Ross Donaldson serves as editor in chief of WikiEM (www.wikem.org), the world’s largest emergency medicine open-source reference resource. He is also the Director of the Emergency Medicine Global Health Program at the Harbor-UCLA Medical Center and holds appointments in the UCLA Schools of Medicine and Public Health, serving as in the departments of Emergency Medicine and Epidemiology. Dr. Donaldson has previously been featured on many media outlets and is an expert on the global provision of emergency and disaster care. He has worked across the globe, working on ways to improve the emergency health care system around the world. We are excited to be featuring him on our series today.
Can you share with us your background? How did you get interested in medicine and how did you choose Emergency Medicine as a specialty?
I am originally from Minneapolis and am the first physician in my family. I first became interested in medicine after a friend of mine in high school got acutely sick (with acute cholecystitis) and, after calling 911, I didn’t feel like I knew much of what to do. So, during freshman year of college I took an EMT-Intermediate course, which led to working on my college ambulance service and in the emergency department as a technician. Once getting to medical school, I enjoyed almost every specialty, but later realized it was during the acute phase of each that I found myself most suited. During my first rotation in the ED, I felt like I had finally gotten home and I have never looked back.
You have written a memoir called The Lassa Ward, what compelled you to want to begin writing?
The Lassa Ward is a memoir about my experiences during time off between the 3rd and 4th years of medical school at UCLA, when I did a Masters of Public Health at the London School of Hygiene and Tropical Medicine and later research on Lassa fever in Sierra Leone. Lassa fever is one of four Viral Hemorrhagic Fevers capable of person-to-person spread and is clinically similar to Ebola.
I was supposed to be in Sierra Leone only as a public health student, not caring directly for patients, but working with Dr. Anriu Conteh, a well-known humanitarian in the war-torn country. However, through a series of events, I eventually became in charge of the Lassa Ward for several weeks without supervision. This was one of the toughest experiences of my life and the book is about coming to terms with the life-and-death responsibility we must accept as providers when caring for patients. This is something that all physicians-in-training must come to terms with, but which I had to do in a very short period while in a uniquely adverse environment. I felt compelled to write the book after my friend and mentor, Dr. Conteh, died from Lassa infection.
You have worked in Africa, Asia, the Caribbean, Europe, Latin America, the Middle East, and of course the US. What are some of the most memorable experiences you had during your travels as a physician?
I have spent the last decade working around the world and there certainly have been many memorable experiences during that time. The most important for me was meeting my wife in Iraq, when we were both working for the same humanitarian organization. During the five years I worked there, I spearheaded the development of emergency medical care in the country, including the development of their first prehospital network and the training of over 10,000 people, including doctors, nurses, EMTs, and community members. It was a very rewarding project and I have many memories from the dedicated Iraqi providers who risked their own safety on a daily basis to care for their fellow citizens.
What were your goals in building WikEM?
WikEM first started as a way of organizing a collection of notes and checklists that had been passed down for many years from resident to resident in the Harbor-UCLA Emergency Medicine Program. At the time, we had been keeping these in Word files and then started to feel really high-tech when we began beaming them from one Palm device to another. However, this had many obvious limitations.
After becoming faculty, as previously mentioned, I started spending a lot of time in Iraq. During that time I visited an anesthetist who had a pediatric anesthesia textbook literally sitting on an altar-like pedestal in his office. He told me it was the only copy available in the country. These people seriously valued learning and medical knowledge, and yet circumstances had kept them from having access to it.
I initially wanted to import copies of important texts to the country, but in addition to the pain of doing so, it just became so impractical when you looked at the big picture. Instead, I turned back to the notes and checklists from residency and decided to start an emergency medicine open access resource. If anything should be free and open in this world, then certainly the knowledge to care for your fellow human during an emergency has to be on the top of that list.
My work overseas had shown me that, although internet access might be intermittent and limited, most physicians had a phone and data connection at home. This is one of the reasons that WikEM is available offline, and ironically, this robustness is one of the things our U.S. users also appreciate, since they always have access to it, even when there is poor reception in the hospital, are on a hike, or are in the middle of a disaster situation.
Over the last six years, we have gone from having just a few people accessing the site per day to tens of thousands of sessions per month with over 100,000 downloads of the app to date. WikEM is now the most popular emergency medicine-specific application in the world and is open to all medical providers (including medical students) across the globe to help edit, as a key open access resource. We can now take that life-saving knowledge off the pedestal and put it for free into the countless hands of providers working at bedsides around the globe.