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‘Wherever the Dart Lands’

Volume 14 | Number 1 | September 2012

By Tamara Linse
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On Nov. 12, 1951, just after the breakfast rush in the dining car, the passenger train The City of San Francisco telescoped the last four cars of the passenger train The City of Los Angeles outside of Evanston, Wyoming. The accident was caused by a frigid zero-visibility blizzard that obscured railway signals. Twenty were killed and 67 injured, with relief efforts hampered by the nearly two feet of snow that fell by nightfall.

“The trains, Union Pacific’s smartest passenger carriers to Los Angeles and San Francisco, normally move about 10 minutes apart from Ogden to Chicago,” reported the Nevada State Journal.

The next morning, 11-year-old Brent Eastman and his father joined the rest of Evanston’s citizens to lend a hand. Brent’s father, A.W., was an engineer on the Union Pacific, and the engineer on The City of San Francisco, who was killed, was a neighbor and a friend.

Among the passengers were surgeons who had just attended the Annual Clinical Congress of the American College of Surgeons (ACS) in San Francisco. They crawled from the wreckage and immediately joined with the local physicians to treat the wounded, breaking up dining car fruit crates for splints.

“That was the day—standing there with my father and seeing these mass casualties and these surgeons—that I decided I wanted to be a doctor, specifically a trauma surgeon,” says Eastman, who has practiced surgery and trauma care for 40 years, mostly at Scripps Health in San Diego, where he has achieved the rank of chief medical officer and senior vice president.

He continues, “I think what excited me then, and now, is when a multiply injured patient is coming in, you’ve got to be prepared for everything.  You’ve really got to be capable of dealing with all of the body systems.  That was the academic and intellectual appeal to me—that the multiply injured patient brought together all aspects of surgery and of critical care medicine.”

At that 1951 ACS clinical congress, the central prestigious lecture—dubbed the Scudder Oration the following year—was about fractures. Nearly 60 years later, Eastman had the honor of giving the 77th Scudder Oration. His talk, titled Wherever the Dart Lands: Toward the Ideal Trauma System, argued for a comprehensive national trauma system.

The title references throwing a dart at a map, which Eastman says represents a trauma case. “It won’t matter where the dart lands,” says Eastman, “because if you are injured, it won’t matter whether you’re in downtown San Diego or rural Wyoming—you will be ensured of expeditious transport and care commensurate with your injury.”

Shortly after arriving at Scripps Health, Eastman and two colleagues conducted a study that found San Diego had a 22 percent preventable death rate. They cut that rate to 0-2 percent within a year of implementing regionalized care—based on San Francisco’s model—that designated certain hospitals as Level I or Level II trauma centers. Since then, Eastman has led the charge to create trauma systems blanketing the United States and the world.

“One of my proudest moments was a few years ago when I was able to lead the American College of Surgeons’ Trauma Systems Consultation Team to Wyoming,” Eastman says. “And Wyoming has done a fabulous job of creating a trauma system in the entire state.”

In October, Eastman assumed the prestigious duties of president of the ACS, the pinnacle of a long and accomplished career that has included stints as chair of the Centers for Disease Control and Prevention Research Agenda Steering Committee and as chair of the ACS’ Board of Regents.

The secret to his success? He credits his Wyoming upbringing.

“I think there is something about the wide-open spaces of Wyoming and the challenges of the environment,” he says. “A very strong breed of people come out of Wyoming.  It’s that sense of independence. It’s that sense of confidence in the individual that you have to have to survive in Wyoming.”

Eastman’s ancestors, on both his mother’s and father’s sides, homesteaded in southwest Wyoming. His grandfather had the responsibility of freight agent for the railroad during World War II, when large amounts tanks and howitzers, stock and freight were mobilized.  His father was the engineer for the Big Boy, Union Pacific’s 4000-class articulated steam locomotive, and he would give a special toot on the whistle when he came into town so that young Brent knew he’d arrived.

While Eastman was growing up, Evanston’s trauma care system consisted of the local hospital and Eastman’s Uncle Gilbert, who was the county coroner, undertaker, ambulance driver, first aid teacher and president of the hospital board.  If he was transporting a casket for a funeral in his Cadillac combo hearse ambulance and he received a trauma call—someone kicked by a horse or run over by a tractor—he would apologize to the mourners, off-load the casket, put in the gurney rollers, place a red light on top of his vehicle and rush to the scene.

When Eastman graduated from high school, he decided to attend UW because of its excellent pre-medicine program, and he studied under Dr. Floyd Clarke, chair of the College of Arts and Sciences Zoology Department. Eastman majored in zoology and chemistry.

“He had a profound influence on my life,” says Eastman.  “He was an absolutely wonderful man. He had the most powerful, gentle personality and an enormous intellect.” And that was why Eastman felt so honored in 1994 to give the inaugural L. Floyd Clarke Memorial Lecture.

He continues, “I am forever grateful to Dr. Clarke and to the University of Wyoming for providing me with the educational background to compete with people from the best undergraduate schools from across the United States to get into that medical school.”

While at UW, Eastman met his lifelong friends, Perry and Judy Dray and Mike and Jane Sullivan, and as president of the UW student body, he worked with Al Simpson, Cliff Hansen and James Watt. He also went on to be student body president at the University of California San Francisco Medical School.

“I must say—I’ve often thought sitting there [as chairman of the Board of Regents of the American College of Surgeons] that I owe so much to my Wyoming heritage—that I’ve never felt anything but comfortable with these leadership positions,” says Eastman. “I think my foundation—educationally and socially and certainly leadership at the University of Wyoming—has been the foundation for all that.”

During summers, Eastman was a guide on the Snake River for the Jackson Lake Lodge Grand Teton Lodge Company in Jackson, where, coincidently, Dr. Clarke ran the biological research station. Eastman would require his boatmen to attend Dr. Clarke’s weekly lectures on the area’s flora and fauna.

To this day, Eastman and his wife, Sarita, a pediatrician, own a home in Jackson. Their oldest son is finishing his teaching degree while working as a river guide in Jackson and their younger son is an extreme climber and snowboarder in Jackson, while their daughter followed her dream of working for the Metropolitan Opera in New York City. They have two grandchildren.

One summer, under Eastman’s watch as river boss, First Lady Lady Bird Johnson rafted the river with Secretary of the Interior Stewart Udall. The next year, Lady Bird returned with her daughter Lynda.  Romance blossomed, and Eastman and Lynda dated for a time. Lynda would visit him, Secret Service and all, or he would visit the Johnson Ranch, and once he stopped by the White House on his way to England. They were even featured in Life Magazine.

Eastman then went on to medical school in San Francisco, where he met his wife and also would sometimes treat Jerry Garcia and the Grateful Dead in the emergency room, and then spent his career at Scripps Health.

Once, a dinner was given in honor of Eastman’s friend Harry Jackson, a prominent Western sculptor who lived in Cody and passed away in 2011. The filet mignon was served, and Jackson pulled his pocket knife out of his red-suspendered overalls, at which the host expressed shock. “I always use my own knife,” Jackson said, “even when I had dinner with President Eisenhower at the White House.”

Afterward, Eastman and Jackson stayed up late talking. Late in the night, Eastman rose with a yawn and said, “Harry, the next time we meet, I hope it’s in Wyoming.”

“Brent,” Jackson replied, “wherever we meet, it’ll be Wyoming.”

Eastman says, “When I think about Wyoming, it’s that: wherever I go in the world and I meet somebody from Wyoming, wherever it is, it’s Wyoming.”

Tamara Linse is editor of the UW Foundation.

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