Chapter 1

February 17, 2006.

Dr. Jim Styner stood in front of a small wooden lectern and nervously sized up his audience, trying to grasp the gravity of the moment.  Before him sat two hundred or so of the most respected trauma surgeons in all of Europe, or the rest of the world for that matter.  Each of them distinguished members of the Royal College – the group he came across the Atlantic to address. 

The room he found himself in at that moment was two hundred and seventy years old, and was configured as a big amphitheater.  It could have jumped from one of the old movies where the young doctors sat in rows, looking down on the professor performing an autopsy on the body of a dead peasant, or some other procedure.  Many, many great men had stood in that exact spot, and that alone was unnerving.  The great and ancient hall was silent except for the beating of dad’s thudding heart. 

They had asked him to come to this place in Dublin, Ireland to speak about that night.  He was the only speaker for this, the annual 81^st lecture of the College.  He would find out later that the 81^st lecture, named for Abraham Colles - a noted surgeon and anatomist who died in 1843,  was significant because it was reserved for those whom the College deemed the most important and distinguished speakers. 

He didn’t consider himself all that important just then, nervously standing there before that crowd, a picture of a wrecked airplane projected on the screen behind him.  He felt weird that they had given him a check for five hundred dollars as a speaking fee, which was customary.  He tried to politely turn it down, but they insisted.  He realized that in thirty years it was the only money he had ever gotten directly because of ATLS.

He never wanted money for it.  From his point of view, he had an idea once, wrote it down, presented it to some people, and then went on with his life.  He had left his home in Lincoln for good in the mid-80’s, and had become quite content with his workers comp practice in California.  He had faded into anonymity.  It was quite a pleasant change, being away from the thousand-mile-an-hour life of a trauma surgeon.  ATLS had gone on into perpetuity without him, and that was fine with him. 

But now these people wanted to hear him talk about it. 

A couple of months before and out of the blue he was asked to speak about ATLS at an American College of Surgeons convention in San Francisco.  That was the first time he had ever told the story in public.  He ended with a standing ovation and met many doctors from all over the world who enthusiastically shook his hand and thanked him for what he had done. 

That had led him here.

He felt privileged and humbled.  It was indeed a great honor, to stand there before this crowd.  All of these doctors knew of him.  Perhaps they had discussed him and his story, although never by name until now.  For almost thirty years, he had been to them a mythical sort of figure, sculpted in the form of darkness and shadow from the words the ATLS textbook.  Someone they always wondered about, but never thought they’d actually meet.  Some wondered cynically if he even existed at all.

Now he stood before them, flesh and blood, not at all at home in the long black academic robe that they gave him to wear, draped neatly over his shoulders and making him look like an old-time professor.  The look wasn’t really his style, but he went with it. 

He lowered his head to consider the words on the pages stacked neatly on the lectern before him.  He thought about the date.  The significance of it, February 17, 2006, did not escape him, of course.  It wasn’t planned this way, but these things have a funny way of happening. 

He spoke, softly at first.  He thanked the President of the College who had introduced him, and then turned his attention to the audience.  He took a slow, deep breath and paused to shift his mind back to the field, the cold, the blood.  Drinking from the memory he began to speak:

“It has been my observation that countries are closer together if they possess something in common,” he said.  “I was fortunate, if that’s the right word, to participate in such a development.  I am here tonight to share with you my experience.”

He glanced back to the pages, more aware of the thudding of his heart in his ears, then back at the audience. 

“As in so many cases,” he continued “It starts with a tragedy and then the recognition of a need.” The memory held him fast now.  His hands trembled slightly as he turned the page.

“Thirty years ago…this very day,” he said, glancing at the large clock in the back of the room, “at about this very time…there was an airplane crash.”

            He paused and saw the audience was held rapt at his words, making him slightly uneasy.  But there was no turning back now, so he pressed on, giving himself to the emotion surging up from deep within him.

            “Out of the mass of metal, the injured, and the dead, ATLS was born…”