Gregg Adams, M.D., Chief of Surgery at Santa Clara Valley Medical Center is on a mission to keep you alive.

For the faint of heart, his job responsibilities would seem daunting; manage over 130 surgeons, maintain VMCs high standards for trauma services and disaster response and – oh yeah – scrub in for between 200 to 400 surgical procedures each year.

VMC Foundation Executive Director

Chris Wilder sat down to talk with Gregg about his career, his day-today-day responsibilities, how he manages the stress of life-and-death situations, and what makes VMC such an inspiring place to work. Chris Wilder: True or false - the trauma team springs into action only when an ambulance drives into the ambulance bay or a helicopter lands on the roof.
Gregg Adams: False. Trauma begins with prevention. We go out and talk about wearing set-belts, and talk about wearing helmets on motorcycles and bicycles, and talk about the problems with drinking and driving and talk about gang violence.

CW: There have been times where you have actually been called to the scene of accident. Can you tell me one of those stories?
GA: I’ll use the example of a young man who was at a worksite. He was digging a hole for a foundation that collapsed around him and was buried up to his neck in dirt. He could obviously not hop into an ambulance because we was completely surrounded by dirt, and they couldn’t just dig him out, because they feared it might destabilized more of the structures around him, endangering everyone around him.
  So we figured out a way to slowly remove the dirt, to reinforce the hole, monitoring his vital signs - because when you are crushed by dirt, actually releasing the pressure can be as dangerous as the crush himself.



CW: That makes me think of every medical drama and movie. Hollywood does a pretty good idea of showing people what an emergency department looks like. But what do they get wrong?
GA: One is that they have an enormous number of exciting things that happen in 60 minutes with time for commercials. The second thing is that we are not all beautiful.

CW: One thing the TV shows do is make the emergency departments feel like controlled chaos. Does it feel like that in real life?
GA: You are never confronted with one problem. You are confronted with 5, 10 or 50 problems. Someone that was hit by a car may be drunk, may have cracked their spleen, have a head injury, etc. The only information you have may be what their vital signs are, or what laboratory tests tell you. So, to a certain degree, it’s a little bit of sensory deprivation and learning to make decisions in a data poor environment.

CW: So it would seem to me that would take a bit of the pressure off if the patient doesn’t survive, but it doesn’t.
GA: No. I think that we are all set up as a system, as human beings, as professionals, as people who have pride in their work - I would love for everyone to survive. Trauma in particular is a killer of young people. That takes a toll and you have to learn to manage that as a human being.

CW: How do you do that?
GA: Everyone does it differently. You get a hobby, you get a pet, you hug your kids, you get involved in public service in a different way, you begin to give lectures on wearing your helmet, safe practices, gang avoidance. They become passions for you because you are tied up in the last patient you treated that didn’t survive.

CW: And you fi nd that passion in so many people who work at VMC.
GA: Oh absolutely. And it’s one of the reasons why people not only come here to work but stay here to work. You come here because you want to take care of the most complex, most interesting, and challenging patients you can imagine. And ultimately you stay here because you are working with some of the best colleagues you fi nd anywhere in the world. Dedicated. Smart. Funny. Compassionate. Absolutely beautiful human beings.

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