The van was packed with medical supplies for the perilous journey from western to eastern Ukraine. Dr. Michael Samotowka crowded in with other medical personnel, including an oral surgeon whose husband was fighting on the front, to deliver badly needed supplies and humanitarian aid.
Their group stayed in an apartment in the city of Kramatorsk on their last night. Samotowka was looking forward to heading home to the U.S. the next day. As they were settling in for the evening, a missile hit nearby. Their building shook.
War raged only 10 kilometers away. A little stunned, Samotowka (pronounced sam-oh-TOW-ka) looked around at his Ukrainian colleagues. One shrugged. “Well, that’s Ukraine.”
Samotowka, a trauma surgeon with Novant Health, has traveled to Ukraine dozens of times over the past 20 years to train surgeons. It’s one of many experiences that prepared him to enhance emergency care at home in the Charlotte region.
He recently led Novant Health Presbyterian Medical Center to become a new Level II trauma center, successfully navigating a rigorous two-year process mandated by the American College of Surgeons and the North Carolina Office of Emergency Medical Services. He credits a hard-working team of colleagues at Novant Health who helped make the new designation possible.
Novant Health emergency rooms are ready to handle any medical emergency, 24 hours a day.
A Ukrainian-American family
Samotowka and his family were part of a large Ukrainian-American community in his hometown of Buffalo, New York. Saturdays were devoted to Ukrainian school, Sundays to church. Samotowka learned the Slavic language alongside English.
He later discovered many family members in Ukraine were physicians. But in the U.S., his grandfather and uncle were both were engineers, and Samotowka figured he would be, too. A few engineering classes in college convinced him otherwise. He would follow those other family footsteps instead.
After completing his residency at the Medical College of Pennsylvania in Philadelphia, he took on an additional year of study in his true passion – caring for victims of trauma – at Hahnemann University.
The Hahnemann program had a Level I trauma center in downtown Philadelphia and several big names in the field working there. He grew to love the role. “The trauma surgeon is the last true general surgeon,” Samotowka explained. “We do a lot of medical management of surgically injured patients. We don't necessarily operate on every trauma patient.”
Trauma surgeons work in the intensive care unit. If you’ve been shot or have an emergency involving the heart or lungs, a trauma surgeon may perform the surgery. Trauma surgeons also handle acute care, such as surgery needed immediately on the appendix, gallbladder or bowels. If you break a leg or have a bleed in the brain, a trauma surgeon may assess you initially to ensure no other issues have been missed, then the appropriate surgeon will take over to perform the surgery.
The excitement of responding to so many medical needs appealed to Samotowka, and the required training didn’t daunt him. He completed a second fellowship at Yale New Haven Hospital as a surgical critical care fellow. After seeing so many patients in intensive care and teaching as a clinical instructor in general surgery, he was ready to start work in trauma centers and help build some of his own.
Responding to gun shots, blunt trauma, chemical weapons
His first job was at a trauma center in Alabama. “I'd never lived in the South and didn't even know where Huntsville was” before moving there, he recalled.
After many years, an institution of world renown came calling. Samotowka became chief of trauma at two hospitals owned by The Cleveland Clinic, as well as coordinator for the clinic’s trauma care program. Later he moved to Florida for Jacksonville Memorial Hospital and its Level II trauma center. Four times in his career, he helped take a trauma program through the American College of Surgeons certification process. He kept it up while pursuing his other passion: providing medical training in Ukraine.
In 2023 alone, Samotowka has taken about 10 trips to the eastern European nation with the nonprofit humanitarian group MedGlobal, an organization that serves in Syria, Bangladesh, Colombia and other countries. Samotowka directs trauma training for the organization in Ukraine.
With colleagues, he runs two-day courses there for 10 to 15 physicians at a time. On the first day physicians learn about managing gun shots and blunt traumas. “Unfortunately, there's a chemical weapon, white phosphorus, being used by the Russians that cause severe burns. We have a lecture dedicated to that,” Samotowka said.
On the second day, students practice skills by dissecting pigs: “We teach how to do an emergency cricothyroidotomy to secure the airway. We open the chest, and we teach how to repair the major vessels, the heart, the lungs. We'll open the abdomen and teach how to do a liver or spleen repair, how to do a temporary shunt if there's a major artery or vein injury.” Doctors also learn how to clean all types of wounds to prevent infection and help the area keep functioning.
Some of these physicians, both military and civilian, have not previously been trained as surgeons. When the 2022 war broke out, people who were urologists or gynecologists “became trauma surgeons and were sent to the front lines,” Samotowka said.
He acknowledges going into a war zone once is frightening, let alone 10 times a year. He does it anyway. “I have a skill set. There's something that I do, and there's people who need to learn that,” he said. “I'm more afraid of what happens if people like me don't do anything.”
It’s his calling, whether caring for trauma patients in Ukraine or Charlotte.
“A huge step”: More emergency care when you need it
Novant Health took “a huge step” in transforming Presbyterian Medical Center into a Level II trauma center, said Dr. Michael Samotowka, who led the effort with a dedicated team. “It’s a game changer in who you can accept as a trauma patient. Somebody who’s critically ill and injured in Charlotte, whether they are shot, stabbed, in a motorcycle or car accident, in a construction accident – they can come to Novant Health.”
The hospital recently added a new trauma intensive care unit with two new trauma bays for emergency assessment and treatment. Additions to the staff include more critical care trauma surgeons, trauma response nurses and orthopedic traumatologists, who handle very serious orthopedic cases such as complex pelvic fractures.
One operating room has been expanded into a hybrid room to respond to major vascular and orthopedic injuries simultaneously. “Ninety percent of the Level II trauma centers in this country and some Level I trauma centers don't have a hybrid room,” Samotowka said.
He was attracted to Novant Health because it already had resources typically in place for a Level II trauma center, long before it received that official designation. They include an attending trauma surgeon on staff and an active research initiative. (An attending surgeon or physician has extensive training and is typically considered a top position.)
He also liked the health care system’s community spirit. “We have a really strong outreach program here at Novant Health” to educate the public on health and wellness, Samotowka said.
The Charlotte region has seen a surge in population, increasing the need for more trauma care. Samotowka compares it to Philadelphia, a city with roughly twice the population of Charlotte but six Level I trauma centers.
As a relatively new resident of the area, he said he’s proud to be part of this change. Novant Health “has made a huge commitment toward the proper care of traumatized patients in the Charlotte community,” he said.
