On an average day at the Air Force Theater Hospital in Balad, Iraq, work in the emergency room is relatively slow.
That is, until a mass casualty situation brings 15 critically injured patients to the emergency room at one time, leaving a team of four physicians to handle the chaos.
In contrast, on a given day at the Ronald Reagan UCLA Medical Center, the emergency room is much more hectic as victims of car crashes, heart attacks and various illnesses consistently arrive, expecting a certain high standard of care from a level one trauma center.
After working in emergency rooms in both Los Angeles and Iraq, Dr. Craig Goolsby, a recent graduate from the emergency medical training program at UCLA, said working in Iraq after training at UCLA was not necessarily more difficult, but the magnitude of injuries was much greater.
Goolsby traveled to Iraq in 2009 to serve as an emergency physician for five months at the Balad Air Force Theater Hospital.
There, he saw patients with injuries unlike those he was accustomed to seeing in Los Angeles.
Patients will come in after an improvised explosive device attack and may need multiple amputations, he said. Others may be suffering from severe craniofacial trauma.
“Being in a combat zone is very unique ““ something that only a small number of (people) will experience during their career,” said Goolsby, who spent his undergraduate years at the Air Force Academy in Colorado before traveling to Los Angeles in 2004 for his residency training.
Goolsby said he credits the training environment in Los Angeles to providing him with the necessary preparation to work in Iraq.
The high patient volume effectively exposed him to numerous unusual diseases and injuries.
Now, Goolsby works as an emergency medical physician at the Wilford Hall Medical Center, an Air Force hospital in Texas.
At UCLA, residents in training are able to see how a physician would handle various cases in an ideal situation, said Jon Crisp, an emergency medical physician at the Ronald Reagan UCLA Medical Center. Physicians are exposed to various injuries and diseases in an advanced and controlled setting and are essentially prepared to go anywhere, Iraq included, because of it.
“Being an emergency physician, you’re faced with mortality more so than other people are,” Crisp said.
When physicians are in training at UCLA they spend about 40 percent of their time in an academic setting and the rest of the time working at the Olive View-UCLA Medical Center or other medical centers in the Los Angeles area, said Eric Snyder, an attending physician at the emergency department of Providence Tarzana Medical Center and a clinical instructor at Olive View as well as at the Reagan center.
UCLA aims to teach its residents how to think critically so they do not miss key diagnoses, whether their patients are crash victims who had gotten in an accident on I-405, or ill and injured officers and infantrymen in Iraq.
“Anyone that comes through the door can present a different case,” Snyder said.