Most people never think about trauma care until they need it. Then, in a single moment, everything changes. A car accident. A fall. A sudden emergency. And suddenly, the quality of care available in your city matters more than anything else.
I have spent over 40 years thinking about exactly that. As a trauma and critical care surgeon, I have worked in military field hospitals, university medical centers, and now at Brooke Army Medical Center in San Antonio. Along the way, I have seen what works. I have also seen what happens when it does not.
What I want to share today is simple. The lessons learned on the battlefield have directly made Cincinnati safer. And that connection is stronger than most people realize.
What War Taught Us About Saving Lives
Modern trauma surgery owes a great deal to military medicine. Every major conflict has pushed us to get faster, smarter, and more resourceful.
During my deployments, including my time as trauma director at Balad Air Base in Iraq, I worked with surgeons and medics who had minutes, not hours, to stabilize patients. The pressure was intense. The innovations that came out of that environment, however, were remarkable.
We learned how to manage massive blood loss more effectively. We refined techniques for damage control surgery. We developed better protocols for keeping critically injured patients alive long enough to reach definitive care. These are not abstract lessons. They translate directly into civilian emergency rooms.
The data supports this. Research from the American College of Surgeons shows that trauma systems built on military-developed protocols have significantly reduced preventable deaths in civilian settings. The gap between military and civilian trauma care has narrowed precisely because surgeons like those I served alongside brought their experience home.
Cincinnati as a Laboratory for Innovation
In April 2014, something important happened in Cincinnati. Our team helped integrate battlefield medical technology into the city’s first responder network. This was made possible through a donation from Western and Southern Financial Group, a Cincinnati institution.
The technology itself was built for war zones. Daylight-readable displays. Rugged construction that survives harsh conditions. Centralized charging systems designed for field use. Long battery life. These features matter enormously when a paramedic is working a roadside accident in January at 2 a.m.
Bringing that technology to Cincinnati’s first responders was a milestone. It was also a signal. Cities do not have to wait for decades to benefit from military medical advances. The transfer can happen faster, and Cincinnati showed that.
This kind of local investment pays off. According to the CDC, trauma is the leading cause of death for Americans between the ages of 1 and 44. Strong trauma systems at the local level save young lives. Full stop.
Building Cincinnati CSTARS
One of the efforts I am most proud of is helping establish the Cincinnati Center for the Sustainment of Trauma and Readiness Skills, known as Cincinnati CSTARS.
CSTARS programs exist at several sites across the country. They serve a specific purpose. They keep military medical personnel sharp between deployments. Military surgeons and medics can lose clinical edge when they are not seeing high volumes of trauma cases. CSTARS sites partner with major civilian trauma centers to solve that problem.
Cincinnati made sense as a location. The University of Cincinnati Medical Center handles a high volume of trauma cases. The collaboration created real benefits on both sides. Military providers maintained their skills. Civilian programs gained dedicated, experienced collaborators.
Over the years, the teams trained through this program positively impacted more than 5,600 military families. That number represents real people who received better care because of this investment in training and readiness.
The PTSD Factor Nobody Talks About Enough
Trauma care is not only about physical injuries. A 2017 study of 5,800 U.S. veterans found a PTSD prevalence rate of 12.9%. That number affects not just veterans but their families and communities.
Surgeons like me see the physical side of trauma. Mental health professionals address the psychological side. The most effective systems treat both. Cincinnati has developed resources on this front, and the military medical community has pushed hard to close the gap between physical and mental health treatment.
If you want to understand more about the intersection of trauma surgery and veteran health, my publications page includes nearly 100 co-authored papers covering these topics in depth.
What I Believe About Trauma Care in America
I believe every city deserves a strong trauma system. I believe the lessons from military medicine should flow directly into civilian care. I believe in training aggressively, staying current, and never assuming yesterday’s best practice is good enough today.
Cincinnati has done a lot right. The partnerships between the military, the University of Cincinnati, and local organizations like Western and Southern have made this city more resilient. That matters to every resident, whether they know it or not.
One of my co-authored papers explored using a single ventilator to support four patients simultaneously. That research came directly from military necessity. It has implications for mass casualty events in any civilian city. Innovation born in conflict can protect communities everywhere.
A Final Thought
I also ride bikes. I explore landscapes and find perspective outside the operating room. Good medicine, I think, requires that kind of balance. Curiosity. Willingness to see the world from different angles.
Trauma surgery demands intensity. But it also demands clear thinking and connection to the people you serve.
Cincinnati is a community I care about deeply. Every advancement in trauma care that reaches this city represents an opportunity to save someone’s life. That matters to me. It should matter to all of us.
Dr. Jay Johannigman is a trauma and critical care surgeon with more than 40 years of experience in military and civilian medicine. Learn more at jayjohannigman.com or read his full biography here.