Dr. Thomas Scalea, Physician-in-Chief of the R Adams Cowley Shock Trauma Center, describes what makes Shock a unique institution, relates his frustrations with recurrent violence in Baltimore, regales us with tales of maximally invasive surgery, walks us through the management of retrohepatic vena caval injuries, and reveals which injury patterns still raise his sphincter tone. Violence Intervention Program: https://www.washingtonpost.com/opinions/how-to-break-baltimores-cycle-of-violence/2017/07/28/54f7fa7e-632a-11e7-84a1-a26b75ad39fe_story.html?utm_term=.5f8c53511896