Over 50 years, Frank L. Mitchell Jr., MD, left his indelible fingerprints on University Hospital. Colleagues described him as a visionary and a man of action. However, when asked about his accomplishments, Mitchell explained the reasons for all of his hard work and long hours.
“Everyone at University Hospital plays a role in saving lives,” he said. "The people of Missouri deserve the best possible medical care. We are the University of Missouri, and I think that University Hospital and the medical school should serve as an example for optimal medical care.”
To make that possible, Mitchell ensured that University Hospital is always at the forefront of trauma care.
In the 1960s, Mitchell founded mid-Missouri’s first hospital ambulance service. Mitchell recognized that patients needed expert care before arriving at a hospital and began the state’s first paramedic training program in the 1970s. When hard-to-travel country roads delayed getting lifesaving care to rural Missourians, Mitchell introduced central Missouri's first emergency helicopter service in the 1980s.
Because of his efforts and achievements, Mitchell became well known at University of Missouri Health Care. Even after 50 years, he continued to play an active leadership role with University Hospital's Frank L. Mitchell, Jr., M.D., Trauma Center — which carries his name in gratitude for his contributions to building central Missouri’s only Level I trauma center. What some people may not know, however, is how far Mitchell's reputation spreads beyond the borders of his home state.
“Frank Mitchell is a member of an elite group of pioneers who paved the way for trauma care, both nationally and internationally,” said Stephen Barnes, MD, chief of the Division of Acute Care Surgery for University of Missouri Health Care. “The world knows who Frank Mitchell is. He helped make modern trauma care what it is today. He did it modestly and quietly, with his top concern always what is best for the patient.”
Lessons Learned on the Battlefield
Mitchell came to University Hospital as a resident physician in general and thoracic surgery in 1959 after serving two years as a surgeon in a U.S. Army hospital in Germany. He had been drafted into the Army during his residency at Vanderbilt University in Nashville, Tennessee, after completing his four-year medical degree at Johns Hopkins University School of Medicine in Baltimore.
In the Army, Capt. Mitchell treated soldiers injured in automobile wrecks on treacherous German roads and victims of tank-crew training accidents in Europe. He also saw glimpses into the future of civilian trauma care, in the form of Army medical evacuation helicopters, which had been first used only a few years before during the Korean War.
“We saw a lot of trauma,” Mitchell said. “I got a lot of experience caring for trauma patients with the Army.”
Early Days of Trauma Care
A native of Excelsior Springs, Missouri, and a graduate of MU — with an undergraduate degree and a two-year medical degree, which preceded today’s four-year degree —Mitchell wanted to bring his experience back home to serve Missourians. When he arrived at two-year-old University Hospital, it offered state-of-the-art health care. But state-of-the-art trauma care then was different from today.
In the 1950s and 1960s, most trauma victims in the United States were transported to hospitals in the back of a funeral home’s hearse. The majority of hearse drivers had no medical training. Regardless, from the time a trauma victim was picked up by a hearse to the time the patient arrived at the hospital, he or she was alone because the back of a hearse was too small to provide care.
So in 1968, Mitchell collaborated with the MU School of Engineering to custom-build an ambulance with lights and a siren, medical equipment and space in the back for the patient and a staff member who could perform procedures such as cardiac massage, airway control and running an IV. He also introduced a radio system, so hospital staff would know beforehand when a trauma patient was en route, and he helped expand radios to hospitals around Missouri. Mitchell recognized that time is critical when caring for trauma patients.
“I don't think Dr. Mitchell and the other doctors slept in the hospital, but somehow, they were at the hospital when we came in the door,” said Carey Smith, MBA, manager of regulatory affairs, who served as a paramedic with Mitchell in the 1980s. “They would be here at 2 o’clock in the morning already when we walked in the door with a bad trauma patient.”
After the introduction of more ambulances in Missouri, Mitchell recognized that if emergency responders had more consistent, specialized training, the responders could provide better care in the field and en route to the hospital. In 1974, he began the state's first paramedic training course. It grew in popularity, and in 1978 he started training instructors to travel throughout the state to teach more paramedics. Mitchell also worked with the state to institute licensing requirements for paramedics, making sure they had the most up-to-date lifesaving skills.
Don Stamper, of Columbia, Missouri, was trained by Mitchell and became one of Missouri’s first 200 paramedics. He worked with and was mentored by Mitchell for two decades at University Hospital and later served as manager of emergency medical services at University Hospital.
“I probably can't count the number of paramedics he has taught and the places he has traveled to teach paramedic classes,” Stamper said. “And there were literally hundreds of medical students and residents that he has influenced.”
Introducing The Staff for Life Helicopter Service
Always interested in improving the quality of patient care, Mitchell conducted a study in 1980 that found 40 percent of trauma victims who died from a serious injury might have lived if they received quick medical care. Central Missouri's rural roads presented obstacles for standard ambulances, so he introduced a trial program using the Missouri Highway Patrol’s helicopter as an air ambulance. The program showed that the hospital should save lives with a helicopter. In 1982, University Hospital's permanent Staff for Life Helicopter Service was born.
His Staff for Life colleagues note with a laugh that despite Mitchell's dedication to academics — with more than two dozen articles and book contributions — he was a hands-on leader. Take, for example, the time flight nurses told him the helicopter landing pad needed a gurney ramp.
“Dr. Mitchell said, ‘OK, we are going to fix that,’” said Leeann Johnson, RN, assistant manager of the helicopter service at that time and currently manager of the trauma program. “He went to the hardware store, bought some asphalt and built us a ramp himself.”
Setting National Standards
In 1987, Mitchell used the expertise he gained in Missouri to help improve trauma care throughout the country, cementing his reputation among leading trauma surgeons nationwide. He played a key role in the American College of Surgeons’ Committee on Trauma and its efforts to create the verification and consultation program, serving as the Verification Review Committee’s first chair from 1987 to 1996. The verification program sets standards that trauma centers must meet to show they provide the best trauma care available. Mitchell and other committee members traveled to hospitals throughout the country. They inspected hospitals, showed the staff how to improve trauma care and verified those that complied with the stringent guidelines of the American College of Surgeons Committee on Trauma.
“I was working closely with Dr. Mitchell as the verification and consultation program was moving out of its infancy," said Erwin Thal, MD, professor of surgery at University of Texas Southwestern Medical Center in Dallas, who served as chair of the Committee on Trauma when the verification program began. “I used to always look forward to going with him to review trauma centers — he obviously knew the program backwards and forwards since he was essentially the one who created it. He was trying to help the centers who were pursing verification or consultation. He always felt that we were there to help them improve their trauma care.”
Through his service with the American College of Surgeons’ Committee on Trauma, Mitchell improved the care of trauma patients throughout the country.
“You can't overstate the accomplishments and contributions of Frank Mitchell. The fear is you will understate his importance,” Stamper said. “I think trauma care in this country would be very different if he hadn't been around to help lead it.”