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The need for a statewide trauma system has much been on the minds of Arkansans of late. It's safe to say part of that is because of the work of Michael Gruenwald, MD, the orthopedic surgeon who is vice chairman of orthopedics and a full professor at the University of Arkansas for Medical Sciences.

Gruenwald has been making the case for a trauma system for years from his position at UAMS and his former post as chairperson of the Governor's Trauma Advisory Council, which helped bring the issue into the public consciousness several years ago.

Born, raised, and schooled in Vienna, Austria, Gruenwald answered a call for a UAMS exchange professor in orthopedic traumatology in the late 1980s. Disgruntled with the realities of socialized medicine in Europe, he and his wife Alexa and their family welcomed the move to Little Rock from Vienna in 1989. The Gruenwalds returned to Austria two years later, but within six weeks decided they wanted to make their life in Arkansas.

"I love the way medicine is practiced in Arkansas. I love the patient population. I love treating patients of every age and walk of life. I love my responsibilities here, so this is the right place for me," he said.

The Gruenwalds returned in the fall of 1991 and have made a home here ever since. The family of six, including two American-born children, are all U.S. citizens now. The youngest Gruenwald is still in high school, and the others are in college or beyond. All are doing very well, the proud father reports.

"I'm a lazy doctor in some ways," Gruenwald says, "Because at the end of the work day, I am out the door and heading home to be with my family to make sure this part of my life does not fail. What I have seen both overseas and here is that physicians that are frequently exposed to a fair amount of potential income are drawn in by the money and can lose sight of the importance of maintaining their family life. I am very proud of my family, and I do hope the Gruenwalds have achieved this balance."

Only by that standard could Gruenwald be considered lazy. Last year he performed more procedures than any other surgeon at UAMS, perhaps more than anyone in the state, and is on track to do at least as many this year.

A hefty portion of the surgeries Gruenwald performs come from the indigent care clinic he runs. He and his residents see from 60 to 100 self-paying or non-paying patients each week; when he can ascertain a true orthopedic trauma in a patient who could not otherwise receive care, he will see they get the surgery or treatment plan they need, regardless of the potential for reimbursement.

"The indigent care clinic is one of the things that sustains me," Gruenwald said. "I truly believe it is the best thing to do for these patients, medically, legally and ethically, and I'm proud of that record."

Gruenwald's track record also is particularly good with patients suffering from recalcitrant non-union, where long bone fractures refuse to heal, despite multiple attempts. "I see a lot of patients who are coming to me as a last resort, when nothing else would work. I really like solving those kinds of chronic problems, besides all the emergency trauma patients who need our help."

The administrative and political side of his job was not something Gruenwald said he would have predicted he would enjoy, but through his service helming the Governor's Trauma Advisory Council and helping organize a grassroots campaign to raise awareness about the need for the trauma system, he found he had a flair for the work, and rather liked doing it.

A pioneer among UAMS staff in digital photography, Gruenwald also loves using the best photography equipment and latest digital techniques, both in work and in his off-hours. "I love everything about digital photography!" he says, "It is one of my passions."

Another passion is wind. Once an avid glider pilot, he said his wife asked him to give that up when they married, fearing for his safety. But Gruenwald found a work-around. Now, those same physics of wind dynamics propel him on his 25-foot ocean-going yacht, currently docked at an Arkansas lake. "Sailing has become one of my favorite things," he said. "I've restored a couple of sailboats, and now we have this probably wild, crazy dream of, after I retire, sailing up and around the coasts, maybe even to the Bahamas or Hawaii."

He said the same philosophy behind sailing and flying is also helpful to him as an orthopedic surgeon.

"Sailing and glider piloting both involve the philosophy of optimizing winds and maximizing equipment to get the best possible outcome, whatever the conditions," he said. "Likewise, the orthopedic surgeon's and the sailor's mental approaches are similar – you always want to maximize the outcomes using a limited set of equipment. Even if you have a patient in poor condition, still, with your skills and the cutting-edge equipment we have at the university, you can provide the optimal outcome for this patient. I really like that challenge."

Gruenwald is delighted the legislation funding the trauma system sailed through the Arkansas Legislature into law, making his work, and that of so many other Arkansas trauma physicians, that much more effective.

"This is what our state needs," he said. "I have been wanting this for so long."

Tags:

Arkansas physician, Austria, Governor's Trauma Advisory Council, J. Michael Gruenwald, orthopaedic, trauma system, traumatology, University of Arkansas for Medical Sciences

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