- Raising His Voice Against Violence
- Growing up in a squalid neighborhood in Havana and
on the rough streets of Chicago shaped Juan Asensio's mission
of trauma prevention and treatment.
- by Brenda Maceo
It was a Los Angeles Times article about trauma surgeon Juan A. Asensio, M.D., that first caught the eye of the producers at CBS' "60 Minutes." After doing additional research on Asensio's work, they decided that they wanted to feature his compelling story. Further, Dan Rather decided to fly to Los Angeles to do this particular interview himself.
The segment, shot over two days in January at the LAC+USC Medical Center, documented Asensio's work and personal mission-to not only treat the most complex and life-threatening trauma cases, but to try to prevent them as well.
The producers and crew of "60 Minutes" were by no means the first journalists to take note of Asensio. Over the years, dozens of national and international newspapers, magazines, television and news programs have covered Asensio's work, especially his efforts to prevent violence among inner-city youth.
And Asensio, like his colleagues in the busy division of trauma surgery, has had little time to respond to the interview requests. "I try to make time for it to raise attention to this problem," says Asensio. "People talk about breast cancer prevention or prevention of heart disease, which are important issues, but not many voices are out there talking about prevention of violence among our inner-city kids. These young people are more at risk from violence than from any disease."
Asensio, using a tough-love approach, has spoken candidly with more than 12,000 at-risk youth and 600 physicians and community leaders about the tragic results of violence. Most of these talks took place in high schools, youth centers or juvenile detention facilities in groups of 200 to 300 people. Using slides and survivor testimonials, Asensio shows them the grim and graphic side of gun shot wounds, stabbings and other violent injuries.
Community partners in this outreach include the Los Angeles County Sheriff's Department's Vita Program, the Los Angeles Police Department's Juvenile Impact Program, the Los Angeles County Probation Department and the Soledad Enrichment Program.
The "60 Minutes" crew taped such an outreach session with Asensio addressing a group of police officers and troubled youth. His presentation included an emotional testimonial from a former patient of Asensio's-Maria Reyes. Reyes and her husband came on stage to talk about their lives as former gang members and about her close call with death when she was shot multiple times with an automatic rifle by rival gang members while sitting in a car.
Reyes described to the audience how, after weeks in the hospital, many surgeries and months of painful recovery, she regained her life. She now helps Asensio deliver the message on the horrible ways that street violence rips lives apart.
After the presentation, Dan Rather conducted one-on-one interviews with Asensio and some of the kids.
"This kind of outreach takes a tremendous amount of time to arrange," said Asensio. "But I feel that remembering where I came from, where I grew up, that I want to give back something."
Asensio emphasized that he understands the impoverished and underprivileged world in which these at-risk kids live. Having grown up in a squalid, tough neighborhood in Havana and later on the rough streets of Chicago, he faced poverty, racism and constant threats from gang members who attempted unsuccessfully to recruit him.
Still, Asensio accepts no excuse for gangbanging.
"We need doctors who have a social conscience because violence is not just a physical problem. It's a social problem," he said. "We do a wonderful job of taking care of people, and researching and teaching, but one component is lagging behind-prevention."
Asensio overcame the challenges of assimilation and poverty to earn his bachelor's degree at the University of Illinois. He went on to receive his medical degree at Rush University and completed his residency at Northwestern University. He undertook further post-graduate surgical training at the Medical College of Ohio and completed fellowships in trauma surgery and surgical critical care at the University of Texas Health Sciences Center and Parkland Memorial Hospital.
Asensio joined the USC faculty in 1993 after serving as associate professor and chief of the Division of Trauma Surgery and Surgical Critical Care and Air Evacuation at Hahnemann University in Philadelphia. He was also an assistant professor at Temple University in Philadelphia from 1988 to 1992. Asensio now serves as a tenured associate professor and unit chief of Trauma "A" Service in the division of trauma and critical care at the Keck School of Medicine's Department of Surgery and as a senior attending surgeon at LAC+USC Medical Center.
Despite all of the attention paid to his remarkable commitment to outreach, Asensio is primarily focused on academic pursuits and furthering the field of trauma surgery.
He has been a visiting professor to most countries in Europe and North, Central and South America and has also lectured extensively in Asia, Australia and New Zealand.
He has received numerous academic honors and has twice been granted the Humanitarian of the Year Award by the Los Angeles Board of Supervisors. In May 2001, Asensio received another humanitarian award from the California State Hospital Association for his efforts in trauma prevention. This award has also been given to Randy Sherman, M.D., professor and chief of the division of plastic surgery for his leadership role in Operation Smile-a worldwide humanitarian program.
"First and foremost we are academicians," Asensio said of himself and his colleagues in the division of trauma. "We are very outcome-oriented. Our outcome studies deal with the worst of the worst trauma cases. We publish on complex injuries, on operative techniques and other aspects of our field that improve outcomes."
When asked about scientific contributions made by him and his colleagues, Asensio fired off a staggering list of scientific publications without missing a beat. It is precisely these scientific contributions that have led to the division's national and international renown.
"We are constantly publishing studies," he said. "We currently have the only two prospective cardiac injury studies in print. These look at outcomes on penetrating cardiac injuries. And we demonstrate a very high survival rate.
"We also recently led two multi-institutional studies-one dealing with superior mesenteric (abdominal) artery injuries. It was outcomes from 250 cases at 35 institutions presented at the American College of Surgeons' Annual Clinical Congress. In February, we published a multi-institutional outcomes study on penetrating esophageal injuries, examining 405 cases at 34 institutions under the auspices of the American Association for the Surgery of Trauma (AAST)."
Asensio described the clinical impact of these studies: "One procedure, the stapled pulmonary tractatomy, published in 1997, has now become an accepted standard for rapid hemorrhage control in pulmonary injuries."
The division's faculty members are working on the largest trauma surgery atlas, which details complex surgical techniques, and are also working on the second issue of the Surgical Clinics of North America, a two volume set on vascular injuries. In addition, a trauma handbook by Demetrios Demetriades, M.D., Ph.D., director of the LAC+USC Trauma/ Surgical Intensive Care Unit, and Asensio was recently published. "This division truly has worldwide impact," Asensio said. "We have authored expert articles for publications in Europe, Asia, Central and South America and Australia. For instance, we have two papers about to come out in the Japanese Journal of Surgery."
Adding to the global impact, Asensio directs the division's program for international research fellows, which trains leaders in the areas of trauma surgery. Asensio says the men and women in the program are also involved in the process of publishing academic papers. The program has had more than 150 fellows as visitors or as research fellows, and currently has more than 10 in residence. Upon completing the program, most have returned to their countries to serve in academic leadership positions.
Asensio's friend and medical school colleague Pablo Valencia says that beyond the trauma division's international impact through publications and teaching, Asensio's work in youth violence has extended outside the U.S.
"It is not only important in the U.S., but in Brazil, Russia, Mexico and elsewhere where such violence is on the rise-tied mainly to worsening economic conditions," said Valencia.
Asensio's initiatives in trauma prevention have played a strong role in the American College of Surgeons' Committee on Trauma/Prevention subcommittee in the development of a trauma prevention presentation and in the plans for a trauma prevention post-graduate course. The division's program is one of the few to be recognized and listed by the AAST. Asensio also participates in the USC Multidisciplinary Trauma Prevention Initiative.
Beyond the outreach and the academic publications, Asensio's compassion and expertise shine brightest through his patients.
On a recent day at LAC+USC, Asensio was making rounds checking on his latest group of recovering patients: a young man shot in the head, chest, heart and abdomen; a teenager with a gunshot wound in the leg that under most circumstances would have been amputated; a young woman in the intensive care unit with multiple gun shot wounds to the abdomen; a man dropped from a rooftop with multiple head and face injuries, and 21-year-old security guard shot while on duty who is now a paraplegic.
"I am not a social worker," said Asensio. "Anyone will tell you, I am an academic trauma surgeon. Many of the health professionals working in this world-renowned department have different, worthwhile causes that they champion. I am driven to try to stop this violence among the inner-city's youth. I want to have an impact in preventing some of these kids from becoming the victims of violence that I see every day."
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