Dr. Leslie Van Dyne is a trauma surgeon and critical care specialist at Monument Health Rapid City Hospital. She also serves as the medical director of general surgery. On any given day, she’s caring for patients who arrive without warning, often after life-changing injuries.
“You never know what’s going to come through the door,” Dr. Van Dyne said. “That’s part of what makes trauma surgery what it is.”
In a region known for outdoor adventure, tourism, and wide-open spaces, her work sits at the intersection of freedom and risk.
What a Trauma Surgeon Actually Does
Trauma surgery is often confused with emergency medicine, but the roles are very different.
“Emergency medicine and trauma surgery are separate fields,” Dr. Van Dyne explained. “We both respond to trauma activations, but trauma surgeons also manage surgical emergencies throughout the hospital and care for critically ill patients in the ICU.”
Her days might include appendicitis, gallbladder surgery, bowel obstructions, or caring for patients with severe infections. When trauma happens, she’s part of a coordinated team responding immediately.
“There are different levels of trauma activation,” she said. “A minor injury may come through the emergency department like any other patient. A high-acuity trauma comes straight into the trauma bay and can look like what you see in the movies.”
Those movie moments, she added, are real. They’re just not constant.
Why Rapid City Is a Unique Trauma Hub
Rapid City Hospital serves as a critical trauma center for a massive geographic area.
“We’re essentially the only major trauma center for much of western South Dakota, parts of Wyoming, and northern Nebraska,” Dr. Van Dyne said. “That means we see a high volume and a high severity of injuries.”
During the summer, the pace accelerates.
“Motorcycles, ATVs, horseback riding, rock climbing, farming accidents,” she said. “Summer is definitely the busiest season.”
Events like the Sturgis Motorcycle Rally bring people from around the world.
“I’ll meet patients from other countries, hear their stories, meet their families,” she said. “It’s unfortunate that they’re here because something went wrong, but that human connection matters.”
What Happens When Someone Arrives After a Major Accident
When a critically injured patient arrives, the response is immediate and structured.
“If someone meets certain criteria, they’re a level one trauma activation,” Dr. Van Dyne said. “They come in with EMS straight to a trauma bay, and the entire team is there.”
Despite the intensity, she emphasizes that most trauma patients are successfully treated close to home.
“I’d say about ninety-eight percent of patients are cared for right here,” she said. “People don’t realize how much we can do locally.”
Rapid City Hospital is a Level II trauma center, meaning it handles severe injuries while meeting national standards set by the American College of Surgeons.
“The difference between Level I and Level II isn’t about capability,” she said. “It’s about research requirements and having certain specialists physically in the building at all times. Our specialists are here and respond quickly.”
Life in the ICU
Beyond the trauma bay, Dr. Van Dyne spends a significant amount of time in the intensive care unit.
“I actually went into trauma for the critical care side,” she said. “I like complex patients. I like thinking about the whole body.”
In the ICU, she manages patients with breathing machines, sepsis, multi-organ failure, and severe injuries. Each day involves constant reassessment.
“What’s their blood pressure doing? Their kidneys? Their glucose?” she said. “It’s a lot of small adjustments that add up to better outcomes.”
She works closely with internal medicine and pulmonary critical care physicians.
“It’s very collaborative,” she said. “We cover for each other, and that teamwork matters.”
The Hardest Part of the Job
Trauma surgery comes with moments that stay with you.
“You’re often meeting families on the worst day of their lives,” Dr. Van Dyne said. “These are people who were completely healthy that morning.”
There’s no script for delivering devastating news.
“You do your best to be honest, compassionate, and present,” she said. “But it’s never easy.”
She credits hospital chaplains and support staff as essential.
“I don’t think I could do this job without them,” she said.
Some moments are painful. Others are quietly profound.
“There are patients who are at peace with where they are in life,” she said. “Those moments remind you why being present matters.”
Why People Should Feel Reassured
For people who live, work, or recreate in the Black Hills, Dr. Van Dyne wants them to know this.
“We have the ability to take care of very sick and very injured patients here,” she said. “Most people never need to leave Rapid City for trauma care.”
That matters when minutes count.
“It’s comforting to know that if something happens, help is already here,” she said.
A Career Built on Perspective
Dr. Van Dyne knew early that medicine was her path, inspired by her grandfather, a general practitioner who once delivered babies, set fractures, and performed surgeries in small-town South Dakota.
“That kind of full-spectrum care doesn’t exist much anymore,” she said. “But trauma and acute care surgery come close.”
It’s demanding work, but it fits.
“There’s never a dull day,” she said. “And even on the hardest ones, you remember that you’re there to help people through something they never planned for.”
In a place built on adventure, having that kind of care close to home makes all the difference.
