Former Vancouver doctor on front line in Boston
Dr. Ron Walls’ disaster scenario practise paid off
The former head of the emergency department at Vancouver General Hospital was the doctor who led the trauma team in a Boston hospital treating patients injured by Monday’s bomb blasts at the Boston Marathon.
Dr. Ron Walls said that shortly after 3 p. m., his office and cellphones began ringing at Brigham and Women’s Hospital. Then he heard sirens. He said he’d never heard anything like it before.
“It was as if every vehicle with a siren turned its siren on and started moving at the same time,” he told the Canadian Medical Association Journal in a story published Wednesday.
Walls, who was born in Prince George, and his team at the hospital had twice rehearsed their response to a similar event — a bomb exploding at a mass gathering. And then it actually happened, at the finish line of the Boston Marathon. Two bomb blasts killed three people and injured more than 170.
Walls’ trauma centre at Brigham was one of a handful of level- one trauma centres in Boston that treated casualties. In the first hour after the two blasts, 28 patients were treated at Brigham, according to the article written by Laura Eggertson in the journal, published by the Canadian Medical Association.
Patients had shrapnel wounds along with head and neck injuries. Some had damaged ear drums and others, smoke inhalation and burns. Some injuries were life- threatening.
“We had patients with very extensive lower- extremity injuries — large pieces of their muscle and skin and bone missing from the blast,” Walls said in the CMAJ story. There were also “very bad fractures — the type of fracture you can only get with a tremendous amount of force.”
Walls went to medical school at the University of B. C. and then took specialty training in Denver. In 1986, he became head of the emergency department at VGH.
In 1993, he was lured away by what he called the “most prestigious academic institution on the continent” — Brigham and Women’s Hospital, which is a Harvard University teaching hospital.
Another Canadian, Dr. Emily Aaronson of Toronto, was also part of Brigham’s disaster response team. Less than an hour after starting her shift on Monday, the second- year resident at Brigham was treating patients with open fractures — some with bones splintered or crushed.
Part of the trauma team’s emergency preparedness was dealing with the possibility that the hospital itself could become a secondary target. There was also the possibility of more bombs going off, which could increase the number of patients coming into the hospital.
“We didn’t want the providers at the bedside to worry about that, but we had an immediate security response, including the police department, to protect the hospital against any secondary target,” Walls said in the article.
“We also brought in devices to immediately detect radiation and make sure there wasn’t any contamination, so it wasn’t a dirty bomb.”
Walls had five fresh trauma teams ready and waiting for additional casualties at the height of the incident. In constant contact with the hospital’s overall disaster response coordinator, Walls coordinated the work of the individual trauma teams.
Brigham and Women’s treated 31 patients aged 16 to 65. Walls told the CMAJ that the bombing was the biggest mass casualty event he’d experienced in the 28 years he has been a doctor working in the emergency department.
Walls said lives were saved because of the emergency medical services at the Boston Marathon and preparations by the hospital and the city’s emergency response teams.
“We had drilled this exact scenario, this idea of having a bomb going off in a mass gathering in town,” Walls told the CMAJ.
“Nobody is ever prepared for this, but we were prepared.
“I would just suggest to people that if they think these drills are silly or unnecessary or that this can’t happen — it can happen.”
Walls is the chair of the department of emergency medicine at Brigham and professor of medicine in the division of emergency medicine at Harvard Medical School. He’s a peer reviewer for five major emergency medicine journals and has more than 130 scientific publications, including 54 original articles in peer- reviewed journals.