Waco Siege leads doctor to his speciality

On his office shelf at the Center for Translational Injury Research in Houston, Dr. Bryan Cotton has a metal lunch box that has a plastic defibrillator on one side and a telephone on the other.

If Cotton ever needs to remember why he has it, he can look at a picture from Christmas 1977. It shows Cotton, then 7, pretending to use the defibrillator to shock his father, who is lying on the floor, faking a heart attack.

Most kids his age had a lunch box commemorating the extraordinary powers of Superman or the wonders of Walt Disney's Magic Kingdom. At that age, he not only wasn't afraid of the guys in the white jackets, he loved them. He'd even beg to go with his brother and two sisters on their doctor appointments.

"I was always interested in medicine as a kid," said the 40-year-old Katy resident. "I was one of those kids who actually enjoyed going to the doctor's office. I enjoyed the whole atmosphere, the diagnostic thing.

His favorite television show was Emergency!, which was about two paramedics who responded to accidents and transported victims to the hospital.

Cotton didn't know he would grow up to be a renowned researcher in the field of trauma and emergency-room techniques for treating patients who are bleeding to death. But he knew he would be involved in medicine.

In high school, he'd volunteer at the office of his family's primary-care physician, shadowing the doctor.

"Even when I learned (the process of becoming a doctor) would take long, I was like, 'Well, I don't really want to do anything else.' I thought about doing other things. Even though I entertained other ideas, I never followed through on anything. I loved teaching, so I was a substitute teacher to make money, and I was a deejay in college. Those were fun, but I never saw them as a lifelong thing."

While an undergraduate student at Baylor, he was able to narrow his interest to a specific area in medicine. The Waco Siege did that.

It began on Feb. 28, 1993, when the U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives tried to execute a search warrant at the Branch Davidian ranch at Mount Carmel, nine miles northeast of Waco. Ten people were killed in a two-hour gun battle. Sect leader David Koresh was wounded. Fifty days later, 76 people, including Koresh, died in a second assault as fire destroyed the compound.

Cotton was an emergency room volunteer.

"Volunteering at the hospital, I got to see first-hand what went down, the whole mass casualty trauma triage, all the gunshot wounds," he said. "That overwhelmed me, and I knew what part of medicine I wanted to go into. It was fascinating to see the whole process and response — the organized chaos, I guess you could call it."

After receiving his medical degree, Cotton completed a residency in general surgery at the University of Missouri and a fellowship in trauma and surgical critical care at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia.

While an assistant professor in the surgery department at Vanderbilt University School of Medicine, he earned a master's degree of public health and led studies involved in reducing mortality in severely injured patients.

He came to Houston in 2009 to be associate professor of surgery at the University of Texas Health Medical School in Houston and director of the Surgical Critical Care Fellowship at UT-Houston and associate director of the Shock-Trauma ICU.

"I was interested in coming here because it's one of the biggest cities, with a lot of trauma," he said. "It's also a very progressive, research-minded community."

Cotton is heading a proposed study that will compare use of whole blood versus blood products such as platelets, plasma and red blood cells for trauma victims. He would like to examine whether using whole blood for patients requiring multiple blood transfusions could decrease the amount of blood products needed in an emergency-room setting.

He and his wife, Carla, have five children: Madeline, 10; Alexandra, 8; Mason, 5; Jackson, 3; and Nolan, 1.