Afghanistan to the East End - meet the Royal London’s new head of trauma

After treating soldiers and civilians on the front line during four tours of Afghanistan and one of Iraq, Lieutenant Colonel Nigel Tai knows almost all there is to about tackling life-threatening injuries.

He has now been installed as the head of the Royal London’s trauma unit, giving him responsibility for the running of one of the most high pressure departments in the hospital.

It is the busiest such unit in London, with responsibility for more than 2,000 patients each year. The trauma ward typically hosts 17 patients each day, and the team has responsibility for as many as 10 others across other hospital departments.

It is, then, easy to see why the task of running such a department could be considered daunting.

“I am responsible for every patient that comes through this ward, even if colleagues have looked after them”, 44-year-old Lt Col Tai said. “The service is my responsibility.”

However, with experience of treating soldiers 24-hours-a-day at Camp Bastion in the Helmand province of Afghanistan and a tour of Iraq under his belt since joining the Territorial Army in 1999, and the Armed Forces’ medical team in 2006, Lt Col Tai is equal to the challenge.

“The military experience complements the civilian experience, and the civilian experience complements the military experience.

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“Military injuries are often very severe, so the techniques utilised are very similar. [The army] is very stressful work, but it’s great to be part of such a professional organisation.”

Despite the pressures of dealing with frontline military injuries, Lt Col Tai maintains that his role at the Royal London is often more of a challenge.

“The hospital in Camp Bastion is a much smaller organisation, and in a smaller organisation it is easier to effect change and to sustain improvement,” he explained.

“90 per cent of the business is trauma-related, but here we have to cater for people of many different backgrounds. That’s a much more complex beast to manage.”

The key to managing this beast, he emphasises, is teamwork. He is one of five consultants working in the trauma unit, with each one overseeing the unit for one week in every five, filling the rest of their time with other surgical duties.

“We are blessed here at the Royal London. We work in such a great team, and the enthusiasm bubbles through.

“A lot of people here have come to London because they enjoy working in trauma, and the relationships that exist across the teams prevent the communication problems which might otherwise exist.

“People look after each other – it’s a very important part of how we do business here. It’s a very demanding job, and people enjoy the pressure, but they need to be aware of the fact that they are part of a team.

“They will always go the extra mile. Always.”

On top of the trauma team’s ongoing duties around the hospital, it will typically deal with several people with life-threatening injuries each day. Road traffic accidents and similar are the cause of around two thirds of these injuries, with gunshot wounds and stabbings accounting for many others dealt with.

Despite the intensity of much of the work undertaken in his role, Lt Col Tai insists he doesn’t let what he witnesses affect his life away from the job.

“Dealing with clinical pressure is what you’re trained for in medical school - but it would be a lie to say nobody’s ever affected. We are very good here at talking through trauma calls with each other where perhaps the patient hasn’t survived despite our best efforts.

“We’re very good at supporting each other and making sure people get a chance to talk about procedures.”

As well as relying on the support of other members of the trauma team, Lt Col Tai concentrates on keeping his profession staunchly separate from his life at home in Greenwich, and enjoys kayaking along the Thames when he’s not in the thick of the action on the ward.

“I am able to demarcate my professional and family time. You have to offer your best to both your professional and family life, so I concentrate on what’s important at the right time.”

The peace he is able to achieve at home contrasts sharply with his adrenaline-filled working life. It is the hands-on nature of his role in the trauma unit which he says is what contributes to his love of the job.

“The opportunity to shape outcomes is far greater in the trauma unit than it is in any other areas of medical practice. If you’re dealing with a 15-year-old stab-victim, you can influence a huge amount in their future.

“You get to see the results of your treatment very directly – you get feedback straight away.”

Having taken on the position of head of the department only a month ago, Lt Col Tai is excited by the challenges lying ahead, and is ambitious about the potential of the team to lead the way in the field.

“I want to make sure the efforts and energies of the staff who work in this hospital lead to better patient care. I am part of the mechanism to harness this and make sure things are as good as they can be.

“We have got global ambitions to make this one of the best trauma teams in the world.”

Coming from a man with Lt Col Tai’s background in one of the most demanding areas of medical practice, it is hard to imagine him treating the task at hand as anything less than a battle to be won.

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