Photograph by Magdalena Papaioannou. Dr. Christine Trankiem’s hands are big and graceful, nails manicured a delicate ivory, steady as they move through the air. She’s a trauma surgeon, so her hands save lives—the victims of stab wounds, folks who have been hit by cars. In 2017, when Representative Steve Scalise was shot at a practice for the Congressional Baseball Game, Trankiem was on the surgical team that treated him. She’s the chief of trauma and acute-care surgery at MedStar Washington Hospital Center, the region’s busiest Level I trauma center, which handles some of the most dire medical emergencies in DC. When I met Trankiem, she’d just done an exploratory laparotomy (“It’s when we open someone up to see what’s going on inside,” she said) and was en route to a gallbladder surgery. We spoke at a table in her office, a model of a torso between us, its plastic flesh held open with a metal retractor. On the wall to her right was a hand-drawn grid with quadrants for “humble,” “cocky,” “wrong,” and “right.” As a surgeon, you have to be confident but not cocky, she explained, and it’s good to be right. “I think it’s thought-provoking,” she said. In a trauma center, Friday and Saturday nights are the busiest. What’s that like? Every trauma center sees people who have been in car crashes, or when our elderly population falls, they might have bleeding in their body or in their brain. But we are unique in that we have a very high percentage of what’s called penetrating trauma: shootings and stabbings. We receive more trauma than any other hospital in Washington, DC. On the weekends, we might have an older person with a brain bleed who we’re monitoring. We might have some college kids who were riding scooters and got in a crash. We might have some gun violence that comes in, and we bring them into the trauma bay, do a quick assessment, then bring them right to the operating room to do an exploratory surgery. It only takes one very sick patient to change the whole night. What’s an example of that? Sometimes the patients are basically pulseless, and in those cases, we might have to do what’s called a bay thoracotomy, where we literally open up the left side of their chest, deliver their heart into our hands, and then perform manual cardiac compressions. How long is the time between the ambulance arriving at the hospital and the heart being in your hands? Less than five minutes, for sure. For some people, they really thrive on routine. But trauma surgeons thrive on not knowing what the next thing is. It keeps it very interesting. What made you want to become a doctor? My parents wanted me to be a physician, but I was always very rebellious and I didn’t want to be a doctor. I went to the University of Pittsburgh on a full scholarship, so I felt empowered to study whatever I wanted. I didn’t take science. I was a religious-studies and classics major. And then I was an infomercial marketing manager. I thought I wanted to go back and get my PhD and teach at the university level—my specialty was the origins of Christianity. And then out of the blue, my father died in an accident. That was the moment when I realized I needed to be more realistic and practical. There aren’t a whole lot of jobs teaching the origins of Christianity. That’s when I decided I was going to medical school. Are you personally religious? No, I’m not. But you work at the extremes of life and death. Does that influence your worldview? I believe there’s something greater than us. And a lot of times our patients have a very deep faith. One of the hardest things that we do is deliver devastating news to a family when the patient is still alive, but it’s not a survivable situation. They tell us that they are waiting for the miracle, and our job is to crush that hope. “One of my favorite things is the first time I hear the patient’s voice once the breathing tube is out. It affects me really deeply.” What do you say? If they say, “I’m waiting for God to de­liver the miracle,” then I say, “God has given us certain medical abilities, and right now God has not made it in our capability to treat or reverse the condition that your loved one has, and I’m really sorry to tell you that.” I try to respect their tradition. But taking away hope is awful. It eats away at your soul. How do you handle it when you lose a patient? It’s kind of devastating. No one knows the devastation of that kind of loss like your partner trauma surgeon does, so we tell each other the typical platitudes—“Well, you weren’t the one who shot them,” or “You didn’t run over them”—but it takes a little time. And sometimes a patient dies but there’s, like, two more in the other trauma bay, so you have to sort of acknowledge the loss and then compartmentalize because that person in the next bay and the one next to them—they deserve your best, too. So you have to refocus. It’s important to acknowledge the emotion, but you can’t let it incapacitate you. What’s a part of trauma surgery that you really like? One of my favorite things is the first time I hear the patient’s voice—like, once the breathing tube is out and I hear them speak. It affects me really deeply. Right, I guess you’re often operating on people you’ve never spoken to before. I try to, actually. When we’re assessing whether or not we need to put a breathing tube in, we do speak with them. Be­cause even if they’re not making sense, if they’re able to phonate, that means they might be able to protect their air­way. So we will oftentimes speak with them. And sometimes the patients will grab your hand and say, “Doc, don’t let me die. I have to live for my daughter,” or something like that. You don’t want to make a promise you can’t keep, but it makes you fight even harder to try to save that life. What’s the worst physical trauma you’ve ever seen someone survive? There are people who get run over by dump trucks. When I see a dump truck on the road, I just give it a wide berth. I think all pedestrians should be very far away from a corner if there’s a dump truck coming by. [The trucks] can’t feel if they’re hitting or running over something. And you’ve seen people survive that? Yes, but we mostly see people not survive it. Do you have hobbies? Yeah, I like whitewater rafting. You like adrenaline. In some ways, I find it similar to trauma surgery, because you have to focus and mitigate your panic response. With panic, the wrong thing to do is to ignore it or try to push it down, because then it’s going to rear its head even more. I find that you [should] accept it quickly, acknowledge it, and then move on. It’s the same thing in trauma surgery. There’s some injuries I see that make me—let’s say, concerned [about the patient’s chances]—and I acknowledge the feeling that the injury is giving me and then I move on. How did you train yourself to do that? Time and repetition. As the team leader for the trauma team, if I express panic, everybody’s going to panic. So it is my responsibility to the patient and the team to maintain a calm external demeanor, even though I might have some internal panic. There are a lot of fictional trauma surgeons on television shows. Is that strange for you to see? If there’s one thing I could dispel on TV, it’s that they’re always so focused on getting the bullet out. Like that’s the purpose of a lifesaving surgery: to get the bullet out. And then when [the surgical team] comes out, the family says, “Did you get the bullet?” And they say, “Yeah, I got the bullet.” But removing the bullet in that lifesaving surgery is not the focus. There are implications of the bullet: some physical ones and certainly some emotional ones. But as far as lifesaving, the retrieval of the bullet is not important. That is my public-service announcement. Do you like doctor shows? I used to like House, and maybe the reason I liked it is that it didn’t have much to do with trauma surgery. But I will tell you what I don’t like to see, and it’s actually kind of funny. I am not good at watching depictions of surgery, either real or simulated on the screen. They actually make me a tiny bit nauseous. Why? I think it’s because, as a surgeon, I’m usually in control of the situation. I’m not in control if I’m watching it on TV. You have a really intense job. How do you recover from the bad stuff? My son is in college now, but I used to just hug him. He knew why I would do that. And when he was little, I could come home and be exhausted and feel terrible, and he would look at me and be like, “Mom, where’s my snack? Where’s my juice box?” And so I couldn’t be dwelling on all these other things, because he was there showing me real life. He was keeping me present. And one thing that my partner [trauma surgeons] and I remind each other is that when you stop feeling that deep sadness in your soul over the loss of a patient, it’s time to hang it up. What does hanging it up look like for you? I don’t know. I love what I do. I’m not really thinking about my endgame right now. RelatedR. Eric Thomas Wants to Solve All Your Problems This article, which has been edited and condensed, appears in the December 2024 issue of Washingtonian. The post Dr. Christine Trankiem Can Restart Your Heart With Her Hands first appeared on Washingtonian.