By Polly Roberts

How does the chief of one of the highest volume trauma centers in the country stay grounded, motivated and committed in a field known for some of the highest rates of burnout?

For starters, Thomas M. Scalea, M.D., doesn't believe in stress. Or accidents. But amid the daily life and death decisions, he's certain we all need a place of peace - and the people who help us find it.

As the chief of the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center, Scalea, an alum of the Virginia Commonwealth University School of Medicine, was inducted into the Baltimore Sun Hall of Fame in 2025. The newspaper cited his tireless dedication while caring for the most direly injured patients, on top of his teaching and research responsibilities.

Beyond the hospital walls, Scalea has led missions to China and Haiti after earthquakes, expanded Shock Trauma's clinical and research offerings, advocated for violence prevention and funding within the state, and has overseen Maryland's Stop the Bleed campaign.

We sat down with the international thought leader to learn more, including how his stellar career in medicine began on a dare that ultimately led him to the MCV Campus.

First things first, is it true you had no intention of applying to medical school until a friend bet you that you couldn't get in?

It's 100% true. A friend bet me that I could not get in. My plan was to go to graduate school in experimental psychology. I only applied to four medical schools and got two interviews. It snowed the day I interviewed in Richmond. I got there late. And the first interview I had was with Miles Hench, Ph.D., who was dean of admissions. He said, 'Come sit with me.' He was the only one who interviewed me not from across a desk. He had a table and two chairs. 'Tell me something that's important to you.' I talked about my family. That night, I said, 'I'm still not going to medical school, but those people in Richmond are the only people who have any idea who I am.' I was working in a factory and then got rejected from graduate school. MCV put me on the waitlist and I finally got in. Medical school seemed like a pretty good idea then.

Now you've spent nearly 30 years leading the nation's only freestanding trauma center, setting the standard for integrated trauma care, especially in the prehospital phase. What's next in the evolution of the field?

If we're not approaching injury at its root cause, then we're not solving the problem. Injury is not an accident. It's a preventable event. Look at car crashes. When I was a kid, it was drinking and driving. We've replaced that with distracted driving. If you wreck your car while you're texting, this is a predictable event. You fix it not by taking a piece of the liver out. You fix it by addressing distracted driving.

You can go through almost any injury and it's got a prevention strategy, a treatment strategy, a rehabilitation strategy. It's no different than cancer or any other disease. We don't look at it that way, but we should. Start at the beginning and you don't stop till you're done. If we are not going to dream big, why are we here?

Your trauma center has been inundated with violence these past years. How do you cope with this never-ending cycle?

I try to find a place of peace. I have a rooftop garden where I can reflect, even for a few minutes. If you're up on the roof, you forget - or you can forget - that you're in downtown

Baltimore, a place that has certainly had its time with urban ills.

Those seeds were planted in me originally by my mother. She raised five kids by herself. This was a highly unusual thing in the 1960s. She taught me to do for others before I do for myself. I try to live that principle every day.

Did your time in medical school also help shape who you have become?

The people I met at MCV altered who I was. Our class just had a way of being. We lived

Thomas Scalea's MCV Campus favorites

together, we partied together, we studied together. The lessons I learned allowed me to express myself in a different way. Being around them made me a more caring person. They made me a better person than I was when I got to Richmond. Finding inner peace is central to who I am. It has allowed me to do this high-tech, high-stress work - if you believe in stress.

I don't know that I believe in stress. If you do what I do for a living, you don't last very long if you get nervous. A couple of nights ago, we got four really sick people, all of them shot, within 15 minutes. And it's go time. You can't be sad that these people are so badly injured. It's your job to make sure they stay alive. Is that stressful? Maybe. Not to me. I simply go into my zone. It is just working. I can feel bad on my own time, not while I'm taking care of them.

You met the late Rao Ivatury, M.D., a surgeon who later became chief of the VCU Medical Center's Trauma, Critical Care and Emergency Surgery Division, when you both worked in New York City in the mid-1980s. What kind of influence did he have on your career?

For the last three months of my fellowship at New York Medical College, I trained with Rao Ivatury, M.D., at Lincoln Medical and Mental Health Center in the Bronx. We had very similar interests, in the evaluation of shock and resuscitation. We continued our discussions when I went to Brooklyn, where I eventually served as director of critical care and trauma. We made fundamental, substantial inroads in the evaluation of badly injured patients. We had a ball. Fast forward a little bit, I went to Baltimore. The trauma chief job came open in Richmond and I encouraged him to apply. It worked out for both of us.

He also inspired you to lead efforts to establish the Rao Ivatury, M.D., Professorship here on the MCV Campus. Why?

Rao was a man of peace. He was kind, he never yelled, he was the perfect role model. He was a master clinician and a truly gifted surgeon. I try to emulate him in almost every way. It goes back to the lessons from my classmates - a willingness to do the right thing, no matter how inconvenient or time-consuming that may be.

Do you consider yourself an advocate in terms of trauma influencing healthcare policy?

Maybe. I strive to provide the finest care possible. Maryland has the most sophisticated prehospital and trauma delivery system in the country, maybe in the world. Much of it is funded by surcharges on vehicular registration. Years ago, the trauma system had become increasingly stressed. Delivering emergency care had become a lot harder. The legislature voted to increase that surcharge. It was the right thing to do, but I spent a lot of time in Annapolis [Maryland's capital], talking to people and testifying to show why this was a good investment. For $40, every time you register your car, you have the right to hear the helicopter. You have the right to land on my roof. And this is an institution that has about a 97% survival rate.

Earlier, you said trauma surgeons should dream big. What's your end goal?

I want to reduce the effect of injury in the world. How will we accomplish that? People much smarter than me need to help, but we need to be loud voices. Injury crosses all economic, gender and ethnic boundaries. Everybody gets hurt, so everybody ought to have a stake in preventing it.

We will finish where we started, with the notion of peace. Many will find this unusual for a senior trauma surgeon who works in a high-end academic institution, but this is who I am. As long as my health allows, I will continue to listen to the lessons I learned from my mother and in Richmond. I will do for others first and will do my best to reduce suffering.

This story was originally published in the spring 2026 issue of 12th & Marshall. You can find the current and past issues online.