Sonoma Raceway's medical team ready for IndyCar

SONOMA — The final and clinching race of the IndyCar season should be a cause for celebration. Instead, the flags are at half-staff at Sonoma Raceway for the GoPro Grand Prix of Sonoma Sunday, and a palpable gloom hangs over the garages. The racing circuit is mourning the death of Justin Wilson, a talented and popular Brit who was killed by a flying piece of debris last weekend at Pocono Raceway in Pennsylvania.

Wilson's death was the occurrence every raceway dreads. Considering the power — Indy cars go well over 200 miles per hour on oval tracks — and fragility of the machines, it's a wonder there aren't more fatalities. For that you can thank the skill of the drivers, the safety features introduced and enforced by IndyCar, and the expertise of people like Dr. Brian Schmidt and Todd Axberg.

Schmidt and Axberg, both affiliated with Santa Rosa Memorial Hospital, have overseen the medical center at Sonoma Raceway since it was created in 2005. They have a small but veteran staff, and they are responsible not just for professional drivers who skid into walls, but every man, woman and child who passes through the gates off of Highway 121 on a race weekend.

Their duties are as varied as the IndyCar paint schemes.

'Their primary responsibility and their training is to respond to an accident on the track, but that's a very small percentage of what they actually end up dealing with,' Sonoma Raceway president Steve Page said. 'Cuts, bruises, bee stings, allergies. The ability we have to deal with even minor medical or health issues, from all the guests — fans, sponsors, officials, crew members — just really sort of radiates throughout our whole facility.'

The litany of maladies includes concussions and spinal injuries, fractures and dislocations, chest pain and 'foreign bodies' in the eyes, and the dehydration that easily sets in at a track where temperatures can reach 122 degrees on the asphalt on summer race days.

The raceway, known as Sears Point and Infineon in earlier incarnations, has always had medical attendants. It used to be staffed by doctors from Sonoma Valley Hospital. They were perfectly competent, but the on-site facility was basically a small room with a couple of gurneys. The doctors were severely limited in their ability to diagnose and treat.

In 2003, with NASCAR providing some pressure, Sonoma Raceway owner Bruton Smith approved a more sophisticated medical center at the track. Schmidt and Axberg were obvious resources. As Schmidt notes, Santa Rosa Memorial is the second largest non-university trauma center in California, and has the highest injury severity scoring in the country.

Schmidt, the trauma director, has worked at the hospital since 1988. He's a Santa Rosa native whose father, Leon Schmidt, worked in the area for decades as an anesthesiologist. Brian's sister and brother are doctors, too. Axberg, the chief lead nurse in the emergency room at Memorial, is a 25-year veteran. Two years ago, NASCAR recognized him with its national Nursing Director Award.

'Brian's terrific. The whole group of docs is amazing,' Page said. 'And Todd really is the glue that ties the whole thing together and keeps it organized and staffed.

The duo quickly learned that trauma care is a different job at the raceway. On the positive side: A hospital emergency room doctor might see a critical patient 30 minutes after he or she is injured; during a race, a doctor in a fire suit might get to an at-risk driver in 30 seconds. On the negative side: This is not the controlled environment of a hospital.

'You're on the track, and all of a sudden you realize you can get hurt,' Schmidt said. 'You can touch the wrong thing, get burned. Every year someone gets hit, (for example) in the pits. So you've gotta have situational awareness.'

There's another big difference. The crashes at Sonoma Raceway are violent, even terrifying. But the drivers are so talented, and the vehicles engineered so thoroughly for safety, that the injuries are frequently less severe than at a downtown intersection.

'If Brian and I are working in Memorial in the trauma suite, and we get a ring-down with a motorcyclist that goes off at 100 miles an hour, we are obviously expecting the very worst of the worst,' Axberg said. 'It is not unknown for a motorcyclist to go down here at 100 miles an hour and get up and walk away.'

Depending on the event, Santa Rosa Memorial will provide eight to 10 nurses and three or four doctors for a race. The team has remained largely the same for the past seven years.

The medical suite at the track is an easy-to-miss office right next to the drivers' lounge. It comprises one large room and several side rooms with a total of nine beds (they try to reserve the ones closest to the door for drivers), including four resuscitation beds. Schmidt and his team have a digital X-ray machine, a defibrillator and an eye kit — bits of flying debris are always a hazard here. They are able to run EKGs on a laptop, and they have a hand-held lab device that can analyze things like cardiac enzymes and electrolytes in as little as six minutes.

The room was mostly quiet Friday and Saturday, with nothing worse than a couple of fainting episodes and a few dehydration-related issues. One driver in a lower-level series was unable to continue after a crash, but he was just a little bruised up, Axberg said.

Sunday, though, the team expects a buzz of activity. A typical IndyCar race day might yield 25 ambulance trips, most of them to the on-site medical center, and perhaps 50 to 60 patients.

The NASCAR Sprint Cup race is more chaotic than that.

'This NASCAR, just before the race it was quiet,' Schmidt said. 'But within 20 minutes of the start of the race, we had 10 ambulances to the door. We ran about 80 ambulance calls that day, and only eight or 10 of those were to a hospital. We were constantly going.'

They saw 400 patients over the long weekend.

The raceway will be equipped with 12 VeriHealth ambulances Sunday, including some perched at four strategic spots along the track, along with firefighting vehicles, tow trucks (or 'wreckers,' as they're called out here) and a REACH emergency helicopter that can get a patient to Santa Rosa Memorial in eight minutes. There will be a nurse at Turn 7 and another under the grandstand, and four rudimentary first-aid stations on the property to hand out water and Advil.

Each racing series supplies its own medical personnel, though the standards vary. IndyCar brings two physicians and two nurses; NASCAR just nurses. NHRA, the drag-racing circuit, arrives with one doctor. All of them are strictly for support. The local med staff calls the shots here.

The series liaisons are vital, though, because they know the drivers — their personalities and, most important, their bodies.

'If somebody crashes, we'll sit there and say, 'Oh, that's the 25 car,' ' Axberg said. 'Then the liaison nurses will quickly pull up the driver's information. And by the time the driver comes in, we'll have his complete profile laid out in front of us. We know who he is, if he has any past medical history, what medications he may be on.'

If an accident occurs Sunday, the race control team will direct the response from high in the tower, telling which emergency vehicles to respond. One doctor will be in a fire suit at all times. Beyond their medical knowledge, they and the paramedics/EMTs must know how each type of car is assembled and equipped, so that they can extract an injured driver as quickly as possible. If it's really bad, the fire team will cut off the top of the car.

It's an efficient system, but it isn't enough to prevent dire situations. A raceway will always have its dangers.

During one NASCAR event, a car went into a barrier less than 10 laps into the race. Three minutes later, while the crew was responding to that incident, a track worker went into cardiac arrest. He was flown to Santa Rosa via the helicopter and was back at the track to thank everyone at the next event. Two years ago, at another NASCAR race, a large forklift delivering ice tipped over with the tines raised and pinned the driver's thigh and upper arm. It took responders 45 minutes to extract him. The man survived but lost both limbs.

As for the racers, motorcycle riders are particularly vulnerable, for obvious reasons. 'We had several very complicated spinal injuries from those,' Axberg said. And one fatality. In 2010, rider Augustine Alves died in the hospital from injuries sustained on the dirt track in the West Coast Moto Jam. A kart driver died at Sonoma in 2009.

And then there was the time Dale Earnhardt Jr. caught fire.

Earnhardt had agreed to participate in an American Le Mans Series event in 2004, at what was then Infineon Raceway, and it was a big deal. Page was in his office, set high above the track, as a practice session began.

'I looked out the window, 8:01 or 8:02 (a.m.), and it's an enormous cloud of smoke going up,' he said. 'I see in binoculars it's a yellow Corvette, and I go, 'Oh, jeez.' '

Page's mind raced. The most popular race car driver in America was on fire. Earnhardt had spun into a wall coming out of Turn 7 on the first lap of the day. His crew had overfilled his tank, and fuel had backed into the fill tube. It ignited, and the car was immediately engulfed in flames. Earnhardt had briefly blacked out. He regained consciousness in time to unbuckle himself and clamber out of the car.

Within minutes, the emergency team was administering an IV and pain medications, and Earnhardt was soon on a helicopter bound for the UC Davis Regional Burn Center.

'I saw that team respond, and it was just such an impressive thing to watch,' Page said. 'Any injury to anybody is of concern. But we have someone here that high profile, and you just think about the implications if we don't do our job right.'

Fortunately, these people almost always do their job right.

'I do feel 100 percent safe,' IndyCar points leader Juan Pablo Montoya said Friday. 'Accidents can happen. To be honest with you — somebody asked me the same question the other day — (you) probably have better chances racing here than going home in your car.'

No amount of care can bring back Justin Wilson. But if Schmidt and Axberg have their way, we'll never see another track fatality at our tricky little road course.

You can reach Staff Writer Phil Barber at 521-5263 or phil.barber@pressdemocrat.com. Follow him on Twitter @skinny_post.