’s in someone else’s hands now. We have done all we can do. The medicine needs time to work’,” Angie said. As Shannon pulled through that night and the next and the next, her mother remembered, “We pretty much lived at the hospital those three days.”

During a month-long hospitalization at Palmetto Health Richland, the teen underwent five more surgical procedures, receiving a total of 11 units of blood and four bags of platelets. In addition to Dr. Bynoe, other physicians in the Department of Surgery were involved in Shannon’s care. Six surgeons in the department work with trauma patients, with Dr. Bynoe, Dr. James Morrison, and Dr. Stephen Fann specializing in trauma surgery. There’s no doubt that their services are needed. Every year some 2,000 critically injured people are brought into Palmetto Health Richland, which is designated as one of only four Level I trauma centers in the state. “Trauma sees no color and no sex; it can happen to anyone,” said Dr. Bynoe.

Since Shannon’s traumatic injury, her family has learned what Dr. Bynoe understands after years of practice. “The recovery is a lifetime process,” he said. When Shannon was discharged after a month of rehabilitation at HealthSouth Rehabilitation Hospital, she still had an open abdominal wound. The wound would have to continue healing from the inside out. Once at home, she became dehydrated easily. Trips back to the Emergency Room became commonplace as a number of complications arose.

A little over a year later, Shannon continues the healing process. Though back in the swing of things at Wagener-Salley High School, the senior experiences ongoing pain in her abdominal area. At the computer, she types using only her right hand. Her left hand still functions slowly after her entire left side was impaired by the accident. She tires more easily these days and is more prone to infection.

And while Shannon’s surgical scars are everyday reminders of the accident that nearly took her life, her perspective is a positive one. She plans a career in the medical field when she starts college in the fall. Though always close to her family, she’s developed an even tighter bond with her parents and 15-year-old brother. “A lot of things that that used to matter don’t matter any more,” said the teenager who no longer obsesses about her appearance. “She used to be 30 minutes late just so she could look good,” her mother recalls. “Now she just wants people to accept her as she is.”

Dr. Bynoe appreciates the young woman that he continues to follow medically. “It’s rewarding,” he said about her recovery process. “It’s the thing that keeps you going.” And while he appreciates that Shannon pulled through a serious accident, he stressed that her survival was not enough. “Trauma care is not just about saving lives, but that patients like Shannon can get back to being productive individuals,” he said. He noted the unfortunate fact that trauma is the number one cause of death for people under 45 years old. “It’s bigger than cancer and heart disease and all the diseases that people think about,” he said.

Because teenagers can be particularly at risk for traumatic accidents, Dr. Bynoe and the other surgeons frequently present programs that help teens understand the risks of driving, taking chances, and risky behaviors that could bring them harm. “Driving is not a right, but a privilege. Kids need to be prepared to get out on the highway,” he said. “We also stress that if necessary, calling a cab is not a bad thing to do.”

And while Dr. Bynoe hopes their educational efforts will steer some teens away from making bad choices, the reality is that trauma will never be eliminated. “I look at what we do the same way as the ambulance and fire and police services. You never want to see us, but when you need us, you want us to be available,” he said. The Johns family was certainly grateful those trauma services were available on a rainy November night in 2004. “Theirs was an example of a family’s worst nightmare,” Dr. Bynoe said. “Yet it didn’t end as a nightmare.”

Reprinted from Connections newsletter, February 2006

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