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  Chicago ER doc skips TV drama for real thingBy Peggy Peck  Dr. Roxanne Roberts, right, oversees a 37-bed unit that serves 5,000 trauma patients a year. RELATEDHEALTH LIBRARYYOUR E-MAIL ALERTSCHICAGO, Illinois (MedPage Today) -- Ask Roxanne Roberts what she thinks about television's "ER," and she will fire back a two-word review: "Not realistic." And Roberts is more than a tough critic. She knows from experience. A trauma surgeon, the 50-year-old is director of the division of trauma clinical services at the real ER, the one that producers used as a model for the TV show. The emergency room is in what used to be called Cook County Hospital. In 2002, the hospital underwent a name change and became John H. Stroger Jr. Hospital of Cook County when it moved into a new state-of-the-art building. Roberts represents a cross between Kerry Weaver, the TV show's doctor-turned-administrator, and Peter Benton, the take-charge trauma surgeon from the program's early years. As a reality check, the producers of "ER" invited Roberts and her colleagues to see the show's pilot before it debuted in 1994. That preview showing, she says, is the only time she has watched "ER." Roberts explains her initial reaction to TV's take on the world of emergency medicine: "No one could ever be that busy all the time. We couldn't survive." Sometimes, of course, the trauma unit resembles "ER." "I remember, for example, a school shooting. We got four victims -- one was the perpetrator. They came in simultaneously, and we actually had to open up [the chests of] all four in the unit. The victims were all in middle school. The perpetrator was a cop. Only one survived, one of the kids," says Roberts, her voice dropping and fading off as she recalls the incident. Such dramatic events are more the exception than the rule. Nevertheless, Roberts puts in at least 60 hours a week, overseeing a 37-bed unit that serves 5,000 trauma patients a year. Not a natural studentLife in the ER, she says, is a long way from her days as a dyslexic, hyperactive girl who spent her first school years as "the worst kid in the class." She credits her parents for her journey from those early days as "a military brat -- the only child of a Coast Guard-lifer" to her position as assistant professor of surgery at Rush University School of Medicine and head of the trauma center. "I am one of only two people in my family to attend college," she says. "I'm the first in my generation. But my parents were education fanatics -- maybe because they didn't have any education -- so they always insisted that I have the best in education." Early help and attention from her parents started to pay off around fourth grade. "It was like a light bulb went off in my head," she recalls. "I went from being the worst kid in class to one of the best kids." By the time she was attending a small, private girls' high school in Beaverton, Oregon, she started thinking about medicine as a career. Romantic notions of medicineShe attended college at the University of California, San Francisco, and went to medical school at the University of Washington in Seattle. What made her choose trauma surgery? "I was a romantic. I had read 'The Three Musketeers,' and I wanted to be the renaissance physician -- a really smart internist who could operate." Fueled by that desire, she applied to old Cook County Hospital for training. "It was five long years, but it was wonderful training," she says. She arrived at Cook County 25 years ago, and except for a year in private practice, it has been her professional home since. "I started doing this before we had CT scans. Can you imagine?" she recalls, referring to computed tomography, a noninvasive way to view injury to the brain. 'Golden hour' to treat injuriesThe key to effective trauma care is fast treatment. Based on research, trauma surgeons know that they have about an hour from the time of injury to work their magic. Technology, Roberts says, has revolutionized trauma care, making it possible to render the maximum care during that "golden hour" after injury. For instance, X-rays are stored on computers so Roberts "can pull up the patient's X-ray any place in the hospital -- the operating room, a trauma room, any place." Equipment that used to be stationary is portable, "so we can do tests like ultrasound at the bedside. Instead of sending blood down to a lab ..., we have handheld devices that can analyze the blood." In yet another contrast with TV's "ER," Roberts and her colleagues continue to follow trauma patients long after their discharge from the unit. "It is amazing really because when we first see these patients they are in really bad shape, then they come back and they're healthy, so we don't recognize them," she says. "We have to look at the chart to ... identify the patient. That's very rewarding." Roberts admits that "it's true that you don't see many old trauma surgeons," but she adds that many physicians and nurses at Cook stay for decades. And what makes a great trauma surgeon? "You have to like night work," she replies. 
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