Local gun violence is driving an increase in patient volume at Regional One Health’s Elvis Presley Trauma Center, emphasizing the need for the hospital’s $750 million planned expansion. 

“I don’t think it registers with people, the magnitude of the gun violence that we’re seeing,” said Dr. Andrew James Kerwin, the center’s chief of trauma since 2021. 

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According to Memphis Police Department data released in October, “part one” crimes in Memphis were up 23.8% through the first three quarters of 2023. Those crimes include homicide, aggravated assault, auto theft, burglary, larceny, rape and robbery (including carjacking). Homicides were up 30% from last year.

At Regional One, Kerwin leads a multidisciplinary team that provides lifesaving care for critically injured patients at one of the nation’s busiest Level 1 Trauma Centers. It’s also the only designated Level 1 center in the region, so it treats patients from Tennessee, Arkansas, Mississippi and Missouri.

“Each of the last two years, we’ve had 1,400 patients come in from gun violence, and this year, we’re on pace to break that, which is really unthinkable,” said Kerwin, who’s also chief of the Division of Trauma/Surgical Critical Care at the nearby University of Tennessee Health Science Center College of Medicine. 

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“I know people see it on the news each night and they hear about it, but each story kind of comes and goes.” 

In 2022, the Elvis Presley Trauma Center saw a total of 12,566 patients. Regional One Health estimates patient volume for 2023 will show an increase of more than 30% over last year.

“I told a colleague of mine how many patients we have from gunshot wounds, and he said that’s about how many total trauma patients he gets each year,” Kerwin said. 

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According to Kerwin, trauma centers all over the country are seeing an increase in patient volume, much of it due to gun violence. In Memphis, most pediatric victims of gun violence are routed to nearby Le Bonheur Children’s Hospital. But the Elvis Presley Trauma Center has also treated older children with gunshot wounds. 

“We get some younger patients,” Kerwin said. “We’ve had as young as 12 over here. We get our share of 15- and 16-year-olds, as well.”

The impact on the trauma team

Historically, most patients have arrived at the trauma center with injuries from falls and motor vehicle accidents. 

Because it’s a Level 1 trauma center, Regional One Health can provide total care for every aspect of a severe injury, from prevention through rehabilitation. To do so, it takes a multidisciplinary team of medical professionals, including trauma and critical care surgeons, anesthesiologists, trauma nurse practitioners, pharmacists and respiratory therapists. 

There are also orthopedic surgeons to fix fractures and neurosurgeons to work on spine injuries and brain trauma. And there are vascular surgeons, oral surgeons and plastic surgeons. 

“Literally hundreds of people may at some point provide some care for a patient who has multiple injuries, and those hundreds of people will help restore that patient back to health,” Kerwin said.

But caring for such a high volume of patients suffering from wounds inflicted by community violence also takes its toll on the well-being of those medical professionals. 

“After a case when we’re covered in sweat and there are puddles of blood on the floor, and it’s soaked through shoes or socks, you go talk to a family and tell them their son or daughter or dad or mom isn’t coming home because they didn’t survive,” Kerwin said. “Taking care of trauma patients is very physically demanding and emotionally demanding and mentally challenging.”

As the numbers of patients climb, the trauma team is also dealing with the limitations of an aging facility. The Elvis Presley Trauma Center was built 40 years ago and wasn’t designed to accommodate today’s volume. 

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“It’s way too small,” Kerwin said. “That’s why we need a new hospital.”

But Kerwin hopes policy changes will also be part of the solution to this current public health crisis. 

“I think more and more people want to see sensible gun laws to make people safer,” he said.

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What’s next

Regional One Health is planning a $750 million project to replace its outdated hospital with a contemporary facility.

Dr. Reginald Coopwood, longtime CEO of Regional One Health, said the hospital is “providing great care within old bones.” 

The health care system was established in 1829, and the facility’s power plant is 80 years old. The hospital’s Chandler Building, where patients access outpatient rehabilitation and interventional radiology, was built nearly 60 years ago.

The cost to upgrade Regional One’s existing facility would be more than $1 billion, meaning it’s more cost effective to replace the hospital. That plan would occur in phases. 

The existing trauma center would be razed. In fact, so would everything but the Turner Tower, which houses the Firefighters Burn Center, Surgery Center, Extended Care Hospital, Wound Care and the Rehabilitation Hospital. 

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Regional One Health is also working in partnership with the University of Tennessee Health Science Center to transform the hospital into an academic medical center. 

This would give the State of Tennessee partial ownership of the new entity, which could bring state dollars to Shelby County’s aging public hospital.