Dr. William Long’s heart and clinical expertise influences Oregon’s trauma system
It is the ability to save patients from traumatic injury, the opportunity for continual learning and the collaboration among the clinicians and staff that drives William “Bill” Long, M.D., who retired from clinical practice last month, 35 years after coming to Legacy Emanuel Medical Center in 1983. Many colleagues, family, former patients and friends paid tribute to Dr. Long at a recent retirement reception held at the medical center.
Dr. Long, a board-certified cardiothoracic/vascular surgeon, was Legacy Emanuel’s first trauma medical director. An accomplished physician, he was instrumental in developing Oregon’s statewide trauma system and Legacy Emanuel’s designation in 1988 as the first Level I Trauma Center in the Pacific Northwest by the American College of Surgeons Committee on Trauma (ASCOT). He is also credited with making Oregon the first state to link small rural and suburban hospitals to ASCOT-verified Level I trauma centers.
Jonathan G. Hill, M.D., retired cardiothoracic and vascular surgeon, Legacy Board member and clinical vice president for Legacy Medical Group, is a long-time friend and surgical partner. He describes Dr. Long’s impact on Oregon’s trauma system. “He was a driving force in its vision and implementation across the state,” says Dr. Hill. “At Emanuel, the trauma system drove the level of infrastructure and design of the physical plant to allow us to provide care for the sickest of the sick. Without Dr. Long, Emanuel would simply be yet another high functioning community hospital, not the regional quaternary powerhouse that it has become. Oregon owes him a debt of gratitude.”
Dr. Long was born in Baltimore and grew up on Maryland’s eastern shore. As a boy, he worked on his grandfather’s vast tomato farms. He credits his early years for giving him the “country wisdom” that influenced his decision to pursue a career in medicine and to specialize in trauma.
His father, William Long, M.D., was a general surgeon who had a successful career and Mary, his mother, believed in education. Dr. Long graduated from the University of Maryland Medical School in 1968. Following an internship in medicine, he began his surgical training at Edinburgh University in Scotland, which included a two-year research fellowship in septic shock. He completed his general surgery training at the University of Maryland. Dr. Long claims he “was educated beyond his intelligence.”
Commitment to care for all
One of Legacy Health’s values is to “treat all people with respect and compassion” and this is reflected in Dr. Long’s personal commitment to patient care. He tells the story of an incident early in his residency when a patient arrived in the emergency room, who appeared homeless. “The patient was unshaven, dirty and incontinent and staff, thinking he was a ‘drunk’, left him on a stretcher to ‘sleep it off’," says Dr. Long. “The next morning when I started my shift a nurse pointed at this patient saying they were waiting for him to wake up. I examined him, found his identification and family photos. The patient was a very wealthy executive who, after an afternoon relaxing on his boat, was later attacked, beaten and left on the ground. The delay in care left him with permanent injuries. I vowed that day that I wouldn’t tolerate any medical staff judging any patient by their physical appearance and delaying care.”
Timing is everything in trauma care
“Timing is everything if a critically injured patient has any chance for survival,” says Dr. Long. “The stop watch starts at the moment of injury, through EMS notification, response, immediate trauma life support techniques, and transport to a trauma center where there is capability to do immediate surgery if necessary. Dr. Long says this time has been described as the “Golden Hour”, after which the hemorrhaging patient has decreasing chances for survival.
To decrease the response times within an advanced or level 1 trauma center, the trauma surgeon, anesthesiologist, and operating room nursing team, and blood banking and imaging personnel must be present in the hospital always to start immediate surgery as necessary. There should be ”back up” personnel who can be called immediately to replace those who are going to the Operating Room with a patient.
Understanding trauma care- think of the race car in the pit
The direct to operating room allows the trauma surgeon to do surgery on a hemorrhaging patient immediately to stop the bleeding. Trauma requires much more staffing and equipment than a typical emergency operating room. Dr. Long gave some differences:
- Trauma operating rooms have enhanced lighting.
- Trauma operating rooms are well stocked always with needed surgical equipment and surgical supplies.
- Nurses in trauma operating rooms are trained in multiple surgical specialty techniques.
Dr. Long says trauma patients with multiple life-threatening injuries may require multiple surgical specialists to operated simultaneously on a particular body part (i.e., neurosurgeon, head and neck surgeon, abdominal surgeon, orthopedic surgeon, vascular surgeon). “There has to be room for these surgeons along with their assistants to stop the bleeding and stabilize the patient. The average emergency room does not have this capacity. “Think of a pit crew at a motorcar race track. The longer the racing car is in the pit, the less chance of winning the race. The longer a trauma patient is in shock from blood loss, the less likely the patient is to survive.”
Leaving a Legacy
Dr. Long pioneered an emergency care system that will continue to save countless lives. Together with Dr. Hill, at Legacy Emanuel he created ways to race the clock and save more lives. “There is a 16-fold increase in survival at Legacy Emanuel in the care of the penetrating thoracic injury, compared to other hospitals and trauma centers that don’t have this policy and geographic layout of the ambulance (land and air) entrance into the emergency department with two well-stocked operating rooms, supplies for emergency surgery, a blood bank with blood products immediately available, and an intensive care unit, two cat scanners ICU nearby.”
Thanks to both Dr. Long and Dr. Hill’s desire to deliver the highest level of trauma care, Legacy Emanuel:
- Had the ﬁrst EMS helicopter program in the Pacific Northwest and the fourth EMS helicopter program in the U.S. in 1977.
- Had the ﬁrst cat (CT) scanner on the West Coast located in an Emergency Department (ED),
- Was one of the first to locate an operating room right next to the emergency department and next to the intensive care unit.
- Had a purposely designed trauma corridor so everything necessary is on one floor – from the moment a patient leaves the helicopter or ambulance bay, they enter a corridor that takes them to either the emergency department or operating room. And, there’s a CT scan, lab, satellite blood bank and intensive care unit just steps away.
- Can treat multiple trauma patients at one time.
Dr. Long's other accomplishments
Wall of Hope
This wall captures many stories of the patients saved by Dr. Long or other trauma surgeons. A multitude of patients whose lives have been saved have graciously sent their photographs and recovery stories to be framed and posted on the walls of the corridor. This heartfelt response continues to bring instantaneous comfort and hope to current patients, visitors and all members of the trauma health care delivery team. These survivor stories are located near the Legacy Emanuel Trauma Recovery and Acute Care Unit.
The Corridor of Life
The “Corridor of Life” is unique to Legacy Emanuel – the shortest passageway from helicopter/ambulance bay to the treatment areas. The specially designed floor plan was created to provide optimal treatment of critically injured patients and consists of Trauma resuscitation rooms, trauma/cardiac/emergency operating suites; advanced imaging equipment for full radiographic services and is near the Neuro Trauma Intensive Care Unit and the Trauma Recovery and Acute Care Unit.
For more information contact: Vicki Guinn, Legacy Emanuel Medical Center public relations, firstname.lastname@example.org, or 503-413-2939.
Photos: Courtesy Legacy Health Foundation. William Long, M.D., and Vicki Guinn (retirement celebration photo of Dr. Bill Long and grandaughter).