Even now, Barbara Motis can't really remember how it happened. One moment, the Northridge school secretary was driving her Datsun 280-Z, her daughter Andrea beside her. The next, they were lying near death in the shattered remains of the car, which had collided with a garbage truck.
Rushed to the trauma center at Northridge Hospital Medical Center last Aug. 7, Barbara, 54, went into cardiac arrest and had to be revived four times. Twenty-one-year-old Andrea, her head badly injured, underwent emergency surgery but slipped into a coma, where she remained for six weeks.
But Sunday, mother and daughter were among three trauma survivors who smilingly accepted bouquets during a brunch fund-raiser for Northridge Hospital's trauma unit, one of only two such emergency-treatment centers in the San Fernando Valley.
At a time when Los Angeles County's once-vaunted hospital trauma network is gradually collapsing due to heavy financial losses, Northridge Hospital remains committed to keeping its trauma unit in operation, said spokeswoman Leslie M. Wither.
Although the trauma center loses about $1 million a year, it remains open because of the hospital's overall profitability, its relatively high percentage of insured patients and new county rules intended to prevent the county's 13 remaining trauma units from being swamped with patients, officials said.
"We're so lucky to be doing well. We've got an 85% occupancy rate," said Wither, referring to the hospital's healthy financial condition. That means the trauma center is "not folding," she said.
To help offset its trauma losses, the hospital holds several fund-raising events each year. One such event was Sunday's brunch at a Granada Hills restaurant, which attracted more than 140 trauma survivors, hospital volunteers, nurses and doctors. The event was expected to raise about $10,000.
"Because of the trauma unit, we're here today," Barbara Motis said. "If it hadn't been for their persistence--the doctors and the nurses--I wouldn't be here."
Trauma centers differ from emergency rooms--which also treat severe injury victims--because they have specially trained teams of surgeons, nurses and other specialists on duty 24 hours a day. Trauma centers also have round-the-clock access to special equipment, such as brain-scan machines.
The county's trauma network, launched in 1983 with 23 participating hospitals, now has only 13 trauma units in operation. And that number will drop to 12 on May 1 when Huntington Memorial Hospital in Pasadena closes its trauma facility.
The only other trauma center in the San Fernando Valley is Holy Cross Medical Center in Mission Hills, which lost $2 million last year. St. Joseph Medical Center in Burbank pulled out of the system last April.
Faced with rising financial losses caused by reduced government reimbursements and uninsured patients who cannot pay for their medical care, officials at hospitals throughout the county say they are being forced to drop out of the trauma network.
Jeffrey E. Flocken, Northridge Hospital's chief executive officer, said the hospital expects some relief as a result of $1.4 million earmarked for it under Prop. 99, the tobacco-tax initiative passed by voters in 1988.
Dr. Barbara Koenig, the hospital's trauma services director, said it also has benefited from "at least a balance of paying and non-paying patients."
She also cited new county rules intended to protect the remaining trauma units from being overloaded. Under those rules, paramedics and other emergency medical workers are required to take trauma victims to the nearest hospital, even if it doesn't have a trauma center.
Although some doctors and nurses have ethical qualms about the rules, they are necessary to "keep from destroying the entire system," Koenig said.