‘We see people on the worst days of their lives’: Inside Montreal’s adult trauma centre

Trauma bay at the Montreal General Hospital adult trauma centre. (Robin Della Corte/CTV News)

Summer is the busiest time at the trauma centre at the Montreal General Hospital.

It is only one of three adult Level One trauma centres in Quebec, and it is where the most serious and life-threatening physical injuries in Montreal are treated.

The types of patients that come to the trauma centre are those who sustain injuries resulting from car, motorcycle, scooter, or bicycle collisions, gunshot wounds, stab wounds, falls, fires, explosions, construction sites, or home renovation projects.

When a patient arrives at the centre, the multidisciplinary medical team may only have seconds to make decisions that can help prevent lifelong disability or save the patient’s life.

Vanessa Turgeron De Bonis is the centre’s nurse manager. She’s been a nurse for 14 years, and 10 of those years have been in emergency services.

“You see people on the worst days of their lives,” De Bonis told CTV News.

“But having the ability to make that person feel safe, to make that person feel like you’ve got them (…) that’s the best feeling to have.”

The centre is separate from the hospital’s emergency department and has its own trauma bay, examination area, operating room, intensive care units, and rehabilitation unit.

It is equipped to manage the highest-acuity trauma cases, including Level One and Level Two traumas.

Patients who have vital signs that are abnormal after a trauma, or those who have sustained an injury to their chest, abdomen, or head, are typically classified as Level One traumas.

‘It’s not just routine. It’s feeling their pain’

The centre sees 12,000 patients every year, and 1,500 are admitted for trauma care.

In the summer months, the centre sees a slight increase in admissions.

From mid-October 2024 to March 2025, the centre had 645 trauma admissions, compared to 744 admissions from April 2024 to mid-October 2024.

According to the centre, trauma causes nearly 4,000 deaths and 10,000 disabilities in Quebec each year.

“There are some harder days when you have to talk to the family, and you know it’s going to hurt,” De Bonis said.

“Those are the tougher days, but those are the days that they bring a human side back to the profession. It’s not just routine. It’s feeling their pain. I have to help them through their pain.”

Medical team must assess quick

When a patient is injured and being transported to the trauma centre, ambulance services communicate with the centre about the patient’s condition.

The team at the trauma centre can have less than a minute to prepare for the patient’s arrival.

What specialists need to be called? Is the patient conscious? Does the patient need a blood transfusion? What type of emergency surgery may need to be performed?

These are some questions that the team is asking as they prepare for the arrival of the patient.

There are times, however, when paramedics do not have enough time to provide advance notice, forcing the medical team at the centre to quickly assess the patient and make critical decisions.

‘It’s like organized chaos’

Given the high-stakes nature of their work, Dr. Kosar Khwaja, medical director of the trauma centre, says the centre is organized to extraordinary precision.

“It’s like organized chaos; It’s chaos there, but it’s managed well, and we’re trained to do this. This is our specialty,” Khwaja told CTV News.

“I’m very proud to be part of our team. We are the cream of the crop when it comes to this sort of trauma care in Canada,” he said.

Khwaja says the trauma centre is ranked first in trauma care delivery in the province, citing data from L’Institut national d’excellence en santé et en services sociaux (INESSS).

The centre has the lowest mortality rate for trauma at 4.5 per cent and the lowest adjusted mortality rate for severe trauma at 8 per cent.

Comparative national statistics also confirm the centre has one of the lowest trauma mortality rates in Canada, the centre says.

Khwaja says the medical professionals at the centre spend years completing specialized trauma training beyond their initial education and clinical practice – a level of dedicated training he says is unique in Quebec.

The team also takes part in simulation exercises almost every day to maintain the skills needed to perform under intense pressure.

“What makes the centre so special is that the people who are working here are dedicated to trauma care,” he said.

Improve mortality with injury prevention

The centre also has programs dedicated to raising awareness on injury prevention. According to the centre, 90 per cent of injuries are preventable.

“The best way to improve mortality is injury prevention,” Khwaja said.

During the summer months, the centre sees a lot of trauma cases involving people who were not wearing helmets while riding motorcycles, scooters, or bicycles.

He also says impaired driving, speeding, and distracted driving from texting remain major causes of trauma cases.

Drownings are another common cause of serious trauma during the summer.

But despite the demanding nature of the profession, Khwaja says it is a rewarding one.

“A lot of these people that we see in trauma, it was very unexpected for them to be in the situation, so it’s very abrupt for them also. Trauma is not only physical but psychological, for patients and their families,” he said.

“Unfortunately, we can’t save everyone, and even the ones that we don’t, the families are very appreciative of the work that we do. But the ones that we do save, it’s very rewarding, and that’s why we do it.”