On a normal day of her fellowship in pediatric surgery, Kimberly McCrudden, M.D., now an assistant professor in the Department of Surgery at the University of Michigan Medical School, would arrive at the hospital around 5:30 a.m. to prepare for rounds on all of her patients. The rest of her day would be spent in the OR where McCrudden continued to polish her operating skills.

And as chief resident in charge of the pediatric surgical service at U-M, there were many days when she had to respond to a new trauma coming to the U-M Trauma Center.

As a pediatric surgery fellow, McCrudden acted as the team leader for all pediatric trauma patients coming to U-M. She managed the overall care of these trauma patients and coordinated the efforts of different specialties and disciplines to make sure no bone was overlooked, no symptom left untreated.

“Not all pediatric surgery programs see a lot of traumas, whereas at U-M we get kids from all over the state with a wide range of injuries,” says McCrudden. “We get such a broad experience. And even though very few cases require our particular operative skills, all these children need a pediatric surgeon for appropriate identification and work-up of their various injuries. It is essential that someone watches over them and assumes responsibility for their overall care.”

Her other duties as a fellow were managing the operating schedule, teaching medical students and general surgical residents and performing rounds with them, which included reviewing the medical issues and concerns for each patient, developing a daily plan of action and answering any questions for nurses, patients and their families.

McCrudden says that when it came time to apply for her fellowship she applied all over the country, but Michigan ranked very highly on her list. “I think the pediatric surgery fellowship here is among the best in the country, and I feel my training here was superb.

“It’s fulfilling to work with a staff that gives such excellent care. There’s a lot of pride that goes into the work at U-M,” says McCrudden. “No one ever says, ‘That’s not my job.’ We’re all in it together to care for sick children.”

McCrudden says that all her trauma patients have left a lasting mark.

“One teenage girl came in with a severe head injury and what the orthopedic trauma surgeon described as the worst pelvic fractures he’d ever seen. She was on our service for three or four months. Watching her and many others go from critically ill to walking out of the hospital has been a most rewarding experience.”

Learning by Living It
“We always have the latest technology at U-M,” says McCrudden. “We have the CT scanners, the MRI, the angiography suite and extremely skilled physicians in every pediatric specialty. But that is not what makes a trauma center great. It is about building relationships with the families of these injured children and guiding them through their time of trial.

“I have learned in my training to be delicate with everything and everyone, with the families, with the children. Excellent medical care cannot be delivered with a cold and callous hand. How you deliver your care makes a difference,” says McCrudden. “Because it could be your son or sister—it’s important to remember that, and to treat these children as if they were your own.”

Another lesson McCrudden has learned quite well is how tragic traumas can be, especially because of what she calls the “preventability factor.”

“So many of the injuries we see are entirely preventable, if only the child had been wearing a seatbelt or a helmet, or not drinking alcohol or doing drugs,” says McCrudden.

Working in trauma has inspired McCrudden to educate children and parents.

“I have started delivering a trauma-prevention talk to all our kids just prior to discharge, to catch them when they are feeling better but before the shock of the injury is gone,” says McCrudden.

She teaches about the risks involved and what safety precautions to take, with the hopes of preventing the next trauma before it comes through the emergency room doors.