Revolutionizing Trauma Care — and Saving an American President

By Karen L. Brooks

Joseph Giordano was examining a patient on the sixth floor of George Washington University Medical Center the afternoon of March 30, 1981, when he heard an intercom page urging him to the emergency room. The head of GW’s trauma team, Giordano was often called to the ER — but not over the loudspeakers.

“Clearly, something important was going on,” he says.

That something important was the arrival of U.S. President Ronald Reagan, who had been shot after addressing union representatives at a nearby hotel. Giordano raced downstairs to a room buzzing with Secret Service agents and found the president on a gurney, surrounded by residents who had just discovered that a bullet had entered under his left arm and punctured his lung. Until then, the president and his guards believed the injury was simply a cracked rib suffered during the mêlée.

The wound was serious; Giordano inserted a chest tube and worked with his team to stabilize Reagan’s dangerously low blood pressure and pulse. Within half an hour, the president was wheeled into surgery to remove the bullet. He left the hospital 11 days later and made a full recovery.

Giordano is widely credited with saving Reagan’s life but humbly emphasizes the roles of many key players. “The real hero of the day was actually Jerry Parr, the special agent in charge of security. His decision to bring the president straight to the hospital rather than stopping at the White House — which his motorcade almost did — is the reason the president survived.”

Although that day’s events proved the most memorable from his 40-year career, Giordano says his proudest accomplishments involve overhauling trauma care in the Washington area — a challenge he didn’t initially pursue by choice. After graduating from JMC, he completed a surgical residency at GW and three years of basic science at the Walter Reed Army Institute of Research. In 1976, he returned to GW intending to work as a vascular surgeon. Instead, he was asked to lead the emergency department following the sudden departure of its chair.

“I was explicitly charged with setting up a trauma unit, which took a lot of effort because at that time, there were almost no major established trauma centers. We didn’t have specific trauma surgeons, teams or communication systems,” he says. “So, first things first: I had to learn how to manage trauma.”

To do so, Giordano spent a month at the R. Adams Cowley Shock Trauma Unit in Baltimore, one of the few premier trauma centers in the country. He learned what a good trauma model looked like — with stateof- the-art facilities, properly trained clinicians and distinct protocols — and used that knowledge to impose a similar approach at GW, which the American College of Surgeons certified as a Level I Trauma Center in 1979. Giordano also became involved in local Washington politics, pushing for the creation of a regional emergency medical communication system.

“When I started all this, our trauma unit was nonexistent,” he says. “But by the time President Reagan came in five years later, our unit was solid. The late 70s and early 80s saw a real emergency care revolution that changed medicine forever.”

Giordano stayed at GW for his entire career, being named chairman of surgery in 1992 and holding the position for 18 years. He devoted much of his time to honing the institution’s surgical resident training program and building a strong department of surgery.

Even though he retired two years ago, Giordano is not resting on his laurels. He serves on the board of Partner for Surgery, an organization that provides surgical care to rural Guatemalans, many of whom have never before seen a physician. He no longer operates but still visits Guatemala and continues to recruit American surgical teams to volunteer their services.

“Way back when I was a student at Jefferson, I traveled to help patients in Haiti, and as a resident at GW, I did the same in Honduras. I always wanted to do more of that, but you graduate, you get married, you have children, you develop your career — you’re just busy. I am grateful that now I can focus on this service, and I hope to recruit many more teams from all over the United States.”

Giordano says that while he is best known as “the doctor who took care of President Reagan,” he considers his work to improve trauma systems and his volunteer efforts among his greatest contributions to medicine.

“A president being shot, that’s a big piece of history, and I’m glad I was there to help. But all over the world, there are countless people in need, and I’d like to be remembered for improving healthcare access and delivery for as many patients as possible.”
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