All Bleeding Stops: Life and Death in the Trauma Unit

by Stephen M. Cohn, Paul Heitsch (Narrator)

7 hours and 43 minutes.

For all the hospital dramas that dominate the ratings on television or awe-inspiring medical stories we might hear, most of us have no conception of the daily, herculean efforts of trauma surgeons. A good trauma surgeon must be a conductor presiding over an orchestra of healthcare providers as their patients cling to life by a thread. They are also a steely quarterback who can’t be rattled when they throw an interception—lingering on a past failure would only ruin their ability to care for the next patient, and the next. They have an encyclopedic knowledge of medical science and are practiced in the art of instinctively reacting to whatever emergency comes flying at them on a stretcher. All of this is in addition to doing anything they can to comfort distraught family and friends receiving some of the worst news of their lives. Dr. Cohn gives readers an intimate look at the controlled chaos that goes on inside a trauma center.  Having lived and breathed trauma for four decades, Dr. Cohn is an ideal guide to demystify the role of the trauma surgeon and their place in a hospital. He pulls back the curtain to clarify such questions as:  His answers are infused with sobering tales from his career as a military surgeon and in trauma centers across the country as well as his descriptions of high-profile medical stories.

Genres: Medical, Nonfiction, Medicine, Memoir, Audiobook, Biography Memoir, Health

8 pages, Audible Audio

Published December 5, 2023

Reviews

[Heather Adores Books · Rating 4 out of 5]

4⭐
Genre ~ medical non fiction
Setting ~ hospital
Publication date ~ December 5, 2023
Est page Count ~ 256 (intro + 11 chapters)
Audio length ~ 7 hours 43 minutes
Narrator ~ Paul Heitsch

This is a fascinating behind the scenes look at what goes on in trauma units ~ babies, teenagers and adults, gunshot and stabbing wounds, motor vehicle, bicycle and falling accidents...medical trauma can happen to anyone in anyway at anytime.

Surgeons face a dying trauma patient without knowing their underlying medical history, extent of their injuries or the dying wishes of the patient or their family. The author explores the insanity they encounter, obstacles of optimal care and frustrations they must overcome to save lives.

I do not have any experience with anyone I am close to having any trauma surgery, but when I had my hysterectomy I asked the doctor to take a picture of my uterus and she did! So cool to see!! I wish I could have watched the whole surgery on video.

Narration notes:
Paul did a fine job.

*Thanks to the author, Dreamscape Media and NetGalley for the ARC. I am voluntarily leaving my honest review*

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[Zayna · Rating 4 out of 5]

Every once in a while i read a Non fiction which blows me away, this is one of those books!
I rarely choose to read Non fiction but this one had me hooked right from the beginning and didn't disappoint up until the very end
In part funny, humorous, brutal and tough to read, i thoroughly enjoyed this one and at times it felt as if i was present with the author in the trauma rooms while listening to this !

[India M. Clamp · Rating 4 out of 5]

Most appreciable telling and controversial gift of wisdom by a 40 year trauma veteran Stephen M. Cohn. He engages most of our senses by shining a bright light on a windy and pungently strange smelling voyage to his world of trauma centers and the loud eccentricities of surgeons he came to know.

“Today most cardiac procedures have been replaced with catheter-based procedures, which the medical guys, the cardiologists, perfected. This has left the cardiac surgeons with few procedural morsels left to sustain them."
—Stephen M. Cohn

He illuminates for us what is a good trauma surgeon. He tells tales of a “most nefarious training" down a dark road all surgeons must undertake to find the "maven morsel" we don't mention in common conversations. Definitely must read for any future physician or nurse.

[The Yellow Chair Bookclub || Alix · Rating 4 out of 5]

All Bleeding Stops: Life and Death in the Trauma Unit
Stephen M. Cohn, M.D.
Pub: Dreamscape Media; Mayo Clinic Press
Pub date: December 5, 2023
Format: ARC audiobook (@netgalley)
4 /5

Thank you to NetGalley, Dreamscape Media, and Mayo Clinic Press for this audio ARC!

All Bleeding Stops is a “behind the scenes” look at the life of a trauma surgeon. This
book was a very refreshing break from all the blood and gore I have been reading of late, and I found it interesting and funny. Dr. Cohn was very succinct in his writing and made it very easy to follow along as a lay person. He was very matter-of-fact and brutally honest at times, much like I imagine any trauma surgeon would be. The book was filled with stories, experiences, and advice. We learn of Cohn’s successes and losses, as well as experiences that he had with other surgeons throughout his career.
What I found especially intriguing about this book was the wide array of experience that Cohn had throughout his career. Anywhere from his time as a resident, to being deployed, to training fellows in Israel. It is clear that he has a wide array of experience and knowledge, and that they have all made an impression on him as a man as well as a surgeon.
A short read, if you like documentaries as much as I do, this is a perfect read for you. He does get a bit graphic at times, so be warned. I learned so much about a world I have thankfully not had to encounter.

[Charlene · Rating 5 out of 5]

Very informative!
Praying to stay healthy and away from hospitals!

[Katharine · Rating 3 out of 5]

Interesting stories from his and other doctors experiences.

[Lindsey · Rating 5 out of 5]

Easy, light reading of interesting surgical trauma stories and cases.

[Nikki · Rating 3 out of 5]

A fascinating look into the life and cases of a Trauma Surgeon. The stories and chapters were a bit disjointed and felt a bit like they were jumping all over the place. That being said it was so cool to learn about how different specialties handle different cases, how different injuries can be catastrophic even if they don't seem like it, and how the most catastrophic looking injuries can lead to full recovery.

[Mary Murtland · Rating 3 out of 5]

I started this book excited to read about what it is like to be a trauma surgeon. The author does give you examples of patients but he also wants you to hear about what he thinks of guns, seat belts, helmets, …This didn't turn out to be what I thought it was going to be.

[Tina · Rating 4 out of 5]

This book is excellent. I love all the real-life examples Cohn had to share. Very interesting.

[Cheyenne · Rating 3 out of 5]

3.5 ⭐️ I really enjoyed this surgeons stories, wisdom, passion, and sense of humor. There were definitely moments where my jaw was on the ground just thinking about some of these cases. My favorite part of the whole book was the second to last chapter, basically rapid firing stories from a bunch of different surgeons and their message to the reader. Ultimately I felt there wasn’t a lot of organization to the book so it felt that it just went on and on. I also listen to audio books coming to and from work, and sometimes I just didn’t feel like listening to work stuff after work 🤷🏼‍♀️

[Taylor Pitzl · Rating 3 out of 5]

This is the first book I’ve recorded that I listened to on audio, so I’m not sure if it should count. I did enjoy listening to this book on my drives, and it probably made me drive safer hearing stories about the car accident victims that he took care of. The book was a little choppy at times, but I liked all of the little anecdotes.

[Natalie · Rating 3 out of 5]

All Bleeding Stops is written by a trauma surgeon giving the inside scoop of surgery and the reasons behind it. The author discusses the personality traits of trauma surgeons in general while offering lots of personal insight. There are several anecdotes told throughout the book that get graphic at times. There are even several graphic descriptions of victims of attempted suicide. The author mostly discusses the dangers of not wearing seatbelts and helmets as many trauma cases result from motor vehicle accidents, but there are also several mentions of gun violence. Several statistics are given in this book, and while citations are understandably hard to provide in an audio format, hopefully the citations appear in the print version. The narrator’s performance was good and appropriate for the subject matter; even at faster speed settings the narrator’s voice was clear and concise. Ultimately, this was an informative and entertaining read, but it’s not for the squeamish or those who may be triggered by discussion of suicide.

Thank you to NetGalley for providing me an advanced audiobook copy of this book.

[Sandi · Rating 3 out of 5]

Essentially a partial biography. Gave insight into the life of trauma surgeon that I had not considered even though I am trained and work in medicine and have interacted with and shadowed trauma surgeons/PAs. Definitely a niche read with more graphic descriptions that would be acceptable to the lay population of readers.

[Sarah Ewald · Rating 5 out of 5]

This is both one of the most fascinating books that I have read, and also one of the most frightening. The incidents that the author, a trauma surgeon, writes about are real, and you can only hope that you are never caught in similar situations.

He relates stories from his own life, about his own family members... Such as this about a condition that is called SAE, meaning 'sudden acceleration of the elderly.', after which he relates this story of his own grandmother...facing the age-old problem of when to take away the car and driving privileges' (Mind you that he has, as a trauma surgeon, seen horrible injuries in his work.)

"A good example of this dilemma was experience by yours truly when my beloved grandmother, Rosie, was eight-eight years old. Having just cared for several older people involved in driving disasters as the chief of trauma at a busy trauma center I returned to Northern California to visit her at her apartment. Typically, I drove her to a nice lunch in her car. She owned a 1965 Pontiac Bonneville (one of the longest cars ever made). It was painted a metallic light green and was covered with a large gray spots where a body shop had banged out large dents and then applied primer following contact with many different stationary objects. The car resembled a huge leopard poised for mayhem. Because Rosie had abrasions on her legs from falling on the single star at the entrance of her apartment building, I was concerned that she was too wobbly to be driving. She was also blind as a bat. Later that evening, I discussed this issue with my parents at their house. They responded in unison, 'You tell her.' So I took in a deep breath and called her to suggest that we needed to retire her car, as it was unsafe for her to drive. She was naturally really upset, despite my offer to get her taxi vouchers so she cold manage her affairs. She only drove to the doctor's office (which was my father), and my parents' house anyway. The next day, she called me all excited. Her nephew Hal (he was in his seventies) was going to get her a used Cadillac. 'No. Rosie, you don't under stand, you should not be driving yourself anymore,' I said. Silence. Then she said 'You just don't want me to drive!' 'Correct,' I responded. She never forgot that I (her favorite, and only, grandchild) had taken away her car for the remaining years of her life. But I think she forgave me."

He relates stories, his and from his fellow surgeons, that encompass every injury that you could ever imagine, and in graphic detail. The book is peppered with them, that as awful they are to read, are fascinating as well.

The chapter that made me most incensed was the one relating to gun injuries.

"In the aftermath of the 1996 massacre in Tasmania, Australia enacted gun laws that led to a dramatic and sustained decrease in both gun-related homicides and suicides. In contrast, the response of the US Congress to the Australian massacre was to pass the NRA-supported Dickey Amendment in 1997 which cut finding to the CDC for gun-related research and put in regulations mandating that an institution would lose federal finding if it performed investigations on this subject."
We should all be appalled at the pure aggradation of fire-arms especially after even just the many incidents in the past year, 2023. To say nothing of Uvalde, in which DNA was required to even identify the children shot in the school. Where are our senses??? One has to ask.

Sorry that I got up on my soapbox just now, but the author relates a story from his own life in regards to guns.
"I moved to the Southwest when my son was turning thirteen. I was deathly afraid of my boy, the wild man, being injured to an accidental discharge of a firearm. Guns are ubiquitous in that part of the country. So I bought a 22-gauge rifle and took him target shooting to learn about gun safety. On one of these outings, he discharged his weapon at the target until it failed to fire.
'I'm out,' Sam stated.
'Did you clear the chamber?; I asked.
'I counted, and I am empty' he responded authoritatively.
I made him clear the weapon and out popped a live round. He turned pale. That experience was worth he price of the rifle."

I learned a lot about the human body and about the injuries which are inflicted in so many situation. Reading parts of it made me queasy, but made thankful that doctors like him exist, and I hope I never need his services.

[Jerry Smith · Rating 3 out of 5]

I work in the medical non-profit sector so I am regularly exposed to the medical community and my admiration and respect for physicians, especially surgeons is deep. I am fascinated and impressed with surgeons and whilst I sometimes idly speculate as to whether that is a career path I should have considered, I realize that I lack the type of intelligence required and more importantly, I don't think I have the temperament, especially for the critical care provided by trauma surgeons and ER folks.

However, I greatly enjoy reading about them, and the world they inhabit. Hopefully I never find myself in a position needing their expert care but of course, we all hope that and live lives that expose us to danger either by our own folly, or simply because we are in the wrong place at the wrong time. I will never forget the anecdote, told here, about a man sitting in a barber's chair for a regular hair cut having his spinal column separated by an errant nail, accidentally fired through the wall by a nail gun wielded by a remodeling crew next door. How horrifying and random.

However, by far the most common occurrence likely to land you in a trauma unit is a traffic accident, closely followed by some act of violence. In the US this is a gunshot wound of some description. At such times you will be glad of the services of these cool under pressure providers. However, I was interested to discover that they are also the "all hands on deck" surgeons likely to be pulled into operations as needed because most of what they do is concerned with identifying and staunching blood loss as indicated by the title of the book.

I enjoyed it a lot and it is written in an easy style but essentially consists of a series or stories about the life of a trauma surgeon which necessarily becomes anecdotes about cases, some of which are horrifying indeed. This is a good way to give us an idea of the life, but somehow becomes a little less compelling as once goes as it is somewhat disjointed even though SMC does a pretty good job of grouping them into some sort of common theme by chapter.

Very much enjoyed it but it was somehow less compelling to me than "This is going to hurt" which is one of my favorite books on this subject. That is not to say this is at all bad. Read this for some insight into a world we hope that we rarely, or ever need to experience close up, although sadly too many of us will at some stage of our lives!

[Marius · Rating 3 out of 5]

Having read Atul Gawande’s “Complications” immediately before this book, the contrast is stark. While Steven Cohn’s All Bleeding Stops is undeniably an entertaining and fast-paced read – I flew through it in just a few sittings – it left me with a bad aftertaste.

The primary difference between the two authors is one of depth. Gawande treats the complexities of medicine with deep reflection and humility; he is constantly asking difficult questions about ethics and human fallibility. In contrast, Cohn simply tells “war stories.” While I have no reason to doubt that he is an accomplished surgeon and a caring doctor, he often presents systemic issues without a fraction of the reflection they deserve. For example, he describes instances of complete incompetence among fellow doctors as mere facts of life, offering no insight or inquiry into what could be done to prevent such failures.

This lack of introspection extends to the book’s humor, which often feels dated and callous. He recounts episodes – like the difficulty of locating a morbidly obese patient’s penis – that are played for laughs but feel insensitive on the page. In another instance, he mentions a choleric surgeon making a sexual remark to a nurse and simply notes that “everyone had a good laugh.” By leaving these moments without any modern comment or critique, the narrative feels like locker room humor that hasn't aged well.

The book finds its heart when Cohn moves from the operating table to public policy. His reflections on the availability of guns and his advocacy for mandatory helmet and seatbelt laws are serious and clearly heartfelt. When he speaks on the preventable nature of trauma, the macho surgeon persona fades, and he offers a sobering, important perspective on the real-world consequences of our laws.

All Bleeding Stops is a gripping record of a 40-year career in trauma surgery and gives the reader a vivid image of what the discipline is all about. I found it a readable but ultimately flawed companion to a book like Gawande’s.

[The Bibliophile Doctor · Rating 2 out of 5]

Before reviewing the book, I would like to say that I'm a medical professional with about 15 years of experience on and off for the casualty. There will definitely difference in how medical world works in author's country versus mine but I will tell you one thing, it is never as dull as the experiences in this book are.

I am fan of medical books, I always try and grab one once in a while as I crave my residency days. The thrill, the pressure, the stress of handling ER in the dead of the night when whole world is sleeping but not you. It gives a sense of accomplishment, saving lives making your place in the world, bold and enigmatic.

All bleeding stops however did not give me that sense of urgency, like time mattered minutes even seconds. It was not as exciting as I thought it would be. The narration wasn't great either maybe that's why I couldn't really connect to the book or enjoy the book. Also it annoyed me that after every case, author pointed out how one can avoid it. Like drunk driver shouldn't be driving. Weapon laws in US needs changing, don't we all know that how devastating the results are.

Everyone knows it and yet nothing changes so it was getting frustrating when author kept mentioning corrective measures for every accident that happened in the book but the accounts of the accidents were not detailed but the measures to avoid them from happening were long.

Thank you Netgalley and dreamscape media and mayo clinic press for the ARC in exchange of an honest review.

[Pamela Dodd · Rating 4 out of 5]

All Bleeding Stops is a mostly autobiographical book written by an experienced trauma surgeon. During the course of the book, the reader learns how a trauma surgeon differs from other surgeons, how being a military doctor influenced the author, and quite a bit about the different ways that people end up in an emergency room. I chose this title, in part, due to a mishap wherein I ended up in an ER and had orthopedic surgery. As Dr. Cohn says, patients choose elective surgeons and develop a bit of a relationship prior to their procedure, but in an emergency, whoever is on call becomes the doctor. I certainly didn't choose the guy who rebuilt my shoulder, as I certainly didn't plan to break it into four pieces! Anyway, I identified with some of the patients described in this book.

While I'd like to say this is a five star read, the not so linear organization takes it down a notch for me. That said, I really enjoyed this book, as it provides many anecdotal stories about trauma surgery, not only those performed by the author, but also those he heard about from colleagues. Many of the cases described survive, but there are those who don't make it, and there is a certain dispassionate tone in this narrative. That's not intended as criticism, but an acknowledgement that doctors who deal with trauma must maintain some distance in order to remain sane.

Again, I enjoyed reading this book, and for those who want to know more about how lives are saved and people put back together after terrible trauma, this book is quite enlightening.

[Ellie Pretsch · Rating 5 out of 5]

Thanks to NetGalley and Dreamscape Media for an ARC audiobook of this book.

I have always harbored an interest in both medicine and trauma (in another life I would have become a trauma nurse...maybe still in this one...who knows). This book reads as quickly as trauma codes are called- fast. Cohn's narrative carries a wealth of knowledge, among a multitude of first hand stories- which is what I really enjoyed about it.

As you read, you really became invested in the cases that Cohn was going through, both in a human sense (caring for these people) and in the medical sense (how the doctors made the choices, was there something different could have been done, was the best choice made etc.)

Absolutely fascinating. This was very much nonfiction that reads like fiction. And of course I have to shout out Paul Heitsch on an excellent narration. I actually didn't realize that Stephen Cohn himself wasn't the narrator until the end of the book because Paul read so genuinely.

I would recommend this book to medical students, science seekers and anyone with a fascination of medical shows, trauma calls, and medical mysteries (which have to be solved with zero time).

[Emma Browall · Rating 3 out of 5]

I enjoyed this book and appreciated the author’s takes on prominent public health issues in the US, including gun safety, seatbelts, helmets, drunk driving, and drug use. As a trauma surgeon, he provides a unique insight to the end results of these issues. I would have liked him to talk more about his research endeavors. I would have also liked him to lay out a little more clearly his own training - from the book it seems like he has served as a doctor all over the US. I would have liked to hear more about his journey and the differences he found in the medical field throughout the US. I think he also could have spent more time talking about his military service. Instead, he details the (many!) injuries he suffered throughout this life, including (but not limited to) - being electrocuted, being struck by a drunk driver, a broken leg, a skiing injury, a broken nose, and undergoing joint surgery without anesthesia (at his request). The ending of the book was somewhat weak as he just included several small stories from various other doctors. I did not think it was necessary and a better ending could have been written.

[Kristin · Rating 5 out of 5]

While it may sound like an unusual topic for a book to read right before going to sleep, I found All Bleeding Stops to be a fantastic choice for doing so. Cohn mixes the right amount of medical knowledge and terminology with his own opinions. The chapters are loosely divided by subject, namely the variety of traumas that bring his patients to the ER and he peppers in quotes from famous figures in medicine throughout. At the end, Cohn allots space to memorable patient encounters experienced by some of his colleagues. many of whom work overseas and see different traumas than we do in the USA. While I didn't necessarily agree with all of his opinions, he's speaking from experience and has seen the devastating effects that guns, dog bites, being in a car sans seatbelt, etc. can have on the human body.
Definitely someone I would read again, though I think he would have a hard time topping this one. A second volume with additional patient vignettes would be welcome for sure.

[Twainy · Rating 5 out of 5]

CAPTIVATING

You don’t need to have a medical background to understand but having heard the terminology helps. The author shared simply enough for me to understand.

You get what’s important to him & even after all of the horrors he’s still got a sense of humor. You hear about his military career, colleagues he’s admired, funny stories & sad situations, a huge variety of successes/losses over decades of being a trauma surgeon & patient.

It’s a bit shocking what he’s experienced & at times it’s funny and sometimes heart breaking. Having seen the results, he’s got a definite opinion on gun violence, etc. & he’s not afraid to tell you how he feels.

Thank you #NetGalley & #Dreamscape Media! Another fascinating book!!

[Ellie · Rating 3 out of 5]

This book is probably best enjoyed by people who are not in an ER/OR environment and are curious about a specialty that either they don’t interact with or by someone not in medicine at all. Perhaps a read for someone interested in looking into getting into the field.

The stories (as other healthcare workers have noted) could’ve been told with a greater emphasis to bring out the chaos that often ensues in the hospital as truly serious traumas come in. If you are someone who works in this field, it’s probably a read to skip as you’ve likely experienced the same stories. As the writer is a trauma surgeon, the TACS team ego certainly comes through despite his best effort and that alone was a good chuckle.

[Bonni · Rating 4 out of 5]

This is a super interesting and informative look into the medical field--specifically trauma surgery. The storytelling is fast-paced, but also includes thoughtful asides about research, possible law reformation, and unique quotes. Should there be a content warning? Here's mine-- if thinking about bodily functions makes you queasy, maybe this isn't the book for you. I appreciate the sacrifices people make to save lives even when the cause of injury is stupid. Even though there are badly educated medical professionals or those who are just plain bad at their jobs, I hope the majority are taking their work seriously and I end up with those true professionals on my case if I'm in need.

[Leslie Reams · Rating 1 out of 5]

DNF audiobook after 2 1/2 hours. I expected a book by a surgeon to be self serving. I've worked with enough of them to know that 99.9% of them are narcissists. I thought the medical anecdotes would be entertaining.
What I didn't expect was this book to keep delving into the author's obsession with gun bans. Yes, he kept low-key praising socialized medicine, but how many of his gun ban lectures am I supposed to tolerate? As I'm sure the author thinks he is always the smartest person in the room, but he's apparently too ignorant to know that gun bans don't keep guns out of the hands of the thugs who shoot each other.

There are too many other books to read to continue with drivel.

[Debbie · Rating 5 out of 5]

Trauma surgery Uncovered

Dr. Cohn has opened trauma surgery that's clear and understandable for non-medical readers. He is humble about his wins and honest about his losses. He describes surgeries with enough detail to make them understandable, but not so much to be confusing. A Whipple surgery is a perfect example.

I particularly liked the essay about listening to patients, family, & nursing State. It emphasized that these entities have information that the doctor doesn't. Listening well means you care and doctors who listen are less likely to be sued.

I didn't like the long chapters and the italics were distracting.

[Megan Rang · Rating 5 out of 5]

*****I received this audiobook free from NetGalley in exchange for my honest review.

I loved this! Granted, I am someone who enjoys learning about what happens with strange medical cases and how the trauma unit works. I am fascinated by some of the gross but true instance.

This book was very easy to listen to. I finished it in 2 days. It kept my interest and gave me a new perspective of a few things in the medical field.

I would highly recommend this book if you are in to these types of books!!!

[Lisa Davidson · Rating 4 out of 5]

I usually enjoy books about modern medicine, and this was no exception. This surgeon has had many different kinds of experiences and has even been a patient himself. He tells story after story after story of the events he personally witnessed.
It was fun, especially when he expressed his own amazement. Even someone with his education and experience was not able to predict with accuracy which patients would make it, as some people managed to recover from insane injuries.
The narrator was good, with just the right amount of emotion.
Thanks to NetGalley for letting me read this

[Tim Blackburn · Rating 4 out of 5]

The author is a 40-year trauma center surgeon. In this book he shares with we laypeople the controlled chaos that is a modern trauma center. He includes personal experiences of cases in which he performed surgery most often emergency surgery. The emotional gamut of cases are included - humorous, tragic, thrilling, heartbreaking, and touching. The doctors lends his perspective on the reasons behind trauma emergencies and offers potential practical solutions that society probably won't heed (ie wear a helmet if you ride a motorcycle or bicycle!!!!). I thoroughly enjoyed this book.