She dropped back into a softer register. “Nobody gives two shits about the black people in North Philadelphia if nobody gives two craps about the white kids in Sandy Hook . . . I thought white little kids getting shot would make people care. Nope. They didn’t care. Anderson Cooper was up there. They set up shop. And then the public outrage fades.”
Goldberg apologized and said she wasn’t trying to stop me from writing a story. She just didn’t expect it to change anything.
THE HOSPITAL’S MAIN BUILDING IS A NINE-STORY TOWER on North Broad, the street that traces a north-south line through Philadelphia. If you think of Broad as the city’s spinal column, the hospital is about level with the heart. Stand on the sidewalk outside the hospital and look south on a clear day and you can see the pale marble and granite of City Hall, about four miles away, near Philly’s pelvis.
You can go to Temple for high-end elective surgery, like getting a knee replacement, same as at any other major teaching hospital in the country. As Jeremy Walter, Temple Hospital’s amiable director of media relations, reminded me more than once, “Temple isn’t just a hospital that treats drug addicts and gun victims.” Still, it was founded 125 years ago by a Samaritan to provide free care, and that public-service mission persists. Some of the most violent blocks in the city are within a four-mile radius of the hospital, and crime victims funnel in.
I first met Goldberg one summer weekday, in the hospital lobby. I had arranged to stay and observe for 24 hours, accompanied every moment by Walter, who carried a trauma pager and a yellow folder of consent forms. The rule was that I could observe a surgery if the patient or a family member consented, and if I wanted to do an interview, the patient had to sign a form. Goldberg is five feet two inches tall, with a runner’s build. She wore a gray mock-turtleneck sweater with no sleeves. Her hair is short, and there was a little gel in it that made it spiky. She explained that there are two main categories of trauma: blunt and penetrating. Blunt trauma is like a beating, a fall. Penetrating is a gun or stab wound. “Unfortunately we get a lot of penetrating traumas,” she said. Temple sees 2,500 to 3,000 traumas per year, around 450 of which were gunshot wounds in 2016.
The trauma pager buzzed shortly after noon. LEVEL 1 PED, it said—a pedestrian struck by a car. I followed Goldberg to the ER, and she disappeared behind a windowless set of double doors, into the trauma resuscitation area. A few moments later, she emerged and waved me inside.
The trauma area is a rectangular room with three bays, each of which can accommodate two patients side by side when it’s busy. It’s an organized place—there are small trays on wheels for different surgical procedures, each tray holding a particular complement of instruments—but the tubes and cables snaking from poles and machines make it feel a bit chaotic to the untrained eye. The goal of a trauma surgeon is to limit the amount of time that a patient spends in a trauma bay, to stabilize the patient until he can be transferred for a CT scan or to the OR for surgery. The temperature in the room feels about five degrees hotter than in the rest of the hospital. The air doesn’t seem to move.
The pedestrian was awake but silent. This concerned Goldberg because by all rights he should have been screaming in pain. He looked to be in his late 20s. He had black hair and his shirt had been removed. He spoke Spanish. There was a laceration above his right eye and a small amount of blood on the sheets near his head. Goldberg and about 20 other doctors and nurses in blue scrubs clustered around him, checking vital signs, asking questions. Goldberg wore purple latex gloves. She tapped lightly on the patient’s left forearm with one hand. The arm was broken.
“No dolor?” she asked in Spanish. No pain? He shook his head. “Really?” she said. “No?”
Goldberg walked over to another doctor and said, “So are you troubled by the fact that he’s not screaming? He has an arm that’s so freaking broken and he’s not screaming.” She frowned. “I’m troubled by that.”
The patient’s vital signs appeared stable, but Goldberg was worried about internal bleeding. A lack of pain could indicate a hidden injury. He needed a CT scan.
Staff wheeled the patient out of the trauma unit and into a nearby procedure room for the scan. Goldberg took off her latex gloves and threw them in a biohazard trash can. Two police officers had been observing from a distance with pens in hand and notepads open. One of the cops, a large man with a buzzcut, got Goldberg’s attention by saying, “Doc.”
“I’m Goldberg.”
The officer asked what the police should put down in their report for the patient’s condition. She said “critical.” This has been Goldberg’s policy for years, she explained to me as she exited the trauma bay and walked down a hallway toward the CT scanner. “I always make the patients critical until I know they’re fine. It’s a jinx thing.”
Goldberg is superstitious. On days when she’s on call, she shaves her legs. She can’t say why, she just started doing it years ago and now she will not deviate. She’s been wearing the same style of tan Timberlands for 15 years; her current pair, given to her by a colleague when she became chair of surgery, has the Temple logo inked on the heels. She parks her gray BMW in the same spot every time. “It’s so hard to take care of patients without making mistakes that you need every edge.” She recently hired a sports psychologist to talk to the residents about strategies for peak performance. Visualization. Positive self-talk. Breathing. For most of her career, she has stopped at the same Dunkin’ Donuts to order a large coffee with cream and two Sweet’N Lows. A few years ago, the store stopped carrying Sweet’N Low, so she bought a box and left it there; they keep it under the counter for her. “It’s pink,” she told me once. “Sweet’N Low is pink, Equal is blue, Splenda is yellow. And that is how you have to build a good system, believe it or not. So nobody makes a mistake.”
In the hallway next to the ER, she opened a door, and I followed her into a small, darkened room where six young doctors sat at computers. A window looked into the bay next door that held the CT scanner. “Billie Jean” played at low volume from a tinny speaker. Goldberg watched through the window as staff moved the patient from his gurney onto the bed of the machine. He cried out. Goldberg said, “That seems more appropriate.” Now they gave him some pain medicine. She looked at me and winced. “He has a broken humerus. I mean, you can feel it.” She streaked the thumb of her right hand against her fingers. “It’s one of my least favorite injuries. You can feel the bones rubbing together.” The CT scan showed some clotted blood in the patient’s head, appearing on the screen as patches of white. Goldberg ordered some additional scans.
When a shooting comes across the trauma pager, the code is GSW. There were no GSWs that night, only assaults. One patient was an older man who had been beaten up and complained of stomach pain. Another had been stabbed in the abdomen during a fight. His assailant was brought in, too, in handcuffs, a white-haired man in a red T-shirt, his left eye bloodied and swollen shut.
The injuries weren’t life-threatening. Goldberg attended to the patients in the trauma unit. When she wasn’t there, she went on rounds, taking the elevator up to the eighth and ninth floors to check in with patients recovering from earlier traumas. She walked fast from one place to the other and I would lose her sometimes behind corners and doors and she’d have to double back for me. These are busy shifts even when there aren’t a lot of fresh traumas coming in. During a down moment, Goldberg mentioned that she was thinking about scaling back her call schedule now that she’s chair of surgery, with large administrative and educational responsibilities. “I’ve been doing this 30 years,” she said. “Do I need to be on call? Do I need to do Saturdays?”