In July, Baylor University Medical Center at Dallas (BUMC) was thrust into the national spotlight with the shooting of 12 police officers and two civilians in downtown Dallas. A number of the victims were cared for by the hospital’s Level 1 Trauma Center under the direction of Michael Foreman, MD, FACS, medical director of Trauma and 1987 graduate of the BUMC surgical residency program.
While Dr. Foreman was featured prominently in a number of press accounts about the shooting and the care the wounded received that night, the ability to treat so many critically injured at once is thanks largely to the work he has quietly put in over the past 30 years. Over three decades, he has established the BUMC Trauma Program as one of the most capable programs in the nation.
The Spark that Led to BUMC
A native of Odessa, Texas, Dr. Foreman first learned about BUMC just before leaving for medical school. His mother had her gallbladder removed in Odessa, but experienced severe complications. She was referred to BUMC and Robert Sparkman, MD, who was the chief of surgery and an expert in complex biliary reconstruction.
“Before my mother’s second surgery, I remember having the hutzpah to ask Dr. Sparkman to explain exactly what he was going to do – after all, I was about to go to medical school,” explains Dr. Foreman. “He just looked up at me and chuckled a little bit and said, ‘why don’t you come talk to me after you get out of medical school and we’ll see if you can understand it.’”
But what Dr. Foreman remembers most about Dr. Sparkman was his kindness. Dr. Sparkman picked Magnolia flowers from the tree in front of Truett Hospital and brought them to his mother throughout her stay, floating them in water in an emesis basin at her bedside.
While Dr. Sparkman left a lasting impression, Dr. Foreman hadn’t considered BUMC for residency until a classmate at UT Health Science Center in San Antonio returned from a rotation at the hospital and told him of the great experience he had. So when it was time, Dr. Foreman applied, interviewed – including interviewing with Dr. Sparkman – and was matched.
“I reminded Dr. Sparkman what he had told me to do four years before, and he got a chuckle out of that. Then he explained the operation to me, and I still didn’t really understand it,” says Dr. Foreman.
A Bare Service Turned Renowned Program
Entering medical school, Dr. Foreman thought he was going to be an emergency medicine physician after working as an EMT during college. But he fell in love with everything about surgery.
Early in his residency, surgery residents gained experience in trauma through their rotation at John Peter Smith Hospital in Fort Worth. While BUMC received some trauma patients, there was no formal program around it, and the Emergency Department was small and hard to get to in the basement of Hoblitzelle. Consequently, nearly all trauma cases in Dallas ended up at Parkland.
“Roberts Hospital opened in 1986 with a new Emergency Department. At the same time, crack cocaine came to Fair Park – and Dallas in general – and turned the area into a war zone. It was the peak of the violence in the city,” explains Dr. Foreman.
By the time he was chief resident, every night he was on call at BUMC he was operating on trauma.
As he approached the end of his residency, Dr. Foreman began considering doing trauma full time, which was unheard of in private practice. However, one of the staff surgeons he had trained under had some unused space in his office and invited Dr. Foreman to set-up shop for free, while one of BUMC’s administrators arranged a small stipend for him.
A decade after hanging his shingle in a free office space, BUMC became the first non-university, non-county hospital in the state of Texas to be designated a Level 1 Trauma Center by the American College of Surgeons. The Division of Trauma, formed in the mid-90s, has now grown to include critical and acute care surgery and was renamed accordingly a few years ago, the Division of Trauma, Critical Care and Acute Care Surgery.
The Division he now directs includes 11 physicians, three critical care fellows and 15 nurse practitioners on the medical staff, as well as specialized nursing and research staff at BUMC.
At Their Best on the Worst Night
On July 7, 2016, Dr. Foreman, along with everyone else in the BUMC Emergency Department, was unaware of the mass shooting in downtown Dallas, until the first bullet-riddled police car pulled into the drive carrying the first victims. The Trauma team is used to handling multiple gunshot victims, but the circumstance surrounding the tragedy was something they couldn’t have been prepared for.
“In trauma, we have to be empathetic immediately to all our patients…But police officers are like part of our family. Emotionally, that night was overwhelming,” says Dr. Foreman.
The night only got worse for so many families and the city, but Dr. Foreman and the BUMC trauma team remained at their best.
“I was so proud of every single person that was there…They did more than ’just their job.’ Even the environmental services staff who swept the floors between patients did better than usual. Everyone. The performance of the entire Baylor family was just incredible,” he says with emotion.
Despite the emotional toll, being able to help in a time of tragedy is what Dr. Foreman has dedicated his career to and why he stayed at BUMC after completing his residency. He has had other offers over the years, and even entering residency he didn’t see himself spending his career in Dallas. But he says the organization and mission have remained strong.
One of the things that made me stay was the board and administration’s commitment to taking care of patients – insured or uninsured,” he says. “This is my home and the culture I identify with. This is what I want to be known as being a part of.”