Dell Children’s chief surgeon Dr. Nilda Garcia helped create research group with 5 other children’s hospitals that is changing patient care.
When Nilda Garcia first meets a patient at Dell Children’s Medical Center of Central Texas, it’s never for a good reason. She’s a pediatric trauma surgeon, who came to Dell as the director of the trauma department in 2010 and became the surgeon in chief in February.
She tries to sit down, make eye contact, talk to the patient and always talk to the mom. She thinks about what she as a mom would want a doctor to say. She’s a mom, after all, to 16-year-old Greg.
She always includes the family and the patient in the conversation, no matter how young. “It makes them feel part of it,” she says. “It makes them feel good.”
She gets a lot of information, especially from the moms. What happened right before the accident? What was the kid doing? What happened right after?
She’ll draw a picture on a piece of paper towel to make sure the family understands the injury. Then, in her head, she goes through the worsecase scenario. She shares that with the family.
“Other surgeons and doctors will keep that to herself,” says Kelly Gettig, the lead pediatric nurse practitioner for trauma services at Dell Children’s. “She shares it. She’s preparing families for the absolute worst. … Families are really prepared from the get-go for what’s going to happen.”
“Dr. Garcia takes it so seriously that these are real possibilities,” Gettig says. “There’s complete honesty, which is really unique.” She spends a great deal of time with families, Gettig said, and will tell them when she just doesn’t know the answer.
Then Garcia has to make a decision. Will they operate or will they wait?
Garcia, 54, has helped create the guidelines for trauma by building a consortium of Level 1 pediatric trauma centers around the country. She and doctors from Children’s Medical Center Dallas, Phoenix Children’s Hospital, Arkansas Children’s Hospital, Children’s Hospital at Oklahoma University in Oklahoma City and Le Bonheur Children’s Hospital in Memphis now share data and have developed guidelines for care, especially surrounding injuries to solid organs — that’s the liver, spleen and kidney. One hospital would not have enough data to be able to really study and create best-practices, but six working together do. They and other hospitals will continue best-practice sharing at the Austin Trauma & Critical Care Conference at the AT&T Conference Center May 31-June 2.
That data collection has taught Garcia something that’s hard for surgeons to understand. Sometimes it’s best to do nothing surgically. Sometimes it’s best to let the body heal itself.
Her research has changed what doctors now do when it comes to a spleen injury. Instead of automatically removing the spleen, which can prove dangerous later in life because the body doesn’t have that organ