So Temple launched one. It’s called the Philadelphia Immediate Transport in Penetrating Trauma Trial (PIPT), an elaborate undertaking that has involved close coordination with emergency personnel and also dozens of community meetings where doctors explained how the study works (over the next five years, some victims of penetrating trauma will receive immediate transport and some won’t) and how people can opt out of the study (by wearing a special wristband). In that same spirit, Goldberg has been gathering data on the Turning Point program. For years, patients have been randomized into a control group and an experimental group. One group gets typical care and the other gets Turning Point, and then patients in both groups answer a questionnaire that quantifies attitudes toward violence.
In November the hospital published its first scientific results from Turning Point, based on 80 patients. According to Temple’s data, the Turning Point patients showed “a 50% reduction in aggressive response to shame, a 29% reduction in comfort with aggression, and a 19% reduction in overall proclivity toward violence.” Goldberg told me she was proud of the study, not only because it suggested that the program was effective, but also because it represented a rare victory over the status quo. Turning Point grew out of her experience with that one patient in 1992, the three-time shooting victim who died the third time. It took her that long to get the authority, to gather the data, to get it published, to shift the system a little bit.
Twenty-four years.
EACH TIME I WENT TO THE HOSPITAL, I ASKED GOLDBERG what else was going on with her aside from work. She usually talked about running. She likes to run along the Schuylkill River while listening to music and thinking about nothing at all. She competes in a few half marathons a year.
I never learned much about Goldberg’s personal life. She lives alone in an apartment in Center City. She has a rowing machine there and access to a treadmill in the building’s gym. Her religious faith is still strong—it’s not that she goes around talking about it, she told me, it’s just that she has worked for 30 years in trauma and seen a lot of death, and it’s hard to do that and not feel something about God. I noticed one day she was wearing a white Lokai bracelet, a ring of plastic capsules said to contain mud from the Dead Sea and water from Mount Everest. “The highs and the lows, to stay even-keeled,” she said. “I probably need ten of them, five on each hand.”
The major nonrunning events in her life tend to be awards ceremonies. She has reached the point in her medical career where people gather and say nice things about her, and there are plates of olives and prosciutto. Her med-school alma mater, Mount Sinai in New York, recently invited her to give a special lecture at Grand Rounds, a hallowed medical tradition. On March 16, Temple threw a party for her “investiture,” a ceremony where she passed from being merely the chair of surgery to being the George S. Peters, MD, and Louise C. Peters Chair of Surgery. Endowed chairs at universities are a big deal. Past colleagues from all over the country came to speak about her qualities. One compared her to Teddy Roosevelt’s famous Man in the Arena, “whose face is marred by dust and sweat and blood . . . who spends himself or herself in a worthy cause.” (“Or herself” is not actually a part of Roosevelt’s quote, but the guy modernized it for Goldberg.) She gave a brief acceptance speech focusing on the importance of teamwork to medical excellence. She said she used to dream about being a sports coach, and now she’s coaching the next generation of surgeons. As she once put it to me, “One of us can’t give perfect care. But together, maybe, we can give perfect care.”
One of the speakers at the investiture called Goldberg a “realistic idealist,” and when I saw her later, she said she’d been thinking about the phrase. At first it surprised her that people saw her that way, but she realized it captured something true. “When I get angry, and hurt,” she told me, “it’s because I can still be a little naïve.” Even after all this time, the sense of horror she first experienced as a resident treating gun patients has never completely gone away.
One evening when I was at the hospital, I saw what she meant. Two shooting victims came in, a man and a woman, about two hours apart, and were quickly patched up. The man was shot twice, in a wrist and a thigh—four holes, not life-threatening. The woman was shot once in the thigh with a small entry wound but no exit wound—a stray bullet that struck her while she was walking down the street. In the trauma bay, the surgeons taped a paper clip over the entry wound so they could identify that spot on the X-ray. Goldberg wheeled the monitor over to show me the X-ray image: paper clip and bullet. “Very small,” she said, pointing to the slug, “like a .22.” As so many other patients do, the patient asked the trauma surgeons if they were going to take the bullet out, and the surgeons explained that they fix what the bullet injures; they don’t fix the bullet.
They left the wound open to prevent infection and put a dressing on it. “We’ll probably send her home tonight,” Goldberg said. “Isn’t that awful?”
She meant it as a strictly human thing. There’s no medical reason for a patient to be in a hospital longer than necessary. The point was the ridiculousness of the situation. A woman gets shot through no fault of her own, she comes to the hospital scared, and if she’s okay, Goldberg says, “It’s like, here, take a little Band-Aid.” The woman goes home, and for everyone else in the city, it’s as though the shooting never happened. It changes no policy. It motivates no law. In a perverse way, the more efficiently Goldberg does her job inside the hospital, the more invisible gun violence becomes everywhere else.
Which is why she pours so much of herself into the outreach programs, the scientific studies, and any other method she has of finding control and making the problem visible. Then, as always with Goldberg, she does her call shifts. “We care,” she told me once. “We’re gonna be here. We’re gonna be here. We’re gonna be here, and then you know what, we’re still gonna be here. And then we’re still here. That kind of thing.”
The last time I saw Goldberg, I was eating breakfast in the hospital’s basement cafeteria, one corridor away from the morgue, where bodies are kept, pending transport. It was at the end of a relatively quiet overnight call shift in late March. She walked in with a coffee, looking calm and fresh. The forecast showed rising temperatures. The crust of snow on the sidewalks would soon melt, the days would lengthen, people would leave their houses to enjoy the weather. Spring was coming, and the shootings would pick back up.
Originally published by Highline for HuffPost, April 2017
Checkpoint Nation
By Melissa Del Bosque
Laura Sandoval threaded her way through idling taxis and men selling bottles of water, toward the entrance of the Cordova International Bridge, which links Ciudad Juárez, Mexico, to El Paso, Texas. Earlier that day, a bright Saturday in December 2012, Sandoval had crossed over to Juárez to console a friend whose wife had recently died. She had brought him a few items he had requested—eye drops, the chimichangas from Allsup’s he liked—and now that her care package had been delivered, she was in a hurry to get back to the Texas side, where she’d left her car. She had a three-hour drive to reach home, in the mountains in New Mexico, and she hated driving in the dark.